Back around 1999-2002, the use of whey, colostrum and goat milk for CFS was popular. My wife was positive for EBV and after 2 months of an EBV specific colostrum, became negative. This was a pre-antibiotic treatment: You infect a pregnant cow with infection X and once the cow calved, you collect the milk which will high in antibodies programming against infection X.  This method was far more expensive than antibiotics and did not scale well…. hence it was forgotten once antibiotics came along. Unfortunately, this EBV specific form of colostrum is no longer available.

“Colostrum and milk are rich in proteins and peptides which play a crucial role in innate immunity when transferred to the offspring and may accelerate maturation of the immune system in neonates.” [2005]

A reader asked about these, so a fresh look at the literature is done below.

Human versus Cow Milk

The chart below illustrate well the difference [source]. They are VERY different.

Colostrum

“Colostrum (known colloquially as beestings,^[1]bisnings^[2] or first milk) is a form of milk produced by the mammary glands of mammals (including humans) during pregnancy. Most species will generate colostrum just prior to giving birth. Colostrum contains antibodies to protect the newborn against disease. In general, protein concentration in colostrum is substantially higher than in milk.” [Wikipedia]

It is heavily promoted in some alternative health circles [Example by a provider with citations to studies]

• Bovine antibodies targeting primary and recurrent Clostridium difficile disease are a potent antibiotic alternative.[2017]
• Milk-derived proteins and peptides in clinical trials.[2013]
• Molecular and biotechnological advances in milk proteins in relation to human health[2009].
  • “Taken together, milk-derived proteins and peptides are bio-available and safe for the prevention and treatment of various disorders in humans and may play a complementary [natural agents] rather than a substitutional role to the toxic synthetic pharmacological drugs.”
• [Therapeutic properties of proteins and peptides from colostrum and milk]. [2005]
  • “chewable tablets (Colostrinin) was recently found to improve or stabilize the health status of Alzheimer’s disease patients….In conclusion, preparations derived from milk and colostrum are effective, easily bioaccessible, and safe, finding wide application in prevention and therapy for newborns and adults.
• Treatment of multiple sclerosis with anti-measles cow colostrum. [1984] “
  • “As a result, of 7 high NT titre (512-5120) anti-measles colostrum recipients 5 patients improved and 2 remained unchanged. Among 8 low NT titre (8-32) anti-measles colostrum recipients 5 patients improved and 3 remained unchanged. However, of 5 negative NT titre (less than 8) colostrum recipients 2 patients remained unchanged and 3 worsened. No side-effects were observed in colostrum recipients. These findings suggest the efficacy of orally administered anti-measles colostrum in improving the condition of MS patients (P less than 0.05).”

Whey

Whey protein is a mixture of globular proteins isolated from whey, the liquid material created as a by-product of cheese production. [Wikipedia]. As you can see from the figure above, why content varies according to source.

Back in 2000, “Non-denatured Whey” was a hot topic. “Undenatured whey protein isn’t heat-treated, so the fragile bonded cysteines that later form glutathione aren’t broken down in pasteurization.”[source] — so no pasturization (or homogenization) so the chemical structures of the whey are not damaged. At a philosophical level, this appears logical.

• “These findings indicate that the effect of heat treatment on whey proteins should carefully be investigated further.” [2017]
• Biochemical and clinical effects of Whey protein supplementation in Parkinson’s disease: A pilot study [2016].
  • “This study is the first to report that Whey protein supplementation significantly increases plasma reduced glutathione, the reduced to oxidized glutathione ratio, BCAAs and EAAs in patients with PD, together with a concomitant significant reduction of plasma Hcy.”
• Limiting prolonged inflammation during proliferation and remodeling phases of wound healing in streptozotocin-induced diabetic rats supplemented with camel  undenatured whey protein [2013].
  • Camel whey protein enhances diabetic wound healing in a streptozotocin-induced diabetic mouse model: the critical role of β-Defensin-1, -2 and -3.[2013]
  • Supplementation with undenatured whey protein during diabetes mellitus improves the healing and closure of diabetic wounds through the rescue of functional long-lived wound macrophages[2012].
• A whey-based glutathione-enhancing diet decreases allergen-induced airway contraction in a guinea-pig model of asthma.[2011]
• The biological activity of undenatured dietary whey proteins: role of glutathione [1991].
  • “The presence in the serum albumin fraction of glutamylcysteine groups (rare in food protein) and the specific intramolecular bond as related to the undenatured conformation of the molecule are considered to be key factors in the glutathione-promoting activity of the protein mixture.”

Other Non-Cow Milks

Looking at other milks, we find that Goat’s milk has less β-lactoglobulin (closer to human milk in a weak sense).

“Because an increase in the plasma Trp-LNAA ratio is considered to be an indirect indication of increased brain serotonin function, the results suggest that dietary protein rich in alpha-lactalbumin improves cognitive performance in stress-vulnerable subjects via increased brain tryptophan and serotonin activities.” [2002]

” The main components of whey proteins in camel milk and colostrum were similar to that in bovine, except for the lack in β-lactoglobulin.” [2007]

• Undenatured Goat Whey (Available from Swanson’s)

• Certified Organic Undenatured Bioactive Whey Protein (Swanson) – cheaper than ImmunoPro which was very popular in 2000.
• High alpha-lactalbumin whey Isolate is available (Davisco) [Product]

Bottom Line

There are no PubMed studies on whey and CFS/FM/IBS. There was one study for FM and one for IBS, one for CFS (by a questionable author – conflict of interests)

• “The objective of this clinical pilot study was to examine the induction of apoptosis in mononuclear cells on treatment of patients with chronic pain syndrome with oral immunoglobulin produced from bovine colostrum (BCC)….These results were accompanied by a relief of the pain symptoms [in 3 out of 4 patients]” [2009]
• “After 4 weeks (i.e. immediately after treatment), the endotoxin levels of [IBS] patients in the colostrum group showed a decrease in 44.4% (4/9) patients, no interval change in 11.1% (1/9) patients, and an increase in 44.4% (4/9) patients.” [2014] – helps some, makes other worst!
• Inconclusive (but positive) study for Gastrointestinal Infections[2008]

I would recommend trying them, especially the high alpha-lactalbumin whey Isolate because of it’s impact on cognitive function and also improvement of sleep.  Please be aware that results are mixed — it’s a for better or for worst supplement.

I wish the infection specific colostrum were still available, and would love to see one specific for staphylococcus aureus [post].

“”

I have done summary of different DNA variations associated with CFS/IBS/FM before:

• DNA: Irritable Bowel Syndrome’s SNPs
• Fibromyalgia DNA SNP’s
• A Serotonin SNP in CFS
• Methylation Testing via 23andMe
• Case Study on Using DNA: Multiple Chemical Sensitivity
• Is CFS in your DNA?

My model has DNA + microbiome shifts –> Symptoms. The DNA reduces tolerances for swings of metabolites produced the microbiome and with a dysfunctional microbiome, some people are pushed over a threshold and develop symptoms. Fixing the microbiome is possible today, fixing DNA is likely a few decades off.

I happened to stumble across some PubMed studies involving hyperacusis, phonophobia and DNA Snps. This post looks at what I found for other conditions with hyperacusis or phonophobia.

Phonophobia (light sensitivity)

• “Dopamin Beta Hydroxylase gene +1603C>T polymorphism” [2016]

Hyperacusis (noise sensitivity)

The recognized associated conditions [2003] are

• ” The most informative marker (69%) was D7S1870, followed by Hei (55%) and ELN 17/exon 18 (44%). The microdeletion was present in 56% and absent in 22% of patients….Two of the syndrome characteristics (an overfriendly personality and hyperacusis) were more frequent in the microdeletion group and these differences were statistically significant (p = 0.006 and p = 0.02, respectively).” [2010]
• ” OCRL gene deletion revealed involvement of several flanking repeat elements… hyperosmia and/or hyperacusis were reported recurrently.” [2015]
• “hemizygosity for a chromosomal deletion at 7q11.23…  hyperacusis [1999]

A reader asked me to look at the results they just got back. I was pleasantly surprise to see some significant improvements in their report

Lactobacillus and Bifidobacterium is now reported

This is a classic CFS profile!

Akkermansia is cleanly reported

Again, a classic CFS result. See this post on Increasing Akkermansia I did earlier.

Rare Bacteria are listed simply

Checking a few other uBiome results that I could access, we did find a strong pattern for three. And an over representation (25% of the CFS samples versus 13% of general samples)

• Thermonaerobacterales 2/8
• Gelria:  2/8
• Synergistaceae: 2/7
• Low Akkermansia 6/8
• Low Lactobacillus 8/8
• Low Bifidobaceria 7/8

One reader was very rich in rare results:

Bottom Line

Three groups appear to be very common as low to non-existent

• Akkermansia  75%
• Lactobacillus 100%
• Bifidobaceria 87%

There is work going on in getting an Akkemansia probiotic approved for sale. Remember to avoid most lactobacillus because it will push out bifidobacteria… instead, focus on only bifidobacteria probiotics.

Metabolism Reports

Another new set of reports have been added, as shown below. This is done using data derived from the KEGG Pathway Database,

Each of these can expand, for example:

We see two items of interest, ALA (alpha-linolenic acid metabolism) is low and Arachidonic acid metabolism is high. See ALA article and Arachidonic acid metabolism: role in inflammation (1991)

• So, taking ALA supplements would be strongly suggested

Spot checking other ubiome results, I saw one reader had

• D-arginine and D-ornithine metabolism being a very low 0.09x
• Flavonoid biosynthesis a low 0.27x

Again, this hits at specific supplements in lieu of gut bacteria doing their jobs.

Bottom Line 2

The ubiome results give much more friendly data and at a low cost. If you are unsure that you have CFS/IBS/FM, then comparing your results to the above may answer the question. Of greater interest is the additional tables of what part of the KEGG pathway may suggest supplementation.

Back in 1999, Dave Berg (Hemex Labs) publised “Chronic Fatigue Syndrome (CFS) &/or Fibromyalgia (FM) as a Variation of Antiphospholipid Antibody Syndrome (APS): An Explanatory Model and Approach to Laboratory Diagnosis. and stated “We have found that 3 out of 4 CFS &/or FM patients have a genetic deficiency”. A reader wrote yesterday:

• “I have APS.  Positive on Lupus Anticoagulant. …and now some clogged veins (ischemia disease) and perivascular tunnels. Having POTS also doesn’t help…Latest to tack on is Sojogrins to all the others… Dad had three strokes”

Hemex has been sold, Berg has retired, and their specialize suite of coagulation for CFS is no longer available 😦 . The reader asked for what tests to get to detect these defects. I had testing from Hemex, and had a known defect — fortunately one that was easy to compensate for with Piracetam and Tumeric(with pepper). In fact, 4 out of 4 that went for testing were positive, with some 5 different defects (one had three of them!).

These are the tests that should be done for hypocoagulation (thick blood) and how often they are found in the general population.

A reader forward me a link to “Find the cause of fibromyalgia” article (Spanish) which states:

• “Thanks to a study carried out with 3,000 people – of which two thirds of them were affected by fibromyalgia and chronic fatigue – it has been possible to determine that there are 90 polymorphisms in the DNA of the patients that affect the nervous and nervous system.” I have a few of them listed in this 2016 post.

The problem with DNA causing FM/IBS/FM etc, it the tendency towards resignation (“It’s in my DNA — how can we fix it!!!”).  This is very wrong, a very important concept to remember is epigenetics – “In simplified terms, epigenetics is the study of biological mechanisms that will switch genes on and off.”[A Super Brief and Basic Explanation of Epigenetics for Total Beginners]. The key factors of turning genes on and off are items like stress and diet (including availability of minerals, amino acid etc – often a by product of the microbiome).

Microbiome is also inherited in two ways

“microbes (and their genetic material, collectively known as the microbiome) within the body can influence all kinds of traits as disparate as digestion and behavior, and can be passed down to offspring, he says. Just like a person’s own DNA.” [Newsweek]

“A genome-wide association analysis of over 1,000 twins in the UK supports that some parts of our microbiomes are inherited and shaped–not through a spread of microbes from parent to child, but through our genes. The results, revealing new examples of heritable bacterial species–including those related to diet preference, metabolism, and immune defense — appear May 11 in Cell Host & Microbe‘s special issue on the “Genetics and Epigenetics of Host-Microbe Interactions….The investigators used the genome-wide association approach to look for connections between genetic variations between twin pairs and certain bacterial types that were present and stable in the study subjects.” [Science Daily]  So DNA impacts the microbiome … but the microbiome is much more changeable than DNA!

Model

• “Events” trigger DNA to turn some FM/IBS/CFS genes ON (epigenetics)
  • Same event to someone else with different DNA has no problems.
• The change of genes may also result in alteration of the microbiome

Model prediction

• Create an epigenetic event by altering microbiome, supplements.
• Epigenetic events shuts down the genes.
  • Remission (NOT cure).

Bottom Line

There is no defined universal protocol possible for CFS/FM etc. We have at least 80 SNPs for FM, likely a similar number for IBS, CFS etc. Each person has some combination (not all of them), which supported the epigenetic change/microbiome change. The microbiome changes are likely even more complex.

There are commonality that most patients have in common. You may be high in one bacterial genus and the CFS person next to you may be low in the same genus.  What is common are low lactobacillus, low bifidobacterium, low in typical E.Coli (possibly high in atypical E.Coli), low in typical Enterococcus (possibly high in atypical Enterococcus).

With this complex situation, we have very little research, extremely few tools,  and the tools tend to be crude. In one way we have a big box of nuts and bolts in front of us and a bunch of metal connectors with different size holes in them. Some nuts and bolts are metric and some are SAE. This does not mean we are helpless — it means we need to be patient to find the right nut to match with the right bolt and then find the right metal connector where it is a tight fit. There is no handy IKEA assembly manual with all of the parts nicely bagged.

The stuff goes together if we approach it in an organized manner. Take one nut at a time, try different bolts until you have some possible matches. If frustrated, go on to the next nut (or bolt).

What are these nuts, bolts and connectors — herbs, spices, supplements, probiotics and antibiotics. Not all will be needed by everyone. Trying too hard to fit a nut to a bolt may end up jamming it.

In my last post we found that magnesium enhanced the growth of bifidobacteria and lactobacillus — two groups of bacteria that CFS patients are low in. The majority of PubMed studies found that it also improve symptoms. Yet magnesium levels were found to be normal in blood cells — which raise the issue of “selective rationing of minerals and vitamins to the most critical components”. The blood is far more critical to maintain magnesium levels than incidental bacteria in the gut. Often testing assumes that the body is naive and does not do selective rationing.

In this next re-examination of supplements shown to help CFS/FM/IBS, I will look at Vitamin D. I have written often about the need to take sufficients (Mythology of Vitamin D toxicity,  changes from increasing Vitamin D, Vitamin 25D and 1,25D). A few citations:

• “This study demonstrates for the first time a direct antiviral effect of vitamin D in an in vitro infectious virus production system.”[2011]
• “vitamin D is the environmental factor that most strongly influences autoimmune disease development.”[2015]
• “A significant negative correlation between vitamin D level and widespread pain index was found.”[2012] i.e. FM
• Serum 25-Hydroxyvitamin D3 and BAFF Levels Are Associated with Disease Activity in Primary Sjogren’s Syndrome [2017].  “Female SS patients had significantly lower vit D levels  than controls” [2015]
• “Our findings showed that the high-dose supplementation of vitamin D[9 of 50000 IU cholecalciferol capsules for 3 months taken at weekly intervals] affects measures of systemic inflammation: reductions in High-Sensitivity C-Reactive Protein level and Neutrophil-to-lymphocyte ratio (NLR) distribution.” [2017]
  • “The results of the meta-analysis of 10 trials involving a total of 924 participants showed that vitamin D supplementation significantly decreased the circulating hs-CRP level by 1.08 mg/L” [2014]

A longer quote from this year is beneficial

“Vitamin D was first discovered as the curative agent for nutritional c, and its classical actions are associated with calcium absorption and bone health. However, vitamin D exhibits a number of extra-skeletal effects, particularly in innate immunity. Notably, it stimulates production of pattern recognition receptors, anti-microbial peptides, and cytokines, which are at the forefront of innate immune responses. They play a role in sensing the microbiota, in preventing excessive bacterial overgrowth, and complement the actions of vitamin D signaling in enhancing intestinal barrier function. Vitamin D also favours tolerogenic rather than inflammogenic T cell differentiation and function. Compromised innate immune function and overactive adaptive immunity, as well as defective intestinal barrier function, have been associated with IBD. Importantly, observational and intervention studies support a beneficial role of vitamin D supplementation in patients with Crohn’s disease, a form of IBD. This review summarizes the effects of vitamin D signaling on barrier integrity and innate and adaptive immunity in the gut, as well as on microbial load and composition. Collectively, studies to date reveal that vitamin D signaling has widespread effects on gut homeostasis, and provide a mechanistic basis for potential therapeutic benefit of vitamin D supplementation in IBD.” [2017]

Now for some interesting links:

• Oral supplementation with probiotic L. reuteri NCIMB 30242 increases mean circulating 25-hydroxyvitamin D: a post hoc analysis of a randomized controlled trial.  L.Reuteri is low in CFS patients, thus a decrease would be expected.
• Vitamin D Promotes Pneumococcal Killing and Modulates Inflammatory Responses in Primary Human Neutrophils [2017].
• “Vitamin D intake .. Prevotella was more abundant .., while Haemophilus and Veillonella were less abundant … and abundances of Coprococcus  and Bifdobacterium … were inversely correlated with 25(OH)D.”[2017] in other words, Vitamin D alters the microbiome.
• “As a result of these effects on the intestinal mucosa, maintenance of sufficient vitamin D status may be essential for the development of a healthy gut microbiota, particularly in conditions defined by chronic mucosal inflammation such as CF…additional evidence is needed to establish vitamin D as a therapeutic approach for gut microbiota modification.” [2016]
• Vitamin D deficiency changes the intestinal microbiome reducing B vitamin production in the gut. The resulting lack of pantothenic acid adversely affects the immune system, producing a “pro-inflammatory” state associated with atherosclerosis and autoimmunity[2016]. “1) Seasonal fluctuations in vitamin D levels have normally produced changes in the intestinal microbiome that promoted weight gain in winter. Years of vitamin D deficiency, however, results in a permanently altered intestinal environment that no longer favors the “healthy foursome”. 2) Humans have always had a commensal relationship with their intestinal microbiome. We supplied them vitamin D, they supplied us B vitamins. 3) The four species that make up the normal microbiome are also commensal, each excretes at least one B vitamin that the other three need but cannot make. 4) Improved sleep and more cellular repairs eventually depletes body stores of pantothenic acid, causing reduced cortisol production, increased arthritic pain and widespread “pro-inflammatory” effects on the immune system. 5) Pantothenic acid deficiency also decreases available acetylcholine, the neurotransmitter used by the parasympathetic nervous system.”

Bottom Line

The understanding of what Vitamin D does have changed over the last decades. Originally, it was know to cure rickets (and the recommended dosage became some 50 Iu/day), then it impacted bone loss and the dosage increased.  Today, we find that it is implicated in many areas, impacting the distribution of bacteria in the microbiome, and needed for a healthy gut microbiota.

The biggest problem is that MDs are often behind the times and do not work from the latest literature.  For example a single dosage of 600,000 IU of vitamin D is deemed safe on medscape, or 10,000 IU/day for months [source]. One of the studies above cited an average of 60,000 IU/day for 3 months!  [2017]

I wrote about Magnesium and Malate acid back in 2012. There are sites that takes you thru the pros and cons of different magnesiums such as MAGNESIUM SUPPLEMENTS: DIFFERENT TYPES & DIFFERENT BENEFITS. I wish to do a short revisit by looking only at the pH of each because a hypothesis suggests that those having a higher pH (more alkaline) would likely have additional impact beyond just the magnesium.

• Magnesium Gylcinate  9 – 11 [source] – $1.50/gram
• Magnesium Oxide – 11.2   $ 0.02 /gram
• Magnesium Citrate –  4.0 [source] [source]  $0.85/gram
• Magnesium Malate – 7 – 11 [source]  $0.05/gram
• Magnesium Taurate – 9-10 [source]  $1.00 /gram
• Magnesium Threonate  -5.8 – 7 [source]  $ 0.50 /gram
• Magnesium Carbonate – 10.41   $0.02 /gram
• Magnesium Hydroxide (Milk of Magnesia) –  10.5  [source] $0.03/gram

There are three dimensions to consider:

• Ability for magnesium to get absorbed (instead of just passing thru) — see link at top
• pH of the product (more pH is usually better)
• cost of the product.

Importance of Magnesium

• “Low intake of omega-3 fatty acids, vitamin B6, magnesium, zinc and antioxidants may also play a supporting role in symptom occurrence.” [2016]
• “This pilot study suggests that transdermal magnesium chloride applied on upper and lower limbs may be beneficial to patients with fibromyalgia.” [2015]
• “The number of tender points, tender point index, FIQ and Beck depression scores decreased significantly with the magnesium citrate treatment. The combined amitriptyline + magnesium citrate treatment proved effective on all parameters except numbness. Low magnesium levels in the erythrocyte might be an etiologic factor on fibromyalgia symptoms.” [2013]
• Women with fibromyalgia have lower levels of calcium, magnesium, iron and manganese in hair mineral analysis [2011].
• The relationship between serum antioxidant vitamins, magnesium levels, and clinical parameters in patients with primary fibromyalgia syndrome [2011].
• “Magnesium sulphate, a substance known to cause release of cholecystokinin (CCK) from the small intestinal mucosa, was given by mouth (dose 0.1g/kg in 150 ml water) to 20 patients with the irritable bowel syndrome. …These findings provide further evidence that ;functional’ abdominal pain after food may in some cases be related to an exaggerated intestinal motor response to cholecystokinin.” [1973]
• “The diet of IBS patients was found to consist of a low calcium, magnesium, phosphorus, vitamin B2 and vitamin A content.” [2012]
• Magnesium deficit in a sample of the Belgian population presenting with chronic fatigue [1997].
• “[Chronic Fatigue] Patients treated with magnesium claimed to have improved energy levels, better emotional state, and less pain, as judged by changes in the Nottingham health profile. 12 of the 15 treated patients said that they had benefited from treatment, and in 7 patients energy score improved” [1991]
• Cognitive behaviour therapy for the chronic fatigue syndrome. Evening primrose oil and magnesium have been shown to be effective [1996].
• “magnesium was demonstrated effective on ME/CFS patients’ symptom profiles.” [2012]
• [A case of chronic fatigue syndrome who showed a beneficial effect by intravenous administration of magnesium sulphate] [1992].
• Magnesium status and parameters of the oxidant-antioxidant balance in patients with chronic fatigue: effects of supplementation with magnesium [2000]. “Mg supplementation was followed by an improvement in Mg body stores, in serum vitamin E and its interrelated stage of lipid peroxidation.”
• “Magnesium (p = .002) and support groups (p = .06) were strongly associated with fatigue worsening from 6 months to 2 years.” [2005]
• “Red blood cell magnesium concentrations were measured in samples from 89 patients who fulfilled the diagnostic criteria for chronic fatigue syndrome and the results compared to those found in an age and sex matched group selected from the normal population. No significant difference was found. … There is therefore no indication for the use of magnesium therapy in the management of this condition.” [1994] – note that was confined to red cell analysis only.
• Chronic fatigue syndrome and chronic primary magnesium deficiency (CFS and CPMD) [1992].

Microbiome Dimension

• Changes in intestinal bifidobacteria levels are associated with the inflammatory response in magnesium-deficient mice [2010]. Mg+ and Mg- below indicate deficient or increased. After 4 days, both bifido and lactobacillus increased.
  
• “We conclude that calcium and magnesium fluxes play an important role in the physiology of the bifidobacteria and that several metal growth inhibitors interfere with iron metabolism.” [1984]
• Mg improves the thermotolerance of probiotic Lactobacillus rhamnosus GG, Lactobacillus casei Zhang and Lactobacillus plantarum P-8 [2017].
• Mn(2+) and Mg(2+) synergistically enhanced lactic acid production by Lactobacillus rhamnosus FTDC 8313 via affecting different stages of the hexose monophosphate pathway [2014].
• “Nutritional requirements of Lactobacillus delbrueckii subsp. lactis in a chemically defined medium[2004]. “Magnesium was the only essential oligoelement.”

pH factor

Optimal pH for Bifidobacterium bifidum is 7.0 [source] with other sources saying 6.5 – 7.0. Stomach acid is around 1.0-3.0.  This raise the question whether it may be good to take you bifidobacteria with magnesium instead of at a separate time..

From National Institute of Health site:

• “Diets with higher amounts of magnesium are associated with a significantly lower risk of diabetes,”
• “People who experience migraine headaches have lower levels of serum and tissue magnesium than those who do not.”
• ” taking 300 mg magnesium twice a day, either alone or in combination with medication, can prevent migraines”
• “Forms of magnesium most commonly reported to cause diarrhea include magnesium carbonate, chloride, gluconate, and oxide [11].”

Bottom Line

Magnesium impact on CFS etc may be because it encourages the growth of Lactobacillus and Bifidobacteria

Magnesium oxide/Magnesium Hydroxide are cited as less bioavailable. My conclusions today are still the same as in 2012, Magnesium Malate is the best bang for the buck (and bucks are always sparse for CFS patients!). Dosage should be determined by your MD, the literature indicated that 5000 mg/day can create problems with the young and the elderly, I would question more than 1000 mg/day and suggest that 600 mg/day (used to treat another condition successfully) may be warranted.

Note: Magnesium Malate tablets cited as 1250 mg is not 1250 mg of magnesium, just 425mg for three 1250mg tablets. That is  140 mg or magnesium per tablet, so 7 tablets of 1250mg per day would be needed to reach 1000 mg/day.

A very common mistake that CFS patients make in their brain fog is thinking that their dosage are sufficient. “Yes, I am taking Magnesium — it is in my multivitamin!” (Looking at Centrum multivitamins, I see there is 64 mg, approximately 1/10 of what may be needed to do corrective action for low magnesium).

As always, start with a low dosage and slowly work up.

THIS IS NOT MEDICAL ADVICE — this post is an education summary of what has been reported on PubMed. Always consult with a knowledgeable medical professional before changing diet, supplements and prescription drugs.