Continuing heart problems

[bear]

Anne,

Your situation seems to have complications on top of complications.

When I have a low diastolic pressure it tells me to get more salt. I have been following Volek and Phinney's advice (see below) by filling up a salt shaker with the amount of salt I
need each day. I eat very little processed food and I am used to never adding salt from when my blood pressure was higher. I use the shaker to remember to get enough each day.

I suspect a chunk of what is going on is you are low on magnesium with a cascade of effects from there to potassium and maybe sodium. You say you are taking extra Mg. What kind are
you taking, how much and how often? Do you take your magnesium at separate times from calcium and dairy?

Are you taking any meds for your T2 diabetes - particularly metformin?

As you know, you can get neuropathy from diabetes but metformin stomps on your B12 supply - could be bad to worse.

The neuropathy coupled with the homocystine suggests you might want to take a B-complex. If you are also taking metformin you win the Trifecta. I like Jarrow B-Right.
There are others but be careful not to get too much B6. Hopefully the B-Right is not a problem but others here would know. There is a more extensive protocol that makes sure you
get both active forms of B12 in the blood without swallowing but that is for another time.

Researchers have recently discovered that Lyme disease has figured out how to avoid using iron and uses manganese instead.
One of many links: Only registered and activated users can see links., Click Here To Register...

I don't know if you can help things by taking or avoiding manganese but in case your Lyme is active, you might get tested to see if your manganese is low. I think the
manganese test is the one for trace minerals.

When your iron levels are okay (normal tranferrin) a high ferritin level can be caused by the body trying so gobble up extra iron that various bacteria need to multiply. I don't know if
the body's detection of active Lyme would cause a call to go out for ferritin to get as much iron out of the blood as possible.


If you have not read a copy, I strongly recommend you get a copy of "The Art and Science of LOW CARBOHYDRATE LIVING" by Volek and Phinney. They state they wrote it primarily for
healthcare professionals and others in related fields but most of the book is accessible to anyone with a commitment.

They have very specific and detailed information about how to deal with T2 diabetes that may give you a key to figuring out how to get your insulin/glucose levels down and what surprises
might come at you. Along with those changes you lipid profile should improve along with reduced inflammation (from glucose) and potentially reduced insulin resistance.

The book is less a day-to-day how-to book and more a detailed look at the science - they have written may peer reviewed papers.


Are you taking any omega-3's? They are important for lots of reasons, maybe including insulin resistance. I presume you are getting plenty of omega-6's.



I have gone from being a fan to becoming a very big fan of (EVCO) coconut oil. The more I learn the better I like it. I has a very bad name from prior research done using hydrogenated
coconut oil (trans fat) where the authors of the papers often did not specify which kind was used. Any trans fat is bad for you. Because you have T2 diabetes you should proceed slowly
but it might help you to take more. I have trouble taking the oil directly but I can drink it if I mix it with soya lethicin which emulsifies it. The medium chain tryglycerides in the oil
are digested as soon as they leave the stomach and do not go through all the steps larger fats need. The resulting medium chain fatty acids can pass through the blood brain barrier
without help and can be used by neurons. It does not stimulate insulin levels and can prevent the ups and downs you can get from carbs. If you take a tablespoon in the morning you may
notice a big change in you energy level and/or hunger in a couple of hours. About 1/2 the people I recommend it to notice this although some needed more than a tablespoon but one should
build up to that.

Anyway, sorry to lay all this stuff on you. You have been doing a great job trying to keep on top of what is going on with your health. It is easy for others to give advice but if
you try to put it into practice it can take a lot of time and effort. I hope some of this helps. I think you would find the book very useful but that is up to you.

Bear

P.S. Another time you might look into increasing your vitamin D to reduce inflammation but that is not as important as the above.

[nick's mom]

wow, just read through this thread anne. sorry you had so much going on. sure hope you can figure out your low blood pressure. nick is having this problem too. when we went to his last neuro visit, he almost passed out getting up out of the car. his bp that day was 93/57. they neuro thought it was part of his dysautonomia since his insomnia is awful again right now. he's also had some bad reactions to the dyes but not every time. i'll have to be sure to keep his salt levels up next time. thanks for all the info on this thread! hope you're feeling better today anne!

[NancyM]

Since we're on the subject of salt: Another study regarding the truly horrible science behind salt restriction

Only registered and activated users can see links., Click Here To Register...

Limiting salt actually increases death rates, and I've heard this for years, yet it never seems to change the policy recommendations.

One 2008 study the committee examined, for example, randomly assigned 232 Italian patients with aggressively treated moderate to severe congestive heart failure to consume either 2,760 or 1,840 milligrams of sodium a day, but otherwise to consume the same diet. Those consuming the lower level of sodium had more than three times the number of hospital readmissions — 30 as compared with 9 in the higher-salt group — and more than twice as many deaths — 15 as compared with 6 in the higher-salt group.

Another study, published in 2011, followed 28,800 subjects with high blood pressure ages 55 and older for 4.7 years and analyzed their sodium consumption by urinalysis. The researchers reported that the risks of heart attacks, strokes, congestive heart failure and death from heart disease increased significantly for those consuming more than 7,000 milligrams of sodium a day and for those consuming fewer than 3,000 milligrams of sodium a day.

[annelb]

Hi Bear - you asked a couple of questions.

I have Volek and Phinney's book - need to read it. I have increased my salt intake and my last test was 136 so it was still up. I heard Dr. Volek speak on the 2012 Low Carb Cruise. His lecture is here. Only registered and activated users can see links., Click Here To Register...

I take 125mg each of Mg Taurate and Mg Citrate and another 100mg of Mg Citrate in my multi. That may not be enough. My serum Mg was ok - could not get the cardiologist to do a RBC Mg. When I see my PCP in June I will ask for that.

Manganese is in my multi. Have never had a level checked.

Ferritin is high but it is from inflammation/infection not iron overload. Needs to be retested.

My glucose levels are very good on my low carb diet.

3000mg of fish oil

Love coconut oil. That is my main cooking oil too.

I think the last time I checked, my D was 58.

Anne

[annelb]

wow, just read through this thread anne. sorry you had so much going on. sure hope you can figure out your low blood pressure. nick is having this problem too. when we went to his last neuro visit, he almost passed out getting up out of the car. his bp that day was 93/57. they neuro thought it was part of his dysautonomia since his insomnia is awful again right now. he's also had some bad reactions to the dyes but not every time. i'll have to be sure to keep his salt levels up next time. thanks for all the info on this thread! hope you're feeling better today anne!

I dropped the altace and my BP is up by 10 points today. Will keep an eye on it to be sure it does not get too high. Sorry Nick is having trouble with low BP and insomnia. My caution is that a Basic Metabolic Panel should be done a few hours after dye. I don't think this is a routine but maybe it should be. I have to wonder how common is N&V hours after the test and how often is it due to low sodium?
Anne

[NancyM]

Anne, did you say you suffer from neuropathy? If so, you might try a highly ketogenic diet:
Only registered and activated users can see links., Click Here To Register...
The key to getting higher levels of ketones isn't just to limit carbs, but protein as well.

[annelb]

I am on a ketogenic diet but have never checked blood ketones. I know I have ketones in my urine but that is not always a good indicator of nutritional ketosis.

Searching the web for a fix for my neuropathy was what brought me to Braintalk back in 2003. The greatest improvement was when I dropped gluten. Even further improvement following Dr. Bernstein's plan to keep my blood sugar normal at all times.

I like Hyperlipid and I have followed Jimmy Moore in his ketosis N=1.

Anne

[NancyM]

I met Jimmy a few weeks back when he was in San Diego. I was surprised to learn he is holding his protein intake to around 80g. I have probably been having 80-110g most days. That could explain a lot of things for me. He's a big guy. Anyway, I'm experimenting with cutting mine back to around 60g and so far my blood sugar has dropped a lot. It seems I'm very sensitive to too much protein.

Volek and Phinney would throw a fit though, they want everyone to get at least .85-1.5g of protein per kg of "reference" weight.

I eat a lot of vegetables, avocados, mayonnaise and so on. I don't eat dairy, so that makes things challenging!

[bear]

Hi Anne,

I keep noticing a number of things that may tie together low magnesium with diabetes, insulin resistance, celiac disease, age and low potassium.

From the Linus Pauling Institute Only registered and activated users can see links., Click Here To Register...
Diabetes mellitus

Magnesium depletion is commonly associated with both insulin dependent (IDDM) and non-insulin dependent (NIDDM) diabetes mellitus. Between 25% and 38% of diabetics have been found to have decreased serum levels of magnesium (hypomagnesemia) (37). One cause of the depletion may be increased urinary loss of magnesium, which results from increased urinary excretion of glucose that accompanies poorly controlled diabetes. Magnesium depletion has been shown to increase insulin resistance in a few studies and may adversely affect blood glucose control in diabetes. One study reported that dietary magnesium supplements (400 mg/day) improved glucose tolerance in elderly individuals (38). More recently, a randomized, double-blind, placebo-controlled study in 63 individuals with type 2 diabetes and hypomagnesemia found that those taking an oral magnesium chloride solution (2.5 g/day) for 16 weeks had improved measures of insulin sensitivity and glycemic control compared to those taking a placebo (39). A small study in nine type 2 diabetic patients reported that supplemental magnesium (300 mg/day for 30 days), in the form of a liquid, magnesium-containing salt solution, improved fasting insulin levels but did not affect fasting glucose levels (40). Yet, a recent meta-analysis of nine randomized, double-blind, controlled trials concluded that oral supplemental magnesium may lower fasting plasma glucose levels in diabetic individuals (41). Due to conflicting reports, it is presently unclear whether magnesium supplementation has any therapeutic benefit in type 2 diabetic patients. However, correcting existing magnesium deficiencies may improve glucose metabolism and insulin sensitivity in diabetic individuals.
...

Drug Interactions

Magnesium interferes with the absorption of digoxin (a heart medication), nitrofurantoin (an antibiotic), and certain anti-malarial drugs, which could potentially reduce drug efficacy. Bisphosphonates (e.g., alendronate and etidronate), which are drugs used to treat osteoporosis, and magnesium should be taken two hours apart so that the absorption of the bisphosphonate is not inhibited. Magnesium has also been found to reduce the efficacy of chlorpromazine (a tranquilizer), penicillamine, oral anticoagulants, and the quinolone and tetracycline classes of antibiotics. Because intravenous magnesium has increased the effects of certain muscle relaxing medications used during anesthesia, it is advisable to let medical staff know if you are taking oral magnesium supplements, laxatives, or antacids prior to surgical procedures. High doses of furosemide (lasix) and some thiazide diuretics (e.g., hydrochlorothiazide), if taken for extended periods, may result in magnesium depletion (54, 55). Many other medications may also result in renal magnesium loss (3).

Older adults (65 years and older)

Older adults are less likely than younger adults to consume enough magnesium to meet their needs and should therefore take care to eat magnesium-rich foods in addition to taking a multivitamin-mineral supplement daily. Because older adults are more likely to have impaired kidney function, they should avoid taking more than 350 mg/day of supplemental magnesium without medical consultation (see Safety).

Zinc

High doses of zinc in supplemental form apparently interfere with the absorption of magnesium. One study reported that zinc supplements of 142 mg/day in healthy adult males significantly decreased magnesium absorption and disrupted magnesium balance (the difference between magnesium intake and magnesium loss) (4).

However the following is a little scarey.

Toxicity

Adverse effects have not been identified from magnesium occurring naturally in food. However, adverse effects from excess magnesium have been observed with intakes of various magnesium salts (i.e., supplemental magnesium). The initial symptom of excess magnesium supplementation is diarrhea—a well-known side effect of magnesium that is used therapeutically as a laxative. Individuals with impaired kidney function are at higher risk for adverse effects of magnesium supplementation, and symptoms of magnesium toxicity have occurred in people with impaired kidney function taking moderate doses of magnesium-containing laxatives or antacids. Elevated serum levels of magnesium (hypermagnesemia) may result in a fall in blood pressure (hypotension). Some of the later effects of magnesium toxicity, such as lethargy, confusion, disturbances in normal cardiac rhythm, and deterioration of kidney function, are related to severe hypotension. As hypermagnesemia progresses, muscle weakness and difficulty breathing may occur. Severe hypermagnesemia may result in cardiac arrest (2, 3). The Food and Nutrition Board (FNB) of the Institute of Medicine set the tolerable upper intake level (UL) for magnesium at 350 mg/day. This UL represents the highest level of daily supplemental magnesium intake likely to pose no risk of diarrhea or gastrointestinal disturbance in almost all individuals. The FNB cautions that individuals with renal impairment are at higher risk for adverse effects from excess supplemental magnesium intake. However, the FNB also notes that there are some conditions that may warrant higher doses of magnesium under medical supervision (2).

With the above in mind, you might first make sure you are taking your Mg Taurate and Mg Citrate at times different than when you take zinc (I earlier posted calcium which is a mistake). You should also split your doses so that you take most of your Mg at two or more different times in the day as it is not clear how much you can absorb at one time.

After the above is working you might try to carefully increase what you are taking and try to monitor what happens. I presume you can monitor your BP/HR and glucose as well as how you feel. I don't know if you can check yourself for changes in cardiac rhythm.

The only reason I am suggesting this is you have a lot of potentially related things going on and you may be passing more magnesium out in your urine than expected. It might help and you can probably do it in small steps. I can also see why you might not want to try this. Note, if you have kidney problems, forget all of the above. I also do not know what drugs you are taking.

I hope I didn't put too much text in above. You can find all of it at the link.

Bear

Hi Bear - you asked a couple of questions.

I have Volek and Phinney's book - need to read it. I have increased my salt intake and my last test was 136 so it was still up. I heard Dr. Volek speak on the 2012 Low Carb Cruise. His lecture is here. Only registered and activated users can see links., Click Here To Register...

I take 125mg each of Mg Taurate and Mg Citrate and another 100mg of Mg Citrate in my multi. That may not be enough. My serum Mg was ok - could not get the cardiologist to do a RBC Mg. When I see my PCP in June I will ask for that.

Manganese is in my multi. Have never had a level checked.

Ferritin is high but it is from inflammation/infection not iron overload. Needs to be retested.

My glucose levels are very good on my low carb diet.

3000mg of fish oil

Love coconut oil. That is my main cooking oil too.

I think the last time I checked, my D was 58.

Anne

[bear]

Hi Nancy,

If you weigh less than 155 pounds then you are fine with 60 gm of protein a day as that is .85gm/kg of ref. weight.

I too am sensitive to too much protein but I ramp it up on days when I workout. I also make sure I eat before a workout (particularly coconut oil and protein) but I also try really hard to eat protein right after a workout.

Bear

I met Jimmy a few weeks back when he was in San Diego. I was surprised to learn he is holding his protein intake to around 80g. I have probably been having 80-110g most days. That could explain a lot of things for me. He's a big guy. Anyway, I'm experimenting with cutting mine back to around 60g and so far my blood sugar has dropped a lot. It seems I'm very sensitive to too much protein.

Volek and Phinney would throw a fit though, they want everyone to get at least .85-1.5g of protein per kg of "reference" weight.

I eat a lot of vegetables, avocados, mayonnaise and so on. I don't eat dairy, so that makes things challenging!

[NancyM]

I do so much better on lower protein, at least as far as my blood sugar is concerned. I don't weigh 155 pounds. That is my "reference weight" range though. It seems that some of us very easily turn excess protein into glucose.

[bear]

Deleted... posted twice because I forgot it was held up to be moderated - I thought I forgot to hit the post button.

Bear

[annelb]

My serum Mg is "normal". I am in WI so can't tell you the number as all the tests are at home. I take my Mg away from any other supplement. Still planning on getting a red blood cell Mg done when I see my PCP. I am not taking any of the prescriptions that Mg interferes with.

Seem to be doing ok in WI and will start an exercise plan when I return home.

Anne

[annelb]

Had a RBC Mg drawn yesterday. Used Request a test and ordered it myself.

Result: 5.3 mg/dL Range 4.2-6.8

So looks like I am in a good range as long as the given range is optimal. I have not found a resource that talks about a different optimal range for this test. I see my integrative doc in July and she will know.

Anne

[canoe]

Anne,

Good to read that your RBC Mg is in a good range. Yea!

Mine have been in the 5.0-5.6 range but last year when I was doing green smoothies everyday, my RBC Mg was 6.2. I figured that all the kale and parsley where contributing to increase in the level, but that is only a guess.

Will be interested to read what you doc says.

Marilyn