Friday, March 18, 2016

Magnesium is Important for Healthy Bones and RBCs Even if You Are NOT Tackling Mount Kilimanjaro on the Run



I've been a runner since I was about 6 years old. It was just something I did, naturally. I would look at hills or mountains off in the distance and run to them. Half the time my mother never knew where I was. Usually I didn't follow roads...I would just cut though fields and woods while keeping the hill in site the best I could. It might take an hour, or half a day, if it was far away. The distance really didn't mater to me...I just wanted to get to the top. They were magical and drew me to them like a magnet. 

Mount Kilimanjaro is the highest free-standing mountain in the world, looming 19,341 feet high  
over the surrounding Tanzania plains, and its magic is drawing me. This majestic mountain is Africa's most-visited trekking destination, attracting tens of thousands of tourists and adventurers every year. While you don't have to be a technical climber, you need to be pretty physically fit to attempt the 5 to 6 day hike to the summit. Typical issues include fatigue, dehydration, muscle strains, knee pain, bonking (lack of sufficient energy stores) and, of course, the potential for sprained ankles and falls. But the biggest challenge is the altitude. Approximately 75% of the 25,000 people who make the attempt each year develop some form of altitude sickness (1), and only 60% succeed in summiting.

If you prefer running to hiking, the challenge is even greater. Yes, in April, I will attempt a speed ascent and decent of Mt. Kilimanjaro in one day (under 14 hours of daylight).  I love physical tests and running (instead of hiking) Mt. K sounds like a cool one to tackle. Cool yes, but also one fraught with some extreme physiological challenges that I have never dealt with before - ultramarathoning at high altitudes. (2)

Those of you who know me are aware that I can be fairly tenacious.  When I was first diagnosed with severe osteoporosis in my 40’s and sustained 12 fragility fractures over a 5-year period, I did not take it well. I did the research to learn about everything that impacts bone health. I experimented with a myriad of minerals, vitamins, and herbs sifting through all the hype and finding out what really would make a difference to bone health. I became an expert on the subject and developed my own nutritional supplements using natural ingredients chosen for their safety and efficacy. Today, my bone health has improved and I’m back to competing in triathlons and not breaking bones. That said, I have given this Mt. K decision a great deal of thought and deliberation – most specifically the altitude issue, and the endurance consideration. 

Altitude and Oxygen Circulation:
Red blood cells (RBCs) carry and distribute oxygen to your body. People with osteoporosis often have a lower RBC count and therefore a slightly reduced capacity to carry oxygen to their tissues (3). When expending a lot of energy, such a person might feel weak and tired and experience shortness of breath. At the altitude of 19,341 feet there is 49% less oxygen than at sea level, so the potential danger is obvious. To compensate for this paucity of oxygen carrying red blood cells, the heart has to work harder. It beats more rapidly. Up to 20 beats per minute faster than normal. Not only does this take a considerable amount of additional energy but it also places a huge mechanical strain on the heart when calculated over time. The good news is that I have been able to increase my RBC count slightly as I have improved my health AND I have optimized the function of the RBCs that I have. (4)

Most people know that iron is important for blood's oxygen carrying ability. What they don't know is that magnesium also plays a huge role in this capacity. Magnesium is one of the most important nutrients in your body and is a major component of bone. Magnesium is vital for cell energy metabolism, blood glucose control, nerve conduction, cell membrane integrity, electrolyte balance, and the proper functioning of over 300 enzymes. Specific to bones, magnesium helps osteoblast cells make new bone. And, it is extremely important to have adequate amounts of magnesium for the production and release of calcitonin (from the thyroid gland) and parathormone (from the parathyroid glands), for maintaining a balanced bone remodeling system.

Magnesium is also a vital component of RBCs ability to hold on to oxygen molecules. Optimal levels of magnesium in the body are necessary for blood to be able to transport oxygen. Magnesium helps transport nutrients into RBCs so that they can do their job. If a person is deficient in magnesium his or her heart will either have to beat faster and/or they need to take in more oxygen (breath more times per minute) to get the same job done as someone with good magnesium stores. This is why magnesium supplementation often helps lower a person's blood pressure.

Strong Bones and Endurance:
I have to admit that my muscle mass is declining (as is the case with everyone as they get older). I can see muscles starting to sag here and there and just don't feel as strong as I used to. Less muscle leads to less power and with the increased body fat that goes along with aging it will be more dead weight for me to drag up the mountain. The good news is that I have done 3 important things to help keep my "fitness age" substantially lower than my real age.

First, I have been able to maintain a fairly steady training regimen over the years. I am always training for something; whether it is a triathlon or running race; I never let my fitness level drop too much. I’m also pretty consistent about getting to the gym for strength training with weights. The feeling I get from this and the benefit to my bones are what motivate me to keep it up. I feel more "put together" when I lift regularly. Even if it is only 20 minutes a day 3 times a week (although I usually get in 45 minutes, 5 days a week) I feel I get great benefits from strength training.

Second, I train for a multi-sport event...triathlon...which also puts me ahead of the game. Research shows that people who vary their training have more muscular power and higher endurance capacity than athletes who constantly do the same workouts day in and day out.

Third, I often "put the pedal to the metal" during my various training sessions. This habit of "red-lining" with multiple high-intensity workouts each week helps me maintain a good lactate threshold. By doing so, my body's chemistry is able to neutralize and eliminate lactate levels fairly rapidly because I've trained my enzyme systems to do this. 

Physical and Mental Well-being:
I did not accomplish what I set out to do in my last challenge (the Ironman World Championships in Hawaii) - mainly due to a bout of flu.  The good news is that my positive attitude is still intact.  I also eat fairly well and take nutritional supplements. Eating lots of fruits and vegetables (and taking OsteoMineralWhey for its powerful alkalinizing effect) each day helps me stay alkaline and gives me the trace minerals I need to process fats and sugars for energy. One of the most important nutrients I take in everyday is magnesium (available in our OsteoSustain and OsteoMineralBoost). Magnesium, it's not just for skeletal health...your red blood cells need it too. I will certainly be putting both to the test in a few weeks.

Having weighed the pros and cons of this one-day speed ascent/descent attempt, I am relying on my positive attitude, my improved skeletal and over-all health, and my diet and nutritional supplementation to get me through this. I think that I’ve been able to limit some of the normal decline seen with aging and that this will translate into more power and speed up the mountain. I am holding on to the confidence that I’ve been able to keep my body more on the anabolic side of the aging curve and less on the catabolic side. I’m also holding on to a quote from Barry Finlay in his book Kilimanjaro and Beyond:  “Every mountain top is within reach if you just keep climbing.”  I'm hoping that together these will give me the edge I need to succeed in this venture. 

I hope that when you read my next blog that it will tell of my success in finding this next mountain top. But most of all, I hope I have you all thinking about your own next goals: places you would like to see, activities you would like to do, things you would like to accomplish, adventures you would like to tackle. It is an amazing world out there. Go have fun. And don't forget…while you are doing all this, make sure you get your daily quota of magnesium, it will help you reach your own mountain top.


(1) Altitude sickness comes in 3 forms:  Acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACA).  AMS is the mildest form of altitude sickness, causing headaches, nausea, diarrhea, vomiting, and loss of appetite. Not pleasant but bearable. HAPE and HACA (fluid on the lungs/brain) are not just unpleasant, they are life threatening.



(2) When I race in Ironman competitions I often get nauseous to the point of throwing up. The reason for this is that the stomach is constantly being jostled and there is a shunting of blood away from the stomach and toward the muscles in your legs where it is really needed. When there is no blood going to the stomach, any food or liquid you take in just sits there. If it just sits there and you keep cramming it in sooner or later it’s going to come back up the other way. This often leads to extreme gastric distress causing both vomiting and diarrhea. Add into the mix extreme altitude (which in and of itself causes nausea) and I have quite a few nutritional challenges in store for me.



When a trained athlete runs at or just below his or her anaerobic threshold, they have only 3 hours of glycogen stores in their legs. Since I am expecting this run to take a good portion of 14 hours, I will need to consume a lot of calories throughout the day to prevent bonking. My goal is to take in 200 to 250 calories plus 18 to 25 ounces of fluid each hour… and try hard to not throw it all up. I've never run above 14,000 feet before and all I have to train on here in Massachusetts is 1,200 foot Mt. Tom, so this will be all new territory.



(3) Next time you get your Complete Blood Count (CBC) taken by your doctor, check out your RBCs. If you have osteoporosis, your RBC count will more than likely be on the low side. When I was diagnosed with severe osteoporosis 16 years ago, one of the procedures I had performed was a bone biopsy. The severity of my bone loss, my relatively young age at the time of diagnosis, the fact that I am a male, and, that I've been an athlete all my life all made the endocrinologist extremely concerned that I may have a rare form of bone cancer that was the cause of my osteoporosis. To rule this out, he took a core sample of bone from my pelvis and analyzed it under a microscope. What he found was not cancer (thank goodness) but extremely poor bone quality (thus the 12 fractures over a 5 year period) and LOTS of FAT in my bone marrow. All this fat makes for less room for hematopoietic stem cells; the cells that make RBCs.  



Typically, having a somewhat reduced amount of RBCs isn't a huge problem in people with osteoporosis. It is just one of those "interesting" medical facts when looking at someone's lab results. But when the person relies on getting the most out of his or her body as an athlete, then it does present somewhat of an obstacle....especially when planning a run up into the clouds of Mt. Kilimanjaro.



(4) In my 20s, I was a professional athlete competing for the United States in World Championships and the Olympic Games. I had my VO2 max (maximum oxygen consumption) assessed 5 times during those years. A person's VO2 max is a measure of how well he or she utilizes oxygen and for the most part it is genetic. A person can improve it slightly with hard work but in general "you got what you got"...and there is very little you can do to substantially change it. VO2 max is a huge determinate of how well you will do as an endurance athlete. And genetics, when it comes to VO2 max, is really important. At 56 mL, my VO2 max was never that great. Most of my athlete buddies who I competed with had VO2 max's in the 70s and one guy was in the low 80s (thus my excuse for never being a real hot shot). I mention VO2 max for obvious reasons in that if I am attempting a run up Mt. K with its rareified air, having a low VO2 max puts me at somewhat of a disadvantage. The fact that VO2 max begins to tumble at age 40....and I'm 61, presents an even bigger problem. The reason why VO2 max declines is because our heart isn't able to beat as fast as it used to as we get older. If we take me as an example, when I was in my 20s I could regularly get my heart rate up to just over 200 beats per minute during hard workouts. Now, I have trouble getting it to 175.
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