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-   -   Multi-vitamin problems (https://www.neurotalk.org/myasthenia-gravis/110131-multi-vitamin.html)

Sam S 12-11-2009 08:17 AM

Multi-vitamin problems
 
I've had MG for more than ten years, and just recently learned from a new neurologist that taking a multivitamin with magnesium may be contributing to worsening MG symptoms. I couldn't believe no doctor had thought to tell me that sometime in the last decade!

Apparently magnesium causes an exacerbation of symptoms in MG. And a daily dose, well... not good. I never even considered that something in my vitamins could be a problem. Also, a lot of antacids and laxatives have it too, so check the label.

I've yet to find a multivitamin without magnesium, so I take a few of what I consider the most important supplements individually.

Hope this helps someone.

Sam

mrsD 12-11-2009 09:09 AM

Magnesium stearate in vitamins is not absorbed into the body.
It is inert. It is used as a "flow" improver so the powder will
come out of the hopper smoothly and into the tablet press properly, or fill a capsule properly.
If magnesium OXIDE appears on a label, very little of this is absorbed either... studies show 4%. To give a comparison, 3 oz of almonds have 270mg of magnesium! One cup of oatmeal has 57mg.
Here is a link with good information including RDA:
http://lpi.oregonstate.edu/infocente...ium/index.html

Multivits in general do not provide much magnesium if any.

The studies I have seen mentioning HIGH dose magnesium use in patients with MG involved IV mag sulfate given to women with MG who had eclampsia. (malignant hypertension of pregnancy).

I have not seen studies involving RDA levels of magnesium.
From 1990:
Quote:

Muscle Nerve. 1990 Aug;13(8):708-12.
Myasthenia gravis presenting as weakness after magnesium administration.

Bashuk RG, Krendel DA.

Emory University School of Medicine, Department of Neurology, Atlanta, Georgia.

We studied a patient with no prior history of neuromuscular disease who became virtually quadriplegic after parenteral magnesium administration for preeclampsia. The serum magnesium concentration was 3.0 mEq/L, which is usually well tolerated. The magnesium was stopped and she recovered over a few days. While she was weak, 2-Hz repetitive stimulation revealed a decrement without significant facilitation at rapid rates or after exercise, suggesting postsynaptic neuromuscular blockade. After her strength returned, repetitive stimulation was normal, but single fiber EMG revealed increased jitter and blocking. Her acetylcholine receptor antibody level was markedly elevated. Although paralysis after magnesium administration has been described in patients with known myasthenia gravis, it has not previously been reported to be the initial or only manifestation of the disease. Patients who are unusually sensitive to the neuromuscular effects of magnesium should be suspected of having an underlying disorder of neuromuscular transmission.

PMID: 2385256 [PubMed - indexed for MEDLINE]
and
Quote:

Obstet Gynecol. 1976 Jul;48(1 Suppl):35S-37S.
Myasthenia gravis and preeclampsia.

Cohen BA, London RS, Goldstein PJ.

Myasthenia gravis in pregnancy is rare, and its occurence in conjunction with preeclampsia has not been previously described. A case report of preeclampsia in a myasthenic patient is described with recommendations for management. The authors conclude that magnesium is a contraindicated pharmacologic agent in a myasthenic patient.

PMID: 940634 [PubMed - indexed for MEDLINE]
We cannot live without magnesium. It is the HIGH dose sudden administration that appears in the literature as problematic.

Most doctors do not even know that magnesium oxide is useless. And I would not expect them to understand what is in a standard multivitamin either.

If you care to give me the brand I can look it up for you. But if it says magnesium stearate.... don't count on any absorption at all. Magnesium stearate is not soluble and melts at 88 C. It is a fatty waxy material not a significant source of magnesium. It appears on just about every Vitamin label, as inert ingredient.

two other sources:
http://www.absoluteastronomy.com/top...esium_stearate

and
http://www.raysahelian.com/magnesiumstearate.html

The commonest cause of high dose oral magnesium is Laxatives given to purge before tests. In fact Fleets Phospho Soda has been taken off the market. Enemas given too often by Fleets will also present significant problems.

edit to add.... it is not just vitamins that magnesium stearate is found.
Most RX drugs have it too. You can find the inert ingredients listed on the insert the pharmacy can give you that comes with the bottle, or on rxlist.com has many ingredients too.

Therapeutic amounts of magnesium are not in these dosage forms because that would create a HUGE pill...one that most people could not handle.
Here is the link to Mestinon:
http://www.rxlist.com/mestinon-drug.htm
Quote:

Timespan Tablets containing 180 mg pyridostigmine bromide; each tablet also contains carnauba wax, corn-derived proteins, magnesium stearate, silica gel and tribasic calcium phosphate.

Joanmarie63 12-14-2009 08:58 AM

I can't take ANY multi-vitamins. Dr. never told me not to it's just that they make me very sick. I only learned from this site that it makes MG worse, I always thought I was just allergic to them. {still think I am allergic, as I really get sick, not just weak}

ewizabeth 12-14-2009 11:46 AM

Welcome to NeuroTalk Sam! :) As you see we have some awesome forum members here. I'm glad you found us! :)

AnnieB3 12-14-2009 04:30 PM

Sam, Is your MG getting worse? For a doctor to point to a relatively harmless vitamin (in small quantities) as a reason for that should scare you!!!! There are other, more common, reasons why someone with MG would get worse like not enough/right medications, a new thyroid or other condition, etc.

Maybe you should see your primary doctor to talk about checking some basic things like thyroid to make sure nothing else has changed.

Like Mrs. D. said, we need magnesium. Yes, high doses of it can cause a myasthenic crisis. And, yes, vitamins are not regulated by the FDA but there are still guidelines for them.

If you are eating a balanced diet, you may not need a multivitamin. Talk to your primary doctor about that too.

Again, please get help if your MG is getting worse. And if your doctoring is getting worse, please seek out a 2nd opinion from another neurologist!!!

Annie

Nicknerd 12-19-2009 06:34 PM

Greens+
 
Hey guys,

Just wondering if anyone's every tried Greens plus bone builder by Genuine Health...It's a powder...I've heard good things about it, but I'm a bit worried because it says that people on rx drugs should not take it without approval from a physician...

I'm going to ask my doc. about it, but I'm sure he'll just be like, 'yeah, it's fine,' and wont even look at the ingredients (need to find new family doctor yesterday)...Just wondering if anyone's tried this...I'm excited to try it because the ingredients all look promising, and i've heard such good reviews (although they've all been from healthier people)...

One other thing...There's ginko biloba in it, which makes me sorta uneasy...I've always avoided that stuff because it gives me the shakes, but the woman at the health food store said that if anything, she finds that it makes her sorta sleepy (the Greens plus) so it's better to take it at night...Do any of you know if Ginko affects MG at all?

mrsD 12-19-2009 06:43 PM

Can you put up the ingredients for me to look at? Or at least give me a link to them? I'll see what I can do for you.

Nicknerd 12-19-2009 06:56 PM

Sure, thanks Mrs. D!

This is for the 'bones part...

http://www.genuinehealth.com/greens-...uilder-formula

and this is the 'Greens' part

http://www.genuinehealth.com/greens....greens-formula

Thanks again! :)
Nicky

mrsD 12-19-2009 07:01 PM

I am sorry.... this is a very confusing website....I cannot find exactly what you are using from it. I see prices...very high prices however. One formula for bones mentions vitamins but not their amounts or types....I don't like that website....I never recommend products that make you work to find the ingredients or conceal them with fancy wording.

AnnieB3 12-19-2009 07:06 PM

Here you go, Nicky.

http://www.iherb.com/Twinlab-Dr-Gree...lets/8583?at=0

And "super foods" section:

http://www.iherb.com/Superfoods

Have you ever tried using iherb as a source? Mrs. D. knows quite a bit about brands, etc. there. This is only one brand and one type of calcium. I have shopped at this site for ten years. Absolutely no problems. And their prices are much cheaper than in stores.

Annie


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