I have been on the NSAID Ketoprofen for Psoriatic Arthritis for nine years now. A couple of weeks ago my partner discovered that NSAIDS are implicated in bowel related problems. I went off the Ketoprofen for a week then my joints felt very bad so I took one only. Instantly I had a flare up of what we now know to be MC. I stopped taking the Ketoprofen and it's now four days into my elimination diet and things are feeling 100 times better.
I have decided not to replace the Ketoprofen at any cost, but to try doing without it.
NSAID - Ketoprofen (UK)
Moderators: Rosie, Jean, CAMary, moremuscle, JFR, Dee, xet, Peggy, Matthew, Gabes-Apg, grannyh, Gloria, Mars, starfire, Polly, Joefnh
Yes, for those who react to NSAIDs, stopping the medication and avoiding it is necessary in order to stop the MC symptoms and prevent them from returning. In some cases, no further intervention is necessary. IOW, diet changes are not necessary in some cases if the drug was the only cause of the MC symptoms, and the problem was caught in time. For most of us though, we still have to carefully follow the diet. Many other drugs can also cause MC, including antibiotics, PPIs, statins, SSRIs, SNRIs, beta blockers, and bisphosphonates, for example.
However please note that for many of us, avoiding gluten and dairy will stop the symptoms of AI diseases such as psoriasis and arthritis. It usually takes a year or so of being faithful to the diet in order to heal and stop the symptoms, but as the gut heals, the symptoms will slowly fade away, and many members here have eliminated their psoriasis after changing their diet.
About 15 years ago I had arthritis so bad that I had to use a cane just to get around. Changing my diet eliminated my arthritis problems, permanently.
That said, I have no idea whether the diet will control psoriatic arthritis, but there is good reason to believe that it might.
Tex
However please note that for many of us, avoiding gluten and dairy will stop the symptoms of AI diseases such as psoriasis and arthritis. It usually takes a year or so of being faithful to the diet in order to heal and stop the symptoms, but as the gut heals, the symptoms will slowly fade away, and many members here have eliminated their psoriasis after changing their diet.
About 15 years ago I had arthritis so bad that I had to use a cane just to get around. Changing my diet eliminated my arthritis problems, permanently.
That said, I have no idea whether the diet will control psoriatic arthritis, but there is good reason to believe that it might.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
I'm hoping for a good outcome all round but doubt very much that Ketopofen is the only offender. I'll stick rigidly to the elimination diet and hope to discover other food items I can't tolerate.
if I do have a flare up again do I have to go back to square one on the elimination diet or can I resume where I left off and was happy?
if I do have a flare up again do I have to go back to square one on the elimination diet or can I resume where I left off and was happy?
That's a tough question, because it depends on a lot of things, especially your healing stage. But in general, if your diet is "clean", and you have been healing for at least a few months, an accidental, isolated exposure to a small amount of a problem food should only cause a brief setback of a few days or less. And the longer we heal, the milder the reaction will typically be, and the shorter the reaction time.
For most of us, the safest policy is to drop back to a simple, bland diet that worked for us while we were recovering, just to be on the safe side. Often only a day or 2 of that will ensure prompt recovery. Doing so may not be essential, but things can get out of hand in our digestive system surprisingly quickly if things continue to snowball, so the safest policy is to err on the side of caution. As time goes on, we learn to interpret what our body is telling us, and we become better able to judge the seriousness of a reaction, so that we can deal with it appropriately.
Tex
For most of us, the safest policy is to drop back to a simple, bland diet that worked for us while we were recovering, just to be on the safe side. Often only a day or 2 of that will ensure prompt recovery. Doing so may not be essential, but things can get out of hand in our digestive system surprisingly quickly if things continue to snowball, so the safest policy is to err on the side of caution. As time goes on, we learn to interpret what our body is telling us, and we become better able to judge the seriousness of a reaction, so that we can deal with it appropriately.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Thanks Tex.......
I'll definitely err on the side of caution. The past few months have been the most devastating ever and I never want anything to get out of hand or control again. I can't get a diagnosis in the UK for gluten intolerance because I refuse to eat the gluten one nedds to in order to prove it. It mskes no sense because its tantamount to self harming - it makes me very ill. I'll likely not have a colonoscopy again because its a frightful procedure so no ones getting a biopsy to diagnose MC. I had a colonoscopy done privately and the Colorectal surgeon didn't take a biopsy. I had a very tender tummy for weeks afterwards.
I see you have a "naughty step" for those who want to own up to breaking their diets - you won't find me there. It's just too painful so I plan to be very strict and self disciplined with my food.
I'll definitely err on the side of caution. The past few months have been the most devastating ever and I never want anything to get out of hand or control again. I can't get a diagnosis in the UK for gluten intolerance because I refuse to eat the gluten one nedds to in order to prove it. It mskes no sense because its tantamount to self harming - it makes me very ill. I'll likely not have a colonoscopy again because its a frightful procedure so no ones getting a biopsy to diagnose MC. I had a colonoscopy done privately and the Colorectal surgeon didn't take a biopsy. I had a very tender tummy for weeks afterwards.
I see you have a "naughty step" for those who want to own up to breaking their diets - you won't find me there. It's just too painful so I plan to be very strict and self disciplined with my food.
You definitely have the right idea. That's what it takes to get your health back, and to remain healthy.
Tex
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
I am suffering from frozen shoulder, bursitis, calcification tendinitis and mild arthritic in both shoulders! Has anyone been able to take NSAIDs (I've heard there might be other things you can take with them to reduce or elimate the MC symptoms) or found anything else that can significantly reduce inflammation? My shoulders are both so inflamed and all I want is some Advil to take the edge off. Tylenol does nothing, I've tried tramacet, gabapentin and nabilone....none of these help the pain. I'm not sleeping. Any help is appreciated. Thanks
Stephanie
Hi Stephanie,
I'm sorry to hear that you're having so much pain. I don't have any experience with safe forms of NSAIDs, but I can tell you from experience (and research) that calcification problems are typically caused by a chronic magnesium deficiency. I had similar problems (though not as bad as you are experiencing) for many years (decades, on an occasional basis) and I didn't have a clue what was causing them.
And then about 2 years ago I finally discovered my chronic magnesium deficiency and resolved it. Just prior to that, my symptoms had slowly became worse over a period of a couple of years until I even had a couple of kidney stones about 6 months before I figured out the cause of the problem. My doctors were no help at all, because they couldn't recognize a magnesium deficiency if it bit them on the end of their nose.
It never occurred to me that I had a magnesium deficiency because I had been taking a magnesium supplement for years, and my magnesium blood test results were always "normal" But I wasn't taking enough magnesium and I wasn't taking the right type. So my deficiency was slowly becoming worse and worse.
Too much calcium in the blood (even normal amounts) without a sufficient amount of magnesium causes calcification. This happens because magnesium is necessary for transporting calcium out of the blood to take it to the cells where it is needed. Without adequate magnesium, the calcium level builds up in the blood and it begins to adhere to blood vessel walls, slowly forming permanent deposits. When blood levels of calcium become too high (or stay high too long), there's a significant risk of an adverse cardiac event. So in order to lower the calcium blood level, some of the calcium is dumped in various locations, such as shoulder joints. While shoulder pain can come from other causes, chronic bursitis is almost always associated with calcium deposits.
Taking magnesium to stop calcification problems can prevent future problems, and it will probably reverse some of the existing damage, but I doubt that it can reverse all of the damage that has been accumulating for years. I haven't had any bursitis or similar issues since I corrected my magnesium deficiency.
I'm guessing that you are taking a calcium supplement, or you have taken one in the past. Most people get plenty of calcium in their food (even when on a restricted diet), so that out in the real world (that is, outside of the incorrect thinking that's typically found in doctors offices regarding calcium), calcium supplements are almost never helpful. The problem that causes osteoporosis and other calcium-related problems is virtually always either inadequate vitamin D (vitamin D is necessary for the absorption of calcium into the blood), or inadequate magnesium (magnesium is necessary for the removal of calcium from the blood). Taking a calcium supplement without taking an approximately equal amount of magnesium supplement is asking for trouble. For example, anyone who takes 400 mg of calcium supplement per day should also be taking 400 mg of magnesium supplement per day.
Magnesium deficiency is a common cause of pain from other issues also. For example, muscles cannot properly relax without an adequate supply of magnesium so they tend to remain clenched, and this can cause pain. And to make matters worse, a magnesium deficiency interferes with sleeping in addition to any pain caused by the deficiency.
I hope that some of this is helpful.
Tex
I'm sorry to hear that you're having so much pain. I don't have any experience with safe forms of NSAIDs, but I can tell you from experience (and research) that calcification problems are typically caused by a chronic magnesium deficiency. I had similar problems (though not as bad as you are experiencing) for many years (decades, on an occasional basis) and I didn't have a clue what was causing them.
And then about 2 years ago I finally discovered my chronic magnesium deficiency and resolved it. Just prior to that, my symptoms had slowly became worse over a period of a couple of years until I even had a couple of kidney stones about 6 months before I figured out the cause of the problem. My doctors were no help at all, because they couldn't recognize a magnesium deficiency if it bit them on the end of their nose.
It never occurred to me that I had a magnesium deficiency because I had been taking a magnesium supplement for years, and my magnesium blood test results were always "normal" But I wasn't taking enough magnesium and I wasn't taking the right type. So my deficiency was slowly becoming worse and worse.
Too much calcium in the blood (even normal amounts) without a sufficient amount of magnesium causes calcification. This happens because magnesium is necessary for transporting calcium out of the blood to take it to the cells where it is needed. Without adequate magnesium, the calcium level builds up in the blood and it begins to adhere to blood vessel walls, slowly forming permanent deposits. When blood levels of calcium become too high (or stay high too long), there's a significant risk of an adverse cardiac event. So in order to lower the calcium blood level, some of the calcium is dumped in various locations, such as shoulder joints. While shoulder pain can come from other causes, chronic bursitis is almost always associated with calcium deposits.
Taking magnesium to stop calcification problems can prevent future problems, and it will probably reverse some of the existing damage, but I doubt that it can reverse all of the damage that has been accumulating for years. I haven't had any bursitis or similar issues since I corrected my magnesium deficiency.
I'm guessing that you are taking a calcium supplement, or you have taken one in the past. Most people get plenty of calcium in their food (even when on a restricted diet), so that out in the real world (that is, outside of the incorrect thinking that's typically found in doctors offices regarding calcium), calcium supplements are almost never helpful. The problem that causes osteoporosis and other calcium-related problems is virtually always either inadequate vitamin D (vitamin D is necessary for the absorption of calcium into the blood), or inadequate magnesium (magnesium is necessary for the removal of calcium from the blood). Taking a calcium supplement without taking an approximately equal amount of magnesium supplement is asking for trouble. For example, anyone who takes 400 mg of calcium supplement per day should also be taking 400 mg of magnesium supplement per day.
Magnesium deficiency is a common cause of pain from other issues also. For example, muscles cannot properly relax without an adequate supply of magnesium so they tend to remain clenched, and this can cause pain. And to make matters worse, a magnesium deficiency interferes with sleeping in addition to any pain caused by the deficiency.
I hope that some of this is helpful.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Thanks Tex.
I don't actually take a calcium supplement. My MC was caused by a SSRI and since going off, only NSAIDs seem to bring it back now. So other than being GF (I'm celiac) I eat a very balanced diet. I do take about 4-5000 UI of vitamin D daily. You said you were taking the wrong magnesium. What type should I take? And if not taking calcium supplements, how much magnesium should I start on? I know there is topical and pills. I assume I'd be fine absorbing pills as it's been a full year since my last (short) bout with MC symptoms. Thanks again!
I don't actually take a calcium supplement. My MC was caused by a SSRI and since going off, only NSAIDs seem to bring it back now. So other than being GF (I'm celiac) I eat a very balanced diet. I do take about 4-5000 UI of vitamin D daily. You said you were taking the wrong magnesium. What type should I take? And if not taking calcium supplements, how much magnesium should I start on? I know there is topical and pills. I assume I'd be fine absorbing pills as it's been a full year since my last (short) bout with MC symptoms. Thanks again!
Stephanie
Most of us here take at least the RDA (320 mg for women), more if we suspect a chronic deficiency. The RDA for men is 400, but I take 500–600 mg per day because I seem to have trouble absorbing normal amounts of magnesium. Some of us have genetic issues that prevent us from properly absorbing magnesium (and possibly other vitamins and minerals).
The thing is, most diets contain plenty of calcium, but research shows that at least 68 % of the population do not get adequate amounts of magnesium from their diet. And to add insult to injury, many of the things we ingest these days prevent the absorption of magnesium, or deplete our reserves. Many meds deplete magnesium, and even coffee and tea interfere with it's absorption.
Most of us here take Doctor's Best Chelated Magnesium (magnesium glycinate). It contains 100 mg of magnesium per tablet. It's well absorbed and the least likely of all the magnesium supplements to cause diarrhea in larger doses. And of course for anyone who's digestive system is so sensitive that taking oral magnesium can cause D, the topical magnesium supplements work quite well.
Tex
The thing is, most diets contain plenty of calcium, but research shows that at least 68 % of the population do not get adequate amounts of magnesium from their diet. And to add insult to injury, many of the things we ingest these days prevent the absorption of magnesium, or deplete our reserves. Many meds deplete magnesium, and even coffee and tea interfere with it's absorption.
Most of us here take Doctor's Best Chelated Magnesium (magnesium glycinate). It contains 100 mg of magnesium per tablet. It's well absorbed and the least likely of all the magnesium supplements to cause diarrhea in larger doses. And of course for anyone who's digestive system is so sensitive that taking oral magnesium can cause D, the topical magnesium supplements work quite well.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
I got lucky. One morning I had tachycardia (my heart rate was almost twice my normal resting heart rate), I had trouble breathing, my blood pressure was low, and I felt so bad that I could only eat about half my breakfast. I always take my pills after breakfast, but I skipped them that day and went to the ER. My heart rate was still in the upper 90s when I got to the ER, so naturally they checked for markers of a heart attack, but my troponin enzyme level was normal. As usual, they ordered a serum magnesium test (instead of an RBC magnesium test), among many other tests. The serum magnesium test is pretty much worthless because magnesium is a critical electrolyte so our body will always draw magnesium from cells in the body (until they run completely out of magnesium reserves) in order to keep the serum level of magnesium in the normal range. If the blood level of magnesium gets too far below range our heart can stop. Only about 1 % of the body's magnesium supply is in serum. The rest is in bones and other cells in the body.
But because I didn't take a magnesium supplement that morning, the half-breakfast I ate didn't supply enough magnesium to keep my serum magnesium level in the normal range, and my cells were apparently completely drained of magnesium reserves. So the serum magnesium test actually showed a result below the normal range. If I had eaten a full breakfast, or if I had taken a magnesium supplement, the test would have yielded a normal result. So I was lucky that day.
When the ER docs looked at my test results they told me that everything looked normal, so they sent me home.
Fortunately when I got home I felt a little better, so I ate a normal meal and survived. 
But the next day I felt rough again, and I was no better the second day, so I looked up my test results online. Sure enough, the lab had flagged the low magnesium level and high creatinine level, which caused my EGFR (kidney function) to be very low (so it was also flagged). IMO their opinion of what constitutes "normal" test results leaves a lot to be desired. Online medical records saved the day.
I increased my magnesium supplement rate and the next day I felt much better. In about 3 days all my symptoms were gone, so I knew I had finally found the problem that had been bothering me for years. Certain antibiotics also deplete magnesium and the reason why my magnesium deficiency suddenly became much worse is because I had been taking Bactrim for some dental work. Here's where I originally posted about my experience at the ER.
Even ER Docs Don't Recognize The Importance Of Magnesium
Tex
But because I didn't take a magnesium supplement that morning, the half-breakfast I ate didn't supply enough magnesium to keep my serum magnesium level in the normal range, and my cells were apparently completely drained of magnesium reserves. So the serum magnesium test actually showed a result below the normal range. If I had eaten a full breakfast, or if I had taken a magnesium supplement, the test would have yielded a normal result. So I was lucky that day.
When the ER docs looked at my test results they told me that everything looked normal, so they sent me home.
Fortunately when I got home I felt a little better, so I ate a normal meal and survived. But the next day I felt rough again, and I was no better the second day, so I looked up my test results online. Sure enough, the lab had flagged the low magnesium level and high creatinine level, which caused my EGFR (kidney function) to be very low (so it was also flagged). IMO their opinion of what constitutes "normal" test results leaves a lot to be desired. Online medical records saved the day.I increased my magnesium supplement rate and the next day I felt much better. In about 3 days all my symptoms were gone, so I knew I had finally found the problem that had been bothering me for years. Certain antibiotics also deplete magnesium and the reason why my magnesium deficiency suddenly became much worse is because I had been taking Bactrim for some dental work. Here's where I originally posted about my experience at the ER.
Even ER Docs Don't Recognize The Importance Of Magnesium
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.