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Which type of magnesium do you take?

  • By emicrania

    I need to ask my headache specialist, but in the meantime wonder what type of magnesium you take. Do you take:

    1. Magnesium oxide (I currently use this type at my pharmacist’s direction)
    2. Magnesium citrate
    3. Magnesium glycinate

    Thanks.

    Emily

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  • By Ellen Schnakenberg

    Hi Emily,

    The thing about magnesium, is that it must be absorbed in a very small portion of our intestinal tract. When our Migraines are bad, sometimes this isn’t very efficient. Sometimes the best way to take magnesium is actually through our skin!

    The type of oral mag I have found easiest for me to absorb, is dissolvable in water and easy to take by drinking. It’s called Calm and is a combination of citrate and Mag carbonate. When hot water is added, mag citrate is produced, and that is what ends up in my stomach and hopefully my whole body. I didn’t personally do well on Mag oxide. Perhaps because they were in pill form?

    ~Ellen

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  • By emicrania

    Thanks, Emily. I’ve never heard of that, but it most certainly makes sense. I’ve noticed zero benefit on magnesium oxide and thought I’d see at least some improvement. My mag oxide and tablet form of administration could very well be the reason why. Also, my mag oxide tablets almost choke me each time I take them. Thanks so much for the info. I’m going to look for Calm and mag citrate.

    I have a related question I always forget to ask my neuro: If people with chronic migraines are often found to be deficient in (or do not absorb well) certain vitamins and minerals, could a blood test check for vitamin deficiencies?

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    • By emicrania

      I can see why blood tests may not be entirely useful in determining all nutritional deficiencies. I asked to have my vtamin D blood levels checked a few years ago, was found to be very deficient, and needed to supplement at high dose under my doctor’s close supervision with updated blood testing. I still continue to have it routinely checked and, due to the importance of vitamin D, always recommend my friends ask their doctors to include a test for vitamin D when blood is drawn.

      Regarding magnesium and migraines, below is an article that alleges magnesium levels are not accurately tested through a blood sample.

      http://www.ncbi.nlm.nih.gov/pubmed/22426836

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  • By Ellen Schnakenberg

    emicrania

    Yes, I encourage patients to rule out vitamin deficiencies by having them checked. Vitamin imbalances quite often interact with our Migraines and other medical conditions. Not all vitamins nor their tests are created equally however. Each vitamin must be separately tested. Thanks to bariatric surgery, labs are getting better about testing vitamins and how carefully it must be done for accurate measures, however there are still a lot of people out there getting inacurate results. This is one place where being a knowledgeable patient is really important.

    For example, B12 is actually tested with 3 different tests, and the results of the B12 test itself in the US won’t be flagged until well after the point at which neurological damage (often permanent) has occurred. Here is some important info on B12 testing:

    What Can I Expect From B12 Testing? Part 1 https://migraine.com/blog/what-can-i-expect-from-b12-testing-part-1/

    What Can I Expect From B12 Testing? Part 2 https://migraine.com/blog/what-can-i-expect-from-b12-testing-part-2/

    Magnesium blood levels are not equal to tissue levels, and often the best test for deficiency is to do weekly, then monthly mag infusions (IV) for 6 months or so. This gets the levels higher in your body than you can orally.

    Folic acid levels can be messed up by a single meal. The levels in your blood are reflective of the last meal or two you have eaten and do not reflect tissue levels. Because taking folic acid can do some bad things (including cover up B12 deficiency as well as cause “headache”) it’s not recommended to just go ahead and take it.

    Calcium levels reflect what your parathyroid glands are doing, not what you’re eating. Correct calcium levels will also require a parathyroid hormone (PTH) test to be accurate.

    Many vitamins are toxic when taken in excess, which is why I always tell patients to be tested before just arbitrarily taking them. Many of them in excess, can cause/trigger “headache” which can include Migraine and intracranial hypertension (often caused by large doses of vitamin D).

    Obviously it’s always the best to get your vitamins from the food you eat. Ideally we would all be able to absorb what we need that way. However, when our guts aren’t working properly, as they tend to do when we’ve had Migraine for a while, take medication for reflux, as well as the results of some other diseases, this just doesn’t work. So, testing and supplementing accordingly can be an important part of Migraine management for many of us.

    I now do something called IV Micronutrient Therapy (IVMT) and have written about it here:

    Migraine Treatment: Intravenous Micronutrient Therapy (IVMT)https://migraine.com/blog/migraine-treatment-intravenous-micronutrient-therapy-ivmt/

    I am also a person who did the “impossible” by becoming low in biotin levels. Eating raw eggs can cause this, however I am not a raw egg person. We found the deficiency, but I had to put up my dukes to get it done as the doc didn’t think there was any way I could be deficient in anything because I “Look too good.” It took about two years of supplementation to get me back up, but in the meantime we learned the important part of HOW the tests are drawn in the lab. This particular test needs to be protected from light, and my first results had notes attached stating the results weren’t reliable because they didn’t properly protect them from light. The doc missed these notes, so it was a good thing I was getting copies of all my own lab results – the originals straight from the lab. Phone calls were made and protocols adjusted, and from that point we were good. Until that is, we switched labs. I informed them of the procedure to protect the sample from light, to no avail. An argument ensued, and they were very embarrassed when they had to call me in 3 additional times that same day to re-draw the specimen because they’d done it wrong. Had they just listened to me, we’d have been fine. Come to find out, they told me Quest labs had it wrong in their instructions, so we got the main Quest lab to make those changes as well. What an ordeal! But, it shows the importance of getting your own copies of results, and being educated about how things are supposed to be done. I’m just one little person, but because I pushed, people sending samples for Biotin tests to that lab are now getting them done properly.

    A great site for information on vitamins is the top research facility in the US and arguably the world. You can find it here:

    Linus Pauling Institute at OHSU in Oregon http://lpi.oregonstate.edu/infocenter/vitamins.html

    Another great place for information is Consumer Labs which tests supplements to be sure they’re as potent as promised, and don’t contain unhealthy things that could hurt you. They have lots of good information and will tell you which brands didn’t have what they promised. You can find them here: http://www.consumerlab.com/

    Hope this has been helpful 🙂

    ~Ellen

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  • By emicrania

    I appreciate your observation regarding naturopathic medicine’s limited role in this highly advanced and specific field of migraine disease. I have never visited a naturopath in my life and none of my medical team have ever recommended I see a naturopath.

    On my upcoming visit with my neuro/headache specialist, I’m going to voice my specific concerns. This large clinic and hospital is very highly esteemed, and I’m fortunate to be seen at our headache clinic by one of the best headache specialists in the nation. The headache clinic has always been very agreeable at working with me on a very personal level and works in tandem with my GP at the same hospital whenever warranted (and vice versa).

    As for the labs, I’ll educate myself to the best of my ability in advance.

    Thank you!

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    • By Ellen Schnakenberg

      emicrania,

      When you hit the reply button for that particular comment, the reply will post directly below it. This makes it appear to be out of order, but really it makes the comment fall directly under what you’re commenting about! Hope that makes sense 🙂

      You’re doing it right, so just keep on…

      ~Ellen

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  • By emicrania

    Hi Ellen,

    I can’t thank you enough for this invaluable information on testing for nutritional deficiencies, proper testing protocols, etc. Your reply is a definite keeper … and one I’ll re-read a few times and refer back to often.

    Now, the naive question. If one goes to a reputable naturopathic college that also provides medical services by experienced naturopaths, is the testing protocol (generally speaking) more reliable? I ask this because otherwise it would seem I need to know way too much about an array of testing protocols in order to pursue this wisely … and that’s in addition to the wealth of information you provided. I’m currently seen by MDs and a neuro/headache specialist at a very large, highly reputable hospital, but I’m assuming they have complete faith in their large in-house testing. I’m thinking of adding in naturopathic medicine, but that would be at my expense with no insurance coverage.

    Thanks for your continued help! 🙂

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  • By Ellen Schnakenberg

    emicrania

    I think the thing that bothers me most about your proposal is just that most naturopathic physicians have little knowledge about Migraine and may end up causing you problems. If you see one, I would suggest doing it in concert with seeing a Migraine and headache specialist. The two can often work together synergystically to really be a huge, and unique benefit to your health.

    The lab who is drawing your blood is really where the magic happens re: how the test is done. Nearly all these tests are sent out, not done in-house. It takes specific equipment to do them that almost no in-house labs are going to have available to them. When I had new testing done that I wasn’t familiar with, I looked it up, but I also asked the lab techs for a copy of the protocol of how the test was to be prepared. Then, sometimes I could get away with asking to watch them prepare it (to be sure it is done right. The prevention from light is the biggest one they tend to ignore for several minutes or hours, and can really mess up a test in just seconds) Knowing ahead of time what tube is to be used and exactly what is to be done can be really helpful in knowing that the results you got back were good. Sometimes playing naive’ and asking a ton of questions will tell you a lot that you need to know, and give you a good idea if the tech doing the work has a clue.

    Naturopaths are often pretty good at checking vitamin levels etc because they concentrate on this more than the average PCP. Now that bariatric surgery is so prevalent, these tests are much more well-known though, and you might try getting your testing done where a bariatric clinic is popular. After bariatric surgery, patients must have these tests done regularly, because the part of the digestive system that absorbs most vitamins is nearly eliminated during the surgery. Without the testing and significant supplementation, the patient will often die.

    I’m not sure if that was the answer you were looking for, so let me know if you have further questions 🙂

    ~Ellen

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  • By emicrania

    Hi Ellen,

    My reply is you is above dated January 13. It appears I posted it out of order. Let’s see if this works! Oh, my migraine brain today is not behaving. 😉

    My headache clinic and hospital have a very extensive and sophisticated in-house laboratory at my location. I’ve never seen a lab test outsourced, although one highly specific test I had performed was sent to the clinic’s main campus in another part of the country. Luckily, all lab and medical records are available to me online. If I need more detail, I’ll have to consult my migraine specialist or in-house laboratory.

    Thanks again.

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  • By Ellen Schnakenberg

    emicrania,

    There are two ways for you to get results from your lab work. One is directly from the lab that did the testing, and the other is via the hospital or office that received the results. Both will look official, but the correct one that you want to be sure you’re getting and keeping, are the original test results that come from the place of testing.

    I’m not saying that your lab isn’t capable of these tests, but I can’t think of any off-hand that would be able to do all the tests you likely need if you’re testing for all vitamin and mineral needs, as well as depletions etc. The way to know the answer is to just be sure and ask for and confirm that you’re receiving coies of the original labwork. Because all online programs are different, I have no idea if you’re getting originals or a compilation with their hospital/office name attached to it. You’ll have to ask.

    As to learning more about the testing methods, this is most easily done when the blood work is being drawn. The people drawing your blood have an online source and/or book where they look up the instructions for preparing the sample. They’ll have to do that before drawing your blood. Simply ask them for a copy of it. When you get home, then look it up to be sure it was kept current so you are getting valid answers. It’s really not that difficult, just sad that we have to do this to be sure we’re getting the answers we really need. *sigh*

    Hope that helps 🙂

    ~Ellen

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