Dr. Coimbra discusses Vitamin D, Magnesium, Folic Acid, B12, Autism, Depression, etc – Sept 2018

Rádio América Interview with Dr. Cícero Galli Coimbra – About Vitamin D, Folic Acid and Magnesium

Original is in Portuguese. YouTube has the English translation below

Good afternoon for you that follow the “Mais saúde” in this Tuesday afternoon, welcome Dr. is a joy to receive you here in Radio America.

Thank you.

Well, my guest today is the professor Cicero Galli Coimbra, he is a Doctor, graduated from University of Rio Grande do Sul. Has a specialist in internal medicine title and neurology from the same institution. And also pediatric neurology from Miami University. Has a Master Degree in Neurology from the Sao Paulo Federal University and Post doctorate from University of Lund in Sweden. Nowadays he is a assistant professor from the neurology and neurosurgery of Sao Paulo Federal University where he directs the experimental and physiopathology clinical laboratory. He is the founder and president of the autoimmunity research and treatment institute. He works in the medicine field, neurology and clinical medicine with emphasis in neurodegenerative e autoimmune diseases. That's exactly what we are seeing more in our clinics today. Welcome Professor Coimbra, it's a huge pleasure to have you here in “Mais saúde”, it's a honor, and I would really like to let the microphone for you to give all the information you judge that our population, not just from Brazil, cause we have a lot of brazilian listeners that live in other countries, EUA, Italy, Japan… So we have many times online contact with them. I don't know if today we will be able to open to questions?

Yes, through our whats up 11 940359617 you can send your question and Dr. Coimbra will answer it. So today it's a very special day. I will just turn on instagram that you can have our live record that we can make it available later in other ways. Professor, we were talking before the program about the vitamin D, we know you are very passionate about Vitamin D, but it's is not just Vitamin D, it is also a different view of medicine, looking from another angle. What is the most worrying thing you see nowadays in therms of health, and even public health?

First, I am very thankful for this opportunity to be able to pass this information to your listeners. And if I had to highlight something really important, there are many things, but I would say the progressive arising of more and more children affected by autism. In 1975 in USA, we had 1 autistic child for 5,000 normal children. Now, 1 autist for every 46 children at the end of 2014. This has been called as an autism explosion, the reasons that lead to this are been really researched now. But what in fact calls attention is that this theme calls for two fundamental points, one is the pandemic Vitamin D deficiency worldwide, that affects 9 in 10 people in the planet, it has deep implications over the brain development of the fetus during pregnancy. And the other refers to the so called “cycle of folic acid”. That's an inadequate name. folic acid, called vitamin B9, in reality what is used as folic acid it's a substance that does not exists in nature.

Exactly, the human body understands it as folate? right?

Exactly. So the Folate existent in foods, that's the natural form, is called methylfolate. And the supplementation of folic acid, that is a non natural substance, harms the use of the methylfolate in the body, the natural form present in foods. And this fact is directly linked with the effects of Vitamin D deficiency in the general population. Provoking a huge increase of children with autism, câncer, neurodegenerative diseases, cardiovascular disease... The list is really huge. Also provoking depression, because these people won't be able to produce adequate quantities of this neurotransmitter that let them happier and more peaceful called serotonin which is the target of the most common antidepressant drugs. The list of diseases caused by those two factors is really huge.

People get really surprised in my clinic when I tell them that folic acid doesn't exists, that in fact, it is just the way that the pharmaceutical industry found to make this substance a supplementation. Wouldn't it be possible to manipulate a better form, like methylfolate, that the pharmaceutical industry would be able to supplement them instead of folic acid?

That's what it should be done because in reality there is a lot of misinformation in the medical environment where you have to supplement pregnant woman with folic acid.

5mg right? It's actually a medicine that is ready in the market with this absurd dosage.

Right. As folic acid is a non natural folate, it displaces from it's metabolic route, the methylfolate, that's the natural folate present in foods and the one that pregnant woman should have. If you consider, well we are giving a bigger dose of folic acid to supplement pregnant women, in reality, as it displaces the methylfolate, you are actually giving just 2% of this acid folic to be used for this metabolic routes. And specially in pregnant woman who has a genetic polymorphisms alteration, that can affect 50% of these pregnant women and population, that is a genetic alteration of an enzyme that has a very complicated name, we don't need to memorise the name of the enzyme. What we have to know is that the alteration of the gene that originates this enzyme are really common. Can affect 50% of the population. And specifically those people found to have this genetic alteration will be extremely impaired from the use of folic acid. The obstetrician that doesn't know that his pregnant patients have this genetic alteration (which is very common) and he is supplementing them with folic acid, he will be getting the opposite effect that he actually wants, that is avoid embryo malformation and also other problems that can happen during pregnancy because of this methylfolate deficiency. He is actually impairing pregnant women that have this genetic alteration that affects this enzyme.

As we are talking to a lot of people, it is possible to make this genetic painel but is there a test that we can know if this person could have this genetic modification?

This is the common knowledge present between doctors that are practicing medicine today. It's thought to be enough to measure homocysteine. In reality, many of those who have alterations in this system, because of mutations in this enzyme or other enzymes involved in this metabolic route, don't have their homocysteine levels over the normal, but they suffer the effects provoked by the deficiency of this substance that they are looking to produce that's called “Sam-e” or “AdoMet”. This substance productions is the aim for this metabolic route. And many times you can have a deficiency of this substance and still have homocysteine between the normal levels. So to measure the homocysteine is not an adequate way to deal with this problem. The simplest and correct way is to stop supplementing people with folic acid and start supplementing them with methylfolate. And tell people to consume foods that have high level of methylfolate like vegetables and specially leafy greens, they must often consume them to have this substance present in their bodies. And if it is the case, supplement people that have a acute deficiency of this enzyme with methylfolate and never with folic acid.

So today, all our listeners that are thinking about getting pregnant and are being advised by their gynecologist to take folic acid, what could they do?

First place, not take folic acid. In second place, a simple way to deal with this situation is to eat lot of vegetables. And these vegetables cannot be cooked. Because the methylfolate is destroyed by cooking so it has to be raw leafy greens. Other thing that this pregnant woman can do is supplement with methylfolate.

Is there already a medicament for that in the market?

Yes, I cannot mention here cause I cannot make merchandise for products but yes, there is and you don't need prescription.

It would not be a problem to mention a medication name, cause if it is for the good we can say. If there is something that causes harm then I don't give them names not to make merchandise but if you find important then please, you can say what medication is that.

Yes, I find it very important for public health. The form that I found in the market for use without prescription, without side effects is called O-folato.

How much is the dose?

It's recommended to have a one pill per day but in pregnancy I would suggest that 2 pills are taken in a day. But if she can make a test to know if she has this polymorphism, she can probably take 3 pills a day.

If she takes 3 pills a day without being able to make this test, will this harm her?

No, no side effects.

I have being in a lecture where Dr. Cicero showed babies that really impressed the audience. They had a fantastic development with just 30 days after birth. Their mothers have being daily supplemented with 10.000iu Vitamin D.

Now we start to talk about another subject that interacts with what we were talking before. About the other misinformation in the medical class around the necessary Vitamin D dose to maintain a good health. It is important to know that Vitamin D controls almost 10% of our genes expressions. So you can imagine, to be in a situation that 9 between 10 people in our planet has Vitamin D levels under the normal. Vitamin D is not a vitamin, so it doesn't matter if you have a well balanced diet looking to have adequate Vitamin D levels. It is not a vitamin, it is a hormone. Nowadays we already know that it is even more than a hormone. We know that there is not even one cell in our body that work properly without Vitamin D. So Vitamin D deficiency, as the folate problem, will affect all our cells and metabolic routes, cause all of our genes are dependent of the “Sam-e” that we produce, and it depends also of a normal folate level. And 10% of our genes needs Vitamin D to express themselves correctly. And this is a huge public health problem because this problem is affecting everybody. To make it clear in percentage, I would say, 9 between 10 people on the planet, from orient to occident, have insufficient levels of Vitamin D and 80% of the occident world population are having problems related also to Magnesium deficiency.

Professor, we finish the first block, and as soon as we come back, we have a very interesting question here that I am sure you will like to answer because it is about depression. It is the second cause of work absence. depression today is something really important and it is another drama. People this program today is a bless! So the question is from Ellen, she is asking how Vitamin D can help with depression. She says: “good afternoon listeners and Dr. Is it more dangerous the deficiency or excess of Vitamin D? And Vitamin D deficiency influences in the mood oscillations? Thank you. Ellen, Sao paulo.

So we have three nutritional metabolic factors that provokes depression. One is the deficiency of Vitamin D, the other is Magnesium deficiency. Just to explain, the measurement of Magnesium in blood won't help you to know your real levels, it won't detect deficiency. If someone has a low Magnesium level in the blood she is just about to have a heart attack or sudden death. So, most of our Magnesium, around 60%, is located in our bones, 39% inside the cells and just 1% is located in this serum. So a serum test won’t express the real quantity of Magnesium we have. And the third factor is this folate cycle problem. Many people that have acute depression, have important genetic alterations in this enzyme we mentioned before (Methylenetetrahydrofolate reductase (MTHFR)), even if they don't have elevated systein, they still can have depression. These three factors interact between them. For example, the enzyme that produces this substance that it is the finish product of this metabolic route that uses folates, the Sam-e, the last protein that produces the Sam-e, need Magnesium. If it doesn't have enough Magnesium it won't work properly and you won't produce your sami. There are studies in medical literature, that show that if you use elevated doses of Magnesium the only thing that can happen to you is to have diarrhea. Then you just need to stop supplementing, wait to the diarrhea to subside, lower the dose and have it again until you figure out what's the maximum dosage for you that does not provoke diarrhea.

What would be generous doses?

Now it is important to say that the form of Magnesium that we find easily in the market is the Magnesium chloride.

People ask us all the time, is this chloride really good?

It is a very good source of Magnesium. But it is important to know that just 12% of the Magnesium Chloride is actually Magnesium. The other 88% are Chlorides and water. This substance absorbs a lot of water. For example, if you take a capsule of 500mg of Magnesium you are actually just taking 60 mg of Magnesium. So, what would be a generous Magnesium dose? It varies between 800-1200 mg Magnesium for an adult, depending on their weight. But from essential Magnesium, not Magnesium chloride.

When we are going to manipulate in the lab we have different types of Magnesium, so when you are supplementing, what is the best form?

Let's talk first about the cheapest form and most efficient that is the Magnesium chloride. You find it in a normal pharmacy without prescription. You find it from many brands, little packages or jars, Magnesium chloride PA, which means “for analysis”, meaning that it is a pure form. And you can put the Magnesium of one of this little packages of 33g of Magnesium Chloride in 1L of water and if you take from this 1L solution 50ml, it will contain 200mg of Magnesium itself, that is technically called elemental Magnesium. So if you drink 50 ml of this solution you will have 200mg of elemental Magnesium. If you drink it 4 times a day you will reach the 800mg of elemental Magnesium that you wanted. If you want you can try even higher doses. But always be careful to drink preferably one hour before meals because if you mix it with the water containing in your meal this will facilitate the occurrence of diarrhea. So we suggest that people consume first the 50 ml of the solution one hour before the meal to absorb the Magnesium, then one hour later when you are going to eat the Magnesium is already absorbed and won't cause diarrhea.

People, let's recapitulate, the package of Magnesium must be written, Magnesium Chloride PA. So it's is a 33g package, that has to be mixed with 1L of water and 50ml, a little coffee cup, so if you drink 4 little cups you will have exactly 800mg, that's a good dose but the minimum.

Approximately in a water glass it would be 2 fingers or 2,5 fingers depending on the width of the glass that you can consume to obtain the 50ml. But you can also use a syringe and put 50ml. You take a syringe with 10 ml and put it 5 times this amount into a glass and you can mark the glass to know everyday how much you have to take from the solution.

A lot of people complain about articulation pains, pain here and there.

It is going to get much better with Magnesium.

Magnesium is wonderful. I always tell it doesn't matter to have a beautiful orchestra if you don't have a master. I tell that the master is the Magnesium.

Chronic pain is associated with Vitamin D deficiency and Magnesium deficiency.

And B12 in chronic pain?

The B12, it's a little complicated, because what we have available in the B12 supplements is the cyanocobalamin, it's the cheapest form of vitamin B12, the one that is present in almost all the B12 supplements. But if you have problems with that enzyme we talked before, it won't help if you take cyanocobalamin, you have to take the methylcobalamin, that is the form already methylated by the methylfolate system. Then you have to take actually the methylcobalamin. I forgot to say, when we talked about the commercial name of the methylfolate, that you also have the option to use pharmacies that you can manipulate the formulas. You Dr. can prescribe you, maybe it can be even cheaper, methylfolate under the manipulated form using a trusted pharmacy.

But as we are talking in terms of population, the person that is listening to us cannot find a Dr. that will give them a prescription for supplementation. So your tip of finding a pharmacy with this supplement that is so important was really fantastic.

Just to complete the answer. All of this 3 things that we comment, Vitamin D, folic acid and Magnesium, if are deficient or if the person has problems with mutation of that enzyme, the person will have problems producing serotonin. And she will as a result of this, live in depression. You will be taking antidepressant pills for your whole life that aim to try to avoid the serotonin destruction when you are in fact having trouble producing it from the start element that is the tryptophan amino acid that is present in food. So, all of these things should be used to treat the metabolic cause of depression. Otherwise you will pass your whole life taking these medications and won't resolve the problem.

Professor, talking about Vitamin D. Has this Vitamin D deficiency always being a problem in the world, or is it something more recent? Magnesium for exemple, I noticed in the clinic that people actually stopped having real food, they are just having foods that rob nutrients to try to be excreted. But what is it happening, did this deficiency always happened?

No. it's estimated that in human history, our current days is the moment that we have the lowest level of Vitamin D in the general population. Do you believe that we have never reached a situation like this, 9 in 10 people on the planet with Vitamin D deficiency. And this is happening because people simply stopped exposing themselves to the sun or when they do, they use sunscreen. It's important to say that factor 8 already blocks 95% Vitamin D production. So this is a wrong recommendation to tell people to avoid the sun completely, as it is also wrong to tell them to expose themselves as long as they want. A couple of minutes are enough, depending on which areas of the body you have exposed to the sun, depending on your skin colour, depending of how long you are exposed, depending of the time of the day you are exposed… It's enough for example, 20 min of exposure if you have for example, light skin and wearing shorts and short sleeve shirts, 20 min of sun exposure it's enough to produce 10.000 of vitamina D, and also if you are not using sunscreen.

And at what time professor?

In the time that the dermatologists don't recommend. This is the time between, more or less because it changes depending on the season of the year, depending on the latitude, but it's is around 10AM and 4PM, that's when you have the ultraviolet solar radiation Type B, that produces Vitamin D on the skin. It is important to emphasise that although it is called Vitamin D, it is not a vitamin, it is much more than a hormone and it is produced on the skin when you are exposed to the sun without sunscreen. People with a high pigmentation on skin need even longer sun exposure to obtain 10.000iu of Vitamin D that is a physiological dose. Absolutely physiologic. After this time you can put sunscreen. If you are young, with light skin, and wear just bath clothes like bikinis or shorts, to have almost all your body exposed to the sun, in the horisontal, at this time i mentioned, without putting sunscreen, in 10min you can reach 25.000iu of Vitamin D, produced in such a short period of time.

So, if the human being was made to produce it in this way it is because there is the necessity to have this amount in the human body. But professor, our program it's at the end! Just repeating about the Magnesium Chloride, you buy on a common pharmacy and it has to have PA written in the label. Then you take a package with 33g, put in 1L of water and drink 50ml, 4 times a day to get 200 mg of this bless called Magnesium. And it is a very cheap form, accessible form, at least 4 times a day 1 hour before meals. Professor we have to close. How would you like to finish the program today? What would be the message that you would like to give?

You mentioned that you saw a video of a child right? It was a 22 day newborn, that had a psychomotor development of a 3 months old child. He was able to lift his neck when he was laying down on his belly and look around and see people faces. Which is something that sounds scary, to see a child with 22 days old doing that. I have a dream. I would love to see genius children being born in my country. So I would like to give this information that for pregnant women to have children like this, to have a normal life, to be healthy, to go to university, to vote for honest politicians, they have to take methylfolate, 10.000 of Vitamin D, eat lots of raw vegetables. And look how interesting, the same foods that have methylfolate also have a large quantity of Magnesium, because the main source of Magnesium are leafy greens, Magnesium is in the center of chlorophyll molecule, so leafy greens are a wonderful source of Magnesium. If you are pregnant and has financial problems, you can have lots of vegetables that will provide you lots of Magnesium o-folate and you can expose yourself on the sun in the time that is forbidden, without the use of sunscreen using shorts, short sleeve shirts, if you don't have dark skin, 20min are enough, if you have dark skin, you will need around one and a half hours.

Today's program is to start the year in a great style and please, when you have this genius children, when you observe that in school they are the first one in class, send us an email, because they do that professor. After putting to action what we talked, we have lots of interesting testimonies. I hope to be able to share them with you that is sharing all this knowledge and clinical experience that we will be able to have in the future all these blesses happening. Professor I hope this was the first from lots of programs, I know you have a pretty full agenda. But we can also make it through skype, sending us more and more information for our population.

Perfect. Just to say you can also buy in the internet Vitamin D 10.000iu in soft gel for just 50R$ for one years of treatment. You can use during the whole pregnancy and more 3 months of breastfeeding.

You can buy them in imported websites from USA. So there is a lot we can use and get benefits from. Thank you Professor. Happy new year.

Video granted from Canção Radio Nova, https://goo.gl/peJ9RX
Translated by Patricia Mascarenhas / Youtube Channel: Healthtech Pati

Translation is on Google Docs