This Is MS Multiple Sclerosis Knowledge & Support Community

hi nice to see this update.
one of several things may be going on here.

1. timing.
re gelcaps + mag not working, i've been advised (for good reason) to take some mag at the same time as d3 and to take another portion separately. your post info was unclear re timing specifics. maybe careful timing of mag, around your routine d3 intake, could have mitigated your issues.

2. if d3/mag intakes were correctly timed/coordinated, then consider magnesium dosage.
if the intake via gelcaps was 10,000 IU/d and the gel form was well absorbed, depending on your diet and other personal details, 300 supplemental mag glycinate may not be adequate, with or without proper attention to timing.
some mag math:
7-10 mg / kg body weight of daily mag intake has been recommended in the literature - and at that, outside the context of supplemental d3 intake.
in the context of high dose d3, it may be wise to assume you need *at least* 10 mg / kg body weight of daily magnesium from all sources. this may exceed DRI for your sex and age.
for every added activity that forms a drain on mag resources (such as: stress from any source whether emotional or physical ranging from exercise to injury to surgery; regular use of antacids, specifically PPIs; regular consumption of caffeine and/or alcohol), increased mag intake is in order.
it is always best to maximize food sources before topping up with a supplement. if you don't know the contribution your diet is making (or not) to daily intake, it's worth making the effort to understand and optimize that part of your routine.

3. d3 composition.
strangely enough, it could be because the d3 powder caps are not as good, that that particular d3/mag combo works better to address your side effects. i would need more product info to have any certainty about that. in the meantime:
if the powder capsule intake was also 10,000 IU and 300 mg mag glyicinate worked, it's possible the powder cap form of d3 was less efficiently absorbed, meaning that 300 mg mag glycinate was adequate to the task (with or without considering timing).
sadly if this is the case it may mean you are excreting the excess d3, with unintended downstream impacts.

ps i went back and checked on an earlier mag info link posted above, and it was broken. now repaired.

I think you may try daily 600 mg magnesium (safe) and see if it helps. I am almost sure that you need much more magnesium.

I do 5000 IU daily and 600 mg magnesium citrate is my bottom limit. Please consider more monitoring/tests for D3 and magnesium.

glad you are keeping d3 to 5K/d with lots of mag in the mix, z
your consistent efforts re testing have been so helpful for fine tuning the regimen.
i still hope you can get past the mag citrate hurdle at some point!

Thanks jimmylegs and Zyklon,
Actually there's a little confusion, my mistake. I'm taking 15,000 IUs of Vitamin D in the morning along with 150 mg Magnesium Glycinate, in the afternoon I take another 150 mg Mag and in the evening I take another 150 mg of Mag. But not sure if it's the right dosage or way to take it, I weigh 97lbs (44 KGs?). RE diet, my diet is clean, lots of fresh, organic (when possible) vegetables and fruits, nuts, seeds, only clean meat on rare occasions, green tea...no alcohol, no antacids, no drugs but LDN.
A total of (daily) Mag 450mg and Vitamin D 15,000 IUs. Hope this makes sense now and sorry for the confusion


dlynn

It looks like I am OK J

Dlynn can you please share your last 3 magnesium test results with dates?

good news, z

dlynn thanks for the details.

ok based on this info, your daily supplemental mag intake looks like it should meet your basic needs without any supplemental d3 in the mix

with supplemental d3 in the mix, given that the morning dose is given up to d3, re the rest of the day:
in addition to the 2nd and 3rd 150mg magnesium glycinate inputs of the day, your diet may cover the balance
(or may not - depends whether specific magnesium-dense choices are represented, and losses from caffeine, stress, etc are not excessive.
i also see hints in the literature that magnesium excretion is elevated with lower vit K intake. do you have a sense of your dietary vit k sources and intake?
and on a slightly tangential note, may i inquire as to the typical amount of green tea consumed daily?)

re the morning dose of d3:
150 mg mag glycinate at the same time as 15K IU of d3 is likely not enough. might be wise to try 300 mg mag glycinate at the same time as the d3. that will align neatly with recommendations i've been given elsewhere about giving half of daily supplemental mag to d3, reserving the other half for other body functions.

i second z's inquiry re most recent serum mag tests. his own serum mag levels have not been the easiest to keep in an optimal range, in conjunction with higher daily d3 inputs.
i'm also curious re your most recent few serum 25(OH)vitaminD3 test results, and what specific serum vit d3 target you are working to achieve.

i'm interested as well, in learning more about your specific d3 supplements. do you have links for the gel cap and the powder cap products you've been working with?
overall, glad you are finding combinations that provide relief. still interested in nailing down *why*, if possible!

jimmylegs and Zyklon,

I have no test results for Mag. I will have bloodwork in Nov. and "biochemistries" (not sure what that means) mid Sept., soon.
As for Vit.K, I rarely eat meat and I don't eat dairy as cheese is a good source of it, yikes,I could be in trouble!! My protocol Dr. never mentions supplements and just this a.m. recieved an email from him saying "Mag. is fine" but no mention of the strength I'm taking. Maybe when he increases the Vit.D, he will reccommend supplements. As for my caffeine intake, I use 2 teabags caffeinated in the a.m. and 1 teabag decaffeinated in the evening. I will take your suggestion and increase my a.m. Mag. Do you think caffeine is depleting my Mag.? I'm so thankful to have you all to help me through this and make sense of it.
This is the Vit D brand I prefer that didn't cause the muscle/joint pain, I take 3 capsules in the a.m. (15.000 IUs)
https://www.amazon.com/Pure-Encapsulat ... 017Q948U/

https://www.amazon.com/Magnesium-Glycin ... 01LXB13M6/

And the gelcaps I started with when I started having pain
https://www.amazon.com/Vita-Optimum-Vit ... 00EDU4K6I/
dlynn

Can you please share your doctors name?

hi again some questions:

1. what does 'mag is fine' mean? adding a serum mag test is fine? or that he somehow magically knows your status is fine? that your chosen supplement is fine? that your status quo intake should be fine?? i need clarity ;)

2. if it's not already in place, can you / will you push for serum magnesium testing in conjunction with one or both of your upcoming bloodwork appointments?

3. can we assume september's 'biochemistries' are things like this?:

https://labtestsonline.org/tests/compre ... -panel-cmp
Glucose, Calcium, Proteins (Albumin, Total Protein)
Electrolytes (Sodium, Potassium, CO2, Chloride) (right here is where i wish they would include serum magnesium on standard panels)
Kidney Tests (BUN (blood urea nitrogen), Creatinine)
Liver Tests (ALP (alkaline phosphatase), ALT (alanine amino transferase, also called SGPT), AST (aspartate amino transferase, also called SGOT), Bilirubin)

revisiting vit K. i get why you're talking about k2 food sources but i'm not sure the study that mentioned mag depletion with low k diet was even referring to k2.
maybe just k1.

4. how is your diet for food sources like these?:
http://www.whfoods.com/genpage.php?tnam ... #foodchart

5. and how do your amounts consumed from among those choices line up with your own daily requirements according to public health standards like these?:

https://www.canada.ca/en/health-canada/ ... -2005.html

(note here that there is no breakdown of vit K in the daily requirement - it's not talking about k1 or k2 specifically)

i wish i could be amazed and appalled that you have a 'protocol doctor' giving you megadoses of one essential nutrient without addressing interactions and cofactors. sadly it seems to be depressingly status quo.

your caffeine intake does not sound excessive to me, but it will trigger higher excretion of mag (doesn't mean you can't enjoy your cuppas, just means you have to be certain you compensate)

i'll have a look at your links and check back in again later.

ok to reiterate, what is the target serum d3 level you are going for?

all your supplement products linked above look fine. i wonder what would happen if you tried alternating the powder caps with the gelcaps once you have both on hand again.
i'm not happy about the idea of 15000 IU per day long term, esp without up to date serum magnesium records and a target serum d3 value that when reached, will trigger a return to normal daily public health recommendations for daily d3 intake.

that's just my 2c! some years back i had a running debate in a different TiMS forum, with i think a pharmacist from the uk who was insisting everyone needed to go straight for a given d3 target and never mind cofactors until there was trouble achieving the desired level.

when we know about these interactions, why not address them right from the start :S

anyhoo looking forward to more info, and to new results once you have them

The guys above all know what they are talking about but as an ordinary person on the D3 therapy I would certainly change your protocol doctor. I am on 80,000iu every day and take three different types of magnesium four times a day. Riboflavin I do take but from what I understand it doesn't always agree with people. For someone to put you on high D3 without Magnesium is ludicrous. He should not be a protocol doctor.

related http://www.thisisms.com/forum/natural-a ... ml#p254742

vit d3 dose response / diminishing returns
https://journals.plos.org/plosone/artic ... 11265.g001

question kittie what is your 24 hr urinary vit d3 excretion? fecal d3 excretion?

hey there dl still curious re questions above, eg @
http://www.thisisms.com/forum/coimbra-h ... ml#p254614 (emphasis added)
and items 1 thru 5 @
http://www.thisisms.com/forum/coimbra-h ... ml#p254680

@k - guessing your doc does not in fact track 24 hr urinary or fecal d3 excretion?

bump ...

I guess he can't write because of self-followed coimbra protocol...