By Richard Podell, MD, MPH
Cognitive function tends to declines as we age. For most people the decline is modest. This “semi-normal” decline is thought to be due in part to a decrease in the ability of cells to form communication contacts called synapses between one cell and another. A similar defect is seen with Alzheimer’s disease.
Animal studies show that one way to increase the number and function of synapses is to raise the brain’s level of the mineral magnesium. When scientists increase brain magnesium in lab rats, the rats become smarter, that is, they are thinking more rapidly and accurately than they did before. But, most forms of oral magnesium don’t pass easily from the blood into the brain. An exception is a new form of magnesium developed by a research team from MIT specifically for this purpose. This form is magnesium-L-threonate, which is being developed by Neurocentria, Inc., a pharmaceutical company, under the brand name of MMFS-01.
Neurocentria’s team with collaborating researchers from both the U.S. and China recently published a very important study. Their results strongly suggest that MMFS-01 can substantially improve mild cognitive function in aging humans. MMFS-01 is not yet commercially available. However, a “generic” magnesium-L-threonate is available from ProHealth under the brand name of Neuro-mag. Likely other "generics" are or will soon be available.
What is truly remarkable about the MMFS-01 study is that improvement in over-all cognitive function was seen within just six weeks. Improvement continued through 12 weeks, the full length of the study. Subjects treated with placebo did not improve much over-all.
Volunteers for the Neurocentria study were aged 50 to 70. All had test score evidence of mild cognitive impairment. Twenty-five subjects took MMFS-01 and 26 took a placebo. The treatment dose was between 1.5 and 2.0 grams per day in divided doses. Four different cognitive tests were taken before treatment and again at six and 12 weeks. These tests measured executive function, working memory, attention and a concept called episodic memory.
With magnesium-L-threonate, executive function significantly improved compared to placebo at six and 12 weeks. Working memory improved significantly at six weeks, but at 12 weeks the placebo group had improved also. So, the difference between the groups at 12 weeks was no longer statistically significant. Attention improved in the MMFS-01 group compared to baseline, but this improvement was not statistically better than for those taking placebo. Episodic memory improved with MMFS-01 by week 12, but was not significantly better than that seen with placebo.
When over-all cognitive ability was calculated by combining results from the four tests, subjects taking MMFS-01 scored significantly better than subjects taking placebo. This was true at week six (P=.017) and at week 12 (p=.003). As important, subjects taking MMFS-01 who had the largest increase in red blood cell magnesium levels were also the subjects most likely to show major cognitive improvement. There were no major side effects.
Separate research suggests that magnesium might also help treat fibromyalgia pain. This might be because magnesium tends to inhibit the activity of NMDA receptors. Activation of NMDA receptors is believed to be one mechanism that creates fibromyalgia pain. A recent open label clinical study from Mayo Clinic found that transdermal magnesium chloride spray taken twice daily for three weeks was followed by a reduction in fibromyalgia pain.
Take Home Thoughts
Should physicians treating FM or ME-CFS “brain fog” offer magnesium-L-threonate as a potential treatment? The arguments against:
We don’t know whether brain fog in fibromyalgia or ME-CFS has any relationship to the cognitive decline that is common with aging.
We have only one clinical study to support the beneficial effects of magnesium-L-threonate.
The argument for:
Brain fog is a major problem for our patients
We have no proven treatments
For most (but not all patients), side effects from magnesium are minimal—mainly diarrhea if we get the dose up too high.
Should patients with FM or ME-CFS try magnesium-L-threonate on their own? I strongly recommend that all patients work with their doctor. Certain patients should not take extra magnesium, especially those with any degree of kidney dysfunction. Also, it would be useful to obtain a baseline red blood cell magnesium level and to monitor that level as treatment proceeds.
Since MMFS-01 is not available, using Life Extension’s or other generic equivalents is reasonable. Of course, ideally, some angel would fund a good controlled study. But, as usual, that’s not likely to happen anytime soon.
If any readers of this decide to work with their doctors to try magnesium-L-threonate, I and other readers would be grateful to learn whether or not it helped. In the absence of research funding, the best way for us to learn which treatments help will be for each of us to report our personal anecdotal experience along to each other. You can let us all know by posting a comment below.
Richard Podell, M.D., MPH, is a graduate of Harvard Medical School and the Harvard School of Public Health. He has been treating patients with ME-CFS and Fibromyalgia for more than 20 years. A clinical professor at New Jersey's Robert Wood Johnson Medical School, Dr. Podell see patients at his Summit, NJ and Somerset, NJ offices.
His website is www.DrPodell.org.