The term ‘evidence’ is used loosely here. The aim is not to provide rigorous proof but to demonstrate that the magnesium deficiency theory is consistent with the general picture of IBS. There are many conditions that are associated with IBS and it’s reasonable to ask why this is so. Any explanation of IBS should address these associations.
A good starting point is a landmark paper by Peter Whorwell published in1986:
The paper details some associated conditions which have extraordinary levels of statistical significance, most achieving p<0.0001. The patients were divided into three groups: diarrhoea, constipation and alternating diarrhoea and constipation. A remarkable finding was ‘None of these symptoms were found to be significantly more common in any one of the different types of irritable bowel syndrome (groups 1-3)‘. This confirms our abstract approach to IBS, a disorder with various forms but a common aetiology.
There are very strong links between fibromyalgia, IBS and hypothyroidism which will be detailed in the Fibromyalgia topic.
Urinary Symptoms / ‘Irritable Bladder’
Whorwell found highly significant associations between five urinary symptoms and IBS. The study states: ‘there is evidence that there is an underlying disorder of gastrointestinal smooth muscle‘ and that ‘irritable bladder may form part of the IBS syndrome‘. Another study by Whorwell provided the first evidence that patients with IBS have a disorder of smooth muscle which is not confined to the gastrointestinal system. Other studies have since confirmed the link between irritable bowel and irritable bladder which supports the concept that IBS is part of a generalised disorder of smooth muscle.
Headache and Migraine
A common symptom of inappropriate contraction / relaxation of vascular smooth muscle is headache and indeed IBS patients do have a considerably higher incidence of tension headache and migraine. Magnesium supplementation is found to be effective in reducing pain conduction by NMDA receptors (including headache) and perhaps inhibiting abnormal smooth muscle contraction.
Mitral Valve Prolapse (MVP)
Mitral valve prolapse is a condition in which the two valve flaps of the mitral valve do not close smoothly or evenly, but instead bulge (prolapse) upward into the left atrium.
MVP is associated with IBS and fibromyalgia. Magnesium deficiency occurs in over 85% of MVP cases, MVP occurs in 26% of those with magnesium deficiency and magnesium supplementation leads to a substantial reduction in symptom level.
Respiratory Symptoms and Asthma
There are conflicting reports of the association between IBS and Asthma. Some studies found an association, others didn’t. There are reports of increased bronchial hyper-responsiveness in IBS patients. Perhaps a generalised smooth muscle disorder in IBS patients aggravates asthma symptoms leading to increased diagnoses.
There are reports of IBS patients whose symptoms improved after they stopped using fluoride toothpaste or drinking tap water containing fluoride, including a contribution to the IBS Network journal Gut Reaction (GR53) – The Fluoride Debate. Calvin Strong, in his book “My Success With IBS” also concludes that tap water was the major contributor to his IBS symptoms.
Fluoride promotes bone growth, harnessing calcium, phosphorus, magnesium and other minerals from the blood and soft tissues to form bone. In a magnesium deficient patient this further lowers magnesium levels. Fluoride has a strong affinity to magnesium, forming magnesium fluoride (MgF), a stable compound that renders the magnesium unavailable. Thus, fluoride exacerbates magnesium deficiency.
I found I could mitigate my IBS symptoms by taking magnesium citrate and using bottled mineral water for drinks and cooking, only using our fluoridated tap water when steaming food. After many months I noticed my symptoms returned, I asked my wife if she had started using tap water, she had ‘I thought you were better‘. Thus, I had a blinded trial of fluoride avoidance. I’ve no objection to fluoridation, but the evidence is that fluoride makes IBS symptoms worse.
It is well known that stress can initiate IBS attacks. A PubMed search ‘irritable bowel stress’ returns over 1,550 studies! Stress acts on the adrenals releasing hormones that cause a magnesium shift from the intra to the extra-cellular space and promotes renal loss. Conversely, magnesium deficit creates a state of hyper-susceptibility to stress. ‘Thus magnesium deficit and stress reinforce each other in a pathogenic vicious circle‘.
A research project carried out by a team including IBS Network’s Christine Dancey showed that IBS symptoms worsened not just during, but to a greater extent two days after stressful events – consistent with the process of magnesium loss due to stress. Other research shows a very strong link between IBS severity and long-term stress. These studies are consistent with a metabolic link between stress and IBS. A direct psychological link would require IBS patients to be very slow witted!
This evidence is not conclusive but it is consistent with the magnesium deficiency theory. There are no other explanations of IBS which explain these unusual associations. We now need to look at the Reasons For Magnesium Deficiency.