This Is MS Multiple Sclerosis Knowledge & Support Community

need help from jimmylegs or anyone else that is knowledgeable of magnesium supplements! I want to buy a mag supplement today, but there are so many, I don't know what to get. I want one that will not cause diarrhea, but one that i can absorb in my body since I seem to be unable to absorb it (could be becuase of my small bowel situation.... Marsh 2, so it looks like celiac, but I am negative DQ2/DQ8 so i do not have celiac, so no one knows why i have a rush of lymphocytes/inflammation or why the crypts are widening. I went on a whole foods diet very healthy, and fixed all my problem of these diarrheal flares and weight loss, but still no one knows why... but it is not from gluten... either way, if i have all this inflammation on my villi, then i am going to eventually start having absorption issues.... and i think my first problem is the magnesium malabsorption). My problem: for 6 months... twitching in all muscles every day all day long and i feel like my cheeks are getting pulled back towards my ears and that hurts, also just feeling on edge and not myself, and not sleeping good (not dreaming), and chest pressure especially after eating that is so bad, and i get labored breathing, worse when laying flat or bending forward.
SO with that being said, 6 days ago I started using Gaviscon becuase i was wondering if it was GERD/reflux with the postprandial SOB/breathing issue/chest pressure. I felt like I could finally expand my chest the first day of taking it and the twitching decreased. By day 4, the twitching was almost non-existant. I look at the ingredients and see magnesium carbonate 105 mg for each tablet... so I guess I have been replenishing my magnesium stores. And, I am sleeping really good, for the first time in a long time, and dreaming, so then i wake up and feel more rested... also, that on edge weird feeling is gone. Yesterday, i kept waiting to feel a twitch and i didn't... I was so happy! I only had a few in my face, arm, leg, abdomen, but they weren't bad and only lasted like 10 seconds each. So I would think this confirms a magnesium problem.
I eat a tons of magnesium rich foods (and I was paleo at one time)... such as organic pumpkin seeds, lots of spinach, broccoli, leafy greens, potatoes, sweet potatoes, almond milk, almonds, etc... but i think in my situation it doesn't really matter and i just need a little boost from a supplement because of the issue with my small bowel. I am just so happy because the twitching was for about 6 months and finally it is stopping. I talked to one of the GI docs i work with and he said take the gaviscon as needed but start taking dexilant... and try the magnesium and then if the twitching doesn't fully stop in a month then i should see a neurologist. The dexilant i will not take for more than 4 weeks (becuase PPIs actually can strip you further of magnesium). The doc says i should be on it indefinitely but i do not agree. So i will take the dexilant for 4 weeks, with Gaviscon PRN, ... but i think magnesium will cure everything. My theory is since the esophagus is a muscle, that was probably twitching causing discomfort as well, and the sphincter that connects the esophagus to stomach was probably weak/twitching thus allowing gastric acid back into my esophagus causing pain... but by taking magnesium, it should strengthen my muscles and lower esophageal sphincter and then i will not have breakthrough GERD any longer.
Long story short.... so what type of magnesium should i take? Mag oxide, mag citrate, a slow type mag? I have no clue! Help!!!

hey LLL good to hear you have been feeling improvements, and REALLY good to hear that you are in the loop re PPIs and consequences for mag status.

see if you can find magnesium GLYCINATE.

I think your theory about magnesium and muscle issues in the esophagus is probably accurate. you wouldn't normally use magnesium to address muscle weakness however. my current theory is that low magnesium could lead to LES dysfunction via spasticity, and the sphincter not being flexible enough to create a proper seal. personally, when I had my worst GERD symptoms (chronic horrific cough) I had to go OFF magnesium after figuring out my LES was probably TOO relaxed. it worked and the cough vanished. so, it's a delicate balance.

what I can tell you is that I personally like to alternate between mag citrate (ok to take before sleep) and mag glycinate (taken when remaining upright after, to ensure that it gets through the stomach properly and down into intestines for absorption), but that I would avoid magnesium BISglycinate as it seems to be too powerful for me.

as for your diarrheal flares.. did you ever have your zinc status tested?

thanks! I never had zinc tested... and i wanted it tested but doctors just don't listen. I feel like even though i don't have celiac disease, i should be treated as one or similar to someone with small bowel disorder since i have the duodenal lymphocytosis. THey just treat me as someone with peptic duodenitis. Very frustrating. I never would have thought about that with relaxing the sphincter too much, but you are right on!!! Do you have MS? I had the diarrheal flares for several months last year... none since i increased fiber and avoid sugars, except for every now and then... i try to pick foods with lower glycemic indexes and basically just avoid anything boxed or canned, no preservatives or additives. I had my stools checked several times. One time it was positive for WBCs but negative for infection. My secretory IgA in my stool was in range but in the 95th percentile. They said i could just be gluten sensitive, but there is no way of knowing for sure. Oh, also, when i took nexium for 3 months... i had major diarrhea on that. There was a possibility i could have also had small bowel bacterial overgrowth, but no one knows definitively. Whatever was causing it, it stopped since i changed my diet and eat whole fresh foods with a lot of diversity. I still eat gluten every day. Never had the zinc checked, though

blech to stubborn docs and nexium :S my doc gave me a sample of that stuff when I was trying to sort out my LES issues. I think I took one before I had time to read, but as soon as I started reading I decided it was a monumentally stupid drug to give people who have nutrient depletion issues in the first place. particularly mag depletion issues. and yes fwiw I do have an ms dx, 2006.

if you are eating gluten and experience GI distress incl diarrhea I would consider some alternate approaches to evaluating zinc status, given that the docs are not cooperative.

The Zinc Taste Test
"The test is based on the knowledge that the functions of taste and smell are dependent upon there being sufficient zinc available in the body. Thus, if zinc is deficient then taste function will be diminished. This principle is utilised in the taste test by offering a standard test solution of zinc sulphate for tasting. The response is then compared with a series of defined standards and the zinc status thus determined."

easy steps from the zinc taste test:
-pick up some zinc sulfate eg http://www.chemistdirect.co.uk/healthai ... _4750.html
-smash up 5 x 200mg pills into powder, and dissolve thoroughly in 1 litre of purified water.
"...Once prepared the solution should be stored in a refrigerator and discarded after six months. The solution should be removed from storage and left at room temperature for about two hours before carrying out the test."

HEY CHECK THIS OUT you can purchase prepared testing solution http://www.iherb.com/Ethical-Nutrients- ... 20-ml/3624

back to the taste test protocol...
"You take a 5-10ml sip and hold it in the mouth for ten seconds"
...
"There are 4 grades of response:
1. No taste: major zinc deficiency, which needs a supplement of 150mg a day.
2. No immediate taste is noticed but, within the ten seconds, a ‘dry’ or ‘metallic’ taste is experienced: Moderate deficiency, needing a supplement of 100 mg of zinc per day.
3. An immediate slight taste which increases over the ten second period: Minor deficiency: requiring a supplement of 50 mg per day.
4. An immediate, strong and unpleasant taste: No zinc deficiency exists, no need for a supplement."

note that you might not like how it feels taking more than 50mg of zinc at one time. so if you find yourself in a situation where you need 100 or 150, spread it out through the day. take with food to avoid nausea.

for the full zinc taste test protocol read more here (p. 39):
Zinc, MS and the Zinc Taste Test
By Dr Bob Lawrence, the GP with MS
www.ms-uk.org/files/npwm_2004_0023.pdf

I have not read through the test protocol in detail but logically you would supplement appropriate to a given response level for a few days, then retest. once you find 'no deficiency exists' then you could get into monthly followup taste testing to see if diet and lifestyle are keeping zinc levels steady.

FYI limiting gluten intakes would allow your body to retain zinc more easily.

I recommend either Jigsaw magnesium or Swanson TRS Magnesium Glycinate.
Both are well absorbed and are very good at not causing stool softening.

No oral magnesium compares to transdermal magnesium though, which never even enters the intestine - Mg oil, etc.

THX1138

dietary intake is the usual mechanism for humans to obtain magnesium, but if you can find magnesium chloride flakes and dissolve some in water, yes you can make a topical magnesium 'oil'. I have yet to find a local vendor for mag chloride flakes, still keeping an eye out though. the other option for topical (less concentrated) is the good old Epsom salts (ie magnesium sulfate) bath.

so i was taking the gaviscon (3 tablets) every day for about 11 days. Yesterday I didn't take it and took one magnesium oxide 250mg. And guess what? No twitching!!!! I took the pill in the morning with breakfast, and I didn't have any twitching until late last night (I guess by that time it was wearing off). I didn't take the gaviscon yesterday because you shouldn't take them together. This is crazy! My whole problem must have totally been from not enough magnesium!!!! And no one believed me!!! Even though i was eating a ton of magnesium rich foods, i guess with the duodenal lymphocytosis, i can't absorb stuff as good as other people. Thanks jimmylegs because you are the one that tuned me in to start to question if I was lacking magnesium (originally i was thinking oh no is something wrong with my CNS or brain)? Other things I am working on: I am currently working on pushing to get a lactulose breath test to rule out small bowel bacterial overgrowth. My theory is that i have motility disorder, so flora that resides in the colon only is pushed up into my small bowel where it doesn't belong. This causes higher hydrogen counts released by that flora, which in turn is absorbed by the villi, thus release of lymphocytes, thus not allowing absorption of nutrients (same deal as people with celiac), then goes into bloodstream, where hydrogen is reuptaked into lungs, thus causing early over hydrogen counts in lungs, almost making a state of resp acidosis, thus is why after large meals or other times i get the heavy labored breathing and chest pressure. So, I am going to get this test, after going through this for a couple years. If it comes back positive, then i will take xifaxin for 10 days. I probably will have to periodically take xifaxin every now and again because it is a motility disorder (the nerves and muscles don't communicate properly with the intestines so peristaltic wave function is all screwed up). The xifaxin will eradicate the hydrogen producing bacteria in the small intestine, thus no more lymphocytosis, thus i will be able to absorb magnesium again and the chest pressure/difficulty breathing/GERD? will be eradicated because there will not be abnormal hydrogen counts in my bloodstream in my lungs any longer. This is just a crazy far out there theory but I will update after i get the breath test and let's see if i am correct!!!!

glad you are feeling better! and good to hear that you are seeing benefits even using magnesium oxide in amounts less than the recommended daily intake. it must be enough given your high magnesium diet, so good job on that score.

if your theory is correct regarding motility disorder, consider the potential benefits just from addressing magnesium deficit alone... if you can get regular serum magnesium testing done that would be an excellent monitoring tool.

have you seen this study?
Small Intestinal Bacterial Overgrowth
A Comprehensive Review
"The goals of treatment for SIBO are threefold:
1) correct the underlying cause;
2) provide nutritional support, if necessary; and
3) treat the overgrowth."

"Treatment aimed at correcting the underlying cause includes dietary, surgical, and medical therapies. ... Nutritional support, particularly in those patients with weight loss or vitamin and mineral deficiencies, is an important component of SIBO treatment. Supplementation and maintenance of vitamin B12 and fat-soluble vitamins, with correction of calcium and magnesium deficiencies, are key components of treatment." (these are also suspect nutrients for ms patients, with the exception of calcium)

as for stage three: to treat the bacterial overgrowth itself, I would consider zinc and possibly also selenium, in order to create conditions in the gut favourable to properly balanced gut flora.

Zinc Deficiency, Malnutrition and the Gastrointestinal Tract
http://jn.nutrition.org/content/130/5/1388S.short#fn-1
"In zinc deficiency, the organism is more susceptible to toxin-producing bacteria or enteroviral pathogens that activate guanylate and adenylate cyclases, stimulating chloride secretion, producing diarrhea and diminishing absorption of nutrients, thus exacerbating an already compromised mineral status."

thanks jimmylegs!!! i will post what happens next... I think I am an interesting case. I am very curious to get the lactulose breath test done. I love researching this type stuff. Another theory I had, was that possibly I was eating TOO HEALTHY, as in all whole grain foods... which means I was eating upwards of 30g of fiber in foods per day.. and I read fiber in whole grains has phytic acid which binds to magnesium, calcium, iron, zinc, thus making those minerals unable to be absorbed in the small intestine. Now, I don't eat whole grain for whenever i eat a grain... I will eat white rice and refined flours but the twitching still occurs without the magnesium... so maybe I messed up myself from eating too healthy temporarily... I was 5'7, 125 lbs, athletic build... eating about 100-125 g protein per day, about 30g fiber per day, very low starch, but a ton of spinach and veggies every day and lean meat, wild salmon, free range eggs, etc. I stopped that diet a few months ago and now i am 135 lbs, and i haven't worked out in about 5 weeks... because i keep on having joint pains and then i had this bad cold for the past 2 weeks which is almost gone though. So I don't know... i feel there is a lot of factors going on with me, and all non-specific... but anyways i want to get the breath test and ill keep u updated. Thanks again!!!

no problem! as for the grains, consider not only phytate, but gluten which is known to strip nutrients if preparation and portion size are not carefully considered.
note that white rice is stripped of a huge percentage of nutrients as are processed flours. sort of leaves the gluten free rein to wreak havoc on your nutrient status.
avoiding refined or processed grains and choosing whole grain breads made with sprouted flours will help reduce the impact of gluten. phytates are handled reasonably well via cooking - i'd have to do some hunting to find the relevant studies but the information is available. I think this is why we generally eat canned or otherwise well cooked chick peas for example, rather than raw. similar idea for various beans. the spinach and veggies and healthy animal protein sound great - given that you were active your nutrient needs would be even higher than average joe. with the infection in the picture I would look extra long and hard at zinc status. with joint pain, consider vitamin d3 as well. these are nutrients that are very very commonly sub optimal in the wider population. there is more recognition re vit d3 compared to re zinc at the neighbourhood doc's office, but the zinc info is definitely in the research. it's just a matter of time for practitioners to catch up to the science.