This Is MS Multiple Sclerosis Knowledge & Support Community

http://www.whfoods.com/genpage.php?tnam ... #foodchart

from this chart, note that the cup of spinach *must* be boiled 1 min (lid off) and drained, and *then* measured as a 1 c serving, to get the 1.37 grams you're after. that's so that you can eat lots without the high oxalic acid content in raw greens like spinach and chard (which has more so requires a 3 min boil).

i also like this USDA resource http://bit.ly/2CvNgZZ which tells me i can expect .76 mg of zinc from 100 g of boiled and drained spinach. i buy bartlett's chopped spinach in 300g boxes, so i tend to consider one box equivalent to 3 servings.

i pile spinach nutrition into everything. when i was strict vegan i ate a lot more east indian food (even though i was really uninformed and hardly ate enough dark leafy greens in general), and saag is still a favourite. from the mediterranean, spinakopita too. i have recipes for spinakopita and for a spinach soup posted on here somewhere. lentil soup with added spinach and red pepper is another fave, delivering both zinc and iron together. spinach pretty much disappears in chili and in pasta sauce, and it actually makes a delightful addition to mashed potato (which for me these days is more of an anti-inflammatory 'mishmash' which includes sweet potato, spinach and sometimes carrot, in addition to potato).

of course, we can't be going after 22 cups of boiled spinach per day to hit 30 mg of zinc, or even 13 cups to hit 18 mg of veg zinc. luckily there are other more potent sources available via smaller servings.

eg per the whfoods link provided above, a daily 0.25 c of trail mix containing plenty of pumpkin seeds and cashews can be expected to contribute another ~2 mg of zinc. (depending on the overall recipe and other ingredients of course)

so, with the daily cup of spinach and the daily serving of trail mix, we are now up to 4 mg out of our bare minimum 18 mg for the day. or 4 mg out of 30 mg if we're going to aim for the safe side.

for context, a single 8 g oyster contains 7.28 mg of zinc. i am really trying to get my head around shellfish, but still have trouble. it' s more pickiness than the vegan back story, at this stage!

when i had my first serum zinc test, i was outright deficient (although the same exact level was spot on the very bottom of the 'normal' range at another local lab - so stupid). doc prescribed 100mg supplemental zinc per day (with no caution whatsoever re impact on iron status, but that is a diff story). the zinc pill made me sick to my stomach so i was not reliably working on it. solution: divided doses, always taken with food.

there's pretty much a different strategy for any nutrient supplement out there. but max intake from whole food sources always comes first!

i would like to caution here against excessive food reductionism

pls note re bread that my friend needed to alter his bread consumption from 'every time he went to the kitchen' *down* to 1 slice per day. which is still more than your 2 slices three times in a week! as long as it's bread designed for good behaviour eg made with sprouted flour or sourdough, and considered along with other gluten based flour products iike pasta, pizza dough, etc, chow down as part of my routine, i'm personally on one entire pizza every month or two. no drama. when zinc deficient, i used to have a very strong negative reaction to bread! no more. moderation is key. outright omission can send you down the road to eventual mis/malnutrition - and all with the best of intentions :S

I LOVE this related page. if i have found it before, i don't recall. but i am really enjoying it today:

DO YOU KNOW HOW TO PREPARE YOUR GRAINS PROPERLY?
https://www.weedemandreap.com/prepare-grains-properly/

here's hoping as a first step, that you can access all blood test results currently on file. hopefully at a bare minimum there's a serum ferritin result. i hope we can also expect serum b12 result details once you have any available info on current status, that will inform the list of additional serum nutrient tests you might wish to ask for, as well as providing the baseline info you'll need in order to proceed safely with any supplements.

Wow! I have read all of this and will need to re-read a few times.

- bread is the big standard plain white bread - I can switch this up
- my son is 3.5years old. I can stand to stop feeding him (it's usually just before dawn he feeds anyways)


I think there is other things going on and I'm glad this forum is here.

So I have been constipated for a while now, with only small bowel movements. This morning I had the most intense pain and was like awesome I'm going to be able to go!
It was a large amount of putrid smelling black poop (I did take a photo but I'll save that for the dr's ;)
II have googled and all manner of thing scome up (funnily enough) and none of them good.

My partner fobbed me off because I have drank alcohol the last two days and that usually happens for him (black poop, not smelly and constipated for three weeks)

But I think this is related to the stomach pain I have had in my lower/upper right side. That is still there (albeit mild now, I can palp it and it's tender) I thought this was just because I was constipated.


I'm tossing up between going to the hospital or just making an appointment for tomorrow (nothing on the web said that balck poop, smell and pain was a good thing

"So I have been constipated for a while now"

A good healthy, natural and highly effective (and inexpensive) solution to this is Psyllium Husk, which is available in capsules or powder which mixes well in a smoothie where it adds virtually no taste and because it is a fine powder, doesn't change the texture of the drink much either.

psyllium husk: my old vegan era egg replacer, and also main ingredient in metamucil

re symptoms. not on iron supplements or anything? that's the only thing that would tend to make me constipated w black stool. (can counteract that problem with magnesium - specifically magnesium oxide since it is poorly absorbed and acts as a laxative)

other than that, not that i deal with this kind of thing much at all but from what i've read it sounds like you'll want to investigate GI integrity and poss bleeding/ulcer. i also saw mention of gi paralysis, which would no doubt contribute to constipation. sounds like a trip to the doc is in order, to investigate.

if ulcer is in the picture, zinc will likely be a good aid to healing. it can help with all kinds of ulcers, inside and out. my nutrient status used to be really bad and i'd get canker sores. no longer. when i had this one chronic open wound on my back, dermatologist said zinc was too simplistic and wrote me a prescription. i took zinc for it and things healed up never to return. never had the dermatologist's prescription filled. ended up self diagnosing with a zinc deficiency induced "periorificial parakeratotic lesion"

a few potentially relevant studies (generally not enough specific research on the subject though):

Serum zinc level : a possible index in the pathogenesis of peptic ulcer syndrome.
http://europepmc.org/abstract/med/7581013
"The low serum zinc level of the peptic ulcer patients is possibly due to the positive shift for the zinc from serum to the gastric mucosa."

and if that level is even low in the mucosa...

Low Concentrations of Zinc in Gastric Mucosa are Associated with Increased Severity of Helicobacter pylori‐Induced Inflammation
http://onlinelibrary.wiley.com/doi/10.1 ... 476.x/full
"H. pylori-infected patients with non-atrophic chronic gastritis had lower concentrations of zinc in gastric mucosa than uninfected patients with the same type of gastritis (251.3 ± 225.3 vs. 426.2 ± 279.9 ng/mg of protein; p = .016)."

looking at the two together:

Peptic Ulcer Disease and Helicobacter Pylori Infection: Does Serum Zinc Level Play a Role?
https://www.ijcmas.com/5-5-2016/Nadia%2 ... t%20al.pdf
"The pathogenesis of peptic ulcer is multifactorial and arises from an imbalance between protective and aggressive factors. This work aimed to assess the possible protective
role of serum zinc in patients with peptic ulcer disease and declare any correlation between serum zinc level and H. pylori infection. ... The mean serum zinc level of the studied patients was highly significantly decreased in comparison to healthy controls (P= 0.002). Moreover, a significant stepwise decrease in serum zinc level was observed with increased severity of gastric (P<0.01) and duodenal mucosal injury (P>0.05)."

in that study, even the normal group's mean serum zinc levels look to be on the low side - although definitely higher than those seen in a couple patient subgroups. interesting to note that the mean serum zinc level was lower in h.pylori patients vs controls (not significantly statistically though)

Zinc deficiency, malnutrition and the gastrointestinal tract
http://jn.nutrition.org/content/130/5/1388S.short
"Because there is a strong association between protein and zinc content in virtually all types of foods, insufficient protein intake may often be the cause of zinc deficiency."

while i definitely benefited from increasing dietary protein after diagnosis, it certainly was not enough to correct the chronic zinc deficiency. therapeutic doses of zinc supplements definitely required in that scenario.

as for gastrointestinal paralysis. research also thin on the ground there. getting a wider array of results using search term gastrointestinal motility. that implies magnesium depletion connection. seeing studies looking at these problems in post or peri operative settings. spasticity in the smooth muscles of the gi tract could feasibly contribute to constipation. in that case, you would not want to use magnesium oxide but a better absorbed form such as magnesium glycinate.

not postop but IBS related:

Effects of oral magnesium sulphate on colonic motility in patients with the irritable bowel syndrome
http://gut.bmj.com/content/14/12/983
"Magnesium sulphate, a substance known to cause release of cholecystokinin (CCK) from the small intestinal mucosa, was given by mouth (dose 0·1g/kg in 150 ml water) to 20 patients with the irritable bowel syndrome. A rapid increase in colonic segmental motor activity (onset within two to six minutes in most cases) was seen (percentage activity increased from 16·2 to 23·7 P<0·05; mean wave amplitude from 7·1 to 9·1 cm H2O, NS; motility index from 144 to 259, P<0·01). This increase was most marked in 10 patients who complained of attacks of abdominal pain after food (16·1 to 29·8%, P<0·01; 6·8 to 9·6 cm H2O, P<0·05; 135 to 350, P<0·05), and after the magnesium sulphate three of these patients experienced an attack of their usual pain. These findings provide further evidence that `functional' abdominal pain after food may in some cases be related to an exaggerated intestinal motor response to cholecystokinin."

magnesium sulphate - meh. even as epsom salts, magnesium chloride is understood to be the more appropriate form... orally, i stick with magnesium glycinate.

Regulation of gastrointestinal motility—insights from smooth muscle biology
https://www.nature.com/articles/nrgastro.2012.168
"Gastrointestinal motility results from coordinated contractions of the tunica muscularis, the muscular layers of the alimentary canal. Throughout most of the gastrointestinal tract, smooth muscles are organized into two layers of circularly or longitudinally oriented muscle bundles. Smooth muscle cells form electrical and mechanical junctions between cells that facilitate coordination of contractions. Excitation–contraction coupling occurs by Ca2+ entry via ion channels in the plasma membrane, leading to a rise in intracellular Ca2+. Ca2+ binding to calmodulin activates myosin light chain kinase; subsequent phosphorylation of myosin initiates cross-bridge cycling. Myosin phosphatase dephosphorylates myosin to relax muscles, and a process known as Ca2+ sensitization regulates the activity of the phosphatase. Gastrointestinal smooth muscles are 'autonomous' and generate spontaneous electrical activity (slow waves) that does not depend upon input from nerves. Intrinsic pacemaker activity comes from interstitial cells of Cajal, which are electrically coupled to smooth muscle cells. Patterns of contractile activity in gastrointestinal muscles are determined by inputs from enteric motor neurons that innervate smooth muscle cells and interstitial cells. Here we provide an overview of the cells and mechanisms that generate smooth muscle contractile behaviour and gastrointestinal motility."

somewhat OT but goes to calcium magnesium balance piece of the smooth muscle picture, and otherwise pretty interesting:

Sex steroid hormones exert biphasic effects on cytosolic magnesium ions in cerebral vascular smooth muscle cells: possible relationships to migraine frequency in premenstrual syndromes and stroke incidence
http://www.sciencedirect.com/science/ar ... 3000004287
"These data indicate that low, physiological concentrations of female sex hormones, estrogen and progesterone, help cerebral vascular smooth cells sustain normal concentrations of [Mg2+]i, which are beneficial to vascular function, whereas high levels of estrogen and progesterone deplete, significantly, [Mg2+]i in cerebral vascular smooth muscle cells, possibly resulting in cerebrovasospasms and reduced cerebral blood flows related to premenstrual syndromes, migraine and stroke risk."

lots of dietitian recommendations for this vegetarian turned vegan with ulcer. zero mention of specific nutrients though. without having any info on nutritional status, still to my mind this individual is more likely to be making things worse with a switch to veganism.

http://www.veggieboards.com/forum/14-ge ... ulcer.html
"I've had stomach ulcer since I lived on my own during the first and second semester of college, it was because I didn't eat properly. ... So I had a severe pain for 2 months, but the side effect I got was constant stomach bloating and feeling hungry all the time. ... I became vegan 6 months ago because my favorite youtuber is vegan and I was encouraged to become vegan and also I watched Cowspiracy and Earthlings (so i'm vegan first and foremost for ethical reason). Even after became vegan, I don't have a lot of energy, usually feeling sleepy, bloating, hungry all the time..."

another vegetarian with an ulcer



and a vegan advisor on ulcer remedies - tsk tsk grettie, your page makes no mention whatsoever of zinc. pathetic excuses for 'references', too. made me look into the 'qualifications'. i'm not too impressed by the 2 week $1260 online course https://www.ecornell.com/certificates/p ... nutrition/

Natural Remedies For Ulcers
http://www.chicvegan.com/all-natural-re ... or-ulcers/

one more *actual* academic reference (it's actually not a very good one but at least it's an actual research paper)

Serum Zinc Status and Helicobacter Pylori Infection in Gastric Disease Patients
http://www.koreascience.or.kr/article/A ... 13n10_5043
"Our study showed that Helicobacter pylori infection has no change in gastritis, peptic ulcer and gastric cancer group, on the contrast, serum levels of Zn were significantly reduced in gastritis, peptic ulcer and gastric cancer group, compared with healthy controls, and the higher* the Zn levels are, the more increased risk of gastric cancer. Helicobacter pylori infection is a cause of gastritis, peptic ulcers and even gastric cancer, while serum zinc level is an indicator of protection of gastric membranes against damage."

Table 2. Serum Zinc Value in Patients and Control Group
Control............18.7±3.9
Gastritis...........16.8±3.8
Peptic ulcer.......14.0±2.8
Gastric cancer...13.7±2.7

Zinc were significantly lower in gastric cancer patients, compared with healthy controls, and decreased serum levels of Zinc may be associated with an increased risk of gastric cancer in people infected with H. pylori."

*they meant lower. ELLs.

here i would like to point out that the mean zinc level in the healthy control group above is actually outside the top end of the range at my local lab. supposed 'zinc excess'. all the other mean zinc levels for the gastritis, ulcer and cancer groups are 'normal'.

compare

The iron and zinc status of long-term vegetarian women.
http://ajcn.nutrition.org/content/34/6/1042.short
"...mean serum zinc (99 +/- 24 microgram/dl) ... were all within the normal range."

so to convert, 99 x 0.153 = 15.2 umol/L. right in the sweet spot for gastritis/peptic ulcer. oh, normal range. you will be the death of us all.