Article for those interested in insulin resistance

I thought this was interesting especially because magnesium was I believe often low in those with cirrhosis also.  Magnesium is also cheap which I always appreciate. I don't think I have heard any downside to supplementing magnesium by the label instructions but maybe someone else knows something I don't.  I have given it to Joe on and off.  Maybe we should stay on?



Magnesium Needed to Help Correct Insulin Resistance
Monday, October 25, 2010 - Byron Richards, CCN
    
Health Newsletter Details
Magnesium deficiency is pervasive in America. And so is type 2 diabetes.  I recently reported on this in an article titled Magnesium Intake Linked to Diabetes Risk.  Several more studies add further emphasis to the importance of magnesium in maintaining proper blood sugar health.

The first study evaluated magnesium levels in men and women ages 60 – 90 with the metabolic syndrome.  Those with metabolic syndrome had lower magnesium levels than those not having the problem.  In particular, magnesium affected blood sugar levels and insulin resistance.

Another recent study showed that taking 600 mg of magnesium per day significantly improved blood sugar metabolism as well as triglycerides and cholesterol.

[Bali05]

Ev,
Since muscle is what uses up glucose I would focus on building new muscle
more than any cardio excersise because that only burns energy while you do it
whereas muscle will burn glucose much more gradual and a lot longer
over time.
It must be very challenging when your Dr. tells you not to lift more than 10lbs because
of varcises. But even light weight training if done daily will increase muscle mass
and if combined with a low glycemic diet will definately bring down blood sugar.
If I go with a smaller weight I do more repetitions.
A great piece of inexpensive excersise equipment is the fitness ball or gym ball.
I use it daily.

Being on tx I am very anemic and pushing any weights requires longer breaks
in between but I keep doing it because it is very important in my view.
If it is to keep insulin down because it cancels out INF or just to stay in shape.
There will be life after tx and no matter what the outcome I prefer to be as physically
in shape as much as I reasonably can.

:-)

[Cory255]

Wonder how much Magnesium you would need to take to get that benefit?  Multivitamins w/ no iron of course have all those minerals like zinc, selenium, magnesium. etc.  

[evangelin]

The article mentions 600 mg in the bottom line.  I don't have a copy of the studies it talks about.  I guess you would want to subtract the amt. from your multi but I haven't had time to read up on magnesium doses and safety yet.  I've read this before but my brain is a leaky seive.  Right now ,I have my 7 year old talking me to death and I can hardly have a completed thought.  I will try to check later unless someone else beats me to it.
Ev

[Cory255]

Oh I see.  600 mg.  I can't hear myself think today.

[Bali05]

I came across this article:

Researchers Discover Hepatitis C Causes Insulin Resistance in Muscle
09 March 2010

We have known for several years that Hepatitis C, a common cause of liver cirrhosis and cancer, also makes people three to four times more likely to develop Type 2 diabetes.

In studying the insulin resistance of 29 people with Hepatitis C, Australian researchers have confirmed that they have high insulin resistance, a precursor to diabetes. However, almost all insulin resistance was in muscle, with little or none in the liver, a very surprising finding given that Hepatitis C is a liver disease.

Insulin, a hormone made by the pancreas, helps the body use glucose for energy. The two most important organs that respond to insulin are the liver and muscle. A healthy liver responds to insulin by not producing glucose, while healthy muscle responds by using glucose. An insulin resistant liver produces unwanted glucose, while insulin resistant muscle cannot absorb it from the bloodstream, leading to high levels of sugar in the blood.

"Contrary to all expectations, not only did we find no significant insulin resistance in the liver of the patients in the study, half of them suffered from a strain of Hepatitis C that causes about three times the normal level of fat to accumulate in the liver," said study author Professor Don Chisholm.

"The fifteen people with very high levels of fat in the liver had the same degree of insulin resistance as the fourteen that didn't have fatty livers."

"A number of important investigators around the world have been arguing that fat in the liver is an extremely important determinant of insulin resistance, perhaps the most important. At least in this context, we've shown that not to be the case."

"Before you get Type 2 diabetes, you must become insulin resistant and your insulin producing cells must also fail to compensate. Insulin resistance alone will not give you diabetes."

"In our study, we gave intravenous glucose, a specific stimulus to insulin secretion, and showed that insulin secretion was not impaired in Hepatitis C patients compared to our control group."

"This finding tells us that people with Hepatitis C who develop diabetes probably have susceptible insulin-producing cells, and would probably get it anyway – but much later in life. The extra insulin resistance caused by Hepatitis C apparently brings on diabetes at 35 or 40, instead of 65 or 70."

"More work now needs to be done into why Hepatitis C causes insulin resistance in muscle. That will give us better insight into the behavior of the disease."

"At this stage, it is helpful for people with Hepatitis C to understand insulin resistance and what it can mean for them. If they have relatives with Type 2 diabetes, they will be genetically prone to developing it themselves and so would be advised to manage their diets very carefully and take plenty of exercise – to slow onset."

[evangelin]

Thanks for bringing this up.  I know Joe's first and only biopsy showing cirrhosis, did not show a fatty liver.  I remember the PA brought this up when I was arguing for Metformin before starting TX.  She said, "No way" and I then took my studies to Joe's regular MD and he gave it to him.  Well, none of it worked in the end but I think the PA would be more agreeable to test him for insulin resistance now.  After many months on TX, I mentioned to his PA that he was on Metformin and apparently without remembering our earlie conversation, she said, "Oh good."  In a matter of a few months enough research had emerged to change her stance.  If there is a next time, we would have to consider predosing before starting.  He was quite a few weeks into it before he got the Metformin. I wish we could get cowriter to comment on this and what all it could end up meaning. So far Joe doesn't have diabetes but his blood sugars are a bit higher than they should be.  We should be taking them now and then but have been somewhat ignoring it for now.  

[evangelin]

I copied this from the University of Maryland.  It looks like taking too much might be a bad idea if you have kidney problems.  Well , here is what they see as a safe dose  and some possible drug interactions:

Adult

•Adolescent and adult males: 270 - 400 mg daily
•Adolescent and adult females: 280 - 300 mg daily
•Pregnant females: 320 mg daily
•Breastfeeding females: 340 - 335 mg daily
A person' s need for magnesium increases during pregnancy, recovery from surgery and illnesses, and athletic training.

Precautions:
Because of the potential for side effects and interactions with medications, dietary supplements should be taken only under the supervision of a knowledgeable health care provider.

People with heart or kidney disease should not take magnesium supplements except under their doctor's supervision.

It is very rare to overdose on magnesium from food. However, people who ingest large amounts of milk of magnesia (as a laxative or antacid) or epsom salts (as a laxative or tonic) may overdose, especially if they have kidney problems. Too much magnesium can cause serious health problems, including nausea, vomiting, severely lowered blood pressure, slowed heart rate, deficiencies of other minerals, confusion, coma, and even death.

More common side effects from magnesium include upset stomach and diarrhea.

Magnesium competes with calcium for absorption and can cause a calcium deficiency if calcium levels are already low. Some medications may lower magnesium levels in the body. These include chemotherapy drugs, diuretics, digoxin (Lanoxin), hormonal supplementation, steroids, and certain antibiotics.

Possible Interactions:
If you are currently being treated with any of the following medications, you should not use magnesium without first talking to your health care provider.

Antibiotics -- Taking magnesium supplements may reduce the absorption of quinolone antibiotics, tetracycline antibiotics, and nitrofurantoin (Macrodandin). Magnesium should be taken 1 hour before or 2 hours after taking these medications. Quinolone and tetracycline antibiotics include:

•Ciprofloxacin (Cipro)
•Moxifloxacin (Avelox)
•Tetracycline (Sumycin)
•Doxycycline (Vibramycin)
•Minocycline (Minocin)
Blood Pressure Medications, Calcium Channel Blockers -- Magnesium may increase the risk of negative side effects (such as dizziness, nausea, and fluid retention) from calcium channel blockers (particularly nifedipine or Procardia) in pregnant women. Other calcium channel blockers include:

•Aamlodipine (Norvasc)
•Diltiazem (Cardizem)
•Felodipine (Plendil)
•Verapamil (Calan)
Medications for diabetes -- Magnesium hydroxide, commonly found in antacids such as Alternagel, may increase the absorption of some medications used to control blood sugar levels (particularly glipizide or Glucatrol and glyburide or Micronase). If you take these medications to control blood sugar, your doctor may need to adjust your dose.

Digoxin (Lanoxin) -- Low blood levels of magnesium can increase negative effects from digoxin, including heart palpitations and nausea. In addition, digoxin can cause more magnesium to be lost in the urine. A doctor will monitor magnesium levels in people taking digoxin to see whether they need a magnesium supplement.

Diuretics -- Two types of diuretics known as loop (such as furosemide or Lasix) and thiazide (including hydrochlorothiazide) diuretics can lower magnesium levels. For this reason, doctors who prescribe diuretics may recommend magnesium supplements as well.

Hormone Replacement Therapy -- Magnesium levels tend to decrease during menopause. Clinical studies suggest, however, that hormone replacement therapy may help prevent the loss of this mineral. Postmenopausal women or those taking hormone replacement therapy should talk with a health care provider about the risks and benefits of magnesium supplementation.

Levothyroxine -- There have been case reports of magnesium-containing antacids reducing the effectiveness of levothyroxine, a medication that treats underactive thyroid.

Penicillamine -- Penicillamine, a medication used to treat Wilson's disease (a condition characterized by high levels of copper in the body) and rheumatoid arthritis, can inactivate magnesium, particularly when high doses of the drug are used over a long period of time. Supplementation with magnesium and other nutrients may reduce side effects associated with penicillamine. If you take penicillamine, a health care provider can determine whether magnesium supplements are right for you.

Tiludronate (Skelid) and Alendronate (Fosamax) -- Magnesium may interfere with absorption of medications used in osteoporosis, including alendronate (Fosamax). Magnesium or antacids containing magnesium should be taken 1 hour before or 2 hours after taking these medications.

Others -- Aminoglycoside antibiotics (such as gentamicin and tobramycin), thiazide diuretics (such as hydrochlorothiazide), loop diuretics (such as furosemide and bumetanide), amphotericin B, corticosteroids (prednisone or Deltasone), antacids, and insulin may lower magnesium levels. Please refer to the depletions monographs on some of these medications for more information

[Cory255]

                                          Are there safety concerns?
      Magnesium is LIKELY SAFE for most people when taken by mouth or when the prescription-only, injectable product is used correctly.  In some people, magnesium might cause stomach upset, nausea, vomiting, diarrhea, and other side effects.

       Doses less than 350 mg per day are safe for most adults. When taken in very large amounts, magnesium is POSSIBLY UNSAFE. Large doses might cause too much magnesium to build up in the body, causing serious side effects including an irregular heartbeat, low blood pressure, confusion, slowed breathing, coma, and death.

                                  Special Precautions & Warnings:
Pregnancy and breast-feeding: Magnesium is LIKELY SAFE for pregnant or breast-feeding women when taken by mouth in the amounts recommended. These amounts depend on the age of the woman. Check with your healthcare provider to find out what amounts are right for you.

Heart block: High doses of magnesium (typically delivered by IV) should not be given to people with heart block.

Kidney problems, such as kidney failure: Kidneys that don’t work well have trouble clearing magnesium from the body. Taking extra magnesium can cause magnesium to build up to dangerous levels. Don’t take magnesium if you have kidney problems.

[Bali05]

Ev,
Since muscle is what uses up glucose I would focus on building new muscle
more than any cardio excersise because that only burns energy while you do it
whereas muscle will burn glucose much more gradual and a lot longer
over time.
It must be very challenging when your Dr. tells you not to lift more than 10lbs because
of varcises. But even light weight training if done daily will increase muscle mass
and if combined with a low glycemic diet will definately bring down blood sugar.
If I go with a smaller weight I do more repetitions.
A great piece of inexpensive excersise equipment is the fitness ball or gym ball.
I use it daily.

Being on tx I am very anemic and pushing any weights requires longer breaks
in between but I keep doing it because it is very important in my view.
If it is to keep insulin down because it cancels out INF or just to stay in shape.
There will be life after tx and no matter what the outcome I prefer to be as physically
in shape as much as I reasonably can.

:-)