成长医学博士博客

有人问焦虑，抑郁症的治疗。分享以前一文（今天与一位20多岁的美国年轻人谈及焦虑/抑郁。焦虑/抑郁在当代美国年轻人中十分普遍。我聊了不少自然的，副作用少的减压方式。下面是关于镁，分享于此。）

镁用于焦虑/抑郁：

如果您或您的朋友或患者患有焦虑症，抑郁症（或失眠症，偏头痛），您应该在使用处方药之前考虑使用镁（可能还有褪黑激素）。(亦可加用CBD油, 但国内可能还没有).

焦虑和抑郁今天如此猖獗，许多人依靠药物来对抗它们。许多这些药物会导致成瘾和其他问题。镁是一种天然营养成分，具有非常强大的抗焦虑，抗抑郁作用，非常便宜和安全。口服镁几乎不可能引起任何严重的副作用（除了潜在的腹泻）。

以下是镁对焦虑抑郁症的近期临床研究。
1.这项2018年多中心随机和对照欧洲研究涉及264名成年患者，镁（乳酸镁300 mg）缓解了这些患者的压力。严重焦虑/抑郁患者可加用维生素B6。 Puteau 2018 [30562392]。
2.在这项涉及126名成年人的2017年临床研究中，研究人员得出结论：“镁（Mg Chloride 248mg）对成人轻度至中度抑郁症有效。它起效迅速，病人耐受性高, 无需密切监测毒性“。 Tarlton 2017 [28654669]。
3.在这项2004年招募了264名患者的2004年临床研究中，发现镁可有效治疗轻度至中度焦虑症。 Hanus 2004 [14741074]。

最后，焦虑抑郁症并非单纯精神系统疾病。焦虑抑郁症有其全身因素，建议使用功能医学原则及手段进行焦虑抑郁症的干预。

镁离子制剂有多种。主要区别在胃肠吸收率以及血脑屏障穿透率（即能够到达中枢神经系统，脑，的能力）。我诊所使用我的配方：Magnesium Citrate/Glycinate （甘氨酸镁/枸椽酸镁）及Magnesium Threonate (苏氨酸镁)。甘氨酸镁/枸椽酸镁既有足够的肠胃道吸收，也有足够的不吸收，促进排便，是我们常用的。苏氨酸镁更易达到脑部，更多用于各种头疼，焦虑，失眠，镇静等。

根据临床用途，镁补充剂有3个主要“类别”：

1. 优异的GI吸收（包括镁的甘氨酸盐，柠檬酸盐，天冬氨酸盐，乳酸盐和氯化物）。这是最常用的一组镁制剂。我们在所有临床条件下使用甘氨酸镁/柠檬酸镁的组合。我们也使用这种组合来治疗便秘或促进肠蠕动。
2. 吸收不良（氧化镁和硫酸盐）。该组肠胃吸收最少，治疗便秘的效果最明显。
3. 血脑屏障穿透：苏糖酸镁。我们将此用于中枢神经问题，包括严重的偏头痛，失眠，焦虑，抑郁等。

Magnesium for Anxiety/Depression:

If you or your friends or patients suffer from anxiety, depression (or insomnia, migraine headaches), you should consider magnesium (and probably melatonin) before using prescription drugs. I recommend Magnesium first, adding melatonin (if sleep is also an issue) and CBD oil.

Anxiety and Depression are so rampant today and many rely on drugs to combat them. Many of these drugs can cause addiction and other problems. Magnesium, a natural nutritional element, has pretty powerful anti anxiety, anti depression effect and is very cheap and safe. Oral magnesium is nearly impossible to cause any serious side effects (apart from potential diarrhea).

Here are a few recent clinical studies of Magnesium on Anxiety/Depression.
1. This 2018 multi-center randomized and controlled European study involving 264 adult patients, magnesium (Mg Lactate 300 mg) alleviated stress in these patients. Vit B6 can be added for severe anxiety/depression patients. Puteau 2018 [30562392].
2. In this 2017 clinical study involving 126 adults, the researchers concluded “magnesium (MgCl2, 248 mg) is effective for mild-to-moderate depression in adults. It works quickly and is well tolerated without the need for close monitoring for toxicity”. Tarlton 1027, [28654669].
3. In this 2004 clinical study where 264 patients were enrolled, magnesium was found to be effective in treating mild to moderate anxiety disorders. Hanus 2004, [14741074].
Me:

Depending on the clinical uses, there are 3 major ”classes“ of Magnesium supplements:
1. excellent GI absorption (including magnesium glycinate, citrate, aspartate, lactate, and chloride). This is the most common group. We use a combination of Mg Glycinate/Citrate for all clinical conditions. We also use this combo to for constipation or for promoting bowel movement.
2. Less well absorbed (magnesium oxide and sulfate). This group is least well absorbed with the most obvious effect on constipation.
3. Blood-brain barrier penetrating: Magnesium threonate. We use this for CNS problems including severe migraine headaches, insomnia, anxiety, depression etc.

最近，一家大型制药公司（Astra-Zeneca，阿斯利康）报告说，他们的新鱼油产品大规模的III期临床试验失败了。我一点也不惊讶。 实际上，这不是第一次这样的失败尝试。 让我在这里预测，这也不会是最后一次这样的失败。 直到医学界和药物开发界发生根本变化。

我不知道任何慢性疾病是由于一个单一原因造成的。我知道我对医学了解不够，尽管我整个成年生活都在医学领域里，已经40多年了。

大多数（如果不是全部）慢性疾病都有增加了的氧化压力（OS）作为其主要特征。这个慢性疾病清单包括但不限于动脉粥样硬化性心血管疾病、糖尿病、癌症、自身免疫性疾病等等，这个单子很长。实际上，所有对氧化压力有过研究的慢性疾病都显示增加了的氧化压力。相信我，我研究了很多。实际上，我会挑战任何人, 找出一个没有氧化压力升高的慢性病。

氧化压力定义为氧化剂/抗氧化剂的比例。（还有所谓氮化压力，但是现在文献中一般并入氧化压力慨念中）。氧化压力并无好坏之分，只有高低不同。就像血压一样。 血压过高对你有害，但血压过低也会杀了你。因此，氧化剂和抗氧化剂的平衡是关键。今天，我们生活在一个被丰富的氧化剂包围的环境里（所有的毒素都是氧化剂），我们的食品的营养价值下降，包括抗氧化剂的减少（我在本文中不会对此进行扩展）。

要真正改变氧化压力升高的状况，人们需要采取多管齐下的方法：一方面，我们需要限制氧化剂的摄入量，另一方面，我们需要增加抗氧化剂的摄入量，以达到临床上有意义的氧化压力平衡，通过只改变氧化剂/抗氧化剂比的一侧，通常不会导致有意义的氧化应激重新平衡。上述Astra-Zeneca的失败，我敢断定，原因在此。

整个医疗和制药行业需要重新思考他们的做法。目前全球奖励制度主要以单一药物专利机制为基础。很多时候，制药公司会改变一个新药的分子结构，使其具有专利性。 这种方法有一个固有的主要问题：改变的，不自然的分子往往有副作用。著名的美国”妇女计划“ (Women’s Initiative) 发现人工合成激素有害，就是一个典型的例子。但是，如果制药公司不改变分子结构，他们便不能申请专利。这是一个二难的困境。因为，没有经济动机来推此类研究。这是我对整体医学（integrative medicine）或功能医学（functional medicine）总结的新三观“整体观“”自然观“”平衡观”中之自然观之反应。慢病防治，养生长寿离不开这新三观。

这需要改变。需要建立一个更完整和更有意义的奖励机制，以鼓励大型制药公司对药物开发进行系统性投资。药物组合或系统的疾病管理平台应可申请专利保护。天然形式的制剂（未改变对人体的异物分子）可以保存在这些更全面的药物开发方法中，然而这些综合形式也可以申请专利。 随着医学领域的觉醒（如整体医学, 功能医学的日益普及），这种新的药物开发模式应该而且将越来越普遍地在可预见的未来。 这最终将使行业和消费者受益。

Recently, a giant pharma (Astra-Zeneca) reported that their new fish oil product failed a large scale Phase III clinical trial. I am not surprised at all. Actually this is not the first time of such failed attempt. Let me predict here, this won‘t be the last such failure either. Until a fundamental change in medicine and drug development occurs.

I don‘t know any chronic disease that is due to a single cause. I know I don’t know enough about medicine, albeit I have been in medicine my entire adult life of over 40 years.

Most, if not all, chronic diseases have increased oxidative stress (OS) as its key hallmark. This list of chronic diseases includes, but not limited to, atherosclerotic cardiovascular diseases, diabetes mellitus, cancer, autoimmune diseases and many many more. Actually all chronic diseases that have such research on oxidative stress that I have studied have increased oxidative stress. Believe me, I have studied a lot. Actually I will challenge anyone to show me a report where scientists looked into oxidative stress and didn’t find it elevated in a chronic disease state.

Oxidative stress is defined as the ratio of oxidants/antioxidants. (There is also a nitrasative stress which in the literature is often included in the OS these days). Oxidative stress is not a good thing or bad thing, just like blood pressure. Too high a blood pressure is bad for you, yet too low a blood pressure will also kill you. so the balance of oxidants and antioxidants is the key. Today we live in an environment where we are surrounded by the abundant oxidants (all toxins are oxidants), and where our foods have decreased nutritional value including decreased antioxidants (I will not expand into this in this article).

To truly change the elevated oxidative stress status, one needs to take a multi-pronged approach: on the one hand, we need to limit the intake of oxidants and on the other, we need to increase the antioxidants intake to reach a clinically meaningful balance, by changing just one side of the oxidant/antioxidant ratio often will not result in meaningful oxidative stress re-balance.

The entire medical and pharmaceutical industry needs to re-think of their approach. The current worldwide reward system in primarily based on single drug patent mechanism. Often times a drug company would alter a potential drug molecule to make it patentable. This approach has an inherent major problem: an altered, unnatural molecule often have long time side effects to human body. Harmful synthetic hormones found in women‘s Initiative are such a typical example. But if a drug company doesn’t alter it, they can‘t patent it. This is a dilemma: there is no financial incentive to invest in such research.

This needs to be changed. A more complete and meaningful reward mechanism needs to be in place to encourage big pharma to invest in systemic approach to drug development. Combination of agents, or propriatory disease management platforms can be patented. Natural forms of agents (not altered foreign molecules to human body) can be kept in these more comprehensive approach to drug development and yet these comprehensive forms can also be patented. With the wakening in the medical field (such as the ever increasing popularity of integrative/functional medicinee), this new model of drug development should and will be more and more common in the forseeable future. This will ultimately benefit both the industry and the consumer.

关于骨质疏松与补钙的问题：

• 骨质疏松不是缺钙引起的；骨质缺钙只是表象，不是病因。
• 骨质疏松也是一慢性”炎症性“疾病（以升高的氧化压力为特征）。氧化压力升高严重消耗抗氧化剂，尤其是维C（VC）。加上其他营养缺乏，荷尔蒙失调，导致骨基质合成不足，骨质疏松。
• 骨基质合成不足，导致钙离子等无法被保持在骨质中，而被动地从
• 骨质中流出，进入血液，沉积于血管壁，及软组织中。
• 骨质疏松的治疗及预防应从：
  • 降低体内引起氧化压力升高的因素：各种慢性炎症，及重金属，化学毒素等;
  • 减少促氧化食物的摄入，增加抗氧化食物的摄入;
  • 健康的饮食习惯（低碳/生酮饮食，间隙性断食);
  • 抗氧化补充剂，尤其是VC，Vit D3，Vit K2，镁，及广谱全细胞营养;
  • 荷尔蒙平衡，尤其是甲状腺（TSH），雌激素，睾酮等。
  • 补钙不仅无助于骨质疏松，而且促进，加重全身软组织钙化，尤是动脉硬化，包括冠状动脉硬化。

详细论证描述，请阅《隐性杀手-补钙剂》成博士编译，Thomas Levy, MD原著。

国内：《隐性杀手-补钙剂》

国际：《隐性杀手-补钙剂》

下面是成博士关于骨质疏松与补钙的问题讲座回放。

http://news.drwlc.com/Chinese_lectures/Dr. Cheng-2019-12-21.mp3