Friday, October 1, 2010

Strokes and Magnesium

Magnesium deficiency can cause metabolic changes
that may contribute to heart attacks and strokes.
National Institute of Health

Dr. Tavia Mathers and Dr. Renea Beckstrand from Brigham Young University published in the Journal of the American Academy of Nurse Practitioners in 2009 that magnesium has been heralded as an ingredient to watch for 2010 and noted that magnesium is helpful for reduction of the risk of stroke.
Journal of the American Academy of Nurse Practitioners. December 2009, Volume 21, Issue 12, Pages: 651-657 “Oral magnesium supplementation in adults with coronary heart disease or coronary heart disease risk”

Population-based information suggests that people with low magnesium in their diet are at greater risk for stroke. Clinical evidence suggests that magnesium is helpful in the treatment of a stroke.

The current RDA is considered to be sufficient but there is mounting evidence that this figure is much lower than optimal intake and that this low level of magnesium contributes to degenerative diseases and even strokes in children.

Experts now believe that a significant number of cerebral palsy cases may be due to strokes before or right after birth and that administration of magnesium sulfate given before birth to pregnant women, is preventing occurrances of cerebral palsy by a significant percent.

In orthodox medicine adult strokes are said to be caused by high blood pressure, high cholesterol, a history of smoking, too much alcohol and obesity. Children’s strokes, on the other hand, are thought to be caused by birth defects, infections (e.g. meningitis, encephalitis), trauma, and blood disorders such as sickle cell disease.

Nowhere do you see in the literature that severe magnesium deficiency could have anything to do with it even though it is well known that high blood pressure, high cholesterol, a history of smoking and too much alcohol and obesity are all correlated with magnesium deficiencies.

In my practice the use of magnesium in the early
stages of a stroke has rendered the best results
for my patients who have the greatest deficits.
Dr. Al Pinto

Primary prevention — stopping the first stroke from occurring — is possible if full magnesium status is paid attention to. It is important to diagnose a stroke quickly when they do happen and start treating with magnesium right away because in this way we can reduce the likelihood of additional strokes as well as massive damage from the first stroke.

This research concludes that it is magnesium status that controls cell membrane potential and through this means controls uptake and release of many hormones, nutrients and neurotransmitters. It is magnesium that controls the fate of potassium and calcium in the body. If magnesium is insufficient potassium and calcium will be lost in the urine and calcium will be deposited in the soft tissues (kidneys, arteries, joints, brain, etc.).

Magnesium protects the cell from aluminum, mercury, lead, cadmium, beryllium and nickel. Evidence is mounting that low levels of magnesium contribute to the heavy metal deposition in the brain that precedes Parkinson’s, multiple sclerosis and Alzheimer’s. It is probable that low total body magnesium contributes to heavy metal toxicity in children and is a participant in the etiology of learning disorders.

The most effective stroke treatments can only be given within the first few hours after a stroke has occurred. Once you are identified by ambulance or emergency personnel as someone who could be having a stroke, doctors need to know when the symptoms started because this is crucial in terms of effective window of treatment. With magnesium treatments, the trend toward a better functional outcome at 30 days in  adult patients is seen when treatments are started much earlier, within 0-2 hours from onset.

Low CSF Mg+2 levels in patients with acute ischemic
stoke at admission predicted a higher 1-week mortality.

In Los Angeles, California, we have what is called the FAST-MAG trial, which has the ambulance personal injecting magnesium quickly upon arrival of stroke victims. The Field Administration of Stroke Therapy (FAST-MAG Trials) is an NIH-NINDS-sponsored study whose goal is to evaluate the effectiveness and safety of field-initiated magnesium in improving the long-term functional outcome of patients with acute stroke.

The FAST-MAG trial addresses the crucial factor of delayed time to treatment which has hindered all past human clinical trials of neuroprotective drugs.

The FAST-MAG Pilot Trial demonstrated that field initiation of magnesium in acute stroke is feasible, safe, and potentially efficacious. The basic design is to inject magnesium within 1-2h of onset of stroke when the benefits of neuroprotective acute stroke therapies are likely to be greatest. By utilizing field delivery via the ambulance medical scientists are conducting the first neuroprotective study ever performed in the 0-2 hour window. Most stroke patients typically don’t receive treatment within these brief windows. Patients typically arrive at the hospital too late; and the consequences as such are great.

While you are waiting for the ambulance if one has magnesium oil in the house one can rub the magnesium all over the body. This will not replace an injection of magnesium that could be offered by the ambulance operators but it opens up quick intervention that will help. One can also drink magnesium chloride. The point is the quicker one intervenes the greater the chance of a quicker and more complete recovery.

Researchers believe that magnesium slows the chemical process that can kill 12 million brain cells per minute during an untreated stroke, leading to long-term disability and death. So every moment is crucial to outcome. At least nine preclinical studies have examined the effect of systemic magnesium sulfate upon final infarct size in animal focal ischemic stroke models. Eight of the nine demonstrated substantial decreases in infarct size in treated animals, with reductions ranging from 26-61% in unconfounded studies.

Early studies using rats and mice showed that if given
at high concentrations, magnesium can decrease the area
of the brain that is permanently lost as a result of a stroke.
Dr. Jose Vega

“How does magnesium protect the injured brain?” asks Dr. Vega. “The response to a lack of oxygen and nutrients (i.e., ischemia) by the brain includes a local release of chemicals which can damage brain cells, even beyond the damage that can be expected by ischemia alone.

Perhaps the most harmful of these chemicals is glutamate, an amino acid used in very low amounts by brain cells to communicate with each other. During a stroke, however, the massive amount of glutamate released produces a flood of calcium inside brain cells which in turn causes them to die prematurely. Magnesium is thought to have the ability to prevent glutamate from causing this flood of calcium in the cells, thus protecting them from premature death.

Dr. Vega continues, “If magnesium infusion is found to be an effective approach for the treatment of acute stroke, it would be a much needed addition to the current armamentarium of medical therapies. Currently, less than 10% of stroke patients can benefit from tissue plasminogen activator (TPA) infusions partly because of the 3 hour limit after the onset of stroke symptoms in which it can be used, and partly because it is contraindicated in hemorrhagic strokes.”

An essential prerequisite for any pharmacological agent to offer significant brain neuronal protection during strokes is its ability to freely cross the blood–brain barrier. Several studies show that magnesium crosses the blood–brain barrier, in both animals and in humans.
Muir KW. Magnesium for neuroprotection in ischaemic stroke: rationale for use and evidence of effectiveness. CNS Drugs. 2001; 15: 921–930.

Magnesium ions cross the intact blood-brain barrier efficaciously so that intravenous magnesium sulfate or chloride significantly raises cerebrospinal fluid and brain extracellular fluid magnesium to supraphysiologic levels.

Magnesium is neuroprotective in preclinical models of cerebral and spinal cord ischemia, excitotoxic injury, and head trauma. Magnesium is economical, widely available, simple to administer and has a long established safety and tolerability profile in myocardial infarction and eclampsia, as well as in pilot human focal stroke studies.

Unlike most synthetic neuroprotective compounds, parenteral magnesium has no major adverse effects in doses that achieve serum levels in the range of preclinical neuroprotective concentrations.

The way to reduce the chances of developing dementia such as Alzheimer’s disease after a stroke is to prevent a second stroke by concentrating on the known stroke risk factors, a British study suggests. Magnesium plays a significant role in relaxing the blood vessels, an effect generally proven to help lower blood pressure. When blood vessels are constricted — not relaxed — the heart works harder to pump blood through the body, causing blood pressure to increase.

Dr. Jerry Nadler says, “Higher dietary intake of magnesium was among the factors associated with a reduced risk of stroke in men with hypertension. In a survey of almost 45,000 men ages 40 to 75, the overall risk of stroke was significantly lower for men in the highest quintile of intake of potassium, magnesium, and cereal fiber, but not of calcium, compared with men in the lowest quintile of intake.

A similar relationship was reported this year by Meyer and colleagues, who observed that a diet rich in magnesium, grains, fruits, and vegetables reduced the likelihood of developing type 2 diabetes in a group of almost 36,000 women. While no consistent effect of magnesium on blood pressure has been noted among persons with diabetes, a significant blood pressure reduction was noted in diabetic patients with hypertension after dietary sodium was replaced with potassium and magnesium.”
Diabetes and Magnesium;

Magnesium is an agent with actions on the NMDA receptor and a low incidence of side effects. It may reduce ischemic injury by increasing regional blood flow, antagonizing voltage-sensitive calcium channels, and blocking the NMDA receptor. Using various mechanisms, neuroprotective agents attempt to save ischemic neurons in the brain from irreversible injury. Studies in animals indicate a period of at least four hours after onset of complete ischemia in which many potentially viable neurons exist in the ischemic penumbra.

Intravenous magnesium sulfate administration during the hyper acute phase of stroke has been shown to be safe in a small, open-label pilot trial, in which more than 70% of patients were treated less than 2 hours from symptoms onset. Dramatic early recovery was achieved in 42% of patients, and good functional outcome (modified Rankin scale </=2) at 90 days post treatment was achieved by 69% of all patients and in 75% treated within 2 hours.
Saver JL, Kidwell C, Eckstein M, et al. Prehospital neuroprotective therapy for acute stroke: results of the field administration of stroke therapy — magnesium (FAST-MAG) pilot trial. Stroke. 2004;35:106-108.

Childhood strokes

There is mounting evidence that low levels of magnesium contribute to degenerative diseases and even strokes in children.

Pediatric stroke is estimated to be the sixth leading cause of death in children. In a study of over 200 children who had suffered a stroke, nearly 80 per cent were found to have abnormalities in the brain’s arteries.

These abnormalities were due to an inflammation, a narrowing or a tear in the artery walls

"In newborns, the first symptoms of stroke are often seizures that involve only one arm or one leg. That symptom is so common that stroke is thought to account for about 10 percent of seizures in full-term newborns.”

Experts now believe that a significant number of cerebral palsy cases may be due to strokes before or right after birth and that administration of magnesium given before birth to pregnant women, is preventing occurrences of cerebral palsy by a significant percent.

The risk of stroke in children is greatest in the first year of life, particularly in the first two months. Stroke also can occur before birth. What this is saying is that a mother’s magnesium status is her child’s magnesium status and the damage can take place right inside the womb.

It is critical to recognize magnesium deficiencies and that is really not difficult to do if one simply looks at the dietary profile of a mother and child. But it is important to diagnose a stroke quickly when they do happen and start treating with magnesium right away because in this way we can reduce the likelihood of additional strokes as well as massive damage from the first stroke.
Extracted from

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