Magnesium: An Essential Supplement for ME/CFS

This article was originally published on ProHealth.

By Erica Verrillo

Found abundantly in leafy greens, fish, nuts, seeds,and dried fruits, magnesium is the unsung hero of nearly all our body's metabolic processes. It is a cofactor in over 300 enzyme systems, and performs vital roles in regulating blood glucose levels, protein synthesis, blood pressure, and muscle and nerve function. Along with potassium, calcium and sodium, it is classed as one of the seven minerals essential for the functioning of the human body. Without it, we would die. 

According to the USDA, fully 68% of Americans do not consume the daily recommended intake for magnesium^.1 Independent researchers place this figure even higher, at 75% - 80%. ²  (Keep in mind that the daily recommended intake is not the optimal amount a person needs to consume in order to maintain a healthy, fully functioning body, but the minimal amount one needs in order to avoid illness.)

Because magnesium is essential for relaying nervous system impulses and for the metabolism of calcium

and for the metabolism of calcium and potassium,the effects of magnesium deficiency run the gamut, from growth retardation to heart failure, from anorexia to learning disabilities and personality changes, from weakness to muscle pain, and, of course, fatigue. Even at the daily recommended intake, symptoms of deficiency can appear. In 1990, Kubena et al. listed the effects of chronic marginal intakes of magnesium, including “abnormalities in reproduction, growth, and development and disorders of neuromuscular, cardiovascular, renal, and immune function." 9 Considering the fact that roughly three-quarters of Americans are functionally deficient in magnesium, we would expect to see at least mild deficiency symptoms in the majority of our population. 

Given both its widespread systemic effects as well as its under-consumption by most of the population, it is not surprising that magnesium has been used as a treatment for such diverse conditions as diabetes, cardiac disorders, migraines, asthma, and major depression. ^3-7

Magnesium Deficiency in ME/CFS

In early 1991, I.M. Cox, M.J. Campbell, and D. Dowson published a preliminary study on magnesium levels in CFS/ME patients. All 22 patients studied had reduced levels of serum magnesium. ¹⁰ (A reduced level of serum magnesium is cause for alarm, given that the vast majority of magnesium is found in tissue, not blood.) The researchers followed up their findings with a randomized clinical study in which 15 of the patients received intramuscular injections of magnesium sulfate every week for six weeks and 17 received a placebo. Of the 15 patients receiving magnesium, 12 reported improvement in symptoms. 

A subsequent article by Dr. Mildred Seelig observed an overlap with ME/CFS and many of the symptoms of latent tetany syndrome, a medical condition resulting from magnesium deficiency leading to sleep abnormalities, vertigo, mitral valve prolapse, headaches, and anxiety. She proposed that ME/CFS patients would improve with the treatment used for LTS, namely magnesium.⁸ Dr. Seelig concluded that “The evidence that Mg deficiency causes a variety of both humoral and cellular defense disturbances, among which are several that have been identified in CFS and FM, is a reason to suspect that either Mg deficiency or its abnormal utilization might be a pathogenic factor in CFS.” 

Dr. Martin Pall's work supports Dr. Seelig's conclusion. Dr. Pall speculated that, given the likelihood that people with CFS/ME are marginally deficient in magnesium before falling ill, magnesium deficiency may actually contribute to the pathogenesis of the illness. In his book,Explaining “Unexplained Illnesses,” Dr. Martin Pall presents a compelling argument implicating oxidative stress in the etiology of CFS/ME. ¹¹ An important part of the cycle of oxidative stress typical of multisystem illnesses like CFS/ME, FM and Gulf War Syndrome is the chronic excitability of NMDA receptors. This over-excitability results in a hyperactive nervous system – along with cell damage, inflammation, and lowered production of ATP. Magnesium is one of the principal inhibitors of NMDA activity, which makes it a valuable treatment for any illness involving chronic oxidative stress.

In addition to its contribution to oxidative stress, Dr. Myhill believes that low magnesium levels in CFS/ME patients is a symptom of mitochondrial failure. When mitochondria fail, calcium leaks into cells and magnesium leaks out. According to Dr. Myhill, this leakage explains why it is useless to test serum levels of magnesium. As she puts it, “Serum levels are maintained at the expense of intracellular levels. If serum levels change this causes heart irregularities and so the body maintains serum levels at all cost. It will drain magnesium from inside cells and indeed from bone in order to achieve this.” ¹² Dr. Myhill's explanation not only accounts for why serum levels of magnesium are inconsistent in CFS/ME, but why magnesium supplementation is so effective.

Treating ME/CFS With Magnesium

Although nearly every CFS/ME physician includes either injectable or oral magnesium as part of their protocol, there are relatively few studies measuring the overall effects of magnesium supplementation. The paucity of studies may be due to the fact that body stores of magnesium cannot be measured via a blood test. However, one of the few formal studies (Manuel y Keenoy et al.) found that supplementation with magnesium led to an improvement in magnesium body stores, as well as serum vitamin E levels in ME/CFS patients.¹³ The results of that study indicate that magnesium supplementation not only leads to increased body stores, but may reduce oxidative stress (as indicated by the increase in vitamin E levels). 

What Form to Take?

Because oral magnesium is difficult to absorb, the forms most frequently recommended are magnesium citrate and magnesium glycinate. Magnesium citrate dissolves in water, which makes it more bioavailable than most other forms of magnesium (such as sulfate or oxide, both of which are inorganic and poorly absorbed ¹⁴).
Dr. Paul Cheney has observed that magnesium glycinate causes the least intestinal upset and is the most easily absorbed.¹⁵ The usual recommended dosage is 200 to 400 mg/day taken with food, although CFS/ME patients are cautioned to start with a smaller dose and increase it gradually. Intramuscular injections of 1 cc of magnesium sulfate (50%) or magnesium chloride can be administered once or twice a week. Because of magnesium's effect on heart function, the first injection should be performed in a physician's office. The main drawback of injected magnesium is that the injections are painful. The simultaneous administration of vitamin B12 or lidocaine helps relieve the pain of the injection. Because magnesium is a cathartic, high doses can cause diarrhea. In patients prone to gastrointestinal upset, a low dose is normally recommended.

Benefits

Most people with ME/CFS who take magnesium, whether oral or injected, report increased stamina and energy. Many include better sleep as an additional benefit (most likely due to magnesium's muscle-relaxing effects). 

MAGNESIUM IN A NUTSHELL

PROS:

• Increases energy
• Decreases pain
• Helps insomnia
• Reduces oxidative stress
• Anti-inflammatory
• Immune system regulator
• Inexpensive
• Oral forms are effective

CONS:

• A high dose may cause diarrhea

FURTHER READING

Excellent summary of magnesium's effects on the body from the Linus Pauling Institute. 
USDA statistics on nutrient consumption by state and nationally.

References

1. USDA Agricultural Research Service, “Percentage of individuals meeting DRI - Magnesium - 32 per cent”  
2. Ford ES, Mokdad AH. Dietary magnesium intake in a national sample of U.S. adults. J Nutr 2003;133: 2879-2882. 
3. Rude RK. Magnesium deficiency and diabetes mellitus: Causes and effects. Postgrad Med 1992; 92: 222-4. 
4. Iseri LT, Freed J, Bures AR. Magnesium deficiency and cardiac disorders. Am J Med 1975;58:837-46. 
5. Mauskop A, Altura BM.  Role of magnesium in the pathogenesis and treatment of migraines. Clin Neurosci. 1998;5(1):24-7. 
6. Marcela Davalos Bichara and Ran D. Goldman, MD. Magnesium for treatment of asthma in children. Canadian Family Physician. September 2009 vol. 55no. 9 887-889.
7. George A. Eby , Karen L. Eby. Rapid recovery from major depression using magnesium treatment. Medical Hypotheses(2006)
8. Seelig, Mildred MD, MPH. “Review and Hypothesis: Might Patients with the Chronic Fatigue Syndrome Have Latent Tetany of Magnesium Deficiency.” Journal of Chronic Fatigue Syndrome, Vol. 4(2) 1998
9. Kubena KS, Durlach J. “Historical review of the effects of marginal intake of magnesium in chronic experimental magnesium deficiency.” Magnes Res.1990 Sep;3(3):219-26. 
10. Cox IM, Campbell MJ, Dowson D. “Red blood cell magnesium and chronic fatigue syndrome.” Lancet. 1991 Mar 30;337(8744):757-60. 
11. Pall, Martin. Explaining “Unexplained Illnesses.” CRC Press, 2007.
12. Dr. Myhill discusses magnesium deficiency and treatment in CFS/ME patients. DrMyhill.co. 
13. Manuel y Keenoy, B, Moorkens, G, Vertommen, J, Noe, M, Neve, J, and De Leeuw, I. “Magnesium status and parameters of the oxidant-antioxidant balance in patients with chronic fatigue: effects of supplementation with magnesium.” J Am Coll Nutr. 2000 Jun;19(3):374-82.
14. Lindberg JS, Zobitz MM, Poindexter JR, Pak CY. “Magnesium bioavailability from magnesium citrate and magnesium oxide.” J Am Coll Nutr. 1990 Feb;9(1):48-55. 
15. Carol Sieverling "Dr. Cheney's Basic Treatment Plan for Chronic Fatigue Syndrome.” ProHealth, 10/19/01. 

Omega-3 Fatty Acids Could Prevent And Treat Nerve Damage, Research Suggests

Research from Queen Mary, University of London suggests that omega-3 fatty acids, which are found in fish oil, have the potential to protect nerves from injury and help them to regenerate.

When nerves are damaged because of an accident or injury, patients experience pain, weakness and muscle paralysis which can leave them disabled, and recovery rates are poor.

The study, published in January, 2012 in the Journal of Neuroscience, suggests that omega-3 fatty acids could play a significant role in speeding recovery from nerve injury.

The study focused on peripheral nerve cells. Peripheral nerves are the nerves which transmit signals between the brain and spinal cord, and the rest of the body.

These nerves have the ability to regenerate but, despite advances in surgical techniques, patients usually only have good recovery when their injury is minor.

Omega-3 fatty acids are vital for the body’s normal growth and development and have been widely researched for their health benefits. Because the body cannot manufacture omega-3 fatty acids, they have to be consumed in foods such as oily fish.

In the new study, researchers first looked at isolated mouse nerve cells. They simulated the type of damage caused by accident or injury, by either stretching the cells or starving them of oxygen. Both types of damage killed a significant number of nerve cells but enrichment with omega-3 fatty acids in cells gave them significant protection and decreased cell death.

Next the researchers studied the sciatic nerves of mice. They found that a high level of omega-3 fatty acids helped mice to recover from sciatic nerve injury more quickly and more fully, and that their muscles were less likely to waste following nerve damage.

The research was carried out by a group led by Adina Michael-Titus, Professor of Neuroscience at Barts and The London Medical School and lead of the Neurotrauma and Neurodegeneration group in the Centre for Neuroscience and Trauma, Queen Mary, University of London.

She explained: “Our previous research has shown that these fatty acids could have beneficial effects in a number of neurological conditions. This new study suggests that they could also have a role in treating peripheral nerve injuries.

“More work is needed but our research indicates that omega-3 fatty acids can protect damaged nerve cells, which is a critical first step in a successful neurological recovery.”

Reprinted with the kind permission of Queen Mary, University of London

Bee Propolis: Nature’s Wonder Food

Those busy little bees really know what they're doing.

"Health Benefits of Bee Propolis"
By C.L. Davis, Herbal Wisdom Blog

The benefits of bee propolis have been well-known for a long time but, as with many natural remedies, some of this knowledge has been obscured in recent times.

Using natural substances to cure various ailments is something that our ancestors did with much success. Many people are now re-discovering the benefits of using natural remedies, such as propolis.

About Bee Propolis

Honeybees collect more than just pollen when they are buzzing around the yard. Resins are collected from various plants and trees, mixed with beeswax and amino acids and used to form structures within the hive, similar to the way that we use cement. Bees need to protect themselves from disease just like we do and propolis is their solution. As the bees travel through the hive, they rub against the propolis and receive the benefits of the natural antibiotic, anti-inflammatory, antifungal and antiviral properties from their building materials.

Active Ingredients & Uses

Immune Boost
Propolis has antibiotic and anti-microbial properties. Because propolis is high in the vitamin B complex vitamins, has significant amounts of vitamin C, and contains vitamin E, it naturally boosts the immune system. High levels of antioxidants are also found in propolis and these also give our natural immune system functions a boost, as well as doing the same for the bees! Because of its ability to enhance the function of the immune system, Propolis is a great treatment for cold and flu symptoms and even food poisioning. It can be taken in the form of capsules or as a tincture and is easy to obtain.

Wound Healing
Bee propolis also promotes wound healing, making it very useful in topical treatments such as ointments and creams. It is easy for burns, abrasions and lacerations to become infected, but when treated with a strong antibacterial agent the body has a chance to heal quickly and with less chance of scarring. Studies conducted in several different countries show that bee propolis has strong antibacterial and anti-microbial properties. As an anti-inflammatory, bee propolis has been shown to be very effective. This is another way in which propolis can be useful as a topical treatment for wounds.

Anti-Inflammatory
Taken internally, it can also reduce the damaging effects of inflammation in the body. Inflammation is the cause of many diseases, including heart disease, inflammatory bowel disease, some bone diseases, pelvic inflammatory disease and arthritis. Autoimmune diseases such as endometriosis have also been shown to respond well to treatments that include the use of propolis.

Anti-Viral
The anti-viral property of bee propolis is another one of its well-known benefits. Viruses such as herpes can cause painful and embarrassing canker sores but relief has been found by using bee propolis. It can be taken internally to inhibit the action of the virus and used topically to treat blisters and canker sores. The antiviral properties of bee propolis are also what make it so effective in treating colds and the flu. Warts, which are thought to be caused by viruses or deficiencies in the immune system, have also been treated successfully with propolis.

Allergy Relief
Rats were shown to produce less histamine when given propolis, indicating that it has the potential to be effective in providing allergy relief.

Anti-Fungal
Propolis’ antifungal property is another one of its benefits. Common fungal infections include yeast infections of the mouth and vagina, foot fungus and jock-itch. Propolis has been shown to be an effective antifungal agent in a variety of studies. It can be used in the form of a topical treatment, as a tincture or in capsule form. Its effectiveness is due in part to enhancement of the immune system, and in part to its natural antifungal properties.

Cancer & Chemotherapy Relief
In some studies, propolis has also been shown to be effective against cancer cells. Propolis was applied as a tincture to cancerous prostate and colon cells, among others and caused significant rates of cancer cell death. Healthy cells were not destroyed, which is what happens in chemotherapy. Studies of the benefits of propolis in treating cancer are ongoing, but show that there is a possibility that some of the devastating effects of chemotherapy could be reduced by making use of bee propolis.

How To Use
Bee propolis is available in a number of forms, such as ointments, lotions, tinctures and capsules. It can be used to heal burns and other wounds, clear up infections, reduce the impact of inflammatory diseases and fight viruses. Some studies have even indicated that bee propolis can be used to treat cancer. Its antibiotic, anti-inflammatory, antifungal and antiviral properties have been known to humankind for ages and proven effective in numerous scientific studies the world over.

Top 10 Nutritional Supplements for ME/CFS

Nutritional supplements are an essential component of any ME/CFS treatment protocol. 

Research has shown that people with ME/CFS are routinely deficient in many important nutrients (notably zinc, magnesium, and carnitine). These deficiencies, in and of themselves, can decrease the degree to which the body can absorb and make use of other nutrients. 

Even when there are no clinical nutritional deficiencies, the physiological demands of a chronic illness make it necessary to provide additional nutritional support – especially in light of the numerous GI problems prevalent in the ME/CFS population which may lead to malabsorption. For these reasons, most ME/CFS doctors recommend supplements.

The ten supplements most frequently recommended by ME/CFS physicians are:

1) An all-round nutritional supplement (multi-vitamin and minerals)
2) Vitamin B-12
3) Magnesium
4) CoQ10
5) Carnitine
6) Fish Oil
7) Vitamin C
8) Essential  Fatty Acids (EFAs)
9) Vitamin D3
10) Zinc

Those are the standard supplements that nearly every ME/CFS physician will instruct you to take at one point or another.

My own experience with nutritional supplements is that recovery is virtually impossible without them. They have helped stop the "wasting" that occurs during severe relapses, they have provided nutrition during times when my body could not digest food, and they have supplied the raw materials without which the body cannot heal itself.

And even when I didn't notice immediate benefits from supplements, I always felt a decline in energy a few weeks after I had stopped taking them. (The liver runs out of its stored reserves after roughly six weeks.)

Here are the ten supplements which have benefited me the most (in order):

1) Fish oil - I take the enteric-coated form, Fisol. This was of immediate benefit to me, and I've taken it every day without fail for seven years. (Fish oil is neuroprotective.)

2) B complex vitamins - I take these in a sublingual tablet (Coenzymate B Complex).

3) Butyrate (ButyRen, Butyrex) - has helped with intestinal healing

4) Vitamin A - has improved my sleep

5) Vitamin C - immediate increase in energy. I take the powdered form (pure ascorbic acid). Most vitamin pills contain very little bioavailable vitamin C.

6) Vitamin D3 (gelcap)

7) Vitamin E (gelcap, mixed tocopherols)

8) Magnesium glycinate

9) Zinc carnosine

19) B12 (sublingual)

For specific symptoms, I also take the appropriate supplement. Carnitine, for example, was very useful for increasing muscle strength and appetite when I was severely ill. (Warning: those with hypothyroidism should not take carnitine, as it blocks thyroid hormone.) 

Ubiquinol (CoQ10) has helped increase my energy levels, as has D-Ribose. And when I was unable to tolerate any supplements (or digest food), spray vitamins (Vitaspray), and Reliv were both essential.

Over the years, there have been many others.

Every person is a little different. With patience, perseverance, and a lot of trial-and-error, you will find your own "Top 10."

My best wishes for your speedy recovery!

Erica