# Switching from Magnesium Citrate to Linzess



## IBSsucks2 (Feb 17, 2016)

I have been taking magnesium citrate (Natural Calm) but, although it seems to provide some relief, I find that I am spending a lot of time in the bathroom and I was hoping for a better way to treat my symptoms. I received some samples of Linzess from my GP and was thinking about trying it but I have read so many horror stories that I have been reluctant to do so. Does anyone have any suggestions for how to start taking it? Can I or should I take the magnesium citrate simultaneously and, if so, how will I know that I no longer need to take it? If I shouldn't take it with mag citrate, how do I switch? Cold turkey?

On a related note, how long does it take to work? For example, if I have a long commute to work, how much time should I set aside in the morning to make sure that I have "taken care of business?"

Just to provide some background about myself, I was first diagnosed with IBS around 1993. Since then, I have had several consultations with gastroenterologists, including colonoscopies, as well as a battery of other tests (e.g., for celiac, SIBO, etc.), all of which have come up negative. My primary symptoms are alternating bouts of diarrhea & constipation (mostly constipation - and by constipation I mean feeling like I have to go but nothing comes out or going but never feeling like it all comes out) and bloating and gas, particularly when I have that sense of incomplete vacuation. But, by far, the symptom that bothers me the most is the feeling of incomplete vacuation. I have been taking mag citrate for about three years and I drink "boatloads" of water every day. As a result, I usually go to the bathroom (typically, about four times a day) but it never feels completely empty. Also, all of the bathroom trips is, needless to say, seriously curtailing my quality of life. However, whenever I have tried cut back on the mag citrate, the incomplete vacuation sensation ramps up and I feel absolutely miserable. So, my choices so far have been, feel somewhat better but have no life or feel miserable but spend a little less time in the bathroom (technically, I guess this should give me my life back but, yet, I find that it does not since I feel so miserable and don't feel like doing anything).

This is my first post so please let me know if I missed something. I would greatly appreciate any help or advice anyone would be willing to share.

Thanks!


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## annie7 (Aug 16, 2002)

one thing about linzess--it works on the same receptors that food does. one of my gastro docs ran clinical trials on linzess and did research on it. the closer you take it to eating the quicker it works. some people have good success by taking it a half hour before eating, as prescribed. if you get too much D that way, try taking it an hour before eating. some people take it at bedtime--2 or 3 hours after eating and find it gives them a BM in the morning that way.

and linzess comes in two strengths--290 mcg and 145 mcg--so if you get too much D with the 290, try the 145.

people also advise drinking a lot of water with it to help it work better.

from what i've read and from what my gastros told me, the time frame for results from linzess varies with people. and it depends on the dose and how soon you take it after eating.

but anyway--a lot of people--especially those on the 290 dose--have results right away. for some people it takes longer. some people have said their gastros told them it might take a couple weeks for their bodies to adjust to linzess... or "normalize" as one person put it. that's what my gastros told me--give it two weeks...

i wish it were a more predictable drug.... it's very YMMV

we have a lot of linzess threads here on the board.

about the incomplete evacuations--have you tried elevating your feet on a footstool or shoe box when sitting on the toilet. elevating the feet helps straighten out the anorectal angle and allows a more complete evacuation. you can also use a squatty potty. it can take some experimentation to find the right height. i started with a footstool, then used a big wide shoe box and finally bought a squatty potty.

good luck with everything. hope you can find some relief.


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## minimalizer (Jun 8, 2014)

http://www.webmd.com/drugs/2/drug-162895/linzess-oral/details#uses -Reviews can also be found here. You still might want to stick with mag. citrate as a supplement though. If it gives you too loose of bowels inclusively while on the Linzess, take the mag. with calcium, which is the usual way it is taken for good absorption, after meals throughout the day especially.


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## IBSsucks2 (Feb 17, 2016)

@annie7 Thank you so much for the information! My wife suggested the squatty potty to me and, although I haven't done that, I always do my best to find a toilet that sits as close to the ground as possible. I agree, I think that the increased flexion helps with evacuation.

@minimalizer Thank you for the link and the information about using mag citrate and Linzess. You raise a good point...perhaps, I have been taking the mag citrate incorrectly. I usually take a large dose with my dinner and a smaller dose first thing in the morning. Is it best to take the mag citrate after meals and, if so, how much longer after? Also, you mentioned to continue to use mag citrate as a supplement. Did you mean that I should take it at the same dosage that I am taking it at now or, rather, only if things aren't moving? Also, will I continue to need to take mag citrate even when taking Linzess and, if so, would there be any benefit to taking the Linzess?

Thanks again for you posts. I really do appreciate any advice you would be willing to share.


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## Suffering Bad (Aug 2, 2004)

IBSsucks2 -

Which dosage did you receive as a sample 145mg or 290mg? I too used magnesium citrate at one time. The linzess its much more convenient and is easier to swallow.

This is important to know... **** Linzess affects users differently.**** If you read the forum you will see that there is a full spectrum of results with linzess. Some have had great success and results... others have not. Some have experienced weight gain others like me have experienced weight loss. There are side effects with linzess so do your homework. If you read my forum posts you will see I had a problem 6 months after starting Linzess which may or may not have been caused by the drug. I was using the drug at 290mg once a day 7 days a week. I cut back to 5 days a week taking the weekend off. I then realized I had better results taking the drug every other day or 3 to 4 times a week.

My suggestion is try this drug for the first time on a day you have nothing else planned. No work or anything else in your schedule the day you try it with a bathroom close by. I take the pill (290mg) at 8:30 in the morning after my commute to work. I typically have 2 - 12oz cups of coffee with creamer. Then I begin to drink water. Approximately 32 to 48oz of water. I typically have results in about 1 hour (more or less). The fireworks (as I like to call them) last approximately 2 to 3 hours. By noon its all over and I feel cleaned out.

I look at this as a quality of life issue. Do nothing and be miserable all day 24/7 ~OR~ take the linzess and be uncomfortable for 3 hours and have 21 hours that are perfectly normal.

Keep us posted how your trial goes and what your results are. Good luck my friend.


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## IBSsucks2 (Feb 17, 2016)

Suffering Bad,

I read your post..I'm really sorry to hear that. That sounds awful. Based on what happened to you, are you still taking the Linzess?

Thanks for the detailed information. That is very helpful. If you don't mind my asking, are you in the bathroom for the 2 to 3 hours or are you able to do things in between (e.g., take a shower, get ready, etc.)? Do you eat breakfast when you drink the water? Can the medicine be taken earlier or is it based on your body's rhythms? The reason that I am asking is that I have a full-time job and, if I'm going to be glued to the toilet until noon, I don't think that I will have said full-time job for very long. To answer your question, I was given the 145mg. Would that make a difference (I also realize that you may not be able to answer that question)?

Again, thanks for the feedback. I really appreciate it.


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## Suffering Bad (Aug 2, 2004)

IBSsucks2 -

My wife does not want me taking Linzess. My wife as well as other family members and friends are convinced the 6 months use of Linzess were the root cause of the diverticulitis and perforation. My surgery was in October 2015. My wife and I did question my doctor and the surgeon several times about Linzess. The surgeon and my regular doctor did not discontinue the medication. To be honest, I started using the drug again approximately 1 month ago and have taken 7 pills since then. I am torn because it does give me relief. However, I never want to go through what happened again. That is why I posted my question out on the forum to other Linzess users. So to answer your question, yes I am sparingly taking Linzess (290mg) for relief of IBS C.

To answer your other questions...

The fireworks last approximately 2-3 hours. During that time, yes I am able to still do work and other activities in between. I would not say I am glued to the toilet but you do need to have one close by. I just have to have a bathroom close by and I am in there 5 to 10 minutes at a crack. Some days I only need 3 visits to the bathroom and some days as many as 5 visits to the bathroom. I work in an office setting, the bathroom is close by, and my employer has not said anything. So all of this works for me.

I will say this. I would not recommend taking this drug as soon as you get up in the morning on a work day. By that, I mean shower, get dressed, eat your breakfast, and drive to work. Take the Linzess when you get to work. If you take it as soon as you get up in the morning on a work day, you may find yourself in a bad situation during your commute to work. Like I said the fireworks for me start approximately 1 hour after taking the medication. It takes me 30 minutes to get ready and out the door in the morning. My commute to work is typically 40 minutes when traffic is good. You can see why I don't take the drug until I arrive at work.

I am not a big breakfast person. I drink the 2 - 12oz coffees first and then drink the 32 to 48 oz of water. I don't see a reason why you couldn't drink the water with your breakfast. I will say this... for me... the more water I drink the more effective the Linzess seems to be.

As far as taking the medicine earlier. I would make that decision based on bathroom access only. Take it as early as you want. Just understand that sometime within the next 30 to 90 minutes you will need to use a bathroom STAT!!!

The drug is going to work or not. Its not based on body rhythms as far as I know or that I have experienced. You take it and your body will react or not. If you read the forum there is a wide spectrum of results with Linzess.

You are on the lower doze (145mg) so your results are going to be different than if you had the higher doze (290mg) like me.

I would not recommend taking this drug after 12pm noon. I would never take this drug in the evening unless you like washing your bedding and doing laundry.

Like I said, and I can't stress this enough. When you try the drug or begin the trial, do it on a *day off* when you do not have to be at work and do not have anything else planned. This way you can get a feel for what the experience will be like for you. Like I said everyone has a different result and reaction to Linzess.

Please keep me posted and let me know how your experience goes. Best of luck my friend!!!


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## IBSsucks2 (Feb 17, 2016)

Thanks for the information! This is very helpful.


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## minimalizer (Jun 8, 2014)

Suffering Bad said:


> IBSsucks2 -
> 
> My wife does not want me taking Linzess. My wife as well as other family members and friends are convinced the 6 months use of Linzess were the root cause of the diverticulitis and perforation. My surgery was in October 2015. My wife and I did question my doctor and the surgeon several times about Linzess. The surgeon and my regular doctor did not discontinue the medication. To be honest, I started using the drug again approximately 1 month ago and have taken 7 pills since then. I am torn because it does give me relief. However, I never want to go through what happened again. That is why I posted my question out on the forum to other Linzess users. So to answer your question, yes I am sparingly taking Linzess (290mg) for relief of IBS C.
> 
> ...


That was very kind of you to post this;I know they take a while to type the way you need to give help.


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## minimalizer (Jun 8, 2014)

What fiber did you try in the past;I drink 10C of water/day and take *non-fermentable/i.e. non-gassy methylcellulose* convenient caplets before everything I eat;Keeps both D and C in check and regulates BMs. You definately have to intake enough water to prevent the gas. The colon needs something to grip, so won't become flacid and spasm.


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## IBSsucks2 (Feb 17, 2016)

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What fiber did you try in the past;I drink 10C of water/day and take *non-fermentable/i.e. non-gassy methylcellulose* convenient caplets before everything I eat;Keeps both D and C in check and regulates BMs. You definately have to intake enough water to prevent the gas. The colon needs something to grip, so won't become flacid and spasm.


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I'm not sure if this was directed at me but I used to take Citrucel but that was probably over 10 years ago. I usually eat about a cup of chopped spinach with my dinner every night (with olive oil). Recently, I have tried adding just a pinch of minced garlic (1/4 tsp?) and, so far, it seems to provide some relief, albeit temporarily. But I am reserving judgment as, I'm sure you are aware, with IBS, nothing seems to "work" forever.


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## Suffering Bad (Aug 2, 2004)

IBSsucks2 -

Have you given the Linzess a try?

Please keep us posted.


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## IBSsucks2 (Feb 17, 2016)

No, not yet. I'm still trying to decide if it's something that I want to try and, if so, I'm trying to find some time on my calendar when there isn't a lot going on, particularly at work. But, if I do give it a try, I will keep you posted with the results. Thanks again for your feedback!


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