Volume4,Issue4

August,2019

DoesMagnesiumThreonateLiveuptotheClaimsMadeAboutIt?—Here'sMy

PersonalExperienceWithIt.byWaynePersky

Brain fog is a very common symptom ofmicroscopiccolitis(MC).It's not evenmentioned in themedical description ofMC,butmostMCpatientssoonrealizethattheyhaveit. Most sources describe brain fog as some form ofcognitive dysfunction that usually includes memoryissues and poormental clarity. Individualswho havebrainfogaregenerallyunabletofocustheirpowersofconcentration on specific projects, especially ifmathematical calculations or logical thinking arerequired. And even if the proper diet is adoptedimmediately, healing often progresses so slowly thattwo or more years may pass before the brain fogcompletely disappears for many MC patients. We

urgentlyneedimprovedwaystoresolvebrainfog.

According to claims based on the results of a randomized, double-blind,placebo-controlled trial, published in the Journal of Alzheimer's Disease in2016,magnesium threonatemight have the capacity to treat brain fog. (1)Resolvingbrainfogwasnotoneofthestatedgoalsofthisresearchproject.Butthe trial proved that magnesium threonate has a very impressive ability toimprovememoryandcognitive function inolderadults,especially thosewhohave compromised memory and cognition. And that certainly appears toaddresstheessenceofbrainfog.

WhyIdecidedtotrymagnesiumthreonate.I've been in remission for over fifteen years, so my brain fog was resolvedmanyyearsago. Therefore, I'mnot inapositionwhere Icouldtestpotentialbrainfogsolutions.However, Ihadastrokealmosttwoandahalfyearsago,and thedamagedoneby thestrokeshouldmakemeacandidate for testingtheeffectivenessofmagnesiumthreonate.

Here'swhyIbelievethatImakeasuitableguineapig.The loss of balance and coordination caused by a stroke appears to be theresultofnervedamagethatcausesthelossofspecialnervestructurescalledsynapses.Theirfunctioninthebrainandcentralnervoussystemistoenableaneuron (nerve cell) to pass an electrical or chemical signal across a gap toanother neuron or to a target such as a muscle cell. If we lose too manysynapses, our ability to control ourmuscles becomes compromised, and ourbalance, coordination, and strength will suffer. In the brain, the loss ofsynapsescaninterferewithourabilitytofocusourthoughts,andourabilitytoretrievememories,becauseofthedisruptionincommunications.

Magnesium threonate is widely promoted as a synapse densityenhancer.Inotherwords,itsclaimtofameisbasedonitsabilitytoincreasethenumberof synapses in the brain (and presumably in the central nervous system).Therefore,thisproductshouldtreatbrainfog.

ThelabeleddoseofthesupplementIselectedisthreecapsulesperday.Sincethis isa relativelynewproduct, I startedwithonlyonecapsuleperday foracouple of days. I had no ill effects, so I began taking two per day andcontinued for fivedays. Aseverything seemedwell, I increased thedose tothreecapsulesperday,andat the timeof thiswriting, I'vebeen taking thatdose for about six weeks. I was taking 300 mg of magnesium glycinateoriginally, so I adjusted that dose as I increased the magnesium threonate.Three capsules of magnesium threonate amount to 144 mg of elementalmagnesium (this canvaryby thebrand). Experimentingwith theamountofmagnesiumglycinate,Ifoundthatone(100mg)tabletisnotenough(Ihadlegcramps),so I'mtaking twomagnesiumglycinate tabletsalongwith the threemagnesium threonate capsules, each day, divided amongmeals and snacksthroughouttheday.Thismakesmytotalmagnesiumdose344mg.

Isithelping?Withoutanyscientific testing, thiscanonlybeconsidered tobemypersonalopinion. Andwe all know that it's very easy tomisinterpret personal resultsbecauseofbias,soweneedtobeverycareful inhowweviewtheseresults.Additionally, because of my advanced age, I have to distinguish betweennormal old-age symptoms and stroke-caused symptoms. That said, I'mwellawarethatmostsymptomsthatdoctorsmistakenlyattributetoadvancingageareactuallydue toeitherdiet issuesandvitamindeficiencies, ormedicationsideeffects.Andofcoursewealwayshavetoremainawarethattheplaceboeffectcanbeverypowerful.

Here'smyimpressionatthispoint.Inormallyhavenoachesorpains,andIhavenoticednonewiththistreatment. After three or four weeks, it seemed pretty clear that my cognizance andmemory had noticeably improved. My ability to recall names and variousdetailsseemstobesignificantlyimproved.Irarelyhavetostopandthinkforawhile to recallanameorsomeother information. Previously, itoften tookahalf-day, or even a full day to recall names or other information that I wasunableto immediatelyrecall. It's toosoontosaythat issuehasbeentotallyresolved,butatthispoint,itseemstobeathingofthepast.

At the four-week point, frankly, I hadn't noticed any improvement in myresidualpost-strokesymptoms,suchasbalance,coordination,andgait,whichwas somewhatdiscouraging. At the six-weekpoint though, I'mbeginning tonoticethatearlyinthemorning,beforemyfirstcupofcoffee,mybalanceandgait seem to be consistently improved. Previously, I was noticeably clumsyandhadpoorbalance,beforemyfirstcupofcoffee.

However,thiseffectcouldbeduetoimprovedsleep.Prior to this treatment, I almost alwayswoke up at least two or three timesduring the night, usually needing to use the bathroom. Then I typically hadsomedifficulty getting back to sleep. Now, during somenights, I'llwakeuponce,andthengettingbacktosleepseemseasier.Onothernights,I'llsleepright through until about half-an-hour-before-dawn, which is when I normallygetup.

Onasidenote,regardingsleepissues.I note that having to get up three or four times during the night to use the

bathroomwas a persistent symptom backwhen I had a chronicmagnesiumdeficiency,anumberofyearsago.It'salsoasymptomofpre-diabetes.Idon'thaveanyothersymptomsofpre-diabetesnow,but Ididbackthen,however. Interestingly,note thatvirtuallyall of the symptomsofpre-diabetesoverlapthesymptomsofachronicmagnesiumdeficiency.Pleaserememberthisifyourdoctor ever tells you that you have pre-diabetes. Either start takingmagnesium, or at least have yourmagnesium level tested. Otherwise, yourriskofdevelopingtype2diabeteswillbequitehigh.Magnesiumdeficiencyiscloselyassociatedwithdiabetes.

Sowillmagnesiumthreonatetreatbrainfog?Weneedmoreevidencetobesurethatthis will work for everyone (or evenmostpeople),butsofar,I'mcautiouslyoptimistic. The advertising claimsseem tobe justified. It appears tobeworkingforme,evenbetterthanIhadhoped. Previously, if I tried to workaround machinery, and I had to duckunder something, or step overanything,IoftenlostmybalanceandIwasatriskoffalling.IfItriedtodobothat the same time, I had to grab onto something for support. I noticed thismorningthatInolongerseemtohavethatproblem—I'msteadyonmyfeetinsuchsituations.

The stroke causedme to have to relearn how to domany things, includingtyping on a keyboard. I notice that while typing out this article today I'msuddenly able to type faster, and I make fewer mistakes. Many of theimprovements are subtle, but all together, I have to say that they're quiteimpressive. I'm hopeful that magnesium threonate is what we've beensearchingfortotreatbrainfog.

Reference:1.Liu,G.,Weinger,J.G.,Lu,Z.-L.,Xue,F.&Sadeghpour,S.(2016).EfficacyandsafetyofMMFS-01,asynapsedensityenhancer,fortreatingcognitiveimpairmentinolderadults:Arandomized,double-blind,placebo-controlledtrial.JAlzheimersDis.2016;49(4):971-90.doi:10.3233/JAD-150538.Retrivedfromhttps://www.ncbi.nlm.nih.gov/pubmed/26519439

FlaresandHelpfulHintsfor

ManagingThem

Microscopic colitis is a life longstruggle. Many of us obtain remissionfor periods of time, but then ourconditiondeterioratesandwegointoaflare.TheexperiencescollectedontheMicroscopic Colitis Forum haveprovided some common themes and

waystofightourwaybacktohealthyguts.Herearethemostcommoncauses.

UnrecognizedGlutenContaminationisCommonGlutenhasasneakywayof finding itsway into foodthatwethinkshouldbesafe.IntheUnitedStates,theFDAdefinitionforafoodbeinglabeled“glutenfree” is less than20ppm. Butpeoplevary in theirsensitivity togluten,andmayreactatthatlevel.

Thenthereisthewholeissueofcross-contaminationinfoodsthatarenaturallyglutenfree.Croprotation,sharedstorageandtransport,andfoodprocessingfacilitiesthatshareequipmentwithwheatandflourareallpossiblesourcesofcontamination.Thisisonereasonwhygluten-freebreadsandbakedgoodsarerisky.Anitemthatworkedwellwhenfirsttriedcanlateronbecomeaproblemwhensourcesofingredientschange.

Restaurants are especially risky, evenwiththebestintentions.Arecentstudyshowed that about 32% of restaurantfood labeled gluten free actuallycontained gluten. And gluten-freepizza and pasta were the biggestoffenders, with around 50%contamination rate. Medications,cosmetics and other body productsneedtobecheckedtoo.

Theother factor tokeep inmind is theadditiveeffect. Even ifan individualitemhasalowamountofglutenthatdoesn’tcauseareactionforyou, ifyouareconsumingseveralsuchitemsonaregularbasis,itcouldbetoomuch.

NewSensitivityEverysooftenanewsensitivitytoapreviouslyOKfoodwillarise.Thiscanbetough to track down, but here are a couple of suggestions. Try keeping adetailedfoodjournalwhereyoulistthefoodsyouatealongwithadescriptionof any symptoms that show up. Many people have found this to be veryhelpful.

YoumightalsoconsiderEnterolabtesting,evenifyouhavebeentestedinthepast.Besidesthemainculpritsofgluten,dairy,soyandeggs,theynowtestforanumberofothergrains,meats, legumesandsomevegetables. Andevennegativeresultsareveryhelpful,asyounowwouldhaveconfidencethatthefoodsyoutestednegativetoareOKtoeatandyoudon’tneedtoworryaboutthem.

AdditiveEffectsofMildlyReactiveFoodsThis type of flare ismost commonwhenwe try to add back toomany newfoodstooquicklywhenwestart feelingbetter. Wegetprettyboredwiththelimiteddiet, so the temptation is strong. Foods thatwe canhandle in smallamounts can cause problems when overdone or when combined, as ourrecovery isstillpretty fragile. Fruits, foodswitha lotof fiber,andhistamine-containing foods are common examples. This is a “tipping point” type flarethatrequiressomeworktofigureout.Whatseemstoworkbestistoreturntothebasic diet thatminimizes fiber, fruit, andacidic foods like tomato sauce.Thenwhen the flaresubsides, slowlyaddbackother foodsoneata time insmalleramounts.

Stress

Stress can be amajor, but often unrecognized contributor to a flare. It canhappennomatterhowwell-managedthatindividual'sdietmaybe,orhowlongsheorhehasbeeninremission.Insomecases,anMCpatientwillsuccessfullyhandle a very stressful situation, only to end up in a flareweeks ormonthslater,afterthecrisisisresolved,andthestressshouldbediminishing.

These flares are often so tenacious that it's necessary to go back to a very

simple diet, even discontinue the useof supplements until the flare isresolved, and sometimes resort tomedications such as Entocort. Themind-bodyconnectionisverypowerful!And when under stress, it can bedifficult to find the motivation andenergy tomaintain a healthy diet andlifestyle.There isa lotof information inpreviousnewslettersandon theForumabouthowtomanageyourstress,so Iwon’t repeat itallhere. Hereare links toatwo-partseriesonstressinpreviousnewsletters.http://www.microscopiccolitisfoundation.org/uploads/5/8/3/2/58327395/newsletter_2.pdf

http://www.microscopiccolitisfoundation.org/uploads/5/8/3/2/58327395/newsletter_3r.pdf

Why is the percentage of

adverse drug reactionsreportedsolow?

Patients have been experiencingadverse drug reactions (ADRs) forthousandsofyears,eversincethefirstdoctors began prescribing concoctionstotreatpatientailments.Andformostof those years, adverse reactions toprescription medications have been

viewedmostlyasanecessaryevilinthemedicalprofession.Evenwhenbothdoctorandpatientarewellawareoftherisks,manyriskydrugsareprescribedanyway. In some cases, even drugs that are known to have possible sideeffectsthatmayleadtoalethaloutcome,areprescribed.

So it's not surprising that under-reporting ofADRsbydoctors is so common.Andthere'sgoodreasonforthislaxattitude.ThemainproblemappearstobethatnoincentiveexiststoencouragethereportingofADRs.

In some other countries, doctors are required by law to report ADRs.Surprisingly,intheUSA,theFoodandDrugAdministration(FDA)doesn'tevenrequiredoctorstoreportADRs.Theyrecommendit,buttheydon'trequireit.Manydoctorsarenotevensureofwhattoreport,andhowtoreportit.(1)Soanythingotherthanalowreportingratecouldhardlybeexpected.TheFDAisaware that even in large trials involving thousands of subjects, some safetyissues will not be discovered. Most drugs are tested on subjects who aregenerally in better health, and who are taking fewer other drugs than thepatientswhowillusethedrugafter itbecomesapprovedforsale. Infact, inmanycases,ahighpercentageofthepeoplewhowillreceiveaprescriptionforthe drug when it becomes available, would not qualify for the initial trial,becausetheyhaveoneormorehealthissues.

Theissueofunder-reportingiswell-illustratedbytheresultsofasurveytakenamongphysicians inGermany in2017.(2)Of316qualifyingphysicians,176completed thequestions in thesurvey. 137of them(78%)stated that theyrarely, very rarely, or never report ADRs to the “competent authority”. ThemostoftenlistedreasonsfornotreportingADRswerelackoftime,theopinionthatthereportingprocessiscomplicated,andtheopinionthatreportingADRsrequirestoomuchtime.Slightlyoverhalfoftherespondents(72)mentionedthattheydon'treportADRsthatarealreadyknown.

Back in 2006 an analysis of 37 studies from 12 countries showed that theoverall median under-reporting rate for general practices was about 95 %,whiletheunder-reportingrateforseriousorsevereADRswasabout80%.(3)Notmuchprogresshasbeenmadeovertheyears,becauseit'sthoughtthatintheUS,onlyabout1%to10%ofallADRsareeverreportedtotheFDA.(4)

In fact, not only are there no incentives, there are often disincentivesassociated with the reporting of ADRs. According to Godwin (2019), somedoctorswhohave reportedADRs to theFDAhavehadnegativeexperiences.Doctorswhohavegoneastep fartherandpublishedarticlesaboutADRs, inordertowarnotherdoctors,havehadgenerallynegativeexperienceswiththepharmaceuticalindustry.Oneindividualevenreportedbeingthreatenedwithalawsuitbecauseofanarticlehehadwritten.Fewdoctorshavethetimeorthetemperament for such harassment, so they just stop reporting ADRs andpublishingarticlesabout them. Thissituationhas theattributesofa footballgamebetween thepharmaceutical industryand thephysicians,with theFDAactingasreferee.Unfortunately,thepatientsaretheballinthisgame,sotheydon'tmake the rules, they justgetkickedaround. Needless tosay,changesneedtobemade.

References:1.Jones,J.K.(N.D.).WhyshouldIreportanadversedrugevent?Retrievedfromhttps://www.medscape.org/viewarticle/578160

2.Gahr,M.,Eller,J.,Connemann,B.J.,&Schönfeldt-Lecuona,C.(2017).EuropeanPsychiatry,41(Supplement),S369.Retrievedfromhttps://www.sciencedirect.com/science/article/pii/S0924933817326482

3.Hazell,L.,Shakir,S.A.W.(2006).Under-reportingofadversedrugreactions.S.A.DrugSafety,29(5),385–396.Retrievedfromhttps://link.springer.com/article/10.2165/00002018-200629050-00003

4.Godwin,A.(2019,June2).ASCOposter:Reportingadversedrugeventshaschillingeffect.[Weblogmessage].Retrievedfromhttps://www.medscape.com/viewarticle/913602?src=WNL_confalert_190603_MSCPEDIT&uac=95382HN&impID=1983303&faf=1Godwin,A.(2019,June2).ASCOposter:Reportingadversedrugeventshaschillingeffect.[Weblogmessage].Retrievedfromhttps://www.medscape.com/viewarticle/913602?src=WNL_confalert_190603_MSCPEDIT&uac=95382HN&impID=1983303&faf=1