General Nutrition/MS Research

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lyndacarol
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Re: from the archives: 1964 case: vit D toxicity, mag recove

Post by lyndacarol » Wed Nov 28, 2018 3:17 pm

jimmylegs wrote:Vitamin D-Intoxicated Patient With Hypoparathyroidism
Hypercalcemia, Acute Cerebellar Ataxia, and EEG Changes: Magnesium Sulfate Therapy (1964)


Abstract 1
"A patient presenting with an acute cerebellar ataxia, nausea, and vomiting of approximately one week's duration was found to have a serum calcium of 23.7 mg/100 ml. This was attributed to calcium and vitamin D therapy following previous thyroidectomy on July 3, 1962. Immediately after baseline studies, 20 cc of 50% magnesium sulfate were administered intramuscularly. No further therapy was given. The neurologic findings, as well as the nausea and vomiting, resolved rapidly within 24 hours in conjunction with decreasing serum calcium levels which reached a normal level of 10.9 mg at the end of five days. The urinary calcium excretion in the first 24 hours following MgSO4 was elevated to 803 mg. The EEG changed from abnormal diffuse slow alpha activity to normal within four days. An elevated spinal fluid protein (58 mg%) returned toward normal (43 mg%) in approximately three weeks."

Abstract 2
"The patient, a woman of 26, hypoparathyroid after subtotal thyroidectomy, developed severe signs of vitamin D poisoning, including ataxia and changes in the electroencephalogram, after maintenance for about 21/2 months on 100, 000 "units" of vitamin D and 16 g calcium lactate daily. Signs and symptoms rapidly responded to an intramuscular injection of 20 ml 50% magnesium sulfate, and serum Ca fell from 23.7 mg per 100 ml to normal in 5 days. The patient was subsequently maintained on 25, 000 units of vitamin D and 10 g calcium lactate daily. It is suggested that the neurological findings may have been due partly to Mg deficiency secondary to hypercalcasmia."
jimmylegs, this information on vitamin D3 and hypercalcemia is of great interest to me. About 16 months ago I had hypercalcemia (serum Ca was 14.6 mg/dL, which was corrected to normal after 5-6 weeks of 24-hour IV). If you can, please add the link for the source, I would like to be able to show it to my doctor. Thanks in advance.

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jimmylegs
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Re: from the archives: 1964 case: vit D toxicity, mag recove

Post by jimmylegs » Wed Nov 28, 2018 5:22 pm

a title search in google scholar will get you what you need
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jimmylegs
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caution - 2009 study: cancer after folic acid & vitamin B12

Post by jimmylegs » Fri Nov 30, 2018 4:34 am

Cancer Incidence and Mortality After Treatment With Folic Acid and Vitamin B12 (2009)
https://jamanetwork.com/journals/jama/f ... cle/184898

the paragraph titled Primary End Points by Serum Folate or Cobalamin Levels has useful-looking target range info.
take control of your own health
pursue optimal self care at least as actively as a diagnosis
ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!

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jimmylegs
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peripheral neuropathy, arsenic toxicity & supplements

Post by jimmylegs » Mon Dec 10, 2018 7:51 am

An unusual case of peripheral neuropathy possibly due to arsenic toxicity secondary to excessive intake of dietary supplements. (2013)

A 74-year-old woman presented to the neurology clinic with worsening of her longstanding peripheral neuropathy of unknown cause. There was below knee loss of spinothalamic sensation, reduced joint position of toes, absent below hips vibration sensation and absent ankle jerks. Neurophysiology studies showed further progression of her axonal sensory neuropathy. Urine and blood analysis previously carried out in Australia suggested elevated levels of arsenic. After abstinence from seafood, a random urine sample was collected and this confirmed the elevation in urine arsenic (622.1 nmol/L, reference range <534 nmol/L). The household water was found to be uncontaminated and the patient had no occupational or environmental exposure to arsenic. On questioning the patient admitted to taking fish oils, omega-3 oils and glucosamine sulphate dietary supplements in excess of the recommended dosage. These supplements were identified as possible sources of arsenic and the patient was asked to stop all supplements. One month later the urine arsenic had reduced to 57.5 nmol/L. There was an improvement in patient wellbeing, she no longer required Gabapentin for pain relief and the neurophysiology studies also showed improvement. Clinicians should consider heavy metal toxicity as a cause of peripheral neuropathy of unknown cause. A detailed patient history including all dietary supplements is essential to help elucidate the source of heavy metal toxicity.
take control of your own health
pursue optimal self care at least as actively as a diagnosis
ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!

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jimmylegs
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re zinc status, histamine release and allergy

Post by jimmylegs » Fri Dec 28, 2018 9:29 am

more:
  • Nishida, K., & Uchida, R. (2018). Role of Zinc Signaling in the Regulation of Mast Cell-, Basophil-, and T Cell-Mediated Allergic Responses. Journal of Immunology Research, 2018.
    "Zinc is essential for maintaining normal structure and physiological function of cells. Its deficiency causes growth retardation, immunodeficiency, and neuronal degeneration. Zinc homeostasis is tightly regulated by zinc transporters and metallothioneins that control zinc concentration and its distribution in individual cells and contributes to zinc signaling. The intracellular zinc signaling regulates immune reactions. Although many molecules involved in these processes have zinc-binding motifs, the molecular mechanisms and the role of zinc in immune responses have not been elucidated. We and others have demonstrated that zinc signaling plays diverse and specific roles in vivo and in vitro in studies using knockout mice lacking zinc transporter function and metallothionein function. In this review, we discuss the impact of zinc signaling focusing particularly on mast cell-, basophil-, and T cell-mediated inflammatory and allergic responses. We also describe zinc signaling dysregulation as a leading health problem in inflammatory disease and allergy."
  • Najafabadi, M. M., Faghihi, G., Emami, A., Monghad, M., Moeenzadeh, F., Sharif, N., & Davarpanah Jazi, A. H. (2012). Zinc sulfate for relief of pruritus in patients on maintenance hemodialysis. Therapeutic Apheresis and Dialysis, 16(2), 142-145.
    "According to the inhibitory effects of zinc on histamine release and reported low levels of serum zinc in hemodialysis patients, we aimed to evaluate the effects of zinc sulfate for the relief of pruritus in these patients."
  • Sanada, S., Kuze, M., & Yoshida, O. (1987). Beneficial effect of zinc supplementation on pruritus in hemodialysis patients with special reference to changes in serum histamine levels. Hinyokika kiyo. Acta urologica Japonica, 33(12), 1955-1960.
    "In this study, we examined the serum zinc and histamine levels in 19 hemodialysis patients with persistent pruritus and the effect of zinc supplementation on the pruritus. In patients with pruritus, the serum zinc level decreased and serum histamine level increased, showing a negative correlation between them. Oral zinc sulfate, 445 mg daily for two months, relieved pruritus subjectively in 53% of the patients. After treatment, serum histamine levels decreased significantly, as well as serum zinc levels increased significantly. These findings suggest that zinc deficiency participates in increased histamine levels in dialysis patients, and subsequently in the development of uremic pruritus."
  • Marone, G., Columbo, M., De Paulis, A., Cirillo, R., Giugliano, R., & Condorelli, M. (1986). Physiological concentrations of zinc inhibit the release of histamine from human basophils and lung mast cells. Agents and actions, 18(1-2), 103-106.
    "We have previously shown that physiological concentrations of zinc (≃ 7× 10− 6 M) inhibit the release of histamine from human basophil leukocytes (Marone et al., J. Pharmacol. Exp. Ther. 217: 292, 1981)."
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jimmylegs
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2018 update: Drug–Nutrient Interactions with Chronic Use of Commonly Prescribed Medications

Post by jimmylegs » Fri Jan 25, 2019 5:37 am

Evidence of Drug–Nutrient Interactions with Chronic Use of Commonly Prescribed Medications: An Update (2018)
https://www.mdpi.com/1999-4923/10/1/36/htm

The long-term use of prescription and over-the-counter drugs can induce subclinical and clinically relevant micronutrient deficiencies, which may develop gradually over months or even years. Given the large number of medications currently available, the number of research studies examining potential drug–nutrient interactions is quite limited. A comprehensive, updated review of the potential drug–nutrient interactions with chronic use of the most often prescribed medications for commonly diagnosed conditions among the general U.S. adult population is presented. For the majority of the interactions described in this paper, more high-quality intervention trials are needed to better understand their clinical importance and potential consequences. A number of these studies have identified potential risk factors that may make certain populations more susceptible, but guidelines on how to best manage and/or prevent drug-induced nutrient inadequacies are lacking. Although widespread supplementation is not currently recommended, it is important to ensure at-risk patients reach their recommended intakes for vitamins and minerals. In conjunction with an overall healthy diet, appropriate dietary supplementation may be a practical and efficacious way to maintain or improve micronutrient status in patients at risk of deficiencies, such as those taking medications known to compromise nutritional status. The summary evidence presented in this review will help inform future research efforts and, ultimately, guide recommendations for patient care

take control of your own health
pursue optimal self care at least as actively as a diagnosis
ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!

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Re: 2018 update: Drug–Nutrient Interactions with Chronic Use of Commonly Prescribed Medications

Post by jimmylegs » Tue Jan 29, 2019 4:33 am

[b]Vitamin and mineral needs during the oral contraceptive therapy: a systematic review (2014)[/b]
https://www.ijrcog.org/index.php/ijrcog ... e/view/737

Objectives: There is growing evidence that women using OCs change in serum trace elements and vitamins. Nowadays, in many cases, side effects associated with low levels of micronutrients are not considered during oral contraceptives (OCs) therapy. This review aims at checking the present literature in order to verify the evidences. Our purpose is to underline this aspect contributing to improve the therapeutic approach with OCs.

Methods: Systematic literature search was performed in electronic databases, covering the period from January 1967 to January 2012.

Results: Ninety-five articles were located; a cross sectional randomized and three RCTs studies were considered eligible.

Conclusions: [b]A decrease in the serum concentrations of zinc, selenium, phosphorus and magnesium have been reported in OC users. Such reductions were proportional to the duration of contraceptive use.[/b] These reductions may imply a reduction in the probability of having a pregnancy and/or an increase of serious illness for the unborn. In this regard, a supplementation with the above compounds could be useful in OC users, namely for reducing side effects.

[b]Oral Contraceptives and Multiple Sclerosis/Clinically Isolated Syndrome Susceptibility (2016)[/b]
https://journals.plos.org/plosone/artic ... ne.0149094

Abstract
Background
The incidence of multiple sclerosis (MS) is rising in women.

Objective
To determine whether the use of combined oral contraceptives (COCs) are associated with MS risk and whether this varies by progestin content.

Methods
We conducted a nested case-control study of females ages 14–48 years with incident MS or clinically isolated syndrome (CIS) 2008–2011 from the membership of Kaiser Permanente Southern California. Controls were matched on age, race/ethnicity and membership characteristics. COC use up to ten years prior to symptom onset was obtained from the complete electronic health record.

Results
We identified 400 women with incident MS/CIS and 3904 matched controls. Forty- percent of cases and 32% of controls had used COCs prior to symptom onset. The use of COCs was associated with a slightly increased risk of MS/CIS (adjusted OR = 1.52, 95%CI = 1.21–1.91; p<0.001). This risk did not vary by duration of COC use. The association varied by progestin content being more pronounced for levenorgestrol (adjusted OR = 1.75, 95%CI = 1.29–2.37; p<0.001) than norethindrone (adjusted OR = 1.57, 95%CI = 1.16–2.12; p = 0.003) and absent for the newest progestin, drospirenone (p = 0.95).

Conclusions
Our findings should be interpreted cautiously. While the use of some combination oral contraceptives may contribute to the rising incidence of MS in women, an unmeasured confounder associated with the modern woman’s lifestyle is a more likely explanation for this weak association.
take control of your own health
pursue optimal self care at least as actively as a diagnosis
ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!

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