Study: Does magnesium really help with hot flashes?
Study: Does magnesium really help with hot flashes?
Reference
Park H, Qin R, Smith TJ, et al. North Central Cancer Treatment Group N10C2 (Alliance): A double -blind, placebo -controlled study on magnesium preparations to reduce hot flashes in menopause. menopause . 2015; 22 (6): 627-632.
Design
Four -armed, double blind, placebo -controlled, randomized study
participant
A total of 289 women were inscribed between December 2011 and March 2013; 267 women were included in the end analysis. All participants were postmenopausal with a history of breast cancer and annoying hot flashes.medication and dosage study
The participants were divided into treatment groups with magnesium oxide 800 mg or 1,200 mg per day or corresponding placebo groups in a ratio of 2: 2: (1: 1). The patients started with lower doses and were highly titled over a period of several weeks. The treatment lasted a total of 8 weeks.
target parameter
heat floural frequency and heat fling score (number of hot flashes multiplied by the medium severity) were measured using a validated hot flap diary. A 1-week Baseline period was preceded by the beginning of the study medication. The primary endpoint was the intrapatical difference in the medium heat fling score between baseline and treatment periods, whereby each magnesium group was compared with the combined placebo groups using a gatekeeping process.
important knowledge
medium hot flashes, medium hot flashes and associated changes during the treatment period were similar for each group. In the magnesium arms, an increased incidence of diarrhea and a correspondingly lower incidence of constipation was reported compared to placebo. No statistically significant difference in other toxicities or quality of life measurements was observed.
practice implications
This study indicates that we should rethink the practice of recovering breast cancer patients who complain about hot flashes in menopause.
hot flashes are a common complaint in women in menopause, especially for women with breast cancer in history, the accompanying therapies such as tamoxifen or aromata seed. In the past, two pilot studies have pointed out that magnesium oxide could reduce the number and intensity of hot flashes.
Since bottles with placebo pills are not routinely available, magnesium oxide is a slightly available and safe choice.
At a meeting of the American Society of Clinical Oncology (ASCO) in 2010 in Chicago, Herrada described a pilot study with 22 women who received 400 mg magnesium oxide three times a day. All women received adjuvant treatment for breast cancer. At the end of the study, 10 (45 %) patients reached a complete disappearance of the hot flashes and 10 (45 %) patients suffered at least 50 %fewer hot flashes per day. Two (10 %) patients experienced no change in the number of hot flashes. 1
The results of a second pilot study were 2011 by Park et al. A group of 25 breast cancer patients who also received any form of adjuvant treatment received 400 mg magnesium oxide for 4 weeks, escalating at 800 mg if necessary. Heat flashes were significantly reduced. Out of 25 patients, 14 (56 %) had a reduction in the heat fling scor by> 50 %and 19 (76 %) a reduction by> 25 %. The women also experienced a reduction in fatigue, sweating and stress.
These studies in combination seemed to be clinically significant, and we checked the publication of 2011 in the August 2011 edition Journal of Naturopathy .
The main author of this new, larger and much more comprehensive placebo -controlled study is Haeseong Park, who was also the senior test doctor in the smaller pilot study from 2011. In this clinical study from 2015, magnesium oxide offered no greater benefit than placebo. Both doses of magnesium and the placebo were associated with similar improvements in hot flashes. They all seem to help equally.
It is not that magnesium has not been associated with an improvement; It was as good that the placebo was just as good, which indicates that the advantage of taking magnesium oxide is a placebo effect during hot flashes. Both earlier pilot studies were open and without placebo arms.
These studies let us in a kind of ethical dilemma. There are two ways to interpret and react to this data. We could conclude that if magnesium does not work better than placebo in hot flashes, we should stop prescribing it for this indication. On the other hand, since magnesium and placebo seem to be quite effective in hot flashes in this patient population, we should consider it to treat these symptoms. Since bottles with "placebo pills" are not routinely available, magnesium oxide is a slightly available and safe choice.
Some will note that magnesium oxide is usually not our first choice at magnesium, since it is poorly absorbed and tends to have a laxative effect. The fact that magnesium oxide has this side effect can increase its placebo effect, and we should think twice before switching to "better forms" of magnesium.
hot flashes seem to be pretty good to address a placebo intervention. In the study by Boekhout from 2006, around 25 % of 1,174 patients who received a placebo or the intervention reported from a reduction in hot flashes by at least 50 % and in 15 % of a reduction by more than 75 %. 4 In Sloans review of 7 randomized studies from 2001, the placebo was received, the placebo Average decrease in the frequency and intensity of hot flashes by 25 %.
women with breast cancer in history, whose hot flashes are treated with the frequently prescribed medication venlafaxin, gabapentin or clonidine, have a high risk of side effects. A Cochrane review of 12 studies with a total of 1,467 participants in November 2016 reports that 81 % of women in the treatment group had side effects, compared to only 19 % in the control group. 6 Against this background, an attempt with magnesium, even if it is only a placebo, can be a safer first option than prescription drugs.
- Herrada J., Gupta A., Campos-Gines AF, et al. Oral magnesium oxide for the treatment of hot flashes in women who undergo breast cancer treatment: a pilot study. Chicago: ASCO annual conference 2010; 2010.
- Park H, Parker GL, Boardman CH, Morris mm, Smith TJ. A pilot study of phase II with magnesium preparations for reducing hot flashes in menopause for breast cancer patients. Support-Care Cancer . 2011; 19 (6): 859–863.
- Mahon SM, Kaplan M. Placebo effect in heat flag research. lancet oncol . 2012; 13 (5): E188; Author Answer E190.
- Boekhout ah, Beijnen Jh, Schellens Jh. Symptoms and treatment for cancer therapy-induced earlier menopause. oncologist . 2006; 11 (6): 641-654.
- Sloan yes, Loprinzi Cl, Novotny PJ, Barton DL, Lavasseur BI, Windschitl H. Methodological teaching from hot flag studies. j clin oncol . 2001; 19 (23): 4280-4290.
- Hervik JB, Stub T. Side effects of non-hormonal pharmacological interventions in breast cancer survivors suffering from hot flashes: a systematic review and meta-analysis. breast cancer treatment . 2016; 160 (2): 223-236.
Kommentare (0)