Q&A 4/19/22 Arthritis and TCM and What’s the Best Form of Magnesium to Take?

Podcast Highlights:

02:30:05 What is TCM’s model of care for arthritis and what is causing the imbalance? And can it be reversed? What would be a combined treatment using functional medicine and TCM involved?

33:38:29 What’s the best form of magnesium to take?

Full video of webinar:

Podcast Highlights:

02:30:05 What is TCM’s model of care for arthritis and what is causing the imbalance? And can it be reversed? What would be a combined treatment using functional medicine and TCM involved?

33:38:29 What’s the best form of magnesium to take?

Transcript from Webinar:

John: Howdy everybody!

Whenever I watch these things, it always says, Be sure to press the subscribe button at the bottom, but we don’t have a subscribe button, so I’ll spare you that. But I do want to thank you for tuning in. The group is getting larger every time we’re on, and I’m getting more and more great questions. Really, really great questions and keep them coming. And again, the ones I’m going to talk about today, I got today, but I was able to throw together some, you know, PowerPoints because that’s what I do all day is talk about this stuff.

But if you have a burning question, try to get to me a little earlier. I have a couple that we got that I won’t be able to get to that are really, really good and I will do those next Tuesday. So I’m encouraging you to tune in next Tuesday. So I’m going to go ahead and talk a little bit. So I’m armed. I’ve got the questions here, the magical questions and there’s one from Tatyana. And Tatyana, I don’t know if this is the Tatyana that used to listen to my radio show or if you’re new or one of my patients. But I would love it if you would identify yourself when you send in a question. And I will answer your questions next week, because I think they’re good question. It’s a good question. But identify yourself a little bit more so I know who I’m speaking with. All right. So let’s go ahead and I’m going to go ahead and share my screen. All right.

I think that’s it. Okay. So if I had three questions for today, the first one was on arthritis. Second one was on magnesium, which is a great question because I talk about this all day in my clinic and patients are often very confused about the need to take magnesium or not and then what form to take. And there’s a huge difference in forms of magnesium. I’m not going to get to the additional question about anemia, but it’s a great question.

And again, it’s one I’m going to work on next week, so I hope you tune in. It’s a very, very misunderstood topic in medicine, and it’s very important for people to understand it, in my opinion. And that’s why you’re here right now, in my opinion. So let’s go ahead and talk about.

00:02:30:05

So here’s the question. Hi, Kathryn. Could you please ask these questions for me today? WHAT IS TCM’S MODEL OF CARE FOR ARTHRITIS AND WHAT IS CAUSING THE IMBALANCE? AND CAN IT BE REVERSED? Yes, it can be reversed depending on a couple of factors which I’m going to get to.

WHAT WOULD BE A COMBINED TREATMENT USING FUNCTIONAL MEDICINE AND TCM INVOLVED? Now that’s a great question because you all know I love talking about functional medicine. I love talking about TCM.

However, today the Western treatments for arthritis are and lab studies, etc. are not extremely different. There are some conditions where functional medicine and mainstream medicine are like 180 degrees out of sync. That’s not so much with arthritis. Now, with functional medicine, they will tend to use less medication, they’ll use more supplements, they’ll use more herbs and more diet. So that’s a piece.

But I’m not going to spend too much time on the functional medicine part today. I’m just going to look at Western medicine and TCM, mostly.

00:03:43:28

Okay, so basic definition of arthritis and this happens, all the patients come in, you know, they said, Oh, I went to the doctor and they told me I have arthritis. And I say, You knew you had arthritis. That’s why you went to the doctor. They didn’t tell you anything new.

It was specially prescient. “Arthro” is a prefix and it means a joint.

You get arthroscopy, you get a joint with a scope. So that’s just a prefix for a joint. And “itis” means a disease that is or a condition actually characterized by inflammation. So what this is saying is you have an inflamed joint. Now, you pretty much knew that when you went to the doctor. And it’s also not always accurate, because sometimes in some types of arthritis, there’s really not a lot of “itis.” There is not a lot of inflammation in some of the types.

00:04:39:24

So anyway, I’m going to go through those and take a look at them. Now the term is generally commonly used is pain, swelling or tenderness, especially in a joint. Now sometimes it won’t seem like a joint because it can be in your lower back, it can be in their spine. But really it’s where those joint where one vertebra comes in contact with them, with another, where one of the facet joints comes in contact with another or an ankle losing spondylitis, basically the whole sacrum is on fire.

So pain, swelling and tenderness, especially in a joint. Now, here’s the fun part. Arthritis doesn’t exist in Chinese medicine.

Now, that sounds like I may be splitting hairs, but it’s actually a lot more important than that.

00:05:30:16

So arthritis is defined as diseases by the ICD-10 code system. So if you go online and you put ICD-10 code “arthritis,” you will see a huge list of different types of arthritis and you press on one or you use that for your code. Now, when I am giving someone a super bill.

With all their information on it so they can turn it into their insurance company or to their health savings account, etc.. Well, I will put an ICD-10 code and it will be arthritis. However, when I’m treating the arthritis, I’m really treating it from a Chinese medical standpoint primarily. So arthritis is defined as a disease and TCM by definition, by definition does not treat diseases. It treats patterns.

00:06:29:03

So the number of types of varies depending on the inclusionary and exclusionary factors.

What are you including in here? Is the only things that are red, where the skin is red, etc. But if you go on Wikipedia, which I did today, it says there are 100 types of arthritis. Cause you always have to be a little bit leery of round numbers. Could be 99, could be 101. At one time I heard something like 200, but they’ve combined some now, but literally 100 types of arthritis.

That’s big. That’s a big category. There are two major types in Western medicine, by the way. There are two major types in Chinese medicine. Also, not a coincidence, osteoarthritis, which is mostly from wear and tear, it will be typically in one joint or one series of joints. If you’re right handed, you generally have more pain and suffering in your right hand. The right thumb base tends to wear out faster than the left thumb base, usually depending on what you’re doing.

00:07:37:20

I mean, if you’re a hairdresser and you dry hair with your right hand, I mean, you coming out with your right hand, while your left hand may actually be getting more wear and tear because you’re brushing it out with the left hand. But in general, it will tend to be more on someone’s dominant side. And rheumatoid arthritis and other of the hotter arthritis are from autoimmune diseases now. The concept of autoimmune disease. We could spend several weeks discussing and not come to an absolute agreement.

I have my theories. Other people that I respect have their theories. Some people say it’s basically almost all genetic. That the body turns on itself for a variety of reasons. There are other people who say, No, not really. There’s actually something there. There’s something in the joint that the body is at this moment trying to attack and eradicate. And the autoimmune disease is kind of a byproduct of that destruction from the inflammatory process.

Other people will say no it’s really a process that got started, maybe in the way I just said, but then the body didn’t shut it off. So there’s a lot of disagreement. Now, I look at a lot of studies and you probably realize that by now, but I’ve seen a good many where they’ve aspirated or taken fluid from inflamed joints and they find infections. They’re not treating for the infection usually.

00:09:18:24

They’re usually treating for the interleukins and the other immune modulating chemicals, which is fine. However, if there’s still an infection there, we might want to go after the infection. So just saying there is not complete agreement about what constitutes or what causes autoimmune disease. The third type I’m going to talk about is generally a good distinction to make. So it’s gout or Gouty, arthritis. It’s because it’s really neither of the above.

It’s not usually from wear and tear solely, and it’s really not an autoimmune condition. It’s really in its own category. So I’m going to talk about that one also.

So here’s a rheumatoid arthritis picture. You’ve probably all seen this. You may have had a grandmother or mother where the joints were disfigured and they could barely move their wrist, for example, or their knees. They became so totally disfigured. This is a classic rheumatoid arthritis picture here. This a little hard to see, but this is a dip in the distal enter phalangeal joint.

This last joint right here, which often becomes inflamed. The fact there’s a diagnostic process for osteoarthritis in particular, or we look for nodes called Aberdeen’s nodes, which are an indicator of arthritis. So right here is the joint line and here you can see this is a void. It’s basically been eaten away by the inflammatory process. And you can see it’s still at work, it’s still eating, tearing down this bone. You also have a little bit over here and a little bit here where it’s a little bit darker.

00:11:10:17

So this is again, this is a very painful joint. I guarantee it’s probably red. It’s probably hot to the touch. It’s probably swollen. Even though the bone is bone disease and eaten away, the tissue around it will be hot and swollen.

And so rheumatoid arthritis, and I bunch of things together bunched a lot of things together, but it’s an autoimmune disorder. You can do genetic testing to see if there’s a predisposition for any of these autoimmune diseases. There are blood tests that can be done to indicate a high likelihood of an autoimmune disorder, although very few of them are extremely specific. 

And some of them I’ve had patients that one month they test positive, six months later they test negative and so on back and forth. So it’s not totally a stationary illness. But it is autoimmune disease where the body, for whatever reason, is attacking its own tissues. It usually affects the hands and feet, can affect anything. Can affect the back, the spine, etc., but you’ll usually see it on the hands and feet. I see a fair amount in in the knees.

00:12:33:00

Also, other types of rheumatoid or autoimmune arthritis can be caused by lupus. Very, very common. They have some joint dysfunction with lupus, fibromyalgia, ankylosing spondylitis. That’s a really nasty problem. It generally affects people mostly in their sacrum and their lower back. It’s very painful. Celiac disease can cause rheumatoid arthritis. Lyme disease causes a lot, a lot, a lot, a lot of autoimmune arthritis.

And then there are dozens more beyond that.

00:13:15:20

Okay. Osteoarthritis. And here we’re looking at the left index finger. So here there’s a little red circle around it. You can see the fingers pretty straight. And then it takes this deviation. And right here, this little bump is a hebridean node. Often, if you squeeze out, it’ll be tender. But there’ll be swelling here and you can look. And those of you who’ve seen me, know that I look at so many things, it’s mind boggling. I look at about 15 different things on the hands.

And one of those things is to look for pre-symptomatic signs right before you have the symptoms of arthritic problems. And this one, this person is also going to have here a problem in this little finger, which has gotten pretty darn crooked. Okay. But notice the other fingers are pretty good. There’s no claw shaped hand and it looks very localized.

00:14:13:21

Let me go back here to rheumatoid for a moment. In rheumatoid. Oh, okay. Rheumatoid. You’ll see symmetrical patterns. Like often, both hands will be affected. At about the same time, at about the same rate or both feet will be affected at about the same time and about the same rate. With osteoarthritis, that’s not the case because each of the joint locations that we are having problems with is caused by a separate injury.

So again, in rheumatoid, it’s a systemic problem that’s going to affect everything and osteo it’s going to be discrete local areas. Now you get someone who is a professional football player. Their whole body may hurt from osteoarthritis because they’ve been banged up so much, but each of those injuries is a discrete injury in and of itself.

Here are osteoarthritis, mostly from wear and tear.

00:15:17:00 – 00:15:45:14

You’ve been running on that knee or running on that… Pounding that joint for decades and eventually you get some bone spurs down here. So from constantly being banged on and from the tendons pulling on this area, you get little spurs of bone. So that’s where you get a a bump, a bump, a bone where it should not be. And then, of course, the tendons and ligaments, etc., are going to rubble and nerves run over the top of that, and that’s going to hurt. And then eventually from all this banging and wear and tear, you’re going to get eroded cartilage. So when people have meniscus problems or when they need a knee replacement, those are almost always osteo arthritis. They get bone spurs, they get degraded cartilage in the joints, and eventually that bone on bone is just too much for them to bear and they’ll get something replaced.

It’s amazing. Pretty much almost anything. All joints can be replaced. Now it’s really wild.

Okay. So you get joints, swelling is possible. It’s a little different than the joint swelling that you generally get in rheumatoid arthritis, which was is usually red and hot. The joint swelling and osteo can be red and hot, but often it’s just swollen. It’s you know, it gets bigger and it’s harder for you to lose your range of motion because the knee is blocked by the dampness, by the fluid in there, or because the bones just lock up and they won’t move.

00:16:55:20

And sometimes it’s out of fear, actually. I have osteoarthritis in my right thumb, and I don’t want to ever use my thumb. I mean, I do. But just simple, simple things like opening a jar are quite excruciating. So often that range of motion, you could move it. You just don’t want to. But then sometimes it actually is a block of range of motion. When the back is affected, you can get weakness or numbness of the arms and legs. You get a breakdown of the cartilage or you get a breakdown of the actual vertebrae.

And so they come closer together and then they can squeeze or pinch the nerves that are coming out of the spinal canal, which will block that nerve impulse and will lead to numbness of the arms and legs. Most commonly involved joints are the two near the ends of the thumb of the fingers. And those one I showed you, it’s called the distal interval angle joint or a dip. And the other one, there’s the proximal interval and you’ll joint or the pip.

And then next ones are the joints at the base of the thumb right in here where you can feel that kind of grinding. If it hurts over here, that’s usually good. That’s usually a tendon problem. But when it’s right here, like I can feel the missing joint or the opening in that joint where the bone has been eroded. Okay. And so that’s the osteoarthritis knee and hip joints are very common and neck and lower back are very common.

00:18:33:29

The third type is gouty arthritis. This picture is classic. Someone walks into my office, they say, my toe hurts. I say, Take off your sock. You have gouty arthritis, I mean, it could be a fracture, but it almost never is right there. So not all gouty arthritis affects the big toe, but over half of it does. I’ve had actually patients that had surgery on their thigh because they were having pain and they pulled out an enormous gout crystal.

So it can settle anywhere in your body, but that’s the most common. So if we come up with this picture here, we can see in this joint we got a lot of redness around it. And then we’ve got this material that’s actually in the joint. It’s stuck in the joint. Well, that’s interesting. So, see, this isn’t really rheumatoid and it’s not really osteo. It’s not this person got banged on the toe too many times and it’s not, you know, a true autoimmune condition. So it is a form of inflammatory arthritis, but it’s not autoimmune.

00:19:40:17

And often it’s you’ll see recurrent attacks of red, tender, hot and swollen joint. And it is excruciating. One of the questions, if you call your doctor and you say, you know, I may have gout, they’ll say, “can you put a towel over your foot?” And if you say “yes,” they’ll say “it’s probably not gout.” That would be so painful you don’t even want a sheet on it. It’s caused by monosodium urate monohydrate crystals. Forget that immediately. Call them uric acid crystals or calcium urate crystals. That’s what your doctor is going to call them. That’s what everybody calls them uric acid crystals.

And so at high levels, if there’s too much uric acid in your body, your body has to get rid of it. Your body has to run in a very, very narrow range of age or acid based balance. It’s actually one of the tests that is most overlooked on basic blood tests. The serum bicarbonate level or the serum CO2 level in the range is absurd.

You can be in alkalosis too much alkaline or severe acidosis before you get out of those ranges.

So in this case, the uric acid has to go somewhere or you’ll die.  You just have to get the pH right. So the uric acid crystallizes and those calcium urate crystals form and they get deposited in the joints, the tendons and the surrounding tissues again mostly in the joints and about 50% in that toe. But when they’ve operated on was the madness of King George, I think.

I don’t remember what the movie was, but when they pulled him out and examined him, whoever that was, I don’t remember which king he was riddled, just riddled with calcium urate crystals. It’s no wonder he was mad.

00:21:36:13

He was in constant pain and I mean in constant pain. That’s very severe. So this is a big deal. And also, when the uric acid is high, it not only forms into the Goudy crystals, it also can form calcium urate kidney stones.

That’s the second most common type of kidney stone. And so my questioning, as I’m going through these labs and talking to the patients, is “anybody in your family had kidney stones?” “Has anybody in your family had gout?” You know, particularly if I see things on the labs that kind of pushed me in that direction.

So gout, 90% of the problem is under excretion in the kidneys of the uric acid. And there are genetic reasons for that and there are definitely lifestyle reasons for that.

However, the big issue is the inability to process Purines properly. And so instead of going to a form that’s easy to excrete, it goes to form the calcium urate.

00:22:45:16

Diet is a huge factor. Alcohol, beer is the worst by far. Not a lot. I have a lot of patients have no problems with other alcohol, but if they drink a beer, they’re going to be off their feet for several days. Sugar sweetened beverages. Now, this is an interesting one.

Gout used to be called the disease of kings. It’s been called a few other things, disease of royalty, etc., because it was really common in people who ate a lot of meat, who ate really well for their time. Again, historically, organ meats weren’t easy to come by. Seafood wasn’t particularly easy to come by. But the royalty could have whatever they wanted and they could have all the alcohol they wanted, and they tended to develop a lot more gout. However, now one of the biggies is sugar sweetened beverages.

And it’s the reason alcohol is severe for this is that there is a high amount of fructose in it. And so with sugar sweetened beverages and high fructose corn syrup, we see that that’s even more significant than what the things that were once thought to be, the big problems like seafood and Oregon meat. But definitely dried anchovies can put you’re right over there. Even the fresh anchovies can push you over that over the hump. Dried mushrooms and seaweed and beer. Yeast. These are biggies.

00:24:11:18

Okay. Now to the question. So those are the major types of arthritis in the West? In TCM, traditional Chinese medicine. We don’t treat diseases, we treat patterns, and the most basic pattern discrimination are the eight parameters. Is it hot or is it cold? Is it internal or is it external? Is it yin or is it yang? Is it deficiency or is it excess? So here we could have a yin deficiency or a yin excess.

We could have a yang deficiency or a yang excess. And so these are all playing together. The pattern always includes, and the most important piece of it are the specific attributes of the patient.

And the pattern includes everything, time of year, etc. Everything’s included in the pattern. So diagnostics, is the patient internally too hot? Are they internally too cold? So I don’t mean there’s that touch on their skin, although that can be a reflection. I’ll get patients whose hands I touch and I get chilled almost to the bone. And almost always, not quite always, but almost always. They have internal cold. Occasionally they have another mechanism that I’m not going to go into.

Is it internal in origin or is it external in origin? Is a patient deficient? Or the condition excess? Is there a iron deficiency or excess? And there is a yang deficiency or excess? So you can see how our thinking is here.

00:25:53:23

It’s a little bit… It’s a lot different, actually. So these are just some, these are not always true. I just put up some really gross examples. So for rheumatoid arthritis, it’s entirely engendered from in Chinese medicine, smoldering latent heat, which is an autoimmune type condition or yin fire, which is very complex, but it’s poor energy movement from metabolic syndromes, diabetes, etc., or damp heat, which would include infection and or inflammation.

So it’s generally going to be internally engendered. It’s not from getting hit by something on the outside. It’s generally a heat condition. As I said before, latent heat in fire, damp heat, all heat conditions. The patient is usually deficient, but that deficiency allows for an excess condition to attack. They’re not strong enough that they can ward off the attack. Now, typically, that’s because one side of the immune system and, you know, there are millions of pieces to the immune system, but it’s generally divided into four parts and more simply into two.

And typically, these are tied to excesses that are causing this problem. So one side of the immune system is excess, and the patient is too deficient to balance it. Now, the patient can be yin deficient or yang deficient, and they’re often both. So, again, that can get a little more interesting.

00:27:27:27

So osteoarthritis, this one’s externally engendered. It’s from overuse or injury. It’s something. It can also be from the weather. You know, I have patients that can tell you what the weather’s going to be like tomorrow by how their bones feel today.

I had an aunt like that. Everybody used her to tell the weather. It’s like, oh Aunt Bessie’s got the rheumatoid, I guess we’re going to have a rainstorm.

Because and this is fascinating actually, with these conditions. Osteoarthritis, you’re generally going to have swelling around the injury, rheumatoid also.

00:28:05:01

But with osteo, you’re going to have swelling. Well, when the barometer shifts, when the barometer gets higher, the pressure is higher. That literally puts more pressure on the body. We don’t think about that. We just, you know, our body automatically responds, but it’s a big deal. And so when we get more pressure on the body, it compresses the tissues and can make it hurt more. When the barometer falls, literally, our tissues expand because there’s not as much pressure and that expansion can cause pain and suffering and injury and more swelling.

So either way, you can have more pain and swelling from the weather. So it’s way more complex. It’s generally a cold condition. It’s going to be worse when there’s cold weather. It’s going to be worse after people haven’t moved for a while. That whole getting up out of the chair and having to walk into the other room. It’s just like, you know, and I don’t even think I want to eat tonight. I’m just going to sit in my chair.

Or the not wanting to go out and run or move, etc., particularly when it’s cold. The patient’s usually deficient. They don’t have enough Yong Qi. Enough heat to really heat their body to keep the fluids moving.

00:29:28:20

Patient can be yin deficient or yang deficient, but the condition usually gets worse as the yang starts to fade. So as we get older, this condition almost always gets worse because we don’t have that internal warmth that’s really coursing through our tissues and keeping our blood moving and making us feel very happy.

Kathryn: Will it get worse at night?

John: Yes. At night. It’s going to be worse. Often it’s worse when people get up in the morning.

00:30:02:09

Aphorisms and principles. In Chinese medicine, we say one disease, many treatments, many diseases, one treatment. And so, for example, I treat. I’ve treated literally dozens of multiple sclerosis patients, and I use many different types of treatments. Some I only do acupuncture, some I only do herbs and supplements. Some I may use a dozen different types of herbs on a dozen different patients. I’m going to do different acupuncture points.

It really depends on that pattern diagnosis that I mentioned.

00:30:38:00

On the alternative, I might see five patients over a few days with completely autoimmune diseases. One comes in with Sjogren’s Syndrome, one comes in with lupus, one comes in with the rheumatoid arthritis, and they might all get the same herbal formula if the pattern fits. So again, it’s not it’s not like Western medicine where I got a headache. Take aspirin. It’s a completely different way of looking at things. Because I’ve got a headache, take an aspirin. Does nothing to take into consideration the pathology or the physiology of the patient.

If your head hurts. Try this. If that doesn’t work. Well, taking acetaminophen. And you just kind of go down the line. Now, in TCM, this depends on a very, very specific diagnosis, and it always depends on the underlying physiology and patterns of the patient.

00:31:36:07

Now, what I didn’t put in here is what usually gets called arthritis in Chinese medicine is generally called “Bi syndrome” B-I, which means an impediment and impediment syndrome. And Chinese medicine, they say if there’s a free flow, there’s no pain. If there’s no free flow, there is pain. And so in Bi pain, it means an impediment. A blockage is keeping the Qi and the blood from moving properly. And so you will have pain as a result of that. It’s extremely accurate.

00:32:13:04

I’ve had patients come in where they never, in the west, the Mayo Clinic in fact I had one woman who was just wonderful.

She just referred someone to me recently. I haven’t seen her in 15 years, but she came in and she was just beside herself. She came back from the Mayo Clinic. It was her second visit there. She’d been to UCSF and Stanford, and she brought in literally stacks of labs and paperwork and went through all of it with her. Took a history, etc. And I said, “okay, let’s go back and treat you.” And she said, “Oh, do you know what’s wrong with me?” I said, “Do you mean from a Western medical standpoint?” She said, “Yeah.” I said, “You’ve just been to the Mayo Clinic twice and they have no idea what’s wrong with you.

So, no, I don’t know either. Fortunately, with Chinese medicine, I can treat you anyway.” And I treated her for a phenomenally short period of time for an autoimmune condition, which it was like maybe 90 days. And then she went on her vacation to Greece and took a year off and traveled and is doing phenomenally well. Like I said, I haven’t even seen her in years. So it always depends on the physiology and the patterns of the patient. Can now the next subject is pretty long.

I may have to rush through parts of it, but I think it’s important and I want to get something up here about it because this is a question I get asked a lot.

00:33:38:29

And so the question is, WHAT’S THE BEST FORM OF MAGNESIUM FOR ME TO TAKE? And it was a longer question that, you know, I go online and everybody’s touting some form of magnesium. And so, you know, what my answer is going to be, particularly after listening to arthritis, it depends. Depends on your physiology and on the condition that you want to treat to go through this fairly quickly.

Magnesium is one of the five. Alkaline is the key term there. Alkaline, earth metals. It’s really critical to have enough of those alkaline earth metals in the body to keep you alkaline, to keep your serum, your blood so that it’s slightly alkaline. Because we’re producing huge amounts of acid in the body and we need those alkaline earth metals to kind of balance the hundreds of physiological processes. I didn’t go through and name them all. Now, this is interesting about adult bodies, 22 to 26 grams of magnesium. That’s less. Then an ounce. That’s not much magnesium. And 60% of that’s in the skeleton, we think of calcium, but there’s tons of magnesium. 39% of it is intra cellular inside the cell, 20% in skeletal muscle, and only 1% is extracellular.

00:35:05:06

Now, that’s a really important number because when you take a, you know, a standard kind of normal metabolic panel or blood chemistry panel, they’re going to measure serum magnesium. Well, if only 1% of your serum is of your magnesium, then the serum, that’s not a very good test.

And so if there is thought that you are magnesium deficient, a much better test is a red blood cell magnesium. And that will give you a lot of information, whereas it’s very rare.

I mean, you’ve got to be in the hospital. And it was a very serious condition for you to show low or high on the magnesium tests that you see from your medical doctor. But the red blood cell, magnesium gives you a totally different story. So magnesium deficiency is it’s more than quite common in the U.S.. There’s not enough magnesium in the fruit and vegetables. Less than 50% of the levels of magnesium versus what we had a hundred years ago.

If you don’t have enough magnesium in the soil, it can’t get into the plant. Alcohol, we tend to consume a lot of alcohol. It utilizes a great deal of magnesium. So a lot of reasons why we’d be magnesium deficient here. But this is the US intake of magnesium. Now if you see over here it says RDA. That means how much is someone supposed to get a day of magnesium. But here’s the problem with RDAs.

They’re generally set at way too low a level. It’s like, how much magnesium do we need to have? So you don’t have a heart attack? It’s like vitamin C and scurvy. The vitamin C, RDA is enough so you don’t get scurvy. But it’s not enough if you’re at the low end of the RDA. Your veins are going to blow out. You’re going to have varicosities, you’re going to have teeth that are loose. You’re going to have collagen and joint problems. So the RDA is way too low. And even with that, even with that, 55% of the U.S. population is deficient.

00:37:27:00

Whoa. That’s a little scary when you realize how important magnesium it is. One of my teachers from Stanford who was a emergency room doctor and a cardiologist. Was talking about, you know, which I already knew, but she really emphasized it. One of the first things they do when someone comes in and cardiac arrest where their heart is not pumping is they pump them for a massive, massive amounts of magnesium because magnesium is required for the muscles to relax and the heart is a very important muscle. And so they pump and follow magnesium so that they can hopefully relax the heart muscle and get it to pump. So muscle cramps.

00:38:11:12

These are deficiencies signs, muscle cramps and spasms. I tend to be have a difficult time with magnesium if I play my guitar without taking my magnesium. Within an hour, my hands cramped up like this. As long as I get my magnesium, I’m fine. You get trouble sleeping, fatigue, headaches, loss of appetite.

That one I don’t see as much. It’s got to be severe numbness or tingling neuropathies in the hands and feet. Those are often caused by magnesium deficiencies, nervousness and anxiety, heart rhythm problems, menstrual cramps, constipation. I had a woman come in to see me once and this is when I was doing my radio show.

00:38:52:29

And again, people that listen to a radio show, generally listen to a lot of them. And she came in with a huge bag of supplements that she wanted me to go through. She had heard me on the radio talking about this stuff, and she had constipation, menstrual cramps, insomnia, headaches, and she was having some muscle cramps.

So I talked to her, did a complete history intake, checked her out from stem to stern, top to bottom. I said, okay, I’d like you to take this magnesium and this form of magnesium. And she said, okay. And then she looked at me like, Well, what else? And I said, No, let’s just try the magnesium first and see what happens. And she was mad. Actually, she didn’t yell at me or anything, but you could tell she’s thinking “I paid to come see this guy and he’s just giving me magnesium.” So she comes back in two weeks. “How’s your constipation?” “I poop like a champ.” “How are your menstrual cramps.” “I had my period. It was the best period I’ve had in years.” “How is your sleep?” “Way better. It takes me half as long to fall asleep.” Okay, then. I think we’re doing pretty well. “How are your headaches?” “I haven’t had one in a week.” Magnesium. $0.50 a day was the problem.

00:40:10:01

So these are common symptoms starting at the top coming down. Poor concentration, migraines, posterior headaches. So that’s the back of your head. Those are often from dehydration, but the dehydration can be a secondary factor to electrolyte deficiencies, cardiac arrhythmias. Uterine cramps. Tingling of the hands and feet calves and toe and thigh cramps. Classic magnesium deficiency.

So in a word about absorbing minerals, this is in general in our diets, we don’t eat isolated minerals. People don’t go grab a hunk of iron and chew on it. They don’t grab a bunch of magnesium, the possible exception of sodium chloride or table salt, but otherwise we don’t eat. And even that’s not isolated. It’s at least to we don’t need isolated minerals. And our digestive system is trained to absorb minerals better if they’re attached to another substance, which will recognize and pull that through the intestines and use them.

00:41:23:09

And that’s generally through what we call chelation, which is the process of bonding to different materials. Now in mineral therapies and supplements. The chelating agent is usually an organic compound. Okay, so you take this mineral, this metal actually, and you combine it with an organic compound and the body goes, Oh, okay, I can do that.

So these are a few of the common supplement types. I’m going to go through a few of them.

00:41:54:16

Magnesium oxide. This is non related so it’s not bound. It’s up to 60% pure magnesium. You don’t absorb it much at all. Almost not absorbed. But because it goes straight through you. It has really strong stool softening and bowel moving properties. You could use it for a clean out if you were going to go in and get an exam. But watch out for disaster pants. You don’t want to suddenly start magnesium oxide and then go out in public. You want to hang around your bathroom for a while. And I rarely use this. About the only time I use it is for severe constipation or significant constipation, particularly if we’re doing a cleanse of some type or detoxification where we must keep the bowels open and moving. But that’s about the only time I use this.

00:42:46:15

Magnesium sulfate. It’s an osmotic type laxative. And this is mostly how magnesium works. It works by drawing water back into the intestines, and that should be mostly large intestine.

So a primary job of the large intestine is to pull as the food going through your GI tract. Very, very watery. And so that it can be absorbed. And as it gets down further and it gets into the large intestines, it would be dangerous if you pooped out all that water. You know, it’s not so dangerous for us where we have a lot. But historically, it could have been a problem. And so the large intestine, one of its major jobs, is to pull the water out of the stool so that you can reuse the water.

But with magnesium, it pulls it the other way. With osmotic pressure changes, it pulls the water back into the intestines. And this is again, you’re going to have some urgency. So think milk of magnesia. This is very strong to move the bowels.

00:43:55:20

Okay. Magnesium lactate here. It’s chelating with lactic acid. Only 12% elemental magnesium. Remember up here?

60% in magnesium oxide, so that’s five times more.

00:44:12:25

So I’m going to go on to magnesium sulfate. Epsom salt like Epsom salt baths is magnesium sulfate is made up of magnesium sulfur oxygen. Got its name from the town of Epsom. It’s generally used in Epsom salt baths. It can be used orally as a clean out agent. Again, it goes right through and cleans everything out and there’s some debate if this form is absorbed through the skin. I personally believe it is. We have a lot of magnesium compounds in our office that there’s no doubt that they’re absorbed through the skin because people notice huge reactions and effects from them.

00:44:53:02

Magnesium carbonate. I don’t use it at all. It’s usually used for its antacid properties and it’s not commonly used anymore.

00:45:01:19 – 00:45:23:24

Magnesium Taurate and the other eight forms. “ate-” gluconate, malate, or orotate, ascorbate. They all have good absorption. They all have good bioavailability. They all cause some low to moderate level of bowel activity. Not severe. It’s not a disaster pants type thing. All of them help with spasms and cramps.

All of them help with anxiety. And then each works to varying degrees on each of the above things. They’ll be slightly better for one than for the other.

00:45:35:10

And take one, for example, is magnesium orotate.

These are clinical benefits that are well known in functional medicine. There are tons of research articles about this. You get improved survival of heart tissue damaged by oxygen starvation. A reduction of premature heartbeats. Increase in exercise capacity.

Correction of magnesium depletion, improvements in skin appearance, you’re going to get more hydrated and a reduction in calcification of damaged heart tissue. Sounds pretty darn good, doesn’t it?

And this cut off a little bit, but the mechanism is expected to be improved availability of DNA and RNA precursors that are needed for repair. The damage tissue and also for synthesis of glycogen, which is the storage form of sugar. Glucose is stored in long branch chains called light chains called glycogen. And when you need that sugar, those chains are broken down and you get to use them.

And ATP. ATP is the energy molecule that fuels the body adenosine triphosphate. Both of these provide energy to and help recovery from the heart muscle.

Now I got this information on magnesium orotate from FXmedicine dot au. So I want to give them some credit on that one.

00:47:12:19

Magnesium citrate magnesium that’s bound to are chelating with citric acid. Very good viability, very good absorption. And this is probably the most proven form of magnesium for supplements there are.

Hundreds of studies looking at… not hundreds, dozens of studies looking at magnesium citrate and showing that it’s very easy to absorb, very bio bioavailable.

Great for spasms and cramps in the hands, the calves, etc.. Very moderate laxative qualities. I don’t worry about it with most of my patients. So this is a form that you’ll see in a lot of the over-the-counter supplements, you know, the calming supplements, etc.. I don’t find it quite as good for sleep. And it definitely does not stimulate the bowels as much. But it’s an excellent form.

00:48:07:15

Magnesium Glycinate. This has been my favorite for many, many years. It’s magnesium that’s related with glycine in a 1 to 2 ratio. Very good absorption, very good bioavailability.

And it’s a very strong GABA. GABA Aminobutyric acid agonist. And GABA is highly implicated in reducing anxiety, causing a relaxation response, sleep, etc. So that means it supports the function of GABA.

It’s an agonist and it’s going to help with all of those things relaxation, anxiety, relief and sleep. It’s my favorite form to prescribe to people that are having anxiety and insomnia, and I have them taken in the evening to help with their sleep. Has low to moderate bowel activity. In fact, if it’s taken at night, most of my patients don’t report much of anything different with their bowel movements. So this is one of my two favorites.

00:49:06:24

My other favorite is Magnesium threonate.

This is my new favorite for many conditions. It’s a newer form. It has not been available from supplement companies until fairly recently. And I use it for anything that involves the brain or neurological issues. Someone comes in with a concussion. We had that question a little while back. This is this is a form of magnesium I would give because it penetrates the blood brain barrier. And magnesium generally is not very effective at that.

It also increases ability to penetrate cell membranes and general tissues as really good absorption, really good bioavailability. And my patients love it for brain fog. I’m not kidding you. I’ve had patients come in and go, “Oh, my God. It used to take me 2 hours to wake up in the morning, and now I’m just getting up and I’m going on a walk. This is just amazing.” So magnesium threonate for brain neurological issues.

Glycinate for anxiety and sleep issues.

Citrate for general stuff.

This is an interesting book on Transdermal Magnesium by Mark Sircus also an Acupuncturist. He’s written quite a few books on similar topics, but he’s got a lot of information, quotes, a lot of studies on the use of transdermal or skin.

Using magnesium on the skin, on the tissue and how it gets absorbed.

Oh, boy, this is jumping all over. So this is my favorite magnesium lotion. This gets rubbed into my feet every single night. It’s magnesium with arnica. The magnesium again helps with swelling, it helps with circulation, it helps with inflammation. And the arnica is a blood mover. So that combination we love. My wife goes through cases of this in treating the 49ers and other athletes. They get bathed pretty much in this magnesium lotion.

And they love it because, I mean, they have millions of dollars at stake here, you know, and like a 1% difference in their performance can be worth huge amounts of money. And they love this stuff. And I love it, too.

00:51:40:00

Here’s my favorite for brain fog. Neurodegenerative, degenerative illness. Any you know. Any stroke issues, anything with the brain.

So this is the CogniMag which is magnesium threonate in it.

And here’s a book called The Magnesium Miracle by Carolyn Dean, who’s an N.D. and an M.D.. That’s a really unusual combination, a Medical doctor and a Naturopathic doctor. And she goes into a lot of studies and a lot of information about why we need magnesium at a much, much higher level than we get and much higher than the RDA. And she does a very good job of presenting her case.

Okay. I think it keeps skipping, but I think that gives you the idea. So magnesium. Those are my favorite forms. Let’s see. Oh, I miss Buffered C. That one’s got skipped over. That’s my favorite formula for general function and magnesium uptake.

It also has vitamin C in it at a  reasonable dose. It’s about 2350 milligrams, which most people are dosing vitamin C at way to lower level. And so since I tend to be vitamin C and magnesium deficient, there are only two things that I take every day.

And one of them is Buffered C for treating people with constipation, slow outlet syndrome, bowel issues. There are hundreds of formulas potentially in Chinese medicine and many, many different formulas that I carry. I pretty much don’t use them anymore. I mean, it’s really rare, unless it’s really severe constipation.

I just have them start the Buffered C at about half the recommended dose, like quarter to half of a scoop and then keep going up until they get perfect bowel movements. At some point they’ll pass the perfect point and they will get glued to the toilet for a couple hours and then they’ll figure it out. And over time it’s magic. You will have perfect bowel movements for the rest of your life. Love that stuff. And you won’t have cramping and spasming and it’ll help your heart. Okay, good.

00:54:02:04

All right. So there you have it. A couple of great questions.

And the answer is the same. It depends on you. It depends on your condition. It depends on your physiology. It depends on your health history. It depends on your genetics, etc.. And that’s really how it should be looked at, not just one size fits all.

However, with magnesium, unless you go for the oxide or the sulphate, one of the really, really bowel stimulating almost any of them are good. It’s just some are gooder.

So I’m not going to run these over an hour. We’re at 359 now. I want to thank you very much for tuning in. Hey, definitely tell your friends about this. I mean, it’s free. I don’t make any money on it. They don’t lose anything. And, you know, just knowing what type of magnesium to take can extend your life by a decade. So thank you for tuning in. I’ll be back next Tuesday. Be happy. Be healthy.


Dr. John Nieters L.Ac, DAOM, is an acupuncturist, Chinese herbalist, functional medicine, writer, teacher, and leader in the community. In this episode, John talks about his experience with the importance of finding your vision and purpose in life, in order to create the right goals for you.

Disclaimer: Dr. John Nieters received his Doctor of Oriental Medicine and Acupuncture degree from Five Branches. His use of “doctor” or “Dr.” in relation to himself solely refers to that degree. Dr. Nieters is a licensed acupuncturist in California. This video is for general informational purposes only. It should not be used to self-diagnose and it is not a substitute for a medical exam, cure, treatment, diagnosis, and prescription or recommendation. It does not create a doctor-patient relationship between Dr. Nieters and you. You should not make any change in your health regimen or diet before first consulting a physician and obtaining a medical exam, diagnosis, and recommendation. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition. TheBalancingPoint.net, Alameda Acupuncture, and Dr. John Nieters L.Ac, DAOM are not liable or responsible for any advice, course of treatment, diagnosis or any other information, services or product you obtain through this video or site.

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