Emotional Balance in the Treatment of Autoimmune Diseases
by Dr. Cícero Galli Coimbra
This is part of an email sent by Dr. Coimbra, with important information for all Protocol patients, about emotional balance and more.
1 - We are used to say that patients who manage to control emotional issues (sustained depression, irritability, fear, etc.) and have not sustained old disabilities by the time they begin high-dose vitamin D therapy may achieve full neurological recovery and live a normal life (sometimes we tell them that they can live their lives as they were "cured").
2 - However, we have clearly stated that they should not actually consider themselves as "cured" because they would have to indefinitely sustain high daily doses of vitamin D adjusted according to their level of inherited resistance to vitamin D (which includes not only a calcium-restricted diet + plus minimal hydration of 2,5 L per day to protect kidney function). In other words, their disease activity can be fully suppressed - which is not the same as "cure".
3 - Because those emotional issues are not under our control, but rather essentially depend on the patient's emotional structure and adequate support of their relatives, we estimate that high-dose vitamin D therapy may achieve roughly 95% of success (meaning 100% of suppression of disease activity in 95% of patients). That percentage (95%) includes patients with no disabilities (who have fully recovered from their relapses by being submitted to pulse therapy with IV corticoids) and patients with old (established, possibly irreversible) neurological disabilities but who manage to keep emotional issues under control from the time they start high-dose vitamin D therapy;
4 - Patients who sustain chronic emotional instability (depression, irritability, fear, etc. - even fear of disease outcome itself) usually already are in the progressive types / phase of multiple sclerosis (either primary progressive MS or secondary progressive MS ) by the time they arrive for the first medical appointment; if these emotional issues are not controlled, they will probably sustain further progression of their disabilities (though disabilities may progress at slower rate) despite they keep receiving the highest possible daily dose of vitamin D individually adjusted according to results of periodic laboratory tests;
5 - Other issues that may compromise the treatment are much more easier to control. They include recurrent infections (usually urinary tract infections), smoking, frequent alcohol drinking and hot showers / hot baths or sauna; hot showers / hot baths or sauna may trigger relapses and a significant number of patients (particularly female patients) may sustain that habit since childhood.
6 - Patients who already have their disease fully suppressed may experience a major stressful life event, exposure to environmental heat or an episode of infection and, as a consequence of that, experience: (A) transient worsening of disabilities that had never completely resolved; or (B) transient mild recurrence of symptoms that had disappeared during the treatment; those are not true relapses, but actually false relapses (a new Magnetic Resonance Image would not demonstrate any additional demyelinating lesion) that would resolve with the disappearance of the triggering factor;
7 - Due to the particularly sensitive or fragile emotional structure of their personality, a minority of patients who experience events like those described in item #6 may completely loose confidence in a future with suppressed disease activity (specially if the event is misused by professionals who are interested in demonstrating that high-dose vitamin D therapy is ineffective); as a consequence, they may get into a chronic state of mixed negative feelings of anguish, disheartenment and fear - which (if not controlled with the help of supportive relatives, friends or other patients who participate in social MS networking reporting the benefits of high doses of vitamin D under proper medical care) may take them into the progressive phase of MS;
8 - That happens because those negative feelings reduce the levels of magnesium and low intracellular magnesium levels enhance inflammatory processes in general in the whole organism, including the brain and spinal cord:
https://scholar.google.com.br/scholar?h ... n&btnG=&lr
https://scholar.google.com.br/scholar?q ... _sdt=0%2C5
http://www.jimmunol.org/content/188/12/6338.short
"Magnesium deficiency contributes to an exaggerated response to immune stress and oxidative stress is the consequence of the inflammatory response."
http://www.sciencedirect.com/science/ar ... 6106001366
9 - Expectedly, emotional stress of any kind are associated with brain inflammation. The most well-studied example is the association with depression and brain inflammation. Accordingly, depression may be successfully treated with magnesium supplementation. Altogether, current data indicate that depression (and probably other chronic negative mood changes like irritability and fear) cause inflammation of the central nervous system in part by decreasing magnesium levels within brain cells and by inducing the production and release a large number of pro-inflammatory substances called cytokines.
https://scholar.google.com.br/scholar?q ... _sdt=0%2C5
https://scholar.google.com.br/scholar?q ... _sdt=0%2C5
http://journals.sagepub.com/doi/abs/10. ... -QMA9-G1VN
"Therefore, our results imply that depression may lead to inflammation and that inflammation may be one of the mechanisms by which depression contributes to cardiovascular risk."
http://www.sciencedirect.com/science/ar ... 9109001135
"Since inadequate brain magnesium appears to reduce serotonin levels, and since anti-depressants have been shown to have the action of raising brain magnesium, we further hypothesize that magnesium treatment will be found beneficial for nearly all depressives, not only treatment-resistant depression."
http://www.sciencedirect.com/science/ar ... 7709007300
"The possibility that magnesium deficiency is the cause of most major depression and related mental health problems including IQ loss and addiction is enormously important to public health and is recommended for immediate further study."
http://www.sciencedirect.com/science/ar ... 7706001034
10 - Recently, we started using higher doses of magnesium (around 150 mg of elemental magnesium three to four times per day administered 1 hour before meals - fourth dose at bedtime to help patients to achieve: (A) a more powerful effect of vitamin D, (B) improvement of emotional stability, (C) prevention of side-effects related to excessive calcium absorption and (magnesium is a natural calcium antagonist) and (D) prevention of osteoporosis / osteopenia. Magnesium chloride provides only 12% of elemental magnesium; magnesium citrate provides only 18% of elemental magnesium; magnesium oxide is poorly absorbed and should not be used.
10.A: The metabolism of Vitamin D and magnesium are interdependent:
"Magnesium is a cofactor for vitamin D biosynthesis, transport, and activation; and vitamin D and magnesium studies both showed associations with several of the same chronic diseases."
http://advances.nutrition.org/content/7/1/25.short
http://www.wholefoodsmagazine.com/colum ... vitamin-d/
http://www.sciencedirect.com/science/ar ... 3674912653
http://europepmc.org/abstract/med/9140864
http://europepmc.org/abstract/med/3079418
10.A: Both vitamin D and magnesium deficiencies are pandemic:
https://www.google.com.br/#safe=strict& ... pandemic&*
https://www.google.com.br/#safe=strict& ... pandemic&*
10.A: Both vitamin D and magnesium deficiencies are associated with autoimmune diseases:
https://scholar.google.com.br/scholar?h ... &btnG=&lr=
https://scholar.google.com.br/scholar?q ... _sdt=0%2C5
10.B: see items #8 an #9.
10.C: Magnesium is a natural calcium antagonist
https://scholar.google.com.br/scholar?q ... alcium+ant
10.D: Magnesium deficiency is associated with osteoporosis, and magnesium replacement stimulates bone formation and inhibits degradation of bone tissue:
https://scholar.google.com.br/scholar?q ... _sdt=0%2C5
Warmest regards,
Cicero G Coimbra, MD, PHD