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Vitamin D and Magnesium Part 6
Are you looking for the science behind health and nutrition? Welcome to this episode of the Nugent report, a definitive source for objective information on health and nutrition, featuring Dr. Steve Nugent the renowned psychologist, author, public speaker, and expert on science, health, wellness, and nutrition. Be sure to visit our website at drnuget.com and follow us on Facebook, Twitter, and Instagram at @thenugentreport.
Hello my friends, welcome to another episode of the Nugent report. I’m Dr. Steve Nugent. In this episode, we are going to conclude our series on vitamin D and magnesium. You may remember in part three of this series, I explained to you the differences between a nutrient deficiency and nutrient inadequacy. That podcast addressed the vitamin D, but in this podcast, we’ll focus on magnesium first we’ll address deficiencies. Magnesium deficiency typically needs to become quite severe before a person starts to show any symptoms. One of the many duties of the kidneys is to limit the amount of magnesium that can be excreted at any time. Individuals who are alcohol dependent or who consume consistently high levels of alcohol are among the first to become magnesium deficient. Another group that’s at risk, but rarely gets the attention that they require. In my opinion, or individuals who are using proton pump inhibitors or PPIs have also discussed this. Previously, these drugs are used to kill the acid producing pumps in the stomach are typically prescribed for chronic heartburn and acid reflux.
They also contribute very significantly to magnesium deficiency. In my opinion, it’s prudent for individuals to supplement magnesium. If they’re using PPIs chronically the prescribing physician may or may not be aware of this. Once again, remember the amount of magnesium in your blood is only 1% of the total magnesium. And if that’s the only investigation your physician is doing, it’s probable that he or she may not know that you need to supplement more magnesium people with type two diabetes, by the way, are also often prone to magnesium deficiencies. If you’re in one of these categories, I would advise to ask your physician, if he or she thinks that you should be supplementing magnesium at request the appropriate tests, ultimately your health decisions should be made jointly between you and your physician. At this point, you might be thinking, how would I know if I’m deficient? What kind of indicators might I look for?
Once again, my first recommendation is consult your physician and get the appropriate tests. But there are some indicators that might motivate you to talk to your physician, perhaps a little bit sooner. Keep in mind that nutritional biochemistry is not a set of absolutes and symptoms can vary between individuals. So having one of the long list of symptoms, doesn’t confirm that you have a deficiency, nor is it necessary for you to have all of the symptoms to confer that you have a deficiency. So I’ll give you a list of things, fatigue, weakness, nausea, vomiting, loss of appetite. These are all common. And they’re common in the early stages of deficiency. The longer the deficiency goes on. And the more deficient you become, you may begin to experience symptoms that relate to the nervous system, such as numbness or tingling, or even seizures in extreme cases. Remembering that muscles require magnesium to relax, calcium causes your muscles to contract.
You may begin to experience muscle contractions that some people describe as Charlie horses. Muscle cramps may occur if you are deficient in magnesium. Remembering that magnesium is essential to brain health, you may be experiencing personality changes, particularly anxiety. Returning to the idea that your heart is the most important muscle cardiac arrhythmia may also occur. Once again, as I’ve cautioned before cardiac arrhythmia may have several different causes. So consult your physician if your heart is not beating in normal rhythm and make sure that you get the appropriate tests from that physician. Remember also that magnesium is required for the transport of calcium and potassium. This may result in something called hypocalcemia, which is low calcium or hypokalemia, which is low potassium. And finally, remember my theory that many people with vitamin D deficiencies actually require magnesium supplementation to solve those deficiencies.
There are also several gastrointestinal disorders that can cause chronic diarrhea and fat malabsorption individuals who suffer from these conditions may find themselves deficient in magnesium. It’s also important to note that individuals who have had gastrointestinal bypass or resection, they also become magnesium deficient as mentioned previously, magnesium is essential to produce energy through glycolysis. It’s also essential to maintain normal, healthy blood sugar through a rather complex set of steps in type two diabetics, depending on the amount of insulin that they are producing, as well as people with insulin resistance, the kidneys may excrete higher than normal amounts of magnesium as a result of these concentrations of glucose in the kidneys. So this can also contribute to magnesium deficiency. According to study, as we age, our intake of magnesium reduces to compound the problem. Typically magnesium absorption decreases and magnesium excretion from the kidneys increases. And these can be significant contributing factors to magnesium deficiency in the elderly.
Let’s talk about high blood pressure. There are those in the nutritional community that will swear by magnesium or lowering blood pressure. If you study the mechanics, it’s very logical to assume that it would have a positive effect on blood pressure. There are some medical studies. However, that show that the effect is small, although positive. Why is there a difference? The study is only as good as its design. And as I’ve mentioned before, and will no doubt say often in the future, garbage in garbage out, that’s a common phrase taught to new information technology students in college. It applies to scientific study as well. You can have a brilliant researcher. The researcher may be a master of statistics, but if that researcher begins with a design or begins with information, which is flawed, then their testing method is going to be flood. They will end up with a flood result since magnesium is an intracellular mineral, and only 1% of your body’s total magnesium is found in the serum.
The studies that measuring serum magnesium as their only gauge for change already sacrificed the possibility of having complete data and virtually in none of those cases with any researchers I’ve spoken with. Were they aware that there are better ways to test for magnesium, including what I’ve previously discussed regarding red blood cell magnesium tests? So whenever I look at a study on magnesium absorption, the first thing I look at is their testing methods. There are many forms of baggies available for supplementation as well, and that can also affect the results of a scientific study. Some forms of magnesium supplements are not well absorbed. Well, others have almost astounding absorption rates. Sometimes when there’s a lack of solid data, assumptions are made based on correlation. As an example, patients using proton pump inhibitors for acid reflux may become deficient in magnesium over time. However, we must also factor in that they are continuing to age as well.
This means that their ability to efficiently digest is almost certainly decreasing with age at the same time. So we need to separate the reduction in magnesium absorption due to age factors versus reduction in magnesium absorption, due to acid reflux, drugs, or magnesium absorption, as it’s known in various forms of magnesium dietary supplements, all of these variables have to be considered in the beginning of this series of podcasts on magnesium and vitamin D. We of course started speaking about osteoporosis. Most people, when you say bone health, the reflex response is to think calcium. However, as we have previously covered, magnesium is required to transport calcium ions to the bone. And magnesium is also required for the conversion and utilization of vitamin D. So this brings us back to the beginning. Scientific studies are quite expensive. There has to be a significant motivation to spend that money.
This is what are more studies on drugs than there are on nutrients. It’s also why some nutrients have very few studies women all over the planet have been thoroughly psychologically conditioned to believe that they need more calcium for bone health. Most of them have no idea that other nutrients are required. So many studies on calcium bone, but many fewer on magnesium in bone health. One notable study done on post-menopausal women showed that adding 290 milligrams a day of magnesium in the form of magnesium citrate [inaudible] suppressed bone cell turnover, as compared to the placebo. What does that mean in play? Like it means that this is an indicator of supplemental magnesium decreasing bone loss in post-menopausal women. By the way, calcium [inaudible] is not as well absorbed as some other forms of calcium. So the numbers in this study have they used a different, better absorbed form of calcium might’ve been much stronger. Remember garbage in, garbage out.
Finally, let’s end this segment about magnesium by talking about the potential toxicity if you take too much. Throughout my career, I’ve been asked the same common questions. When talking about dietary supplements, what do I take? How much do I take? How long will it take for me to get results? And also ask questions about safety on a pretty regular basis. One of those questions is how much is too much? Magnesium toxicity is quite where toxic effects of magnesium or typically experienced in doses greater than 5,000 milligrams per day. That’s for people with normal kidney function. But for those with impaired kidney function, symptoms of toxicity may come at much lower amounts. But my friends, this concludes the series on vitamin D and magnesium. I hope you found this information useful. I hope you will apply it to your personal health program. Until next time, be safe, be sensible, be objective.
Thanks for listening to this episode of the Nugent report. Visit our website at drnugent.com for more objective facts about health and nutrition and email your questions and feedback to info@drnugent.com. Be sure to follow us on Facebook, Twitter, and Instagram at the Nugent report. Stay informed, get the facts with the Nugent report.
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第10期 维生素D与镁 第5部分 Dr. Nugent报告
Dr. Nugent报告，以科学方式分析健康与营养。欢迎收听本期“Dr. Nugent报告”，本节目由Dr. Steve Nugent博士主讲，为您提供健康和营养方面的优质客观信息。Dr. Steve Nugent是著名的心理学家、作家、公共演说家，也是科学、健康、保健和营养方面的专家。请访问我们的网站drnuget.com，并在Facebook、Twitter和Instagram上关注@TheNugentreport。
观众朋友们，大家好！欢迎收听新一期的Dr. Nugent报告。我是Dr. Steve Nugent。本期节目是“维生素D和镁”系列的最后一讲。大家可能记得，在本系列的第三讲中，我解释了营养缺乏和营养不足的区别。那期播客讨论了维生素D，但在本期播客中，我们将关注镁。我们先来讨论一下镁缺乏症。镁缺乏如果出现症状，说明情况已经相当严重。肾脏的功能之一是限制镁的排放量。酒精依赖人群或持续摄入高浓度酒精的人群最容易缺镁。我认为，还有一个通常被忽视的风险群体，即正在使用质子泵抑制剂的人群，我们之前也讨论过这个问题。在以前，此类药物常用来抑制胃酸，用于治疗慢性胃灼热和反酸。
这类药物会在很大程度上导致镁缺乏症。在我看来，补镁是一种审慎做法。如果患者长期使用质子泵抑制剂，开药医生对此可能不十分清楚。再次强调一下，血液中的镁含量只占总镁量的1%。如果医生只要求做血液镁检测，那么他们很可能不知道你有补充镁的需求。顺便说一下，患有二型糖尿病的人，也容易出现镁缺乏症。如果你属于其中的一类人群，建议去问一下医生，进行适当的检测，并询问有无补充镁的必要。事关健康的决定最终应该由你和医生共同作出。这时候大家可能会想，我如何知道自己是否缺乏镁？我要留意哪些症状？
再次强调，我建议大家首先去咨询医生并进行适当的检测。但是，如果一些症状已经出现，大家应当尽快去看医生。请记住，营养生物化学并不绝对，各种症状可能因人而异。如果出现众多症状中的一个，并不能证实你有缺乏症；同样，如果患有缺乏症，并不意味着所有症状都会出现。所以，在此我给大家列出一个症状清单：疲劳、虚弱、恶心、呕吐、食欲不振。这些症状在缺乏症早期阶段很常见。患缺乏症的时间越长，缺乏症就越严重。你可能会出现神经系统症状，如麻木或耳鸣，甚至在极端情况下会出现癫痫。记住，肌肉需要镁来放松，钙会导致肌肉收缩。
你可能会开始感到肌肉收缩，有人将其形容为肌肉痉挛。如果缺乏镁，可能会出现肌肉痉挛。记住，镁对大脑健康必不可少，缺镁可能会导致性格变化，特别是焦虑。再说一遍，心肌是最重要的肌肉，缺镁的话，心律失常也可能发生。我之前谈到过，导致心律失常的原因有很多。因此，如果心脏跳动节奏不正常，要咨询医生，并确保从医生那里得到适当的检测。还要记住，由于钙和钾的运输需要镁，这可能会导致低钙血症或低钾血症。最后，记住我说的，许多缺乏维生素D的人实际上需要镁补充剂。
一些胃肠道疾病会导致慢性腹泻和脂肪吸收不良，患有这些疾病的人可能缺镁。同样需要注意的是，做过胃旁路或胃切除手术的人，也容易缺镁。正如之前所说，镁是通过糖酵解产生能量的必要条件。二型糖尿病患者需要通过复杂步骤维持正常健康的血糖水平，这取决于他们所产生的胰岛素量，而对于具有胰岛素抗性的人群，他们的肾脏排出的镁高于正常值，因此会导致肾脏中葡萄糖聚积。这也会导致镁缺乏症。根据研究，随着年龄的增长，我们摄入的镁减少，从而使问题更加复杂。通常情况下，吸收的镁减少，肾脏排出的镁增加，而这些都可能是导致老年人缺镁的重要因素。
我们谈一下高血压问题。营养学界有一些人认为，镁可以降低血压。如果研究一下其中的原理，自然会认为它对血压具有积极影响。相关的医学研究也有一些。然而，它们表明，效果虽然是积极的，但却不明显。差异为什么存在？研究的好坏取决于设计。正如我之前提到，以后一定也会经常提及的一句话：胡乱摄入的结果是胡乱排出，这是大学里信息技术专业新生常听到的一句话。它也适用于科学研究。研究人员可能很出色，他们也许是统计学专家，但如果采用了有漏洞的设计，那么他们的检测方法将糟糕透顶。他们最终会获得一个糟糕透顶的结果，因为镁是一种细胞内矿物质，而血清中只含有人体镁总量的1%。
将血清镁检测作为唯一衡量标准的研究本身就缺失完整的数据，并且，我所交谈过的所有研究人员都未能意识到还有更好的检测镁含量的方法，包括我之前谈论过的红细胞镁检测。因此，每当看到有关镁吸收的研究时，我首先会留意其中的检测方法。各种形式的补充剂也很多，这些也会影响科学研究的结果。一些形式的镁补充剂不易吸收，另外一些镁补充剂则具有惊人的吸收效果。有时，如果可靠数据不足，人们便会根据相关性做出假设。例如，长期使用质子泵抑制剂治疗反酸的患者可能会缺镁。然而，我们还必须考虑到，他们也在不断衰老。
这意味着，他们的消化能力可能随着年龄的增长也在下降。因此，我们需要把年龄因素所导致的镁吸收减少，与治疗反酸药物所导致的镁吸收减少区分开来，还要考虑膳食性镁补充剂的形式带来的影响。在“镁和维生素D”系列播客的一开始，我们要对所有这些因素加以考虑。当然，我们需要谈一下骨质疏松症。对于大多数人来说，一提到骨骼健康，他们的第一反应是钙。正如我们之前所讲的，要将钙离子运输到骨骼，镁必不可少。维生素D的转换和利用也需要镁，所以，我们又回到了起点。科学研究的成本相当高昂，因此背后的研究动机要足够重大。
因此，针对药物的研究要多于对营养素的研究。也正是因为如此，针对某些营养素的研究很少。全世界的女性已经从心理上默认，她们需要更多钙质来保证骨骼健康。她们中的大多数人并不知道，她们还需要其他营养物质。关于骨骼钙的研究很多，但关于镁在骨骼健康中所起作用的研究却很少。一项针对绝经后女性的著名研究表明，与安慰剂相比，每天以柠檬酸镁螯合物的形式补充290毫克镁，可以抑制骨细胞更新。这实际意味着什么？它意味着，补充镁可以减少绝经后女性的骨质流失。顺便说一下，与其他形式的钙相比，柠檬酸钙螯合物不易吸收。因此，如果在这项研究中他们使用了不同的、更易吸收的钙形式，那么数据可能会更显著。请记住，胡乱摄入的结果是胡乱排出。
在关于镁这一主题的结尾部分，我们来谈谈过量补镁可能导致的毒性。在我的职业生涯中，我常常被问到这样的问题：我该服用什么膳食补充剂？该服用多少？多久能见效？我也经常被问到安全方面的问题。其中一个问题是：多少算是过量？如果每天补充超过5000毫克的剂量，镁会显现毒性。这是对肾功能正常的人而言。对于肾功能受损的人来说，更小的剂量就足以导致毒性症状。朋友们，关于“维生素D和镁”的系列节目到此结束。希望这些信息能帮到大家。希望大家将其应用到个人健康计划中。下期见，请多保重，保持理性，保持客观。
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