Magnesium citrate and serum potassium level and a general rant

[ajs100uk]

Edited to add my original posts which have history and results :-):

First post: healthunlocked.com/thyroidu...

Update/follow up post: healthunlocked.com/thyroidu...

I have been taking 750mg of magnesium citrate a day for a couple of months for chronic constipation and aching legs. I take it at night with calcium and vit C. It did not really help the constipation but helped my legs to some extent. However, a recent blood test my rheumatologist ran has shown a high serum potassium, and looking online magnesium can be the cause? I would be interested if anyone knows anything about this? I do not think high potassium is a good thing so have dropped the magnesium back down to 225g at night in case this is a cause.

This is yet another abnormal blood test to add to my list (others being liver function tests and cholesterol) all if which have been creeping upwards since the end of last year. My GP justs kept asking me to repeat the tests in six weeks! All this has done is show an upward trend. He has found no cause and will not acknowledge it is caused by hypothyroidism, as according to him I do not have this because of normal TSH! He will not even discuss the T4 to T3 conversion problem I have that has been diagnosed by my private doctor (who is also GMC registered so must know what he is talking about).

I have NEVER met such a bunch of uncaring GPs in my life. The whole pratice is the same! The last time they rang to tell me the tests were abnormal they said the GP wanted them repeated (yet again) in six weeks and to see a health care assistant regarding my diet! Well, I told them to forget it, if a GP is not interested in finding out WHY these tests are abnormal, then I am not interested in continually repeating tests for no reason or listening to a lecture about diet. I do not eat much due to gastric bypass! I am so fed up with all this!

I wrote an email to the practice manager the other week. In it I mentioned some of the problems I am currently having and the GP knows what else I am suffering from including chronic constipation with hard large stools (sorry if too much information), going for a wee and the flow stops suddenly and then I cannot go even though I feel like I still need to go, (new symptom of about 4 weeks), cannot lose any of the 3st I have gained since Dec 2015 for NO reason, and the 'fat'/skin that I have cannot be pinched anywhere on my body , the swelling on my lower legs is hard and actually hurts if I press it, I beleive this is mucin. The swelling is there 24/7 and does not go down overnight. I am freezing all the time. My tummy feels so hard and swollen and I think my bowels, large and small are backed up. Anyway, the practice manager, who seems helpful but also gives me the impression I am being a pain said she would show my email to my GP and put it in my notes as I requested. I have heard nothing.

I think I mentioned before that my GP has tested for most if these things in isolation and not looked at/considered that all my symptoms are being caused by one thing ie untreated hypothyroidism! As he seems to have run out of tests he seems to be ignoring me. I think he hope I will go away. I have not made another appointment as they are very strict about having a 10 minute appointment and will only allow a discussion in that 10 minutes of one problem! I always try to blurt out everything and end up getting angry because the GP is so distant, uncaring, and dismissive.

Am I being unreasonable to want my GP to help me according to my symptoms and not relying on just ONE blood test (TSH) which he says is 'normal' whilst all others are turning and staying abnormal? Besides, the TSH test has no bearing on what is going on with me but he will not accept this.

I am concerned I am going to run out of money and will no longer be able to afford the private doctor I have seen, where the treatment is soooo different - I am not made to feel like I am making it all up and I am getting treatment by a caring doctor who listens to my symptoms above all else. One of the first things he said to me was that he could tell I had hypothyroidism just by LOOKING at me - outer eyebrows missing/puffy face. WOW I could hug him! Why is my GP not like this?

Anyway, sorry for rant and thoughts much appreciated as always.

[MiniMum97]

Can you change GP practices? Or make a formal complaint? Personally I would try to find another practice. I went through all the GPs at my practice before I found a good one. I only ever see her now. Refuse to see anyone else!

[ajs100uk in reply to MiniMum97]

The trouble is if you change practice the new practice wants to know why in writing and I am not sure my reason for doing so would be welcomed.

I have seen three doctors at the current practice and they have all had the same attitude so I guess it is what they have agreed behind closed doors ie how they deal with patients.

I had used the same GP all my life until I was 42, they were all very caring. I then moved slightly out of area and had the same GP for 7 years, again very supportive. We then moved temporarily for a year or so completely out of the area and another new GP and that has been when my problems have really escalated. I am now back in another area and have been with the new practice since Jul 2016. I am not used to being treated so poorly but I think it is a worrying trend in quite a few practices from what I read on here

[MiniMum97 in reply to ajs100uk]

See this link. You don't have to tell either practice why you are changing...

nhs.uk/chq/Pages/1088.aspx?...

[ajs100uk]

Ok, I am confused, this is on the website of a practice I had considered:

"Please note that if you are already registered with a doctors practice in the area, a letter needs to be posted / handed in at reception expressing the reason why you are requesting a change from your current doctor."

I am sure if I did not do this I would immediately have a 'black mark' with that surgery.

[Hidden in reply to ajs100uk]

You could just ignore the request, after all, you didn't see it did you?! If they press, just say lightly, Oh, it's just more convenient! Don't be pressured into thinking you have to explain. I'm a stickler for doing things right and 'obeying' the rules, but try to 'wing it' more now

[ajs100uk in reply to Hidden]

Actually, looking more at their site, I see their latest CCQ result was 'needs improvement'. Perhaps they are no better than where I currently am.

I am a stickler too but boy has that got me stressed lately! My adrenals have crashed according to my private docotr so I should be avoiding all this stress lol

[Hidden in reply to ajs100uk]

Better the devil you know heh ?! I know what you mean, all very well when you're on top of things.

In any event, hope you get things sorted out, so that you can get well

[ajs100uk in reply to Hidden]

Thank you x

[greygoose]

So, what is your TSH? Does your private doctor not test the FT4 and FT3?

Is it unreasonable to want your GP to help you according to your symptoms? From the GP's perspective, yes. They know nothing about symptoms. From a patient's point of view, no, it's perfectly reasonable. But, the GPs have all the power, and there's not much you can do about it.

If your cholesterol is getting higher, then you are getting more hypo. But doctors are totally ignorant of the connection.

For the constipation, you could try high doses of vit C - you don't say how much you're taking. You can take up to 5000 mg a day. But, start low and work up to that dose. You might not need it all.

Do you really need the calcium?

[ajs100uk in reply to greygoose]

My private doctor checked everything. I have posted before and received alot of help. This was my initial post: healthunlocked.com/thyroidu...

I did then go on to have vitamin tests as recommended in here and I posted the results but I think it was missed: healthunlocked.com/thyroidu...

I take calcium as I was told to do so for life following gastric bypass, along with a multivit, iron, zinc and b vits.

I take 3000mg of vit c a day, I drink water and take movicol.

Oh the joys!

[greygoose in reply to ajs100uk]

Well, you definitely need an increase in dose - your FT3 is rock-bottom, and your TSH is too high. I'm not surprised your cholesterol is increasing.

Your vit D could be higher.

I think it's very dangerous to take calcium supplements every day, without ever getting it tested. They are not easily synthesised by the body, and the calcium can accumulate in the soft tissues and arteries. If you really have to take them - and I think you should consider that most carefully - then you should also take vit K2-MK7 to help the calcium get into the bones and teeth.

However, if your calcium doesn't test too low, it might be an idea to take vit D - as you need to, anyway - and vit K2-MK7, because vit D will increase your absorption of calcium from food.

[ajs100uk in reply to greygoose]

Every time I have my calcium tested it is normal and that is on supplementation. As I have a gastric bypass I do not absorb as much vit/mins from food (and I believe supplements and medications) as normal people. My calcium has never been high since the bypass whilst supplementing. I feel scared to take it now!

Following the advice I gained from my previous post and my private doctor I take the following:

Metavive NDT 4am

NAC (to see if it helps the swelling) 7.30am

Vit b12 sublingual 1000mg and DHEA 15mg

Vit c 1000mg and solgar gentle iron 25mg at 10.30am

A new Mutlivit as per inital post (changed from sanatogen a-z) with omega 3 oil capsule, q10. Selenium, 1000mg vic c at lunchtime. The multivit has vit D3 2000iu (previously I was taking fultium from GP 800iu a day), it has k2-mk7 and B12 amongst others. I think this is a very good miltivit especially for people such as me with very little spare cash to buy everything individually

Metavive NDT 4pm

Swapped adcal d3 for calcium with vit D and K2, taken at night (Swisse bone health) with magnesium and vit c 1000mg

Bio-identical progesterone lozenge at bedtime.

[greygoose in reply to ajs100uk]

Metavive is not NDT. It is an OTC supplement with no proof that it contains hormones. I'm not surprised your FT3 is low! You need to be on something like Armour, Erfa, Thyroid S, Thiroyd or something.

'Normal' is not a result, it is an opinion. You should never accept from anyone. Is your calcium at the top of the range, bottom of the range, where?

Does your multivit contain iron? If so, you will not be absorbing any of the vitamins. Does it contain iron plus magnesium or calcium? If so you will not be absorbing the iron, either. Does it contain iodine? Your don't want that. Is the B12 cyanocobalamin or methylcobalamin? So many reasons why multivits are rubbish! I know about your problem with the bypass, but a multivit is not the answer, I'm afraid.

[ajs100uk in reply to greygoose]

No iron in the current multivit. I took your previous advice regarding multivit as you looked up the one i was taking and changed to my current one.

amazon.co.uk/dp/B01H08EUT6/...

I simply cannot affird to buy everything separately.

I now take gentle iron with a vit c capsule away from the multivit.

The last calcium I had was bottom of normal, I will try and locate it but they are always in the normal range.

The irony of all my posts and situation is that I am a medical secretary and I used to work for an endo. He often tested my calcium, and iron and said they were always normal. He said vit D was low and to continue supplementing.

It does containe a small amount of iodine. My private doc told me to take iodine up to 1000mg! But I have not done this.

B12 in it is methylcobalamin.

It does not contain calcium. It has 2mg of maganese citrate.

I will send you a private message re metavive.

So, appreciate the help and advice from everyone on here

[greygoose in reply to ajs100uk]

Well, that one is better than most. But, there's still iodine in there, which you really don't want. And, although the B12 is the right one, there's not enough of it to increase your low B12. Did you say you took a B complex? How much B12 is in that?

[ajs100uk in reply to greygoose]

I take a 1000mcg B12 methylcabalamin sublingual daily too. I have the Jarrow B complex but was advised previously not to take that with the multivit so it is sitting in my cupboard.

My PD said for me to take up to 1000mg of iodine! I have not done this

[greygoose in reply to ajs100uk]

OK, that's good for the B12.

But, you really, really don't want to take any sort of iodine.

[LaShell in reply to greygoose]

Have you ever heard of or tried taking "Nacent Iodine" ?

[helvella in reply to LaShell]

There have been many threads in which nascent iodine has been mentioned. Have a look here:

healthunlocked.com/search/n...

[greygoose in reply to LaShell]

Heard of it, yes.

[ajs100uk in reply to LaShell]

Heard of, not tried, scared to

[humanbean]

750mg of magnesium citrate is too high a dose. The tolerable upper intake level for supplemental magnesium is 350 mg/day.

And according to this page :

lpi.oregonstate.edu/mic/min...

Magnesium is required for the active transport of ions like potassium and calcium across cell membranes.

The kidneys are supposed to deal with magnesium toxicity, but perhaps there is a limit to how much they can remove when supplementation is excessive.

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.

Above quote is from my link further up.

This would be worth reading : en.wikipedia.org/wiki/Hyper...

****

You also mention you are taking calcium. Do you know for certain that you are deficient in calcium? Because excessive calcium is going to deposit itself in your soft tissues like your brain and heart. It will end up lining your arteries. Calcium should only be supplemented when there is a known deficiency. Testing should be done to see when a deficiency has been fixed. Then calcium supplementation should be stopped.

****

Aching legs could be caused by being hypothyroid. They could also be caused by low iron. Have you ever had any iron or iron-related tests done?

****

I think you need to :

a) Get hold of copies of your blood tests including reference ranges for the last couple of years, or preferably get a copy of your entire GP record (which will probably cost £50).

b) Then find a new GP.

[ajs100uk in reply to humanbean]

Thanks. It is all so confusing with differnet websites giving different advice. I was led to believe it was quite safe to take 1000mg of magnesium citrate.

Calcium. I was nit treated for a deficiency. I have had a gastric bypass. This is a major bariatric surgery that results in not being able to absorb nutrients from food as well as normal people. I had it in 2009. I was told by the consultant that I should supplement a multivit, calcium, zinc, iron, b vits, for life everyday and I have done that religiously. My calcium has always been normal on supplementation So I hope that means it is not being deposited in the wrong places

Until recently when I posted on this site all my supplements were prescribed by my GP as per the consultants instructions.

[humanbean in reply to ajs100uk]

Oh, I didn't realise you had had a gastric bypass. So my suggestion on the calcium doesn't apply. I would instead suggest that you continue your supplementation of calcium but then have it measured once or twice a year to make sure the levels aren't going too high.

You need magnesium and vitamin K2, but drop the magnesium to a lower level than the 750mg you were taking.

Try and keep your vitamin D to optimal levels as well, bearing in mind that (usually) vitamin D supplementation increases the absorption of calcium from the diet. (Although I wonder if that statement is true in someone who has had a gastric bypass.)

What level of B vitamins are you taking?

A cautionary tale for someone with a gastric bypass :

facebook.com/notes/vanessa-...

I hope you are taking enough thiamine.

For your constipation could you increase your intake of vitamin C?

[ajs100uk in reply to humanbean]

Yep, gastric bypass in 2009. It was a big scary op I was in surgery for 7 hours! Big liver apparently. Anyway it went well, I lost 10st and was very comfortable with that. That is until I started gaining weight for NO reason in Dec 2015, I have now put on 3st and it is not going anywhere. This is without any change to my eating AND having a bypass. With a bypass if weight loss slows, you can go on "pouch reset diet" (in other words liquid only) I did that a couple of times in the year after surgery when I thought my weight loss was slowing. I would literally lose 7lbs in a couple of days and it would stay off and the weight loss would continue. I have tried this several times since the weight gain started in Dec 2015 and have not lost an ounce.

I think you may have posted on my original post. I have always taking b vits since the op, albeit until recently, poor ones. I now take 1500mcg of B12 a day, B1 50mg, B2 30mg, B3 30mg, B5 30mg and B6 30mg.

I have certainly never had any peripheral nerve type symptoms since my gastric bypass, like the lady you mentioned.

My latest vit results (a month ago just prior to the full new vit regime and on still mainly on the GP's prescription vits) were:

Vit B12 402 (140-724)

Folate (serum) 9.94 (3.89-26.80)

25 OH vit D 88.45 (50.0-200)

Ferritin 88.73 (13-150)

[humanbean in reply to ajs100uk]

In your shoes I would want my B12 level to be a minimum of 500, and my folate to be mid-range or upper half of range.

The vitamin D and ferritin are fine.

[ajs100uk in reply to humanbean]

I am hoping they will be a bit higher now I have upped my supplementation

[thyroidquest]

Can you get a referral? Research good endos in your area and request to see them. Then discuss t4 to t3 conversion concerns... Good luck

[ajs100uk in reply to thyroidquest]

Not sure if you have seen my original posts

I had multinodular goitre diagnosed in 2013. Had 3 inconclusive FNAs, a nuclear scan, and no treatment.

Moved house and saw an endo last year. I was referred to her hyper, she reran the blood tests and I was hypo. I saw her three times over a couple of months. She reran all the scans I had previously had. She said "i dont really know what to do with you"! She offered no medication. She did offer total thyroidectomy due to my large multinodular goitre!

I then moved and saw a new GP. Back to square one, no continuation of care. I have been referred (after insisting!) to another endo. I changed my appointment after finding this site. I am sure that to find the ellusive endo that does treat conversiin problems is going to be highly unlikely and I am too tired of it all to bother to be honest.

As it is, all the stressing and battling with an unsuppotive GP has crashed my adrenals. I dont think they would recognise that either.

I do have the appointment that I changed coming up with the endo but do I really want to go along, be examined, have all the scans again, etc, for no doubt nothing?

Sorry, but the NHS has made me feel very negative about ever gaining their support letalone treatment for my condition. After all, they have left me to get steadily worse since I first saw them regarding all this

If anyone HAS seen a "good" endo in East Sussex then I really would like to hear of them