Magnesium Supplement
Magnesium is a mineral abundant in the body and many foods. It is also used as a dietary supplement and in some drugs like anti-acids. Roughly 60% of magnesium in the body exists in the bones and the rest in the blood vessels, soft tissues, and other body fluids.
Within the body, it plays a significant role in more than 300 enzymatic reactions like fatty acid synthesis and protein synthesis. It is also vital for normal bone structure formation and blood pressure regulation. Other functions include glycolysis, oxidative phosphorylation, and production of energy necessary for metabolic functions. Magnesium is also vital in DNA and RNA synthesis and synthesis of glutathione.
In addition, it is required for the active transport of ions like calcium and potassium across the cell membrane which is vital for the construction of muscles, maintaining normal heart rhythm and normal conduction of nerve impulses. Normal levels of magnesium concentrations are between 0.75 and 0.95 mill moles per liter. Levels below 0.75mmol/l induce a condition referred to as hypomagnesia. To prevent this condition, magnesium should be orally ingested by consuming food rich in magnesium. Foods with high fiber content generally contain high levels of magnesium.
The human body contains about 25g of magnesium. However, assessing the level of magnesium in the body can be challenging since most of it is found in the bones and cells. In addition, the level of magnesium in the serum is not a representation of the amount of magnesium in the body. Despite this fact, the serum concentration of magnesium is the most used method to assess magnesium status. Other methods of assessment of magnesium levels include measuring the concentration of magnesium in the saliva, urine, and erythrocytes. Ionized magnesium levels in the blood, serum, and plasma can also be used. In addition, a magnesium self-tolerance test can be performed. None of these methods is considered adequate, but some researchers have recommended the use of the self-tolerance test in adults. This test involves infusion of a magnesium dose through a parenteral route and then measuring the level of magnesium in the urine.
The recommended magnesium dosage
Experts in the United States found that Americans were not consuming enough magnesium in their foods, which made them susceptible to inflammation and health conditions like diabetes and osteoporosis. The food and nutrition board (FNB) developed a reference for dietary intake recommendations for different nutrients. The recommended dietary intake levels range from sex and age. For instance, the recommended dietary allowance for babies under six months is 30mg for both males and females, and for children between one to three years is 80 mg. Different amounts are recommended for different adults. Adults between nineteen and thirty years should take 310 mg for females and 400 mg for male. Older adults above 50 years should take 420 mg for males and 320 mg for females.
Magnesium deficiency in healthy people is usually asymptomatic since the kidneys do not allow total excretion of magnesium. However, some illnesses can cause excessive magnesium loss. Such conditions include chronic alcoholism, third-degree burns, hypercalcemia, polyuria, chronic diarrhea, hyperaldosteronism, malabsorption syndromes like psyllium disease, malnutrition, and inflammatory bowel syndrome. In addition, medication such as proton pump inhibitors aminoglycosides, cyclosporine, diuretics, amphotericin, cisplatin can cause hypomagnesemia. Early signs of hypomagnesemia include fatigue and weakness, vomiting, nausea and loss of appetite.
Exacerbation of the disease causes serious symptoms like seizures, muscle cramps, numbness, muscle contractions, abnormal heart rhythms, tingling, and even coronary spasms. Other serious signs include tetany, personality changes, and anorexia. Severe hypomagnesemia is a risk factor for hypokalemia and hypocalcemia.
Clinical uses of magnesium
Magnesium is effective for the treatment of:
Indigestion
Oral intake of magnesium reduces symptoms of heartburn. Most people use over the counter medication like magnesium citrate or magnesium hydroxide to treat constipation. However, research into the effectiveness of magnesium in relieving symptoms of constipation is minimal. Despite this, patients and healthcare professionals have found magnesium useful in treating constipation proving that the lack of evidence does not mean the lack of effect.
Eclampsia and Preeclampsia
The WHO strongly recommends the use of magnesium sulfate regiments for the prevention and treatment of eclampsia. Intravenous or intramuscular administration of magnesium sulfate has proven effective in preventing seizures in mild and severe preeclampsia. It has also been used to enhancing lung development in babies. However, there is a risk of magnesium toxicity which can prove fatal. Two reviews by Cochrane stated that the use of magnesium in eclampsia provided better results than the use of phenytoin and lytic cocktail and Nimotop. Another review in 2003 revealed that. Intravenous use of 1 to 2 grams per hour of magnesium sulfate reduced risk of eclampsia and preeclampsia in pregnant women by more than 50%.
Arrhythmia
An arrhythmia is an irregular pattern with which the heart beats. The condition can be classified as either tachycardia which describes very fast heartbeat or bradycardia which is a slower than normal heartbeat. Intravenous administration of magnesium is often used to treat ventricular tachycardia of torsade de pointes. Research has also shown that intravenous administration of 1.2 to 10 grams of magnesium sulfate is effective for the treatment of rapid atrial fibrillation. A study by Guerrera, Volte and Mao, (2009) found that magnesium which is taken orally as a supplement by patients with congestive heart failure, secondary to coronary artery disease reduced the occurrence of asymptomatic ventricular arrhythmias.
Relieving Headaches
Low levels of magnesium have been found to cause cluster headaches, classic migraines, and migraines caused by menstruation. A study conducted in Germany found that oral intake of a single dose of 600mg of tri-magnesium dinitrate was effective in reducing the number of times that a migraine occurred. Intravenous magnesium sulfate is also an effective treatment of migraines in patients with aura and improved associated symptoms in patients without aura.
Asthma
Asthma is a long-term incurable disease with a range of treatments for the management of its symptoms. Magnesium sulfate is used to release symptoms such as shortness of breath since it acts as a Bronchodilator. The drug is mostly used to treat severe symptoms of asthma and is administered either intravenously as an infusion and sometimes can be inhaled through a nebulizer. A review by Cochrane found that the magnesium sulfate was effective in the management of severe acute asthma by improving expiratory flow rate and volume.
Dyspepsia
Dyspepsia is one of the main symptoms of gastroesophageal reflux disease. The most common treatment for dyspepsia is antacids. However, several studies reveal that treatment using magnesium as a component in the antacids is more effective. For instance, Holtmeier et al. (2007) found that antacid hydrotalcite which contains magnesium hydroxide significantly relieved heartburn within three hours.
People at risk of magnesium deficiency
Magnesium deficiency mostly occurs due to the presence of medical conditions that cause reduced absorption of magnesium in the digestive system or increase in the loss of magnesium. Some of the people who are at risk include:
People with gastrointestinal disorders
GI disorders like Crohn’s disease cause fat malabsorption and diarrhea which lead to depletion of magnesium in the body. Other disorders with the same effect include celiac disease and regional enteritis. Also, resection of ileum causes malabsorption and subsequent loss of magnesium.
People with chronic alcoholism.
Alcohol dependence is one of the main causes of magnesium deficiency. People with chronic alcoholism usually have a poor nutritional status that leads to GI disorders including vomiting and diarrhea. Moreover, alcohol dependence causes renal dysfunction that leads to excess excretion of magnesium in the urine. Other alcohol-related conditions that cause magnesium deficiency include acute alcoholic ketoacidosis, hyperaldosteronism from liver disease, pancreatitis, and vitamin D deficiency.
People with type two diabetes
Insulin resistance presents a risk for increased magnesium excretion through the urine and subsequent magnesium deficiency. High glucose concentrations in the kidney are suspected to be the cause of increased magnesium loss as they lead to increased urine output.
The elderly
Generally, older people consume less than recommended amounts of magnesium which predisposes them to magnesium deficiency. Furthermore, as one becomes older absorption from the gut decreases and so does excretion from the renal system. This leads to reduced magnesium absorption and increased renal excretion of magnesium. In addition, chronic diseases that are more prevalent in the elderly increase risk of magnesium depletion due to the large number of medication that they take which has the potential to alter magnesium absorption in the body.
Conclusion
It is evident that magnesium is essential for one’s health and wellbeing. The best source of magnesium is through dietary sources; consumption of foods high in fiber or magnesium supplements. Old age, medications and certain medical condition are the main risk factors for hypomagnesemia. It is therefore important to identify the cause of low magnesium levels in the body. Although magnesium supplement is well tolerated, they can lead to gastrointestinal symptoms like vomiting, diarrhea, and nausea. In additions, Magnesium overdose can lead to hypotension, respiratory depression, and sometimes death. It is thus paramount for correct dosages to be administered in patients with hypomagnesemia.
References
JUN JAMES MAO, MD, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania Am Fam Physician. 2009 Jul 15;80(2):157-162.
Holtmeier W, Holtmann G, Caspary WF and Weingartner U. On-demand treatment of acute heartburn with the antacid hdrotalcite compared with famotidine and placebo: randomized double-blind cross-over study. (2007) Journal of clinical gastroenterology. 41(6) 564-570