Insight anyone?

[countingstarsx]

Hello everyone,
I am new here and was hoping that someone here would be able to offer insight into a peculiar problem I have been facing.

About 7 months ago I started taking a bunch of supplements (mostly the MAG protocol + licorice root and probiotics) and was starting to feel a lot better. After 2 months I got what I believed to be the stomach flu, and didn't take anything for a few days. I had an appointment with my doctor, and she expressed concern about how much magnesium I was taking (around 800-1000mg a day) and I decided to take a break on the supplements and see where I was at. I was feeling ok, but after a few weeks wanted to start adding a few things back in, like magnesium. I quickly found out I can no longer tolerate magnesium in any somewhat significant amount. I can get away with some trace minerals drops in water, but anything else (even NUUN tabs with 25mg of mag oxide) causes me big trouble. The symptoms I experience are hypoglycemia, shakiness, anxiety, lowered blood pressure (sometimes leading to orthostatic hypotension), and excessive urination.

I've asked my doctor what she thinks, and she just shrugs it off. I am curious as to why this may have changed for me. It makes me hesitant to take anything else at this point because of how awful I feel taking magnesium now. Is it common for people with AF to not be able to tolerate magnesium? I can't find much information about it searching the web.

 

[alicec]

she expressed concern about how much magnesium I was taking (around 800-1000mg a day)

Many people on PR take that much magnesium - it's not necessarily a problem.

I quickly found out I can no longer tolerate magnesium in any somewhat significant amount.

Suspect that something else has become limiting. B6 is a possibility but you may need to experiment.

In my own case I discovered the addition of calcium plus boron made me tolerate magnesium again. I presumed that the appearance of difficulties tolerating magnesium meant I was exceeding my body's ability to supply calcium. Stopping the magnesium removed this pressure but didn't really solve the problem.

 

[countingstarsx]

Suspect that something else has become limiting. B6 is a possibility but you may need to experiment.

Interesting -- I hadn't really considered that it was because another nutrient was lacking causing what I assume you're saying could be lack of absorption? I would have assumed if I wasn't absorbing the magnesium that it would go out through the bowel, not cause all of the problems it causes me.

I presumed that the appearance of difficulties tolerating magnesium meant I was exceeding my body's ability to supply calcium.

I think this is probably worth exploring. I got an ionized blood calcium test awhile back that showed I was just below the "normal" range. This was while I was still supplementing too. Perhaps the continued magnesium supplementation without added calcium further increased the calcium deficiency.

 

[alicec]

causing what I assume you're saying could be lack of absorption?

No I don't think there is a change to magnesium absorption. The problems just reflect the need for something else.

 

[TigerLilea]

and she expressed concern about how much magnesium I was taking (around 800-1000mg a day)

lowered blood pressure (sometimes leading to orthostatic hypotension)

Magnesium is used to lower blood pressure so taking this high a dose might be the reason yours is low.

 

[countingstarsx]

Magnesium is used to lower blood pressure so taking this high a dose might be the reason yours is low.

When taking that amount I had no side effects. My blood pressure was at my normal, around 100/60-70. Its only after I stopped taking that amount that small doses (25mg) cause the side effects of orthostatic hypotension.

 

[zzz]

The symptoms I experience are hypoglycemia, shakiness, anxiety, lowered blood pressure (sometimes leading to orthostatic hypotension), and excessive urination.

All of these symptoms except hypoglycemia are symptoms of hypokalemia (low potassium). When you raise your magnesium intake by a significant amount, you also need to raise your potassium intake, and vice versa. The extreme reactions you're having to small amounts of magnesium would seem to me to indicate that your potassium levels may be very low. There is also a relationship between hypoglycemia and hypokalemia in that hypoglycemia can cause hypokalemia. It's not at all clear if that's happening in your case, though, but if your hypoglycemia continues, it would be good to investigate what's causing it.

Supplementing your potassium intake would seem to me to be the obvious first step in your case. You can find quality potassium supplements in the form of 99 mg tablets quite easily. Taking one tablet with each meal should put an end to these symptoms. If these symptoms don't disappear completely, you can add additional tablets or capsules with meals, with a maximum of two tablets or capsules per meal, and a total maximum of five per day.

I've asked my doctor what she thinks, and she just shrugs it off.

This is not a good sign. First of all, doctors shouldn't just shrug off symptoms when a solution doesn't immediately jump to mind. Second, if a layperson like me can immediately recognize these symptoms as hypokalemia, and know that that's the most common adverse reaction to raising magnesium intake to nontoxic levels, I would think that this is something your doctor should know, especially given the importance of magnesium and potassium.

The amount of magnesium you were taking originally was not excessive, and if it was part of protocol that was making you feel better, there was certainly no reason to reduce it. If you're taking too much magnesium, the symptoms are quite obvious, usually in the form of excessive daytime tiredness and increased muscle weakness. However, if you have muscle weakness without daytime tiredness, it may very well be caused by low potassium, especially if you have other symptoms of hypokalemia.

In severe cases of excess magnesium intake, you may get respiratory depression, which makes it difficult to breathe. This will generally pass on its own, unless you've taken way too much magnesium, in which case you would need medical assistance.

It does not appear that you had any of these symptoms of excessive magnesium intake, and instead, your doctor was simply going by the amount of magnesium you were consuming. In ME/CFS, excess glutamate is an extremely common problem that can cause all sorts of symptoms, and it may be caused by low magnesium levels, or it may have other causes. But in either case, taking additional magnesium can have many beneficial side effects by blocking the action of excess glutamate. Magnesium also has many other benefits, which you can find with just a little bit of searching.

 

[countingstarsx]

When you raise your magnesium intake by a significant amount, you also need to raise your potassium intake, and vice versa. The extreme reactions you're having to small amounts of magnesium would seem to me to indicate that your potassium levels may be very low.

Interesting, thank you for your input! When taking the large amounts off magnesium daily I was also getting extra potassium from food sources, about 700mg a day. Do you think its possible that I wasn't getting enough, so when tried to start magnesium again I was quite depleted? I suppose at this point it would be best to get a RBC potassium test to know for sure what is going on. Do you think calcium could play into any of this too as suggested by someone above?

but if your hypoglycemia continues, it would be good to investigate what's causing it.

Since it comes on after magnesium and goes away after a week or so I've always just assumed that it was due to the magnesium.

This is not a good sign. First of all, doctors shouldn't just shrug off symptoms when a solution doesn't immediately jump to mind.

I absolutely agree, this was the last time I saw this doctor and I will not be seeing her again due to this reason and a few more.

In ME/CFS, excess glutamate is an extremely common problem that can cause all sorts of symptoms,

Could this relate to me feeling awful when she prescribed me l-glutamine?

 

[zzz]

When taking the large amounts off magnesium daily I was also getting extra potassium from food sources, about 700mg a day. Do you think its possible that I wasn't getting enough, so when tried to start magnesium again I was quite depleted?

Yes. The RDA of potassium for adults is 4700 mg per day. If you were getting only 700 mg per day, you would have a major potassium deficiency.

Do you think calcium could play into any of this too as suggested by someone above?

Hypokalemia is sufficient to explain all of your symptoms except hypoglycemia, and low calcium doesn't cause hypoglycemia. So it doesn't appear that calcium is playing a major role here. It might be a good idea to get it checked, though, along with all of your electrolytes.

Could this relate to me feeling awful when she prescribed me l-glutamine?

Quite possibly. The body routinely converts glutamine and glutamate back and forth to each other; both are important amino acids. When some people take L-glutamine supplements, though, sometimes too much of the supplement is converted to glutamate, which results in adverse reactions. This is not at all uncommon. If the L-glutamine is making you feel awful, clearly it's not helping, and I wouldn't see any reason to take it, as it sounds like it's making your condition worse.

 

[countingstarsx]

If you were getting only 700 mg per day,

Sorry for any confusion -- I was ensuring an extra 700mg per day on top of what was already in my diet. What I am thinking is that perhaps it was enough to diminish any adverse reactions to so much magnesium, but not enough overall leaving me with a deficit.

This is not at all uncommon. If the L-glutamine is making you feel awful, clearly it's not helping, and I wouldn't see any reason to take it, as it sounds like it's making your condition worse.

Thank you for explaining. I didn't take it much longer than a week -- I'm not much for causing myself pain.

 

[Gondwanaland]

I quickly found out I can no longer tolerate magnesium in any somewhat significant amount.

I developed magnesium intolerance as well and I suspect low calcium. My serum phosphorus is above range.

 

[South]

All of these symptoms except hypoglycemia are symptoms of hypokalemia (low potassium)

@zzz An opposing view of this: potassium is known to lower blood pressure, not raise it. The original poster is having low blood pressure problems, not high, and may need to take more sodium, not more potassium, to raise the overly low blood pressure.

 

[zzz]

Sorry for any confusion -- I was ensuring an extra 700mg per day on top of what was already in my diet. What I am thinking is that perhaps it was enough to diminish any adverse reactions to so much magnesium, but not enough overall leaving me with a deficit.

When you're getting potassium from food, it's hard to know exactly how much you're getting; charts of potassium for specific foods are only averages. There may also be other processes that are draining potassium. Getting your potassium levels checked would seem to be a good idea.

@zzz An opposing view of this: potassium is known to lower blood pressure, not raise it. The original poster is having low blood pressure problems, not high, and may need to take more sodium, not more potassium, to raise the overly low blood pressure.

This actually isn't an opposing view. Potassium supplementation is well known to have a hypotensive effect under normal circumstances. However, low levels of potassium can also have a hypotensive effect. For example, the Merck Manual - a highly respected authority - lists hypotension as one possible sign of hypokalemia. You can also find low blood pressure or hypotension listed as symptoms of hypokalemia in the articles What Are the Symptoms of Potassium Deficiency?, Hypokalemia / Potassium Need, and Hypokalemia, among others.

Then of course, large amounts of magnesium can also cause low blood pressure. So why did I associate low blood pressure with hypokalemia here?

First of all, @countingstarsx is not taking large amounts of magnesium. In fact, when she took much larger doses of magnesium, she did not report low blood pressure (which most people don't get with magnesium supplementation).

But the tiny doses of magnesium did trigger many symptoms of hypokalemia. This is very common, although it's a little mysterious why such low doses of magnesium are having this effect now. Nevertheless, when hypotension occurs along with a number of other symptoms of hypokalemia in a situation where hypokalemia can be expected, it's reasonable to associate the hypotension with hypokalemia, especially when it occurs only when the other symptoms of hypokalemia do.

It's also important to note that supplementing potassium does not always result in lower blood pressure, especially when potassium levels are at all low. For example, I have been supplementing potassium at 500 mg/day (the maximum recommended for nonprescription oral supplements) for over two years, and my blood pressure is completely unchanged from what it was before supplementation.

Sodium is certainly a reasonable treatment for hypotension. But if the hypotension is caused by hypokalemia, as it appears to be in this case, supplementing potassium should be all that's needed to eliminate this symptom.

 

[alicec]

Do you think calcium could play into any of this too as suggested by someone above?

I wasn't suggesting calcium was a problem for you, just illustrating my own experience.

Potassium depletion sounds like a very reasonable explanation and is easy to put to the test.

Try taking a decent dose of potassium (potassium gluconate powder is an alternative to potassium citrate tablets) with each meal for a few days and see if it makes a difference. You could then try reintroducing magnesium and see if you tolerate it again.

Blood tests may not help much. Potassium is very tightly regulated and you would need to be in serious trouble for a frankly low result to occur. The best you might see is a low normal result.

Changing doctor seems like a good idea. She doesn't seem to have much clue about the complexities of nutritional supplementation.

 

[Chocolove]

About 7 months ago I started taking a bunch of supplements (mostly the MAG protocol + licorice root and probiotics)

@countingstarsx Licorice lowers potassium.

https://www.ncbi.nlm.nih.gov/pubmed/17320224
Excessive intake of licorice can cause hypokalemia and hypertension and generally, the onset and severity of symptoms depend on the dose and duration of licorice intake, as well as individual susceptibility. We describe a patient with hypokalemia caused by long term consumption of natural licorice root...

Side Effects and Cautions

• In large amounts, licorice, which contains glycyrrhizin, can cause high blood pressure, salt and water retention, and low potassium levels, which could lead to heart problems. ...
• The safety of using licorice as a dietary supplement for more than 4 to 6 weeks has not been thoroughly studied.

Licorice Root | NCCIH

https://nccih.nih.gov/health/licoriceroot

 

[countingstarsx]

In large amounts, licorice, which contains glycyrrhizin, can cause high blood pressure, salt and water retention, and low potassium levels, which could lead to heart problems. ...

Interesting. I knew about the hypertension, but not hypokalemia. If it is due to the glycyrrhizin though it doesn't explain what happened to me -- I was taking DGL licorice root.

 

[Hip]

mostly the MAG protocol

What's the MAG protocol?

Is it common for people with AF to not be able to tolerate magnesium?

What's AF?

The symptoms I experience are hypoglycemia, shakiness, anxiety, lowered blood pressure (sometimes leading to orthostatic hypotension), and excessive urination.

When you say hypoglycemia, did you actually measure a drop in your blood glucose levels?

I am curious as to why this may have changed for me.

It's not unusual for inexplicable changes in responses to drugs and supplements to occur in ME/CFS. You will find a lot of patients have similar experiences.

In your case, you appear to have caught some new pathogen (since you experienced stomach flu — this can be caused by enterovirus, by the way, a virus linked to ME/CFS), and this pathogen may have altered things a bit in your body.

 

[countingstarsx]

What's the MAG protocol?

Its a protocol developed by Morley Robbins in his Magnesium Advocacy Group on Facebook. The goals of it are to raise RBC magnesium levels and ceruloplasmin levels, rid the body of excess unbound iron and copper, and balance the rest of the minerals in the body.

What's AF?

Adrenal fatigue.

When you say hypoglycemia, did you actually measure a drop in your blood glucose levels?

Yes.

 

[Hip]

Its a protocol developed by Morley Robbins in his Magnesium Advocacy Group on Facebook.

Looking at this website run by Morley Robbins, this "MAG protocol" is basically just taking magnesium, with a note that you should also supplement with the co-factor vitamin B6. Hardly much of a protocol; I would just call it "taking magnesium".

By the way, on his website, the hair analysis offered for $250 is not an accurate measure of mineral status (I understand that the scientific consensus is that hair analysis can be useful for detecting heavy metals, but not for measuring mineral levels).

 

[countingstarsx]

this "MAG protocol" is basically just taking magnesium, with a note that you should also supplement with the co-factor vitamin B6. Hardly much of a protocol; I would just call it "taking magnesium".

Its much more in depth than that. I would be happy to tell you more about it if you're actually interested -- it seems however from your light investigation and response that you are not.