G3.6.1.8: If magnesium deficiency is cause of a diabetic patient’s pain, why give opioids instead?

Evidence based clinical research from 2009 could have helped save many lives lost to the opioid epidemic if patients were being told and treated with the discovery. (G3.101) Patients with diabetes and chronic pain often don’t experience much if any relief from the use of opioid medications, however that is the standard pain medication that is provided for chronic pain so it is often prescribed to diabetic patients anyway, just a prescription pad after all not a patient (not true). The research study provided magnesium to the diabetic patients as a pretreatment before providing the opioid or along with an IV drip of the medication, and not only was the pain reduced for patients who received magnesium, but the pain level was reduced for several days for the fortunate patients. And some trials of the experimental treatment didn’t provide the opioid medication and yet pain relief was felt by the diabetic patients.

Well that is exciting and it leads me to say – why even bother giving an opioid medication then, if it won’t help to relieve pain that is actually being caused by a magnesium deficiency? Because there is profit to be made by prescribing opioid medications but there isn’t profit to be made writing a magnesium prescription? Pondering is a waste of time for someone in pain.

The research discussion seemed to focus on using 30 mg of magnesium with IVs of morphine or other opioid medication for better pain control, but didn’t address or stress the fact that the 300 mg dose of magnesium had reduced pain levels for patients on its own, without any opioid medication having been given along with the nutrient. Pain control without needing an addictive drug that can cause death if overdosed?

Common sense can be inexpensive – consider the benefits of resolving a problem instead of treating symptoms and ignoring the underlying cause. (Magnesium can also be deadly in overdoses, but that really isn’t as common a cause of death as opioid overdoses.)

  • Read more: Magnesium ions and opioid agonists in vincristine-induced neuropathy, (G3.101).
  • A more recent study found a significant difference between magnesium levels between the patients with diabetes and the control group. Significantly lower levels of magnesium were also noted in association with insulin resistance factors although not with fasting blood sugar levels. Read more: Association of Serum Magnesium Deficiency with Insulin Resistance in Type 2 Diabetes Mellitus, (G3.122)

Trying to replace a natural function with a patented medication is using patient’s pain for the purposes of profit.

Calcium channel blocker medications (PPIs for example) are trying to close the gates and keep the calcium out – and magnesium would be delighted to do that as nature intended if enough of the mineral were being absorbed from the intestines. However many issues with our modern food supply and the contaminants it may contain, may be leading to poor absorption of magnesium and increased loss of magnesium by the kidneys, (too much active hormone D3 can cause increased calcium absorption and loss of magnesium). Note the frequent use of the word “may” – more research is needed, in the meantime an Epsom salt bath or foot soak or use of a topical magnesium chloride product could bypass poor intestinal absorption problems. The magnesium sulfate used in Epsom salt would also provide sulfate which may also be beneficial due to possible contaminants in our modern food supply.

Talking about doing things “traditionally” is nice but our children are not growing up in the same chemical environment that we did, and we didn’t get to experience the food supply that our grandparents enjoyed.

Calcium channel blocker medications make a large profit for the pharmaceutical company – magnesium cannot be patented.

Now that it is clear that emotions and environmental triggers can cause inflammation, which at the same time is a cause of feeling “pain,” it is easy to see why childhood trauma or severe traumatic experiences or ongoing trauma can lead to developing inflammatory conditions such as inflammatory bowel conditions or fibromyalgia and migraine pain. The next section moves into psychological conditions that can be due to emotional trauma but may cause physical symptoms as well as mental symptoms.

See a healthcare provider for medical advice, diagnosis or treatment.

  • 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.

The Academy of Nutrition and Dietetics has a service for locating a nutrition counselor near you at the website eatright.org: (eatright.org/find-an-expert)

References:

Only one? – yes, it is an important one:

I found a more recent one that supports the premise that insulin resistance and Type 2 Diabetes may involve an underlying deficiency of magnesium.

G3.6: Antihistamines may help if there is a genetic tendency to overproduce histamine.

Genetic differences in more than 70 genes have been associated with increased itchiness, see summary at the end of this section. (G3.24) Calcium and serotonin levels may be involved in increased itch or arthritis pain signals being sent or perceived. (G3.25) Scratching an itch is considered rude and a chronic itch is often considered funny however it isn’t fun.

Some background information:

Too much or too little calcium and magnesium can affect pain, itching, and mood. The minerals are both electrically active, and provide energy for ion channels which control the transport of messenger chemicals like serotonin across cell membranes – such as nerve cell membranes which might feel like a sensation of itchiness or pain.     

Excess serotonin may be involved, (G3.26, G3.27), and scratching an itch can make the urge to scratch more intense, even worse afterwards, even though there may be a temporary feeling of relief while scratching. (G3.28) Adequate magnesium is essential for reducing pain in arthritis or at least may help reduce pain levels. (G3.27) An antihistamine may help for some types of itching related to genetic conditions. (G3.29)

Excess dopamine levels can also be a cause of an overwhelming urge to scratch – see “grooming behavior” in section 7. When to Report?. The solution there is to figure out why dopamine levels are that elevated. Elevated dopamine can be a symptom of hyperthyroidism but it can also be associated with other conditions.

  • An Itch You Just Can’t Scratch; NIH-funded study identifies proteins that may cause chronic itch. Summary points: The HTR7 gene was found most closely associated with chronic itch in an animal based study, however over 70 genes were found to be more expressed, more active in lab animals with chronic itch. The gene expression of the HTR7 gene was most active in the mice with the worst symptoms of scratching compared to the mice with the least sensitivity. The activity of the TRP1 receptor was also increased in animals with more symptoms. (G.24)
  • Transient receptor potential ankyrin 1 (TRPA1) receptor is involved in chronic arthritis: in vivo study using TRPA1-deficient mice. Summary points: The TRPA1 receptor is directly activated by calcium levels inside of the cell, and a variety of toxins or “noxious” (irritating) substances that are produced as a normal part of “oxidative stress” otherwise known as “inflammation” including, “4-hydroxy-2-nonenal, hydrogen peroxide, hypochloride, hydrogen sulphide, 15-delta prostaglandin J2 [2528].” and irritants from the environment or diet can also activate the TRPA1 receptor, *1.mustard oil (allyl isothiocyanate: AITC) [29], *2. cinnamaldehyde [30, 31], *3. allicin [32, 33] and *4. formalin [34]…”. (G3.25) Serotonin and other “Inflammatory mediators, such as bradykinin…[19, 35]” (G3.25) can make the receptors more sensitive which can lead to increased responsiveness of nerve endings – more pain (G3.25) or itch. (G3.24) *See the next section for more information about the chemicals in bold font and where they may be found in the diet or environment.

*People with overactive TRPA1 channels may be sensitive to:

  1. Mustard:  “mustard oil”
  2. Cinnamon:  “cinnamaldehyde'” (G3.43) );
  3. Onion or Garlic:allicin,” (G3.41)
  4. Formaldehyde:formalin,” chemically the two are very similar: (G3.42) and formaldehyde is found in the environmental and as a metabolite of some alternative sweeteners and other dietary sources. (G3.56) Environmental sources include which would include first and second hand smoke, poorly ventilated air or smog, especially when there is brand new flooring or other new plastic or vinyl  material in the living area, it  can release volatile chemicals including formaldehyde at levels that can make a sensitive person feel ill. Metabolites of the breakdown of the alternative sweetener aspartame and Neotame include menthol and formaldehyde. (G3.44) Older packages of fruit juice also may contain increasing amounts of formaldehyde as the product ages, more of the chemical is produced from other chemicals.

Magnesium, Opioids, and Neuropathic Pain.

This list and this section got much longer actually, and eventually led me back to a topic I’ve written about in 2011, and which is one of the underlying causes of overactive TRP channels. Fortunately it also has a simple solution, (G3.101), but – unfortunately – it is so simple a solution that it isn’t profitable – unfortunately for individual patient’s health and quality of life and unfortunately for the economic health of individuals and nations and businesses who are being overcharged by the medical industry for healthcare that isn’t always effective and sometimes causes harm.

It is so effective a solution for improving mood and pain and muscle cramp type symptoms that I’ve been sharing the information online since at least 2011 and the article I shared was research from 2009, (G3.101), – so the clock is ticking on how soon the evidence based medical research will reach the individual patient who is in pain. The racers at the starting line are the physicians and nurse practitioners and other health professionals who make recommendations for opioid medications in an attempt to block pain instead of trying to find and resolve the cause of the pain.

What is a nerve signal? “Pain” or “no pain”? or “on” and “off”?
Pain, however, should not just be blocked without trying to understand the cause. It is a message from the body desperately asking for help but it is not always a clear message. Pain in one area of the body may have to do with an issue in another area of the body. Instead of blocking the pain signals we need to listen to them more carefully and try to figure out what the pain signals mean and how to resolve the underlying cause of the pain. Something might be missing and need to be added back into the diet or something might be happening in excess either in the diet or lifestyle habits and need to be stopped or moderated.

Nerve signals are not specific to send the brain a message of “pain” that exclusively means “pain;” a nerve signal is more of an “on” or “off” and might indicate a variety of extremes: too hot or too cold, or too rough or too light (ticklish), or too hot peppery, (capsaicin, (G3.100), more on that later), or too mustard oily. The nerve signal is simply telling the brain that “something” happened – figure it out captain of the ship – and fix it – such as remembering to wear gardening gloves before handling wild mustard weeds, especially if you have diabetic hypersensitivity.

The TRP channels are the bridge between the world and the nerve signal. There are many types and they can respond to specific temperatures, so some might activate when it is very cold and some might activate when it is very hot. Some might react to the hot pepper and some might react to the mustard oil. They would all tell the same nerve – “something” extreme happened.

Mustard oil can cause an extremely itchy reaction. It is used to induce “hypersensitivity” in lab animals to study the condition in relation to diabetic hypersensitivity. This will be discussed in the next section in more detail. (G3.96) Wearing gloves may be advisable when pulling a patch of wild mustard if you tend to have sensitive skin or allergic reactions.  (p124, G3.97)

Antihistamines taken daily can be helpful if excess histidine is a problem.

Antihistamines taken as a daily precaution may be helpful for people with overly sensitive skin if the sensitivity is related to a tendency to overproduce histidine. (G3.29) If that is an issue, then taking an antihistamine medication daily may also help for some types of chronic pain as well, more will be included in the next section. Acupuncture is a traditional therapy that may help reduce the overactivity of TRPV channels and reduce the production of the inflammatory peptide Substance P and other cytokines. Acupuncture can affect both the opioid and the cannabinoid receptors – but without needing the prescription or having to experience the side effects! (G3.104)

See a healthcare provider for medical advice, diagnosis or treatment.

  • 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.

The Academy of Nutrition and Dietetics has a service for locating a nutrition counselor near you at the website eatright.org: (eatright.org/find-an-expert)

References:

G3.5: Negative stress chemicals may cause symptoms like itching, migraines, pain or IBS.

Our bodies don’t have specific receptors just for sensing “pain.” Pain is a sign that something is wrong in the body and is sensed in a variety of ways. In medical terminology there are two main types of “pain.”

  • Nociceptive pain is associated with physical damage to the body or by sensations of pressure or heat or extreme cold. It might be due to pressure from a cancer tumor. Nociceptive pain might be described as “sharp, aching or throbbing.”
  • Neuropathic pain is caused by physical damage or pressure on nerves. It might also be due to a cancer tumor but one that is pressing on a nerve. Nerve damage can also be due to some nutrient deficiencies such as vitamin B12,  (G3.13), or other “Nutritional imbalance, alcoholism, toxins, infections or auto-immunity.” Neuropathic pain often is described as “a burning or heavy sensation, or numbness along the path of the affected nerve.” (G3.14)

Some types of pain such as migraine headaches may involve both nociceptive pain due to the pressure of inflammation or dilation of blood vessels an neuropathic pain from pressure on nerves by dilated or inflamed blood vessels.

    The next part gets complicated, some background information:

  • Calcitonin is a hormone released by the thyroid that promotes lower blood calcium levels by reducing bone resorption, (G3.15) (Bone resorption: breakdown of the bone and release of minerals, (G3.16)).
  • Calcitonin Gene-Related Peptide 1 and 2 (CGRP 1: (G3.17) and CGRP 2: (G3.18)) cause dilation of blood vessels in the heart and brain and throughout the body. Its prevalence in the Central Nervous System (CNS) also suggests that it may also have a neurotransmitter or neuromodulator role.

CGRP is produced by nerve cells in the brain and throughout the body. The protein has a role in sensations of pain. It is a member of the calcitonin family of proteins and exerts its effects at receptors that are formed from two other types of receptors.

The CGRP protein has two commonly found forms, one helps reduce pain and one helps increase it – luck of the draw. The alpha form of the protein may help reduce pain while the beta form is associated with migraine, temporomandibular joint (TMJ) pain, psoriasis and irritable bowel syndrome (IBS). The beta form is largely produced in keratinocytes found in the epidermis layer of skin. The alpha form is the type produced more within sensory nerves. (G3.19) (Psoriasis is an eczema-like condition believed to be autoimmune in nature.)

After a physical injury like a bump on the shin, inflammation causes an increased output of the Calcitonin Gene-Related Peptide (CGRP) and an inflammatory protein that is called Substance P, possibly for peptide, which is another word for protein. The release of the peptides follows shortly after an inflammatory event and shortly the chemicals are released there is  edema and plasma leakage in the surrounding area. (G3.20) The inflammatory peptides are also released in increased amounts during migraine headaches. (G3.21) The peptides increase the dilation of blood vessels and cause increased leakage from blood vessels (edema) and “degranulation of mast cells.” (G3.19) (G3.21)

Levels of CGRP increase in people who suffer from migraines and a type of prescription medication, called sumatriptan, which has been found helpful to stop migraine pain, has also been found to inhibit the release of CGRP in migraine patients. The medication may be inhibiting the release of CGRP by increasing intracellular levels of calcium. The “cytokine TNF-α” may be involved in migraine pain. (G3.21)

That was the background – the bottom line – magnesium deficiency can make the body more susceptible to the negative effects of CGRP, Substance P and chronic stress. And a chronic stress situation combined with chronic magnesium deficiency may lead to the development of inflammatory conditions like migraines, fibromyalgia, PTSD, or Irritable Bowel Syndrome. The magnesium deficiency associated with the inflammatory peptides CRGP and Substance P may be causing an increase in the level of the cytokine TNF as early as two days after a deficient diet was begun in a research study with lab animals. (G3.22)

So an Epsom salt bath or foot soak may relieve itch by providing the body with a form of magnesium that can be absorbed through the skin bypassing any GI problems that might underlie a chronic magnesium deficiency. It isn’t uncommon to have a diet low in magnesium but it is also not uncommon in the food supply. Problems with poor absorption or increased kidney or bowel loss are common causes of chronic magnesium deficiency.

A variety of tips for reducing Substance P levels are included in the article Trichodynia, Pain, and Substance P. Exercise, hobbies that use repetitive motions of the hands such as knitting, and stretching exercises may help reduce excess levels of the inflammatory chemical according to the article on the website drwardbond.com, see the article for more details: (G3.23)

See a healthcare provider for medical advice, diagnosis or treatment.

  • 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.

The Academy of Nutrition and Dietetics has a service for locating a nutrition counselor near you at the website eatright.org: (eatright.org/find-an-expert)

References: