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This paper (9) emphasizes that tissue Mg levels are well maintained during 4-6 space missions; but there is a severe discrepancy here, A heart to heart because it has been published that the serum Mg levels are significantly reduced (p< .0001) in 196 By William J Rowe MD, FBIS, FACN space shuttle crew members [10]. Furthermore, at the 11th Man in Space Symposium in Toulouse, France in 1995, it was shown that in 143 cosmonauts, the serum Mg, was also reduced to similar levels. Instead of providing a page and table number in the reference text book [10] which shows that the serum Mg levels were significantly reduced, (p 11) the NASA paper [9] provides the reference textbook only on the last page.

Testing the test Although this is entirely speculative, the NASA authors may have an agenda to support their conclusion because they were misled by Dr. Silver’s very reliable tissue “EXA Test” study. The NASA paper, fits the definition of Jim Irwin at the during the flight on which he suffered severe heart “junk science” i.e. “faulty scientific research, complications. NASA especially when used to advance special t a relatively small NASA meeting in have never seen either of these extraordinary interests”. The paper [9] attempts to support Washington DC, in the late 1990s, complications. their case, that the tissue Mg levels were Harrison Schmitt, Lunar Module Pilot When NASA complied with my request, after unchanged, by using the published results Aof , invited me to sit down and have ’s death in 2012, for detailed (on ) of a highly sensitive method of a chat. I didn’t know him at the time. Although information regarding his cardiovascular data determining tissue Mg levels, correlating I hadn’t been invited to present a paper, I had before and after his lunar mission, I asked Joan quite well with tissue Mg levels obtained at made several comments following some of Vernikos PhD, former Director of NASA Life open heart surgery [11]. This technique of Dr the presentations, regarding the published Sciences, to drive to my home from her city, Burton Silver’s is of considerable importance, space flight cardiovascular complications in nearby, and to come armed with a magnifying particularly because routine serum Mg levels addition to my own. I gave him a couple of glass. Since Armstrong’s fame might persist lack sensitivity. my papers [1, 2]. He later mailed me several for many years, I wanted a scientist to share Silver’s unique method is to obtain cells personal unpublished experiences of quite a the responsibility in determining the critical from the roof of the mouth and then quantitate few . difference between Armstrong’s diastolic blood the levels by electron microscopy. But, in Schmitt emphasized that it was his opinion pressure before his lunar mission and on his microgravity, since the specimens are obtained that in the previous 20 years NASA had return, in order to confirm an abnormality in from the head, with a shift of blood flow accomplished very little in addressing the cardiovascular function. there, this would, in turn, bring an excessive medical hazards of space flight and stressed Despite the numbers, having faded after 45 (unreliable) quantity of tissue Mg to the head, his frustration with NASA’s restrictive policy, years, we indeed, found a highly significant from progressively depleted Mg storage sites identified as withholding from an independent difference with a specificity, published at 100% in the bones and skeletal muscles, along with researcher medical information – even when [4]. As I emphasized in my recent editorial, invariable impairment of Mg absorption through it pertains specifically to a mission – until an both Irwin and Armstrong came close to dying the gastrointestinal tract. In addition, there is deceased. He emphasized this in on the with very high heart rates [7]. would be a loss of Mg with sweating, as well his book Return to the Moon [3] as I have done Because of my concern that eventually there as renal Mg loss, with invariable impairment in in my papers, numerous times. would be an EVA fatality, with long missions exercise thermoregulation in Space – with the Because of the Freedom of Information with progressively increasing loss of protective necessity of exercise for at least 1-2 hours a Act, here we are, learning in just the past few magnesium (Mg) storage sites in bones and day [7]. years that four Moon walkers returned with skeletal muscles [8], I sent several emails This microgravity shift of blood to the head, abnormal stress tests, namely Irwin, Shepard, to Richard Williams MD, NASA director of is the mechanism which causes in microgravity, Armstrong, and Scott. The latter, although still medicine. He invited NASA headquarters a reduction of the thirst mechanism [12, 13], alive, only through a NASA publication [4]. physician, Dr. Victor Schneider, to discuss contributing to dehydration, along with leaks of Only now, do we learn that Armstrong had my concern by telephone; this led to two, half plasma through defective capillaries [5]. With probable acute heart failure on the Moon [5] hour ‘phone conversations, with Schneider’s Silver’s method, in space, the tissue Mg levels and that Irwin returned with extremely high insistence that there is, in space, no evidence would appear “normal”, which is inconceivable. stress test-hypertension in excess of 275/125 of reductions in Mg – despite my 25 years of After reading this NASA paper [9], I contacted [6] and cyanosis of the finger nail beds. publications and presentations to the contrary. Dr Silver’s lab and was informed that he was Having supervised over 5,000 hospital based Apparently, NASA was in the process of rechecking the results; I assume that his symptom-limited maximum stress tests, I completing their paper, published in late 2015. studies were correct. I must conclude that, with

172 Spaceflight Vol 58 May 2016 physiology

The rigours of working on the Moon gave Harrison “Jack” Schmitt concerns for astronaut health. NASA

Silver’s method of obtaining the samples from Finally, although six of the 25 crewmembers pertaining to assumed unchanged tissue Mg the head, it cannot be utilized with space flight, in the other NASA study [9], took a levels, provide a good example of a subject in the presence of microgravity. This problem bisphosphonate during flight, which would addressed by Dr. Marcia Angell, a physician would not occur, if exact Earth gravity can be reduce bone deterioration, with 60% of Mg and longtime editor of the New England Journal duplicated both in transit and while exploring stored there, this would have no effect in of Medicine, one of the most trusted journals in the Moon, Mars, or an asteroid. offsetting the progressive deterioration of the world. She states, “It is no longer possible A search of the medical literature was skeletal muscles, another Mg storage site, nor to believe much of the clinical research that is conducted and only one other similar NASA would bisphosphonates offset the Mg deficits published or to rely on the judgement of trusted study was found [14] with again the assertion from impairment of Mg absorption through the physicians or authoritative medical guidelines. that there were no significant changes in tissue GI tract. I take no pleasure in this conclusion, which I Mg concentrations in the 12 subjects who had It is very disturbing that these two NASA reached slowly and reluctantly over my two measurements with Dr. Silver’s technique. papers [9, 14] with the misleading conclusion, decades as an editor.” Furthermore, this was a bed rest “head-down” References study, for convenience and with far less cost, in an attempt to simulate space studies by 1. W.J. Rowe, “Interplanetary travel and and space flight”, Nutrients, 7, pp.10209- permanent injury to normal heart”, Acta 10222, 2015. keeping the head below body level, thereby Astronautica, 40, pp.719-722, 1997. 10. C.S. Leach Huntoon, A.L. Grigoriev and forcing higher cranial blood flow. 2. W.J. Rowe, “The Apollo 15 Space Y.V. Natochin, “Fluid and electrolyte However, I have maintained for many years Syndrome”, CIRCULATION, 97, pp.110- regulation in spaceflight”, Vol. 94, Science that these bed rest studies are unsatisfactory, 120, 1998. and Technology Series Am Astronautical because the adrenaline levels have not been 3. Harrison H. Schmitt, “Return to the Moon”, Soc., p.11, 72, 1998. Praxis Publishing Ltd., p.309, 2006. 11. M.C.P. Haigney, B. Silver, E. Tanglao et shown to duplicate those in space at twice 4. W.J. Rowe, “Moon walkers and urban al., “Noninvasive measurement of tissue Earth levels when supine. I believe that the pollution”, Am J. Med, 126, e1-e2, 2013. magnesium and correlation with cardiac combination of invariable deficits of both Mg 5. W.J. Rowe, “Possible space flight – levels. Exa Tests”, CIRCULATION, 92, ions and plasma are responsible for these induced catecholamine cardiomyopathy: pp.2190-2197, 1995. adrenaline elevations exemplified, for example, Neil Armstrong’s last 20 lunar minutes”, 12. Y. Kawai, M. Doi, A. Setogawa, et al., Res Reports in Clin Cardiol, 5, pp.33-39, “Effects of microgravity on cerebral by Armstrong’s lunar heart failure [5]. 2014. hemodynamics”, Yonago Acta Medica, 46, th When I presented a paper at the 11 Man 6. W.J. Rowe, “Extraordinary hypertension pp.1-8, 2003. in Space Symposium in 1995, I insisted that, after a lunar mission”, J Am J Med, 122, 13. W.J. Rowe, “Microgravity and the plasma based on my studies of extraordinary endurance e1-e2, 2009. volume”, Spaceflight, 52, p.235, 2010. athletes and the Russian animal studies in 7. W.J. Rowe, “Armstrong’s moon cardiac 14. C. Sakowski, V. Starc, S.M. Smith et scare”, Spaceflight, 58, pp.56-57, 2016. al., “Sedentary long-duration head - space, in microgravity the adrenaline levels must 8. W.J. Rowe, “Preventing an EVA fatality”, down bed rest and ECG repolarization be significantly elevated. About eight years later, Spaceflight, 57, p.256, 2015. Heterogeneity”, Av Space Environ Med, my insistent argument was supported [5]. 9. S.M. Smith and S.R. Zwart, “Magnesium 82, pp.416-423, 2011.

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