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Magnesium – essential for eighty percent of our body’s chemistry.

Magnesium is a trace mineral essential for 80% of body function, (muscular contractions, energy production, removal of infected or precancerous cells, etc). It is used in over 300 enzymes required for metabolism and other chemical reactions in the body such as synthesis of DNA or proteins. (1)

This post is eleven pages long and can be read as a tabbed document: (doc)

Health Conditions linked to Magnesium inadequacy.

  • Circulatory System: Hypertension, Heart Disease, Stroke, Arrhythmias, Atrial fibrillation, Dyslipedemias.
  • Metabolic: Diabetes, Metabolic Syndrome.
  • Respiratory: Asthma, COPD, Other Lung/Respiratory.
  • Central Nervous System (CNS): Depression, Anxiety, ADHD, Migraine, Pain Relief, Addiction, Sleeplessness, Stress.
  • Muscle/Skeletal: Low Back Pain, Osteoarthritis, Other musculoskeletal (~ muscle cramps, twitches, other chronic joint pain), Osteoporosis, Sarcopenia.
  • Immune System/Other: Pre-eclampsia, Kidney disease, Crohn’s Disease, Chronic Fatigue Syndrome, Colon inflammatory diseases/IBD, Inflammation, Some Cancers.
  • (todaysdietitian/Modern Day Human Magnesium Requirements)(Seelig/Rosanoff, 2003)

Magnesium and Medications

Many medications can cause loss of magnesium or affect magnesium metabolism in other ways. A list is available on the site by an organization of magnesium researcher Andrea Rosanoff, Ph.D.: magnesiumeducation.com/medications-and-magnesium, coauthor of the book The Magnesium Factor, along with Mildred Seelig, PhD.

Calcium/Magnesium ratio within cells affects our health.

When magnesium within cells is lower than normal calcium is allowed to enter in excess. Elevated amounts of calcium within the interior of cells acts as a signal to start different types of activity. Increased calcium to magnesium balance within a cell may cause different actions based on the type of cell.

  • Elevated calcium to magnesium ratio within cells could cause blood vessels to constrict which would increase blood pressure. Vasoconstriction within the heart could cause a random heart rate (arrthymias). Platelets within the blood would become stickier and more prone to clot which could increase risk of strokes.
  • Cholesterol and glucose over-production may occur in liver cells. Glucose uptake by muscle and fat cells could decrease. Insulin over-production could occur in pancreas cells. Which could lead to Type 2 Diabetes or Metabolic Syndrome.
  • (39, 40, 41, 42) (todaysdietitian/Modern Day Human Mg Requirements)

Summary Points:

  • Magnesium is essential for 80% of body function, (muscular contractions, energy production, removal of infected or precancerous cells, etc), (1),
  • Adequate protein and phospholipids (ATP-AdenosineTriPhosphate –> energy release –> ADP-AdenosineDiPhosphate) are needed for cells to be able to have a full reserve supply of magnesium. (MgATP, 6, 7, 8) Magnesium is located within cells primarily (greater than 99%, 12), as free ion or in an inactive form on molecules of protein or ATP., which means typical blood based lab tests are not helpful for diagnosing chronically low levels of magnesium. See a previous post for more information, food sources and supplement types, and a free etext reference.
  • Magnesium adequacy through diet or supplementation may help improve symptoms for patients with migraine headaches, Alzheimer’s dementia, hypertension, cardiovascular disease, recovery after a cerebrovascular stroke, and type 2 diabetes mellitus (type 2 DM). (9) Muscle cramps may be due to low magnesium levels (9) or an imbalance with calcium levels.
  • Magnesium supplementation may also help some types of psychiatric conditions such as anxiety, depression, bipolar disorder, schizophrenia. See: Magnesium and the Brain: The original chill pill, (psychologytoday.com). Mental health problems have been escalating in the U.S. and other developed countries, lack of jobs and increased social isolation and cyberbullying are involved, however magnesium/calcium imbalance are also factors. See: Latest Suicide Data Show the Depth of U.S. Mental Health Crisis, (bloomberg.com).
  • While you need adequate intake of protein for holding reserve supplies of magnesium within cells, you need adequate magnesium for the body to be able to build new proteins or modify protein structure, and to build more DNA or RNA (which uses the nucleotide ATP), (9, 10, 11, 12, 13, 14, 15) and in ATP hydrolysis (release of the stored energy from glucose metabolism in the Kreb’s cycle), (18) and the Kreb’s cycle. (7) Magnesium deficiency led to lower levels of ATP within red blood cells and increased amounts of ADP, from a 6:1 ratio of ATP:ADP to 2.5:1 at the lowest magnesium level. (19)
  • Which means supplementing only magnesium or only protein may not fully help protect against cardiovascular stroke or migraine pain or other symptoms associated with magnesium deficiency such as hypertension and Type 2 Diabetes.
  • Cancer prevention may also be possible by preventing chronic low levels of magnesium as mutations in DNA may be more likely with inadequate magnesium. Excess calcium or imbalance in vitamin D and calcium/magnesium balance may also be involved in increased cancer risk. (10, 13) Magnesium is used by white blood cells during apoptosis of infected or damaged cells and autophagy, the removal of cells by white blood cells, may help protect against Alzheimer’s dementia. Both apoptosis and autophagy are the typical defense against precancerous cells or mismarked cells that may lead to autoimmune reactions. Once cancer is established magnesium supplements would be inadequate alone as a treatment and would also be providing the nutrient to the cancer cells.

Magnesium and calcium are electrolytes – electrically active ions similar to sodium and potassium.

Magnesium is an electrically active trace mineral/metal that is predominantly found within cell fluid and bone matrix. Only about one percent of the body’s magnesium is found in the blood plasma fluid, circulating throughout the body within blood vessels, and also through the lymphatic and glymphatic systems. (Gervin 1983, ref) (interstitial fluid) Calcium is chemically electrically active in a similar way to magnesium. Both metals can donate or accept two protons and are chemically written with a +2, while sodium and potassium can donate or accept one proton which would be written as +1.

Sodium and potassium are typically referred to as electrolytes however calcium, magnesium and other electrically active ions are also found in blood plasma and in the fluid around cells, called extracellular fluid or interstitial fluid. The fluid within cells is called intracellular fluid or cytoplasm and it also contains ions/electrolytes. The balance of ions within the different types of fluid varies somewhat however the overall average is similar to the balance of ions in sea water. The total fluid volume is about 60% of our body’s weight, of that most is found within cells, 60% intracellular fluid, and of the 40% extracellular fluid, 20% is blood plasma transported in arteries and veins, and 80% is interstitial fluid, transported in the lymphatic system. (Lymphatic fluid, 4) Magnesium would be in greater concentration in the 60% intracellular fluid and calcium would be in greater concentration in the 40% extracellular fluid.

Magnesium powers membrane transport channels – a natural calcium channel blocker.

Within the cells magnesium may be used within enzymes, over 300 require the trace mineral, or may provide their electrical power to cell membrane transport channels which allow certain chemicals to enter the cell while blocking others – when adequate magnesium ions are available to block the channels including some involved in sodium/potassium balance. (16, 18) Magnesium deficiency seemed to decrease the activity of the sodium/potassium channels in an animal based study. It led to increased intracellular sodium levels which could be a mechanism for the increased risk of arrythmias (irregular heart rate) with magnesium deficiency. (17)

Magnesium in muscles and the inner ear (tinnitus).

Magnesium causes relaxation of muscles – blocking entry of calcium into the muscle fiber, and calcium entry causes muscle contractions within smooth muscle fibers (such as the muscle fibers of the gastrointestinal tract) or striated muscle fibers (found in the muscles with voluntary control such as those of the arms and legs, and also in the heart which is not under voluntary control). (31, 32, 33, 34, 35, 36, 37) Magnesium deficiency can be an underlying cause of muscle cramps or twitches (such as a nonstop twitch in the eyelids) (9), and may also be a factor in tinnitus (nonstop or intermittent ringing or buzzing sounds in the ears/ear). (28) Daily supplementation with 532 milligrams of magnesium was found helpful to relieve symptoms of tinnitus in a small clinical trial. (30) Magnesium inhibits glutamate channels which are involved in activating the hair cells of the ear canal. It may also help by helping relax blood vessels to the inner ear and increasing blood flow. (29)

Magnesium is stored within the cell in an inactive form on protein molecules or ATP.

Even within the cells the majority of magnesium stores are not available in the electrically active form. Most of the back-stock of magnesium within cells is stored on proteins or molecules of ATP (the nucleotide involved in the Kreb’s cycle production of usable energy {ATP bonds} from glucose). (MgATP, 6, 7, 8)

This means magnesium deficiency can take a long time to be seen because of the extra stored within cells on proteins and ATP and the extra stored within our bone matrix can be slowly released to continue powering the 300+ enzymes and membrane channels in every cell of the body. What happens eventually however is a depletion of the backstock of magnesium on the cellular proteins and ATP and osteoporosis can develop in the bone matrix leaving fragile bones at risk for fractures — and also cell membranes at risk to an influx of too much calcium, or other excitatory chemicals such as glutamates or aspartic acid/aspartate, leaving brain cells at increased risk from food additives, or dehydration, or ischemic stroke.

Protein deficiency in the diet or increased metabolic need for protein might increase risk of low magnesium levels being available in case of a stroke. If a stroke occurred treating with intravenous magnesium fairly soon can help reduce cell damage and preserve abilities. When the body is well supplied with protein, ATP, and magnesium then the stored magnesium would be available in case of a stroke or physical brain trauma. If protein availability was limited the damage from a stroke might be more severe due to less magnesium being available for release.

Protein-energy malnutrition is a type of malnutrition involving a diet low in protein more than calories. The condition was formerly known as kwashiorkor and was first recognized in tropical infants/children. Severe edema with a bloated abdomen is typical visible symptom. (See image, page 30, 46) When magnesium deficiency is also severe the condition is more likely to result in death and strokes are also more common. The serum magnesium level of children with protein-energy malnutrition was found to be significantly lower than in the control group. Low magnesium in drinking water has been associated with increased risk of cerebrovascular disease or death by stroke. (45)

Incomplete protein in the diet seems to be involved – plant sources of protein do not all contain adequate amounts of all the essential amino acids. Missionary work historically may have increased the risk of Protein-energy malnutrition in recently weaned toddlers due to an educational message that eating insects is wrong – eating a diet with inadequate amounts of essential amino acids is what is wrong. In modern times, unfortunately, children in Africa are now being taught to not catch and eat crickets because they are likely contaminated with the pesticides that are commonly used on farm fields.

The amino acids considered essential for a child’s diet include: Arginine, Histidine, Isoleucine, Leucine, Lysine, Methionine, Phenylalanine, Threonine, Tryptophan, Valine. The traditional African diet in some areas includes complete protein from peanuts and cowpeas are only low in tryptophan. (46) Millet and sorghum are commonly used grains which are low in tryptophan, lysine, methionine, and threonine. (47) The nutrient content of food insects depends on their stage of growth, however on average they are considered a good source of complete protein – providing a similar ratio of essential amino acids as meat or fish. Food insects are also a good source of essential fatty acids, similar to fish, and provide fiber and trace minerals including “copper, iron, magnesium, manganese, phosphorous, selenium and zinc.” (48)

Food insects and breastmilk also have in common N-acetyl glucosamine (within insects it is found in the form of the fiber chitin which is not typically thought of as digestible by humans however the enzyme chitinase has been found in human gastric fluid). (49, p 74, section 6.1.8: 50) Intake of N-acetyl glucosamine may help support a healthy intestinal mucousal lining. Impaired mucous lining of the intestine and reduced amounts of “enterocyte heparan sulfate proteoglycan (HSPG),” and “abnormal sulfated glycosaminoglycan (GAG) metabolism” have been observed in patients with protein-energy malnutrition (kwashiorkor). (49) Providing magnesium sulfate by intramuscular injection helped survival for children with protein-energy malnutrition compared to the control group in a small clinical trial. (51)

Magnesium is needed for vitamin D, CoQ10, and cholesterol production.

Magnesium deficiency can lead to low levels of the inactive and active form of vitamin D. Magnesium supplementation is needed to reverse a type of bone degenerative condition called vitamin D resistant rickets. (20) Supplementing with vitamin D and/or calcium has been popular however the benefits against fracture risk and osteoporosis have been unclear or show little benefit. (22) The need for magnesium supplementation instead of or in addition to vitamin D and calcium supplements is in area worth further study. (21) Magnesium is also involved in earlier steps involved in vitamin D production – biosynthesis of cholesterol (23) from which vitamin D can be formed in the skin when sunshine is available.

Magnesium acts similarly to statin medications and is the natural version of a calcium channel blocker medication. (23) Statins have been prescribed to many people in hopes that chemically inhibiting the production of cholesterol would help protect against heart disease, unfortunately the theory has not been proven effective – while cholesterol levels are reduced in about half the patients using the medication, the lower cholesterol levels have not also been associated with reduced mortality from cardiovasclar risks. For patients without heart failure or renal dialysis or for those over age 75 the use of statin medications helped prevent revascularization and major coronary events in about 20% of research trials that were reviewed. (24)

The cardiovascular benefits of statin medications may be due to the inhibition of an interim step in cholesterol formation – mevalonate. Magnesium would also affect mevalonate formation however in a regulatory way – controlling whether or not the reaction happens rather than only inhibiting it. (23) β-Hydroxy β-methylglutaryl-CoA, (HMG Co A) is converted into mevalonate which then can be converted into cholesterol or the provitamin coenzyme Q10. (26)

Lack of CoQ10 may cause muscle pain and lead to mitochondrial dysfunction.

Statin medication use may cause muscle and joint pain in some users, possibly due to inhibition of Coenzyme Q10 production. Supplements of CoQ10 (200mg/day) may help reduce the muscle pain symptoms for some patients and could also be protecting against a risk of mitochondrial dysfunction caused by low levels of the the coenzyme. (25)

  • Mitochondrial dysfunction may be a cause of chronic fatigue – low energy production by mitochondria within cells would leave every function in the body with less energy to perform their jobs. Mitochondrial dysfunction may be involved in many conditions including autism, Alzheimer’s disease, muscular dystrophy, Lou Gehrig’s disease, diabetes and cancer. (clevelandclinic/mitochondrial diseases)

Magnesium helps protect health, and improve our energy level and mood.

Symptoms of magnesium deficiency are often treated with medications (such as calcium channel blockers or statins) instead of providing magnesium. Other medications commonly used to treat symptoms that might involve magnesium deficiency include: beta blockers, blood thinners, anti-hypertensive medications, insulin or metformin, anti-depressants, anti-anxiety medications, anti-inflammatory medications. (43) (todaysdietitian/Modern Day Human Magnesium Requirements)

Adequate protein and phospholipids are also needed for cells to be able to store extra magnesium in an electrically inactive form and magnesium is needed for their synthesis. This might help explain why supplements of magnesium help some patients more than others. Someone who is more chronically ill or malnourished or who has impaired metabolism may need more complete nutrition support rather than only providing a magnesium supplement. Topical supplements of magnesium may be needed for patients with malabsorption problems or for those who don’t seem to be helped by increasing dietary sources.

Excess calcium in proportion to magnesium in the diet or from supplements may also be part of the problem for some patients. (44) The average modern diet can include calcium rich dairy products at each meal and snack. Tofu, beans, almonds, sesame seeds, and dark leafy green vegetables are also good sources of calcium.

Free Continuing Education credit for nutritionists/diet techs:

  • For any dietitians or diet techs, much of the first reference list is from a free continuing education webinar, register for this: Andrea Rosanoff, PhD, and Stella Lucia Volpe, PhD, RDN, ACSM-CEP, FACSM, Recorded Webinar: Modern Day Human Magnesium Requirements: The RDN’s Role, Today’s Dietitian,   https://ce.todaysdietitian.com/node/69241#group-tabs-node-course-default1  The second list is from the last post from the section about magnesium and hypercoaguability.

Disclaimer: This information is being provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individualized health care guidance. Please see an individual health care provider for individual health care services.

References

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  4. Lymphatic Fluid and Immunotherapy, maxwellbioscinces.com, https://maxwellbiosciences.com/articles/uncategorized/lymphatic-fluid-immunotherapy
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  16. Dorup I, Skajaa K, Thybo NK. Oral magnesium supplementation restores the concentrations of magnesium, potassium and sodium-potassium pumps in skeletal muscle of patients receiving diuretic treatment. J Intern Med. 1993;233(2):117-123. https://www.ncbi.nlm.nih.gov/pubmed/8381850
  17. Fischer PW, Giroux A. Effects of dietary magnesium on sodium-potassium pump action in the heart of rats. J Nutr. 1987;117(12):2091-2095. https://www.ncbi.nlm.nih.gov/pubmed/2826728
  18. Fagher B, Sjögren A, Monti M. A microcalorimetric study of the sodium-potassium-pump and thermogenesis in human skeletal muscle. Acta Physiol Scand. 1987;131(3):355-360. https://www.ncbi.nlm.nih.gov/pubmed/2447746
  19. Flatman PW, Lew VL. The magnesium dependence of sodium-pump-mediated sodiumpotassium and sodium-sodium exchange in intact human red cells. J Physiol. 1981;315:421-446. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1249391/
  20. Deng X, Song Y, Manson JE, et al. Magnesium, vitamin D status and mortality: results from US National Health and Nutrition Examination Survey (NHANES) 2001 to 2006 and NHANES III. BMC Med. 2013;11:187. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3765911/
  21. Rosanoff A, Dai Q, Shapses SA. Essential nutrient interactions: does low or suboptimal magnesium status interact with vitamin D and/or calcium status? Adv Nutr. 2016;7(1):25-43. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4717874/
  22. Jill Jin, MD, MPH, Vitamin D and Calcium for Preventing Fractures, Guidelines, JAMA Patient Page, JAMA Network, April 17, 2018 https://jamanetwork.com/journals/jama/fullarticle/2678617
  23. Rosanoff A, Seelig MS. Comparison of mechanism and functional effects of magnesium and statin pharmaceuticals. J Am Coll Nutr. 2004;23(5):501S-505S. https://www.ncbi.nlm.nih.gov/pubmed/15466951
  24. Cholesterol Treatment Trialists’ Collaboration  Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomised controlled trials., The Lancet, Vol 393, Issue 10170, pp407-415, Feb. 02, 2019, https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31942-1/fulltext
  25. Deichmann R, Lavie C, Andrews S. Coenzyme q10 and statin-induced mitochondrial dysfunction. Ochsner J. 2010;10(1):16–21. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096178/
  26. Pacanowski MA, Frye RF, Enogieru O, Schofield RS, Zineh I. Plasma Coenzyme Q10 Predicts Lipid-lowering Response to High-Dose Atorvastatin. J Clin Lipidol. 2008;2(4):289–297. doi:10.1016/j.jacl.2008.05.001 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2598393/
  27. Mitochondrial Diseases, ClevelandClinic.org, https://my.clevelandclinic.org/health/diseases/15612-mitochondrial-diseases
  28. Tinnitus and Magnesium, tinnitus.org, https://www.tinnitus.org.uk/tinnitus-and-magnesium
  29. Joseph Mercola, MD, Can Magnesium Relieve Your Tinnitus?, Prohealth.com, https://www.prohealth.com/library/can-magnesium-relieve-your-tinnitus-47779
  30. Cevette MJ, Barrs DM, Patel A, et al., Phase 2 study examining magnesium-dependent tinnitus., Int Tinnitus J. 2011;16(2):168-73. https://www.ncbi.nlm.nih.gov/pubmed/22249877
  31. Zhang A, Carella A, Altura BT, Altura BM. Interactions of magnesium and chloride ions on tone and contractility of vascular muscle. Eur J Pharmacol. 1991;203(2):223-235. https://www.ncbi.nlm.nih.gov/pubmed/1800119
  32. Altura BM, Altura BT. Role of magnesium ions in contractility of blood vessels and skeletal muscles. Magnesium Bull. 1981;3(1a):102-114. http://www.magnesium-ges.de/jdownloads/Literatur/Altura/altura_1981_role_of_magnesium_ions_in_contractility_of_blood_vessels_and_skeletal_muscles_444.pdf
  33. Konishi M. Cytoplasmic free concentrations of Ca2+ and Mg2+ in skeletal muscle fibers at rest and during contraction. Jpn J Physiol. 1998;48(6):421-438. https://www.ncbi.nlm.nih.gov/pubmed/10021496
  34. Yang Z, Wang J, Altura BT, Altura BM. Extracellular magnesium deficiency induces contraction of arterial muscle: role of PI3-kinases and MAPK signaling pathways. Pflugers Arch. 2000;439(3):240-247. https://www.ncbi.nlm.nih.gov/pubmed/10650973
  35. Yang ZW, Gebrewold A, Nowakowski M, Altura BT, Altura BM. Mg(2+)-induced endothelium-dependent relaxation of blood vessels and blood pressure lowering: role of NO. Am J Physiol Regul Integr Comp Physiol. 2000;278(3):R628-R639. https://www.physiology.org/doi/full/10.1152/ajpregu.2000.278.3.R628
  36. Yang ZW, Wang J, Zheng T, Altura BT, Altura BM. Low Mg(2+) induces contraction and Ca(2+) rises in cerebral arteries: roles of ca(2+), PKC, and PI3. Am J Physiol Heart Circ Physiol. 2000;279(6):H2898-H2907. https://www.physiology.org/doi/pdf/10.1152/ajpheart.2000.279.6.H2898
  37. Turlapaty PD, Altura BM. Magnesium deficiency produces spasms of coronary arteries: relationship to etiology of sudden death ischemic heart disease. Science. 1980;208(4440):198-200. https://www.ncbi.nlm.nih.gov/pubmed/7361117
  38. Seelig MS, Rosanoff A. The Magnesium Factor. 1st ed. New York, NY: Avery Penguin Group; 2003:278-279; 369-370 https://www.barnesandnoble.com/p/the-magnesium-factor-mildred-seelig/
  39. Resnick L. The cellular ionic basis of hypertension and allied clinical conditions. Prog Cardiovasc Dis. 1999;42(1):1-22. https://www.ncbi.nlm.nih.gov/pubmed/10505490
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  41. Rosanoff A. Nutritional magnesium is associated with metabolic syndrome, cardiovascular disease and its risk factors, and other NCDs: a bibliography. Magnesium Education website. http://www.magnesiumeducation.com/the-mg-hypothesis-of-cardiovascular-disease-abibliography
  42. Rosanoff A, Weaver CM, Rude RK. Suboptimal magnesium status in the United States: are the health consequences underestimated? Nutr Rev. 2012;70(3):153-164. https://www.mgwater.com/articles/Rosanoff/(09)%20Suboptimal%20Magnesium%20Status%20in%20the%20United%20States.pdf
  43. Rosanoff A, Capron E, Barak P, Mathews B, Nielsen FH. Edible plant tissue and soil calcium:magnesium ratios: data too sparse to assess implications for human health. Crop Pasture Sci. 2015;66:1265-1277. http://agris.fao.org/agris-search/search.do?recordID=US201600101821
  44. Rosanoff A. Rising Ca:Mg intake ratio from food in USA Adults: a concern? Magnesium Res. 2010;23(4):S181-S193. https://www.mgwater.com/Ca-Mg.pdf
  45. Karakelleoglu C, Orbak Z, Ozturk F, Kosan C. Hypomagnesaemia as a mortality risk factor in protein-energy malnutrition. J Health Popul Nutr. 2011;29(2):181–182. doi:10.3329/jhpn.v29i2.7863 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3126992/
  46. Florence Dunkel, Learning from Sanambele: Role of Food Insects in Village Nutritional Health, Montana State University-Bozeman (a Power Point presentation) http://www.montana.edu/mali/documents/pptsaspdfs/worldHungerDunkelSanambelepresentationsmallpdfvsn.pdf
  47. Sorghum and Millets in Human Nature, fao.org, http://www.fao.org/3/T0818E/T0818E0d.htm
  48. The Contribution of Insects to Food Security, Livelihoods and the Environment, fao.org, http://www.fao.org/3/i3264e/i3264e00.pdf
  49. Beatrice Amadi, Andrew O Fagbemi, Paul Kelly, et al., Reduced production of sulfated glycosaminoglycans occurs in Zambian children with kwashiorkor but not marasmus., The American Journal of Clinical Nutrition, Vol 89, Issue 2, Feb 2009, pp 592–600 https://academic.oup.com/ajcn/article/89/2/592/4596718
  50. Arnold van Huis, Joost Van Itterbeeck, Harmke Klunder, et al., Edible insects: Future prospects for food and feed security, Food and Agriculture Organization of the United Nations, Rome, 2013, FAO.org, http://edepot.wur.nl/258042
  51. Joan L.Caddell, MD., Magnesium in the therapy of protein-caloriemalnutrition of childhood., The Journal of Pediatrics, Vol 66, Issue 2, Feb 1965, pp 392-413, https://www.sciencedirect.com/science/article/abs/pii/S0022347665801974

Article in the lower right hand column of the Science Direct topic page on Albumin Antibody: – it has a thorough description and graphic (Figure 1) about the blood brain barrier and seizures.

  1. N. Marchi, … D. Janigro, in Encyclopedia of Basic Epilepsy Research, 2009, Inflammation: Cerebrovascular Diseases, Seizures, and Epilepsy Seizures; Epilepsy, and the Blood–Brain Barrier, “Systemic pathologies causing BBB failure may be due to hypertension, stroke, blood hyperosmolarity, or systemically mediated inflammatory processes (due to the production of TNF-α, IL-1β, IL-6, histamine, arachidonic acid, or reactive oxygen species)”

References from the last post on hypercoaguability and the NF-kB inflammatory pathway.

  1. DiNicolantonio JJ, Liu J, O’Keefe JH. Magnesium for the prevention and treatment of cardiovascular disease. Open Heart. 2018;5(2):e000775. Published 2018 Jul 1. doi:10.1136/openhrt-2018-000775 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6045762/
  2. Andrea Rosanoff, PhD, and Stella Lucia Volpe, PhD, RDN, ACSM-CEP, FACSM, Recorded Webinar: Modern Day Human Magnesium Requirements: The RDN’s Role, Today’s Dietitian, https://ce.todaysdietitian.com/node/69241#group-tabs-node-course-default1
  3. Karen Skene, Sarah K. Walsh, Oronne Okafor, Nadine Godsman, et al., Acute dietary zinc deficiency in rats exacerbates myocardial ischaemia–reperfusion injury through depletion of glutathione., British Journal of Nutrition, Vol 121, Issue 9 14 May 2019 , pp. 961-973, https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/acute-dietary-zinc-deficiency-in-rats-exacerbates-myocardial-ischaemiareperfusion-injury-through-depletion-of-glutathione/15953E00DA3E69629F36F9F6FE5079A8
  4. Karl T. Weber,1,* William B. Weglicki,2 and Robert U. Simpson3 Macro- and micronutrient dyshomeostasis in the adverse structural remodelling of myocardium, Cardiovasc Res. 2009 Feb 15; 81(3): 500–508. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2639130/
  5. Li YC. Vitamin D: roles in renal and cardiovascular protection. Curr Opin Nephrol Hypertens. 2012;21(1):72–79. doi:10.1097/MNH.0b013e32834de4ee https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3574163/
  6. Benjamin Senst; Prasanna Tadi; Hajira Basit; Arif Jan., Hypercoaguability, STATPearls, Last Update: April 29, 2019. https://www.ncbi.nlm.nih.gov/books/NBK538251/
  7. Kennedy DO. B Vitamins and the Brain: Mechanisms, Dose and Efficacy–A Review. Nutrients. 2016;8(2):68. Published 2016 Jan 28. doi:10.3390/nu8020068 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4772032/
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High blood pressure and possible ethnic differences

On page 66 of a new book Plagues and the Paradox of Progress: Why the World is Getting Healthier in Worrisome Ways, by Thomas Bollyky, it is mentioned that early Western medical personal working in Africa in the 1920s were surprised to find no cases of hypertension/high blood pressure among the native African people. Only one native woman was known to be overweight and it was noted that she worked in a brewery which led the medical person in the document to speculate whether beer drinking could be fattening (yes it can). The first case of hypertension in a native African person wasn’t noted until the 1940s.

Question: Does the Western style of living or working or export of Western products cause hypertension in native Africans? If native Africans living in their traditional environment using their traditional diet have no risk for hypertension then what changed that caused an increased risk? This topic is also important for prenatal health as preeclampsia can include hypertension/high blood pressure and it does tend to be an increased risk for women with African American ancestry. The DASH diet may be helpful, for more on preeclampsia risk factors and possible tips for prevention or management, see Preeclampsia & TRP Channels, effectivecare.info. 

Dr. Agbai’s discovery that helps protect against symptoms of Sickle Cell Anemia – Thiocyanate.

Yes per Dr Agbai who has worked with patients in Africa and in the U.S., the standard diets are different. There is a difference in type of starch and amount of starch in typical African or Jamaican diet and western U.S. style diet, and there is a difference in amounts of foods that contain thiocyanate. The yams commonly grown in Africa are larger and woodier/less sweet than sweet potatoes and they are also a good source of thiocyanate.

Thiocyanate is a phytonutrient that helps protect against Sickle cell anemia by preventing the red blood cells from forming the sickle shape instead of the normal round indented shape (like a tire or doughnut shape that has a filled in shallower center). It is important to eat adequate iodine and protein rich foods that contain methionine (found more in animal product protein sources than in a vegan diet) in order to protect thyroid health.

Listen to interviews with Dr. Agbai by the radio show Your Own Health and Fitness: http://www.yourownhealthandfitness.org/?page_id=509

Agbai O. Anti-sickling effect of dietary thiocyanate in prophylactic control of sickle cell anemia. J Natl Med Assoc. 1986;78(11):1053-6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2571427/

There may be a slight difference in retention of calcium and loss of magnesium that would be protective with a diet low in calcium might may increase risk of metabolic syndrome type conditions when excess calcium.

I’ve discussed this topic of potential differences between western style diet and traditional African culture and possible differences in health in my early days of blogging when I found a research article from ~ 1970s that noted ethnic differences in health outcomes but did not take into account possible differences in average ethnic diet at the time. (I haven’t found that article in my files yet. I will update this post if I do find it.) To get to the point directly – people with native African ancestry may have kidney differences that conserve calcium better, and possibly not conserve as much magnesium, as other ethnic groups. This would be protective when calcium was not very available in the diet but then would be an increased negative health risk if the diet contained a lot of calcium or phosphorus.

There is known problems in medical research in the U.S. with bias in research studies towards use of white males as study participants with less information gathered about minority groups and females.

Before discussing calcium and magnesium and kidney health in more detail – briefly – there is bias in medical research towards white males. Research studies over the years have often had more limited numbers of minorities and females among the experimental and control groups or as a focus of research. A summary of the issue was included in a recent article in the New York Times that is focused on the potential benefits and risk of bias in the use of Artificial Intelligence (AI) in medical diagnostic processes or other medical roles.

” Medicine has long struggled to include enough women and minorities in research, despite knowing they have different risk factors for and manifestations of disease. Many genetic studies suffer from a dearth of black patients, leading to erroneous conclusions. Women often experience different symptoms when having a heart attack, causing delays in treatment. Perhaps the most widely used cardiovascular risk score, developed using data from mostly white patients, can be less precise for minorities. ” – Dhruv Khullar

“A.I. Could Worsen Health Disparities,” by Dhruv Khullar, The New York Times, Opinion, Jan. 31, 2019

It is not racist or sexist to discuss differences in physiology and the potential effects those differences might have on health. It is discriminatory to only study one group of people primarily and then try to treat everyone else as if they weren’t individuals but were all instead exactly like the group that had been studied. It is discrimination to not treat individuals as individuals or to pretend that differences don’t exist.

Adequate magnesium is needed for preventing high blood pressure, cardiovascular disease, and many other chronic conditions including dementia.

Low magnesium levels, particularly when there is also plenty of phosphorus may increase cardiovascular risks. Adequate magnesium levels are protective and elevated magnesium is unusual and may be increase cardiovascular risks. In good health the body maintains magnesium and other electrolyte levels within specific ranges. (5) Higher magnesium levels have also been associated with higher levels of potassium and of albumin, a blood plasma protein, (6), which is important for fluid balance and transport of a variety of chemicals in addition to magnesium (such as steroids, fatty acids, and thyroid hormones (wikipedia/serum albumin), about 30% of serum magnesium is carried in a non-electrically active form on proteins, primarily albumin (Clinical Biochemistry/serum magnesium) (9).

Alzheimer’s dementia and other types of dementia are more common in blacks than whites in the U.S. and may be a risk earlier in life too, early onset Alzheimer’s can occur in the forties and fifties instead of the more frequent age of diagnosis after age 60. See: African Americans Face Greater Risk of Alzheimer’s Disease than Whites, usatoday.. The reason is not known but the increased frequency on high blood pressure in blacks is thought to be a risk factor.

There may be differences in rate of urinary loss of albumin in different ethnic groups. With the presence of excess abdominal weight participants in a renal study of Hindustani-Surinamese, or African-Surinamese ancestry had an increased likelihood of albuminuria than participants of Dutch ancestry with the greatest risk found in the Hindustani-Surinamese group. (7) Asian Americans and African Americans were found to have better blood albumin levels in a renal study and the Asian Americans had better renal biomarkers compared to other ethnic groups in the study. (8)

When looking at hypertension and high blood pressure risk with the same diet in modern research there is a significant increased risk for African Americans to have high blood pressure and to have it occur earlier in life than in whites. (prevalence in the U.S. of hypertension in adults was “42 % for blacks and 28 % for whites,” (2011-2012)). (2)

So it is a good question – how did hypertension frequency in Africans in the 1920s change from zero to 42% for African Americans in the United States, in 2011-2012? Diet differences that were noted in 2009-2010 between white groups and African American groups were more cholesterol and sugar and less fiber, whole grains, nuts/beans/seeds, fruits and vegetables for the African Americans on average. Dairy intake was not mentioned as being significantly difference. In another research comparison calcium intake was lower on average in African Americans but so was magnesium (Table 1). (2)

Within the introduction and Diet and Blood Pressure sections of the article it is mentioned that ethnic differences in cardiovascular metabolism has been noted in African American groups and that their reduction in blood pressure when following the DASH diet was even better than the reduction in people of other ethnic background who followed the diet (it includes a magnesium rich Beans/Nuts/Seeds group as a daily/weekly recommendation). The INTERMAP study found an increased Sodium to Potassium ratio in urinary excretion and less total Potassium urinary excretion for the African American participants than white participants. (2)

Other research has also supported the idea that high blood pressure may have more to do with excess sodium (salt) intake in relation to low potassium intake than just having to do with the amount of sodium in the diet. Potassium is found in all vegetables and fruits in varying amounts, beans/nuts/seeds, and in liquid milk and yogurt. (Kidney dialysis and other patients with Chronic Kidney Disease have to avoid excess potassium so this article includes a list of potassium rich foods for the purpose of educating regarding what needs to be limited but for people of average kidney health it is a list of good sources to include in the diet: Potassium and Your CKD Diet, National Kidney Foundation.

Learning is an ongoing process, in the meantime some possible health tips for people of any ancestry:

  1. Adequate magnesium is essential for kidney and heart health and high blood pressure is an early symptom of low magnesium levels. Dietary sources may not be sufficient if intestinal absorption is poor or if renal losses are excessive. Epsom salt baths or footsoaks or magnesium chloride are topical forms. Adequate protein and phospholipids in the diet are also important to provide the albumin and other specialized transport molecules that carry magnesium and other chemicals within the vascular or other fluids of body tissue. More information about magnesium sources and symptoms of deficiency are available in a previous post: To have optimal Magnesium needs Protein and Phospholipids too.
  2. Adequate calcium and vitamin D are needed for health however excess may cause an imbalance between calcium and magnesium levels as magnesium is excreted along with excess calcium by the kidneys and less magnesium may be absorbed by the intestines as vitamin D causes increased absorption of calcium and magnesium but calcium may be more available in a modern processed food diet. For more information about vitamin D sources see: Light up your life with Vitamin D, peace-is-happy.org. Deficiency of calcium or of vitamin D can cause secondary hyperparathyroidism which can also be more common in renal failure due to excess phosphorus buildup and deficiency of active vitamin D. The healthy kidney is involved in activating vitamin D. (Secondary hyperparathyroidism, National Kidney Foundation) Calcium is plentiful in most dairy products and is also found in almonds, sesame seeds, beans, dark green leafy vegetables and other produce. Variations of a 2000 calorie menu plan shows that even a vegan diet can provide 1000 milligrams of calcium per day and a menu with dairy products can provide an excess with over 1600 milligrams of calcium, see: Healthy Hair is the Proof-of a healing diet.
  3. The DASH diet (Dietary Approach to Stop Hypertension) may help because it encourages potassium and magnesium rich vegetables, fruits, beans, nuts and seeds. Calcium is provided without being over recommended with two to three servings of dairy group foods. See example daily/weekly diet plan recommendations here: What is the DASH diet?, dashdiet.org.
  4. Adequate without excess protein helps protect the kidneys from having to overwork excreting nitrogen from excess protein breakdown. Adequate water is essential for kidney and vascular health as it helps with excretion of toxins and transport of nutrients and oxygen in the vascular system. More information about protein and water recommendations are available in a previous post: Make every day Kidney Appreciation Day.

/Disclaimer: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./

  1. Thomas Bollyky, Plagues and the Paradox of Progress: Why the World is Getting Healthier in Worrisome Ways, 2018, MIT Press, https://mitpress.mit.edu/books/plagues-and-paradox-progress
  2. Chan Q, Stamler J, Elliott P. Dietary factors and higher blood pressure in African-Americans. Curr Hypertens Rep. 2015;17(2):10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4315875/“Marked ethnic differences exist in bone metabolism and development of calcified atherosclerotic plaque (CP). Relative to European-Americans, African-Americans have lower rates of osteoporosis (despite ingesting less dietary calcium), form fewer calcium-containing kidney stones and manifest skeletal resistance to PTH (1,2,3). Systemic differences in regulation of calcium and phosphorus appear to be involved (4). Related phenomena may include the markedly lower amounts of calcified CP in African-Americans, despite the presence of more severe conventional cardiovascular disease risk factors (5,6,7,8,9). Together these observations suggest biologically mediated ethnic differences in the regulation of bone and vascular health.” […]  “The DASH/DASH-Na diet BP reduction was more pronounced for blacks compared to whites [31, 36, 37]. Although the DASH dietary approach has been incorporated into lifestyle changes recommended for patients with HTN [3], data show that few hypertensive Americans consume diets even modestly concordant with the DASH diet and less so for blacks [38]. Only about 19 % of individuals with known HTN from NHANES 1999–2004 had DASH-concordant diets.”
  3. Barry I. Freedman, et al, Vitamin D, Adiposity, and Calcified Atherosclerotic Plaque in African-Americans,J Clin Endocrinol Metab. 2010 March; 95(3): 1076–1083. [ncbi.nlm.nih.gov/pmc/articles/PMC2841532/?tool=pubmed]  
  4. Potassium and Your CKD Diet, National Kidney Foundation, https://www.kidney.org/atoz/content/potassium
  5. Ryota Ikee, Cardiovascular disease, mortality, and magnesium in chronic kidney disease: growing interest in magnesium-related interventions, Renal Replacement Therapy, 2018 4:1,   https://rrtjournal.biomedcentral.com/articles/10.1186/s41100-017-0142-7
  6. Noriaki Kurita, Tadao Akizawa, Masafumi Fukagawa, Yoshihiro Onishi, Kiyoshi Kurokawa, Shunichi Fukuhara; Contribution of dysregulated serum magnesium to mortality in hemodialysis patients with secondary hyperparathyroidism: a 3-year cohort study, Clinical Kidney Journal, Volume 8, Issue 6, 1 December 2015, Pages 744–752, https://doi.org/10.1093/ckj/sfv097
  7. van Valkengoed IG, Agyemang C, Krediet RT, Stronks K. Ethnic differences in the association between waist-to-height ratio and albumin-creatinine ratio: the observational SUNSET study. BMC Nephrol. 2012;13:26. Published 2012 May 7. doi:10.1186/1471-2369-13-26. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3492102/
  8. Frankenfield DL, et al., Differences in intermediate outcomes for Asian and non-Asian adult hemodialysis patients in the United States, Kidney International, Vol 64, Issue 2, Aug. 2003, pp 623-631 https://www.sciencedirect.com/science/article/pii/S0085253815493706
  9. M H Kroll, R J Elin, Relationships between magnesium and protein concentrations in serum. Clinical Chemistry Feb 1985, 31 (2) 244-246; http://clinchem.aaccjnls.org/content/31/2/244.long
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Glymphatic system – yes- sleep helps protect against Alzheimer’s dementia

Following up on Friday’s easy answer day (previous post) – yes, the glymphatic system of the brain does help protect against Alzheimer’s dementia, (7, 8, 14, 17), and sleep, especially one of the deeper stages of sleep (low-delta), is important. (10, 11, 13) Sleeping on your right side may help promote better fluid drainage through the glymphatic system of the brain (sleeping on your right side puts the left side of your body with your heart farther up above the rest of your body, a pillow between your knees and a neck support may also help). (Social media link, reference source: Neurology Reviews, 2) (12) *I had trouble finding anything very specific about whether right or left side was better for glymphatic and lymphatic drainage – this article from an Ayurveda specialist describes how the anatomy is better suited to sleeping on the left side than the right side – the aorta leaves the heart on the left so laying on the left side allows the flow to go downhill with the aid of gravity. (https://lifespa.com/amazing-benefits-of-sleeping-on-your-left-side/ )

The circulation by the heart can help move fluid through the brain but only indirectly due to the on/off pressure of the arterial pulse. The regular lymphatic system of the body is a drainage system for the brain fluid system but the blood brain barrier prevents direct interaction. Specialized water pumps in some types of brain glial cells help provide circulation within the brain by pumping water in two directions within the second layer of thick membranes that separate the soft brain tissue from the bony skull. (3)(4)(15)(16)

Overall the fluid within the brain does circulate and there is a visible, small, pulsing movement that has been amplified and can be observed in a video: (5). The spread of a dye within the brain can be observed in a different type of brain scan, the fluid diffusion is not rapid taking 24 hours to reach a maximal point, and the movement of the dye was most prevalent (see color chart) near the skull: (6). The glymphatic system as defined as the specialized glial cells with water pump channels is located in the area near the skull. (4) Diffusion of fluid throughout deeper areas of the brain where the blood brain barrier is not found can occur to a small extent through membranes. (9)

Exercise may also help the glymphatic system function better. (18) The lymphatic vessels and lymph nodes in the neck are the initial drainage route for the glymphatic system cleansing of the various fluid filled areas of the brain. Stretching exercises and rhythmic walking type exercise can help move lymphatic fluid from farther areas of the body to the torso and urinary system for eventual excretion.

Small amounts of alcohol – one third of a serving; to moderate – one or two servings per day (too much may not be helpful); may help the detoxification of the brain fluid by mechanisms that are not well understood yet but which seem to involve the glymphatic system. (19, 20) The mechanism may involve the effect of alcohol on GABA receptors, it can activate them which in general would have a calming/inhibitory effect, (23), however GABA receptors also are involved in promoting more production of the water pump Aqaporin 4 channels in neural stem cells within the subependymal zone. (24) The subependymal zone is in the lateral part of the lateral ventricle which is a cerebrospinal fluid filled area near the center of the brain, (27), which is involved in fluid balance and drainage of the glymphatic system. (25) GABA receptors are also involved with flow of chloride ions across membranes (for an inhibitory effect on nerve signaling, (pp 126-131, 1), and affect fluid balance in areas of the brain without the blood brain barrier which makes diffusion of water across the brain membranes more possible. (26)

Alcohol also inhibits the action of the excitatory neurotransmitter glutamate, particularly at the NMDA receptor, (23), which is an excitatory ion channel and also allows calcium to enter the cell where the mineral can activate many functions within the cell. (pp 120-126, 1) If drinking alcohol is not preferred or legal due to age or advised due to pregnancy or possibility of becoming pregnant then GABA (gamma-aminobutyric acid) is available as an over the counter supplement, typically in a form that melts in the mouth to promote more direct absorption. While it is not typically referred to as an amino acid due to its role as a neurotransmitter, it is simply an amino acid, a smaller molecule from which proteins can be formed. The level of GABA a has been found to be reduced in the brains of patients with severe Alzheimer’s Disease and its use as a treatment has been studied, (29), levels in other abnormal brain cells were found to be elevated in a specific area of the brain of patients with Alzheimer’s Disease and treatment to increase transport of GABA has also been studied. (30)

Or sleep, in the form of a short nap, may also help promote GABA. Naps may benefit our health in part because of a beneficial effect on GABA promotion by increased glymphatic action in the brain – twenty minutes of sleep may be adequate. (28)

An overview of the glymphatic system and lifestyle and dietary tactics that might improve its function are described in a video by a nutritionist: (21); and also in a self-help style article by a different person: (22).

Some types of magnesium supplements including magnesium threonate may also help. Magnesium within the brain has many functions including inhibiting the NMDA glutamate receptor which would prevent excess calcium from entering the cell. (pp 120-126, 1)

We tend to hear about neurotransmitters such as serotonin for depression or dopamine and Parkinson’s disease, yet we rarely hear that calcium is the mineral that signals the release of both of those and over one hundred other neurotransmitters that are involved in nerve signals within the brain or throughout the body (page 85, 1.Neuroscience, 6th Ed.). Neurotransmitters include excitatory and inhibitory chemicals and they activate or inhibit the firing of a nerve signal. GABA can be a calming/inhibitory neurotransmitter that may be low when anxiety is a problem. Magnesium is the mineral inside cells which helps control how much calcium will be allowed to enter. Excess calcium can cause excess release of neurotransmitters. Magnesium deficiency can also be involved when anxiety is a symptom.

Adequate fluid is also likely important for adequate cleansing of waste from the brain by the glymphatic system. Problems with edema/swelling in other areas of the body or problems with hypertension may indicate problems with the lymphatic system in general. Moderate exercise helps the muscle power of movement also move extracellular fluid and lymphatic fluid through the lymphatic vessels to lymph nodes to be filtered by blood cells. Waste is removed into blood vessels for later excretion by the kidneys.

Additional note – adenosine was mentioned in the series on demyelination as a chemical that may lead to more breakdown of cells or myelin. It is produced as a metabolite of normal energy production and increased levels seem to be involved in our beginning to feel sleepy, signaling a need for rest – which would then give the brain clean up glymphatic system a chance to work on decreasing levels — so feeling sleepy? Your brain may be trying to tell you it is time to clean up after a strenuous workout whether physical or mental.  (See the What Makes You Sleep? section in the NHLBI article about Sleep Deprivation and Deficiency)

For more general information about promoting sleep and coping with insomnia see the post “Sleep and Health.”

Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4326841/Reference: pp 85-112, “Synaptic Transmission,” Neuroscience, 6th Edition, Editors D. Purves, G.J. Augustine, D. Fitzpatrick, W.C. Hall, A.S. LaMantia, R.D. Mooney, ML. Platt, L.E. White, (Sinauer Associates, Oxford University Press, 2018, New York) (Barnes&Noble)
  2. Glymphatic System May Play Key Role in Removing Brain Waste, Neurology Reviews, 2016 October;24(10):13   https://www.mdedge.com/neurologyreviews/article/114150/alzheimers-cognition/glymphatic-system-may-play-key-role-removing
  3. Understanding the Glymphatic System, Neuronline, adapted from the SfN Short Course The Glymphatic System by Nadia Aalling, MSc, Anne Sofie Finmann Munk, BSc, Iben Lundgaard, PhD, and Maiken Nedergaard, MD, DMSc http://neuronline.sfn.org/Articles/Scientific-Research/2018/Understanding-the-Glymphatic-System
  4. Tsutomu Nakada, Ingrid L. Kwee, Fluid Dynamics Inside the Brain Barrier: Current Concept of Interstitial Flow, Glymphatic Flow, and Cerebrospinal Fluid Circulation in the Brain. The Neuroscientist, May 24, 2018, http://journals.sagepub.com/doi/10.1177/1073858418775027#articleCitationDownloadContainer
  5. Bruce Goldman, The beating brain: A video captures the organ’s rhythmic pulsations. Scope, Stanford Medicine, July 5, 2018, https://scopeblog.stanford.edu/2018/07/05/the-beating-brain-a-video-captures-the-organs-rhythmic-pulsations/?linkId=53912604
  6. Geir Ringstad, Lars M. Valnes, Anders M. Dale, et al., Brain-wide glymphatic enhancement and clearance in humans assessed with MRI. JCI Insight. 2018;3(13):e121537 https://insight.jci.org/articles/view/121537?utm_content=buffer13f62&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer
  7. Brain discovery could block aging’s terrible toll on the mind. University of Virginia Health System, EurekAlert! Science News, July 25, 2018, https://www.eurekalert.org/pub_releases/2018-07/uovh-bdc072518.php
  8. Da Mesquita S., Louveau A., Vaccari A., et al., Functional aspects of meningeal lymphatics in ageing and Alzheimer’s disease, Nature, 185,191, Vol 560, Issue 7717, 2018/08/01. https://www.nature.com/articles/s41586-018-0368-8
  9. Albargothy N. J., Johnston D. A., MacGregor‑Sharp M., Convective influx/glymphatic system: tracers injected into the CSF enter and leave the brain along separate periarterial basement membrane pathways. Acta Neuropathologica (2018) 136:139–152 https://link.springer.com/epdf/10.1007/s00401-018-1862-7?shared_access_token=oYhOYaeYOAlkFhECIjAc6Pe4RwlQNchNByi7wbcMAY7lrBk-VqU01OilsaKMVR9FXaHRKmFQ1tkD03g-Q04DmsYSxRC_gucPZRYlFW0xfyU2pYNfhmwcokVbMCreuzU3wBLsjKpRasKo-6HXTJLMHNXMqFbaSsQVIB34EgzIUsc%3D
  10. Tamara Bhandari, Lack of Sleep Boosts Levels of Alzheimer’s Proteins, The Source, Washington University in St. Louis, Dec. 27, 2017, https://source.wustl.edu/2017/12/lack-sleep-boosts-levels-alzheimers-proteins/
  11. Yo-El S Ju, Sharon J Ooms, Courtney Sutphen, et al., Slow wave sleep disruption increases cerebrospinal fluid amyloid-β levels. Brain, Vol 140, Issue 8, 1 August 2017, Pages 2104–2111, Oxford Academic, https://academic.oup.com/brain/article/140/8/2104/3933862
  12. Krista Burns, American Posture Institute: Proper Sleeping Posture for ‘Brain Drain,’ April 5, 2017, https://americanpostureinstitute.com/proper-sleeping-posture-for-brain-drain/
  13. Patricia Farrell, Sleep: Everyone Needs It and So Do You, March 16, 2017, https://www.amazon.com/dp/152061294X
  14. Melanie D. Sweeney, Berislav V. Zlokovic, A lymphatic waste-disposal system implicated in Alzheimer’s disease. July 25, 2018, https://www.nature.com/articles/d41586-018-05763-0?utm_source=twt_na&utm_medium=social&utm_campaign=NNPnature
  15. Nadia Aalling Jessen, Anne Sofie Finmann Munk, Iben Lundgaard, Maiken Nedergaard, The Glymphatic System – A Beginners Guide, Neurochem Res. 2015 Dec; 40(12): 2583–2599. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4636982/
  16. Maiken Nedergaard, Steven A. Goldman, Brain Drain, Sci Am. 2016 Mar; 314(3): 44–49. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347443/
  17. Rainey-Smith S. R., Mazzucchelli G. N., Villimagne V. L., et al. Genetic Variation in Aquaporin-4 Moderates the Relationship Between Sleep and Brain Aβ-amyloid burden. Translational  Psychiatry, (2018) 8:47 https://www.nature.com/articles/s41398-018-0094-x.epdf?author_access_token=iK09AkugOzYXUjXJCpGfIdRgN0jAjWel9jnR3ZoTv0P4SU0l7P8A1C64dg2xJ-HX7jlpuvyMeHzBYm6I5D0yMRBsx023MtG5Y3KNpj4EoNEqA4ELFuByqeysfTCRKZdGegxohMN9WLBb_S6H0UZYpw%3D%3D
  18. Brown B., Rainey-Smith S. R., Dore V., et al., Self-Reported Physical Activity is Associated with Tau Burden Measured by Positron Emission Tomography. Journal of Alzheimer’s Disease, vol. 63, no. 4, pp. 1299-1305, May 30, 2018 https://content.iospress.com/articles/journal-of-alzheimers-disease/jad170998
  19. Chloe Chaplain, Drinking wine every day could help prevent Alzheimer’s, experts say. London Evening Standard, June 6, 2018, https://www.standard.co.uk/news/health/drinking-wine-every-day-could-help-prevent-alzheimers-experts-say-a3856646.html
  20. In Wine, There’s Health: Low Levels of Alcohol Good for the Brain. Feb. 2, 2018, University of Rochester Medical Center, https://www.urmc.rochester.edu/news/story/5268/in-wine-theres-health-low-levels-of-alcohol-good-for-the-brain.aspx
  21. Brianna Diorio, Glymphatic System 101, video,August 8, 2018,  https://vimeo.com/283708099?ref=tw-share
  22. Sydney, How To Detox Your Brain By Hacking Your Glymphatic System. A Healthy Body, May 18, 2018, http://www.a-healthy-body.com/how-to-detox-your-brain-by-hacking-your-glymphatic-system/
  23. The Effects of Alcohol on the Brain, The Scripps Research Institute, https://www.scripps.edu/newsandviews/e_20020225/koob2.html
  24. Li Y, Schmidt-Edelkraut U, Poetz F, et al. γ-Aminobutyric A Receptor (GABAAR) Regulates Aquaporin 4 Expression in the Subependymal Zone: RELEVANCE TO NEURAL PRECURSORS AND WATER EXCHANGE. The Journal of Biological Chemistry. 2015;290(7):4343-4355. doi:10.1074/jbc.M114.618686. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4326841/ (24)
  25. Plog BA, Nedergaard M. The glymphatic system in CNS health and disease: past, present and future. Annual review of pathology. 2018;13:379-394. doi:10.1146/annurev-pathol-051217-111018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5803388/ (25)
  26. Cesetti Tiziana, Ciccolini Francesca, Li Yuting, GABA Not Only a Neurotransmitter: Osmotic Regulation by GABAAR Signaling. Frontiers in Cellular Neuroscience, Vol. 6, 2012, https://www.frontiersin.org/article/10.3389/fncel.2012.00003 DOI=10.3389/fncel.2012.00003 ISSN=1662-5102 (26)
  27. Kazanis I. The subependymal zone neurogenic niche: a beating heart in the centre of the brain: How plastic is adult neurogenesis? Opportunities for therapy and questions to be addressed. Brain. 2009;132(11):2909-2921. doi:10.1093/brain/awp237. (27)
  28. Robert I Henkin, Mona Abdelmeguid, Sleep, glymphatic activation and phantosmia inhibition. The FASEB Journal, Vol 31, No. 1_supplement, April 2017, https://www.fasebj.org/doi/abs/10.1096/fasebj.31.1_supplement.749.4  (28)
  29. Solas M, Puerta E, Ramirez MJ. Treatment Options in Alzheimer’s Disease: The GABA Story., Curr Pharm Des. 2015;21(34):4960-71. https://www.ncbi.nlm.nih.gov/pubmed/26365140 (29)
  30. Zheng Wu, Ziyuan Guo, Marla Gearing, Gong Chen, Tonic inhibition in dentate gyrus impairs long-term potentiation and memory in an Alzheimer’s disease model. Nature Communications, 5,  Article number: 4159 (2014) https://www.nature.com/articles/ncomms5159 (30)
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Why care about demyelination?

We need to care about demyelination as a society because it may be a factor underlying many conditions that have been occurring at increasing rates. The high cost of health care is not just due to the cost of individual medications or the price of hospitalization but is due to the additive cost of increased numbers of individuals needing care. Autism care alone is estimated to likely reach $500 billion by 2025 for care in the U.S. alone, (link), demyelination or disordered myelin formation is thought to be involved. Our food supply may provide calories but it may no longer be supporting health due to imbalance in some nutrients and lack of sufficient amounts of other nutrients – in addition to personal choices for some people leaning toward convenient and tasty foods that provide very few nutrients besides calories.

The other reason to care about demyelination as a society is because the early symptoms can occur for years without clear reasons and may disrupt relationships or the ability to hold a job – personality changes including anxiety and anger, paranoia and a short temper – problems with impulse control and the ability to follow through on planned actions or with communication and the ability to tell the truth instead of substituting other statements that may seem illogical and obviously far from the truth. Problems with impulse control and a tendency toward mood problems may also include an increased risk for suicide or self injury or violence towards others.

The medical research is complex and I haven’t seen all the loose threads together yet, so I will summarize my summary points in a more concise list here and am working on a more organized document elsewhere. This list combines my tips from the previous post with the work of the other summary article (22) — I was also given the link to another summary article which also has tips which I have not incorporated here. It provides an excellent overview about myelin production and function –selfhacked/myelin – what I and the authors of (22) and {selfhacked} have in common is that we all got sick and sought information about regaining our health for ourselves and are sharing the information in case it might help others.

My personal goal is to not become paralyzed (post: ALS & CBD receptors), number of clicks on a website is not something I pay attention to. The loose threads that I’ve woven together in this series of posts which are not included in the excellent selfhacked article are that a) many of the herbs or phytonutrients found helpful for myelin regeneration are Nrf2 promoting which is also important for myelin regeneration and/or reducing oxidative stress that may lead to more degeneration of myelin. b) Foods that are good for promoting Nrf2 often are also good sources of cannabinoids or phospholipids which can be protective. c) And preventing excessive cell death or excess intracellular calcium may decrease the excess production of cytokines by decreasing release of cannabinoids from cell membrane storage and their breakdown into arachidonic acid and eventual transformation into cytokines and other inflammatory chemicals.}: 

Strategies to help prevent the breakdown of myelin or help promote regeneration of myelin:

{In the past at different points in time, I personally have experienced and improved with supplementation or diet changes physical and mental symptoms of vitamin B1, B5, B6, folate and B12 deficiencies; iodine, magnesium, calcium and zinc deficiencies; vitamin/hormone D and calcium excess at a different stage of health;  cannabinoid/phospholipid deficiency; inadequate protein and general malnutrition due to the zinc deficiency which can greatly reduce appetite at one stage and due to severe bowel mal-absorption more recently; omega 3 fatty acid/omega 6 fatty acid imbalance; and also lack of sleep/melatonin and lack of oxygen/excess toxins in the air; health requires all of the nutrients and adequate oxygen, exercise, sleep and stress coping.}

  1. Vitamin B1, thiamin deficiency, chronic, severe – Wernicke’s encephalopathy may be more of a risk for severe alcoholics and people with anorexia – severe lack of appetite or the eating disorder anorexia nervosa.
  2. Vitamin B12 deficiency – may be more of a risk for people with low stomach acidity, due to older age or chronic use of calcium type antacids; or due to genetic reasons limiting production of Intrinsic Factor; or due to a vegan diet without supplementation of vitamin B12 or inclusion of Nutritional yeast flakes in the diet.
  3. Zinc deficiency (22) or copper  excess (link).
  4. Adequate but not excessive lithium may increase myelin production. (22)
  5. Adequate but not excessive iron intake is needed for production of myelin.
  6. Magnesium deficiency or poor intestinal absorption of magnesium, or lack of adequate protein and phospholipids in the diet for the body to be able to store magnesium in the normal manner within the intracellular fluid.
  7. Inadequate calcium or vitamin D can be a factor but excessive intake of either can also be a factor in cell breakdown and risk of demyelination. If taking vitamin D as a supplement the vitamin D3 form may be most bioactive and taking vitamin K2 with it may help with myelin production (22) and protect against osteoporosis. Green leafy vegetables are good sources of vitamin K.
  8. Adequate intake of cholesterol is needed as a building block for our own production of vitamin D and other steroid hormones and as a building block for myelin. (22) Pregnenolone is a steroid hormone precursor that may benefit some people when used as a supplement. It and other steroid hormones are involved in signaling increased production of myelin. Testosterone insufficiency may also negatively affect myelin production. (22)
  9. Excessive intake of free glutamate or aspartate – excitatory amino acids that are commonly used as flavoring or sweetening agents in foods or may occur naturally in fermented foods or alcoholic beverages.
  10. Adequate protein is needed to support a variety of body functions in addition to supporting magnesium levels. Uridine is a nucleotide base (part of DNA that is a combination of a type of sugar and an amino acid) that is also is involved in energy metabolism, fasting occasionally may increase our own production (more info). Insufficient amounts may negatively affect myelin production and use as a supplement may help some people. (22)
  11. Insufficient calories to provide the body enough glucose to support mitochondrial health. They can use protein or fats for energy but it shifts the metabolism more towards oxidative stress.
  12. Occasional fasting and/or a low carbohydrate diet may help promote autophagy due to increased use of ketones for energy (22) but may cause health problems due to excess oxidative stress or an increased burden of nitrogen waste removal for the kidneys when followed long term.
  13. Lack of antioxidants due to lack of Nrf2 within the body to promote our own production of antioxidants internally; and/or lack of antioxidants within the diet, including vitamin C, (22), would decrease our ability to detoxify the reactive oxidative chemicals produced during normal metabolism or which are produced at increased rates when protein or fats are being used for energy instead of glucose.
  14. Use of the herb ashwagandha or Gingko biloba (22) may help protect against oxidative stress and protect against demyelination by promoting Nrf2. (ashwagandha & Nrf2) (an overview of Nrf2 metabolism, its potential benefits for conditions such as Multiple sclerosis, and Gingko biloba and pomegranate are mentioned as promoters of Nrf2: nutricology/newsletter, see first article) (other Nrf2 promoting phytonutrients/foods and menu ideas: G10: Nrf2 Promoting Foods.) Flavonoids are one of the groups of phytonutrients that helps promote Nrf2; and also may help protect myelin production. (22) Medicinal mushrooms, including Hericium Erinaceus, Lion’s Mane Mushroom,(22), may also help protect myelin production and prevent breakdown by reducing oxidative stress (link) and promoting Nrf2. (link)
  15. Having a healthy balance of omega 3 fatty acids and omega 6 fatty acids in the diet helps reduce risk of inflammation/oxidative stress and also helps us build healthy membranes which are necessary to control flow of minerals and other chemicals from the exterior to interior of cells and organelles such as the mitochondria.
  16. Inadequate iodine for healthy thyroid hormone production, (22); may be a combined problem of excess presence of bromide, fluoride and perchlorate in the diet or environment.
  17. Lack of oxygen due to poor air quality, or smoking, or health problems causing inadequate breathing function. Emotional or physical stress may also increase the need for oxygen or increase the tendency to hold our breath; Take ten deep breaths and think before you speak is good advice for any emotionally stressful situation because oxygen is needed to think rationally and we tend to hold our breath when we are upset.
  18. Avoid extreme physical and emotional stress.
  19. Avoid toxins.
  20. Get adequate sleep at night, and a brief nap during the day may be beneficial for some people. Melatonin helps promote myelin production and inadequate sleep and having lights on at night can disrupt our production of melatonin. (22)
  21. Adequate exercise (22) and stretching regularly helps move nutrients throughout the body and remove toxins in the lymphatic fluid for further detoxification and eventual removal from the body.
  22. Wear a helmet for any activity that may cause head trauma and avoid sports which may cause frequent closed head trauma and especially when helmets are not used (sorry soccer, football, hockey, (link), and boxing fans).
  23. Adequate phospholipid and other phosphonutrients or cannabinoids may be necessary to include from external sources if genetic differences or other health problems or age interferes with the body’s internal production capability. Dark cocoa products, cardamom powder, pomegranate and pumpkin seeds are a few legal dietary sources.
  24. Use of ibuprofen and/or ginger (approximately 1/2 teaspoon per day) may help prevent breakdown of our body’s supply of cannabinoids, breakdown of which may then lead to increased breakdown of cells and may then lead to increased degeneration of myelin.
  25. Lack of any B vitamins or genetic differences in the ability to remethylate folate and vitamin B12 may disrupt the ability of mitochondria to generate usable energy from glucose or proteins and fats, and may reduce production of myelin. (22) Inositol and choline may be particularly important for myelin production. They are considered to be in the B vitamin group but was discovered more recently than the numbered series of B vitamins. (22)
  26. Low Level Laser Therapy – I am not familiar with this, see #10: (22), but I have read elsewhere that certain types of light can stimulate activity levels. (Haier)
  27. Practice, practice, practice – new things. (22) Myelin is produced in response to learning [45] so remaining mentally stimulated with new experiences and learning new topics or techniques keeps signalling the body to produce myelin. 
  28. Brain-derived Neurotrophic Factor, (BDNF), the brain’s growth factor, may help increase production of myelin by increasing production of brain cells, which include oligodendrocytes. (22) Ways to promote BDNF (link, from within 22) fortunately overlap with the strategies for protecting against demyelination already mentioned above or included in the list of Nrf2 promoting foods.
  29. Reducing exposure to electromagnetic fields (EMF) – energy leakage from laptops, smartphones, WiFi, televisions, and other strong sources of electicity may help protect against myelin degeneration. (22)

References and more details for some of this information were included in the last two posts:

  • Good News/Bad News about Multiple sclerosis Research (7/26/2018)
  • Demyelination, continued. (7/28/2018)

/Disclosure: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./