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IAMNOTADOCTOR
Sep 26, 2013

Not a personal attack, just pointing out some things I strongly disagree with. In my experience a lot of people like the OP think they are all about evidence based medicine but still hold very unscientific beliefs.

Hodgepodge posted:

Although I take a small amount of vitamins, I think the only one particularly recommended by medical practitioners on a regular basis is Vitamin D during cloudy winter months.
For a specific subset of the population, and still better to increase dietary intake. For 95% of the population there is no reason to take any supplements and that includes vitamin D.

quote:

Well, and most North Americans are short on Magnesium.
No they are most definitely not. This is most definitely untrue, see the next point for why.

quote:

It's an electrolyte and helps regulate stress,
Nope, symptoms of hypomagnesemia:
neuromuscular hyperexcitability (eg, tremor, tetany, convulsions), weakness, apathy, delirium, and coma.
Cardiovascular manifestations, including widening of the QRS and peaking of T waves with moderate magnesium depletion
And calcium/potassium imbalances.

I think you'll agree that most Americans don't suffer from these, and none of these I would label as stress.

quote:

A lot of the time, the question with a "supplement" comes down to "am I willing to do a lot of research to make sure that it is safe and still, at the least, risk wasting my money"? That this is the same question that I ask before trying a nootropic that is technically not sold for human consumption doesn't really speak well of the regulatory climate.

No, the question is do I want to be fooled by a wide spread marketing campaign and buy stuff I don't need while at the same time buying in to a non scientific view on health and disease? The correct answer is no.

quote:

On the other hand, part of the reason for that is that pharmaceutical companies didn't like natural medicine (don't let anyone sell it) until they realized that they could get in on it (nevermind don't regulate it at all), and that has affected the regulatory schizophrenia around the subject.

Unfounded in reality, most if not all large pharmaceutical companies started with compounds derived from nature and this remains to day one of the most important sources of new drug patents and profit. Moreover, "big pharma" has some but mostly insignificant influence on the standard regulatory process. There are enough issues with pharmaceutical companies, making them up is not needed at all.

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IAMNOTADOCTOR
Sep 26, 2013

Dancer posted:

My one problem with your post: the scope of pharma companies' effect on the regulatory process can be debated, but I take issue with calling it "mostly insignificant". This would take many many words to discuss properly (and would be off-topic for this thread), but it's a legitimate problem and shouldn't be downplayed.

I accept your criticism, the point I unsuccessfully tried to make is that pharmaceutical companies do not significantly shape the general route of which compounds are and are not regulated by the FDA.

Moreover, I do not feel that these companies have a substantial impact on the general route compounds need to take to be accepted : e.g. phase 1 to 4 trials etc. In my opinion the influence is mostly exerted on a compound by compound basis and trial by trial basis, not the general regulatory process for all compounds. Though id be happy if you could convince me otherwise.

IAMNOTADOCTOR
Sep 26, 2013

Hodgepodge posted:

A seem to recall a similar thread in which this came up and was disputed, but "hypomagnesemia" doesn't cover magnesium deficiency, the symptoms of which are:


High blood pressure and anxiety disorders are often stress-related problems.

Meanwhile, "[t]he adult human daily nutritional requirement, which is affected by various factors including gender, weight, and size, is 300-400 mg/day." According to the same, "although many foods contain magnesium, it is usually found in low levels. As with most nutrients, daily needs for magnesium are unlikely to be met by one serving of any single food. Eating a wide variety of fruits, vegetables, and grains will help ensure adequate intake of magnesium." So it's not unbelievable that people might be deficient.

Are they? Wikipedia gives one source claiming that "57% of the US population does not meet the US RDA for dietary intake of magnesium." I'm open to that source being challenged, but I'd like to hear the critique.

In general, the idea of magnesium deficiency seems to be pretty well established in mainstream medicine at this point. Is this in error? Healthier eating is certainly a better alternative to supplements, but there are any number of issues which can make that difficult. And since actual hypermagnesemia is hard to cause, how do I feel about $10 a bottle for a placebo? Man, I sell cigarettes and lotto tickets all day; don't try to be holier-than-thou about how people waste their money to me.

http://en.wikipedia.org/wiki/Magnesium_deficiency_%28medicine%29
http://en.wikipedia.org/wiki/Magnesium_in_biology#Human_health

Meanwhile, I'm on three adrenergics, any of which are capable of causing actual hypomagnesemia through rapid depletion. All three are widely prescribed. There are specific side effect related symptoms which magnesium supplements help to relieve.

In this case wikipedia is apparently a bad source I am afraid. While it is true that there is a difference in the total magnesium content of the body and the blood magnesium concentration, the only thing any MD will be interested in is the blood concentration as this clearly relates to dangerous symptoms.There is no reference in wikipedia for the symptoms listed, and I generally think this is page is mostly bs. This magnesium deficiency you speak of is not well established in mainstream medicine, I couldn't even find it in any of my textbooks.

There is some weak evidence that maybe sub-clinical magnesium deficiency may have some bad health effects, but the evidence level is rubbish and the WHO found insufficient evidence to recommend supplementation of tap water with magnesium.

Ill readily believe that 57% of the US population does not meet the US RDA for dietary intake of magnesium, but that doesn't mean it is a serious health concern. According to that same source, only 15% of the US population had adequate intake of vitamin E and 51% for vitamin C. You'll agree with me that scurvy is not a US problem? Seems that people should just eat healthier, period.

As for you personally, if your doc prescribed magnesium then go wild. I personally don't worry about magnesium with high dosed sympathomimetics, only potassium.

IAMNOTADOCTOR
Sep 26, 2013

Hodgepodge posted:

I would like some sort of citation, considering that there are tons of mainstream sources cited on the wikipedia articles.

Note that a symptom doesn't have to be medically serious for treatment to be desireable.

To the other poster, the spasms are a symptom of magnesium deficiency, so if you stopped taking the supplements and showed immediate symptoms of being deficient, that would be why he wanted you to take them.

Sure, here's one of the first non quack journals I could find:

http://jic.sagepub.com/content/20/1/3.full.pdf+html

quote:

symptom doesn't have to be medically serious for treatment to be desireable

Lets agree to disagree, otherwise i'd have to start treating morgellons aswell.

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