Determinants of Muscle Health

Maintaining muscle health is one of the keys to a comfortable and active life. Understanding muscle function and the factors that maintain optimal muscle function help to explain how things can go so wrong.

Determinants of Muscle Health.

Good blood flow is maintained throughout life by getting adequate exercise. Nicric oxide is the molecule that opens up blood vessels. The production of nicric oxide in blood vessel muscles decreases with age and lack of exercise. Nicric oxide can be enhanced by drugs such as those used for erectile dysfunction (Viagra, Cialis etc) or supplementing the diet with L-carnitine or L-citrulline, both amino acids used in the production of nicric oxide. 

Shivering, something few of us do even in Canada, may also play a vital role in keeping this nicric oxide system optimized. Shivering may turn out to be a crucial factor in the current chronic pain epidemic.

Mitochondria are the power packs in cells that produce the energy required to run cell activities, including keeping the Ca++ pumps working. Regular exercise will maintain the number and function of mitochondria optimal and sufficient for requirements as determined by previous demands. The more you exercise, the better the mitochondrial battery packs will develop in the muscles. Coenzyme Q10 and creatine phosphate are the nutritional factors that are required by mitochondria to produce the ATP molecules that carry the energy used by the cell.

Optimal balance of Ca++ and Mg++ is essential for optimal muscle health, including vascular and heart muscles. Calcium is used by muscles to contract. Low levels of calcium result in muscle weakness, low blood pressure and a weak heart.

High levels of calcium have the opposite effect, with increased muscle strength, a stronger heart and tighter blood vessels. This is obviously useful in times of stress, when one has to run or fight for survival. It is no surprise, therefore, that the sympathetic nerves that put us in the fight/flight response achieve this effect by, amongst many other mechanisms,  altering Ca++/Mg++ balance; causing rapid Mg++ depletion to allow Ca++ to dominate and work less opposed.

Balancing Ca++ and Mg++.

Humans have evolved eating a diet rich in magnesium and potassium. Ideal Mg++ intake should be equal to or double that of Ca++. We are being subject to chronic and unrelenting forces that are both lowering our magnesium levels and increasing calcium levels, putting us in stressful calcium imbalance. The result is high blood pressure, increased heart attacks and strokes, diabetes, agitation, insomnia and muscle pain and stiffness.

Prevailing folklore has calcium considered the good mineral and the more we get into ourselves the better. It is easily found in our food and is added to many foods such as orange juice, mineral water and even some commonly used medicines such as stomach antacids. Advertisers use the added calcium as an enticement to consume the product.

Public policy encourages us to take extra calcium in doses up to 1500mg per day, especially in the older female population demographic. This is often aided with vitamin D3 supplements. Vitamin D3 (or the less bioavailable D2) enhances the absorption of Ca++ from the gut. High acid diets that are a result of eating processed foods and drinks cause bones to release calcium carbonate so that the carbonate can buffer acid. This calcium release depletes bones of calcium (causing osteoporosis). All of these factors promote high levels of free calcium throughout the body.

Calcium is directed into bones and teeth by vitamin K2. This recently discovered vitamin is the key to understanding Ca++ and its movement throughout the body. Vitamin K2 is produced by animals consuming green plant food. This means grass-fed cows and chickens! Depleted K2 levels results in calcification of blood vessels and other “soft” tissues that are not supposed to be calcified. Patients taking the blood thinner Coumadin are severely depleted of K2 and subject to excessive calcification of soft tissue.

We are starting to get glimpses that calcium deserves a second look and a lot more respect. New research is showing that having high calcium intake does not prevent or treat osteoporosis but does increase the risk of vascular disease, causing heart attacks and strokes.

Magnesium is the misunderstood and neglected partner in the Ca++/Mg++ duo. Low magnesium levels in farm soils, poor uptake by fertilized and genetically modified crops have reduced our intake considerably.  Chronic stress and malabsorption syndromes caused by inflammatory bowel disease and even chronic acid-lowering treatments markedly impair absorption of Mg++.

Ironically, the resultant high blood pressure associated with Ca++/Mg++ imbalance is routinely treated with a “first-line diuretic” such as hydrochlothiazide, which further depletes magnesium levels.

Knowing how this system works, it is not too difficult to identify the predisposing factors for muscle pain. Correct them before or after muscle pain occurs seems to be a common sense way to get back to optimum health and preventing chronic pain.

When Muscles Fail.

A poorly conditioned and imbalanced muscle is prone to failure and latching. When demands on that muscle exceed its capability, failure can occur and the muscle will latch. This often occurs within minutes of the injury or up to days later. One muscle or muscle group fails first, causing a specific and recognizable pattern of pain and immobility. If things do not resolve, the resulting pain and immobility can cause other muscles to tighten in a protective response and also subsequently fail. Changing posture and movement patterns to protect the painful muscles can place demands on the functional muscles beyond their ability to cope. Patients recognize this as “favoring the painful part of the body and stressing the other side”.

Acute injuries such as whiplash and other falls/injuries where muscles are stretched and/or tightly contracted can result in muscle failure. This pain onsets immediately but can develop gradually over a few days after the incident. That is why injuries that appear innocuous at the time can result in subsequent permanent and severe disability if left untreated.  I view this as a catastrophic release of calcium.

Our bodies have evolved with a muscle protection mechanism, which we call guarding. The classic example is found in patients with appendicitis, where the abdominal muscles overlying the infected and painful appendix are involuntarily tightened in a protective spasm. After surgery, when the appendix pain is resolved, the muscles should relax. Sometimes they do not. I commonly find persistent muscle pain in patients after their surgery is successfully completed. Not unreasonably, the patient is left wondering if something was done incorrectly during the surgery. This causes some surgeries like back and joint surgeries to be repeated, even multiple times.