:Magnesium:

:Magnesium is essential for bone, protein, and fatty acid formation, regeneration, activating B vitamins, relaxing muscles, clotting blood, and storing energy as ATP. The secretion and action of insulin also require magnesium.

Magnesium is nature's calcium channel blocker. Magnesium can improve vision in people with glaucoma.1 Magnesium can also lower blood pressure. 2

Magnesium can reduce hyperactivity in children. 3 Some children with attention deficit-hyperactivity disorder (ADHD) have low levels of magnesium. In a control trial, 50 ADHD children with low magnesium in red blood cells, hair, and serum take 200 mg of magnesium per day for six months. 4 Comparison with 25 other magnesium-deficient ADHD children shows magnesium supplementation significantly decreases hyperactive behavior.

Magnesium levels are low in chronic fatigue syndrome (CFS), 5 and magnesium injection improves symptoms. 6 Oral magnesium supplementation also improves symptoms in CFS patients with low magnesium, although magnesium injections are sometimes necessary. 7 Other research finds no magnesium deficiency in some people with CFS. 8 9 People with CFS considering magnesium supplementation should check magnesium status.

People with diabetes tend to have low magnesium levels. 10 Supplementation repletes magnesium 11 and improves glucose tolerance in some diabetics.

Magnesium can help bladder control and urgency in women. A double-blind trial finds women taking 350 mg of magnesium hydroxide (providing 147 mg elemental magnesium) twice daily for four weeks, have better bladder control and fewer symptoms than those taking a placebo. 12

Magnesium supplementation can reduce dehydration of red blood cells in sickle cell anemia patients. Six months of magnesium pidolate at 540 mg per day reverses some of the characteristic red blood cell abnormalities and dramatically reduces the number of painful days. 13

Sources: Nuts and grains are good sources. Beans, dark green vegetables, fish and meat also supply magnesium. The best absorbed form is Magnesium Glycinate, which does not loosen the stool. Another therapeutic form is Magnesium Taurate for the heart and retina.

Well documented science-based uses:

• Cardiac arrhythmia
• Congestive heart failure
• Diabetes
• Gestational hypertension
• Kidney stones (citrate in combination with potassium citrate)
• Migraine headaches
• Mitral valve prolapse

Other uses supported by science:

• ADHD
• Asthma
• Celiac disease (for deficiency only)
• Heart attack (IV magnesium immediately following a myocardial infarction)
• High blood pressure (for people taking potassium-depleting diuretics)
• Osteoporosis
• Premenstrual syndrome
• Urinary urgency (women)

Traditional clinical uses also include:

• Alcohol withdrawal support
• Angina
• Anxiety
• Athletic performance
• Autism
• Chronic fatigue syndrome
• Chronic obstructive pulmonary disease (COPD)
• Cluster headache (intravenous)
• Dysmenorrhea
• Fibromyalgia
• Glaucoma
• Heart attack (oral magnesium)
• High cholesterol
• Hypoglycemia
• Insomnia
• Insulin resistance syndrome (Syndrome X)
• Intermittent claudication
• Multiple sclerosis
• Preeclampsia
• Raynaud’s disease
• Retinopathy
• Sickle cell anemia
• Stroke

Magnesium deficiency:

Magnesium deficiency is common in people taking “ potassium -depleting” prescription diuretics . Taking too many laxatives can also lead to deficiency. Alcoholism , severe burns ,diabetes , and heart failure are other potential causes of deficiency. In a study of urban African-American people (predominantly female), the overall prevalence of magnesium deficiency was 20%. People with a history of alcoholism were six times more likely to have magnesium deficiency than were people without such a history. 14 The low magnesium status seen in alcoholics with liver cirrhosis contributes to the development of hypertension in these people. 15

Almost two-thirds of people in intensive care hospital units have been found to be magnesium deficient. 16 Deficiency may also occur in people with chronic diarrhea , pancreatitis, and other conditions associated with malabsorption .

Fatigue, abnormal heart rhythms , muscle weakness and spasm, depression , loss of appetite, listlessness, and potassium depletion can all result from a magnesium deficiency. People with these symptoms should be evaluated by a doctor before taking magnesium supplements.

Magnesium levels are low in chronic fatigue syndrome.

Deficiencies of magnesium that are serious enough to cause symptoms should be treated by medical doctors, as they might require intravenous administration of magnesium. 17

How much is usually taken? Most people don’t consume enough magnesium in their diets. Many nutritionally oriented doctors recommend 250–350 mg per day of supplemental magnesium for adults.
Are there any side effects or interactions? Comments in this section are limited to effects from taking oral magnesium. Side effects from intravenous use of magnesium are not discussed.

Taking too much magnesium often leads to diarrhea . For some people this can happen with amounts as low as 350–500 mg per day. More serious problems can develop with excessive magnesium intake from magnesium-containing laxatives. However, the amounts of magnesium found in nutritional supplements are unlikely to cause such problems. People with kidney disease should not take magnesium supplements without consulting a doctor.

Vitamin B6 increases the amount of magnesium that can enter cells. As a result, these two nutrients are often taken together. Magnesium may compete for absorption with other minerals, particularly calcium . Taking a multimineral supplement avoids this potential problem.

Magnesium deficiency	Magnesium overload
Muscle cramps & spasm	Loose stool
Anxiety
Sensitivity to noise
Lack of deep sleep

Certain medications may interact with magnesium.

• Albuterol (Depletion or interference)
• Alendronate: Absorption of tiludronate, a drug related to alendronate, is reduced when taken with magnesium.
• Amiloride (Adverse interaction)
• Amphotericin B (Depletion or interference)
• Azithromycin: A magnesium containing antacid interferes with azithromycin absorption. Take azithromycin two hours before or after any magnesium product, even though the effect may be from aluminum in the antacid.
• Cimetidine (Reduced drug absorption/bioavailability)
• Ciprofloxacin (Reduced drug absorption/bioavailability)
• Cisplatin (Depletion or interference)
• Oral Corticosteroids (Depletion or interference)
• Cycloserine (Depletion or interference)
• Cyclosporine (Depletion or interference)
• Digoxin (Depletion or interference)
• Docusate (Depletion or interference)
• Doxycycline (Reduced drug absorption/bioavailability)
• Epinephrine and other stress hormones can reduce intracellular magnesium. Ensure a high intake of vitamin C, potassium and magnesium.
• Erythromycin (Depletion or interference)
• Estrogens (Combined): osteoporotic postmenopausal women with elevated urinary zinc and magnesium excretion have less loss of these minerals when using conjugated estrogens and medroxyprogesterone.
• Famotidine: In healthy people, a magnesium hydroxide antacid taken with famotidine decreases famotidine absorption 20 to 25%. Take famotidine two hours before or after antacids or magnesium hydroxide supplements.
• Felodipine (Depletion or interference)
• Fentanyl (Supportive interaction)
• Gentamicin (Depletion or interference)
• Glimepiride (Supportive interaction)
• Glipizide: in poorly controlled type 2 diabetes with low blood magnesium, treatment with glipizide increases magnesium. In healthy people, 850 mg magnesium hydroxide increases glipizide absorption and activity. Consult with your practitioner before taking magnesium with Glipized.
• Hydroxychloroquine (Reduced drug absorption/bioavailability)
• Isoniazid (Depletion or interference)
• Levofloxacin (Reduced drug absorption/bioavailability)
• Loop Diuretics (Depletion or interference)
• Medroxyprogesterone: 37 postmenopausal women taking conjugate-estrogens and medroxyprogesterone for 12 months show better magnesium retention in those with osteoporosis and prior magnesium spilling.
• Metformin: in poorly controlled type 2 diabetes with low blood magnesium and high urine magnesium, metformin reduces urinary magnesium loss with no change in blood levels.
• Minocycline (Depletion or interference)
• Misoprostol (Adverse interaction)
• Mixed Amphetamines (Adverse interaction)
• Neomycin (Depletion or interference)
• Nitrofurantoin (Reduced drug absorption/bioavailability)
• Nizatidine: In healthy people, a magnesium hydroxide containing antacid taken with nizatidine, decreases nizatidine absorption by 12%. Take nizatidine two hours before or after magnesium hydroxide to avoid this minor effect.
• Ofloxacin (Reduced drug absorption/bioavailability)
• Oral Contraceptives (Depletion or interference)
• Quinidine (Side effect reduction/prevention)
• Risedronate (Reduced drug absorption/bioavailability)
• Sotalol (Side effect reduction/prevention)
• Spironolactone (Adverse interaction)
• Sulfamethoxazole (Depletion or interference)
• Tetracycline (Reduced drug absorption/bioavailability)
• Tetracyclines (Reduced drug absorption/bioavailability)
• Thiazide Diuretics (Depletion or interference)
• Tobramycin (Depletion or interference)
• Triamterene (Adverse interaction)
• Trimethoprim (Depletion or interference)
• Warfarin (Reduced drug absorption/bioavailability)

References:

1. Gaspar AZ, Gasser P, Flammer J. The influence of magnesium on visual field and peripheral vasospasm in glaucoma. Ophthalmologica 1995;209:11–3.
2. Kawano Y, Matsuoka H, Takishita S, Omae T. Effects of magnesium supplementation in hypertensive patients. Hypertension 1998;32:260–5.
3. Starobrat-Hermelin B, Kozielec T. The effects of magnesium physiological supplementation on hyperactivity in children with attention deficit hyperactivity disorder (ADHD). Positive response to magnesium oral loading test. Magnes Res 1997;10:149–56.
4. Starobrat-Hermelin B, Kozielec T. The effects of magnesium physiological supplementation on hyperactivity in children with attention deficit hyperactivity disorder (ADHD). Positive response to magnesium oral loading test. Magnes Res 1997;10:149–56.
5. Moorkens G, Manuel y Keenoy B, Vertommen J, et al. Magnesium deficit in a sample of the Belgian population presenting with chronic fatigue. Magnes Res 1997;10:329–37.
6. Cox IM, Campbell MJ, Dowson D. Red blood cell magnesium and chronic fatigue syndrome. Lancet 1991;337:757–60.
7. Howard JM, Davies S, Hunnisett A. Magnesium and chronic fatigue syndrome. Lancet 1992;340:426.
8. Gantz NM. Magnesium and chronic fatigue. Lancet 1991;338:66 [letter].
9. Hinds G, Bell NP, McMaster D, McCluskey DR. Normal red cell magnesium concentrations and magnesium loading tests in patients with chronic fatigue syndrome. Ann Clin Biochem 1994;31(Pt 5):459–61.
10. Paolisso G, Scheen A, D’Onofrio FD, Lefebvre P. Magnesium and glucose homeostasis. Diabetologia 1990;33:511–4 [review].
11. Eibl NL, Schnack CJ, Kopp H-P, et al. Hypomagnesemia in type II diabetes: effect of a 3-month replacement therapy. Diabetes Care 1995;18:188.
12. Gordon D, Groutz A, Ascher-Landsberg J, et al. Double-blind, placebo-controlled study of magnesium hydroxide for treatment of sensory urgency and detrusor instability: preliminary results. Br J Obstet Gynaecol 1998;105:667–9.
13. De Franceschi L, Bachir D, Galacteros F, et al. Oral magnesium pidolate: effects of long-term administration in patients with sickle cell disease. Br J Haematol 2000 Feb;108:284–9.
14. Fox CH, Ramsoomair D, Mahoney MC, et al. An investigation of hypomagnesemia among ambulatory urban African Americans. J Fam Pract 1999;48:636–9.
15. Kisters K, Schodjaian K, Tokmak F, et al. Effect of ethanol on blood pressure—role of magnesium. Am J Hypertens 2000;13:455–6 [letter].
16. Weisinger JR, Bellorin-font E. Magnesium and phosphorus. Lancet 1998;352:391–6 [review].
17. Weisinger JR, Bellorin-font E. Magnesium and phosphorus. Lancet 1998;352:391–6 [review].