Here’s How Magnesium Can Help You Have a Healthy Heart

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

Magnesium is an essential mineral that is abundant in your body and is needed for proper functioning. Magnesium is involved in over 300 different metabolic pathways, such as making proteins, blood glucose control, and blood pressure regulation (NIH, 2019). It is also involved in energy production, the creation of DNA, and plays an important role in muscle contraction. Low levels of magnesium have been associated with health problems like high blood pressure, high cholesterol, type 2 diabetes, coronary artery disease, and sudden cardiac death.

• Magnesium is an essential mineral that is involved in over 300 different processes in the body.
• The recommended dietary allowance (RDA) is 400–420 mg/day for men and 310–320 mg/day for women.
• Magnesium may contribute to heart health by helping to maintain regular heart rhythm, decrease high blood pressure, decrease the risk of diabetes, and decrease the risk of heart disease.
• Magnesium may also be beneficial in migraines, sleep, depression, and osteoporosis.
• Too much or too little magnesium can lead to health problems.

A healthy adult has approximately 25 grams of magnesium in their body; 50–60% is kept in your bones, while most of the rest of it is in your soft tissues (NIH, 2019). A small amount of magnesium, less than 1%, is circulating in your blood. Despite being such an essential element, studies show that a significant proportion of Americans do not get enough magnesium in their diets (Schwalfenberg, 2017).

Unfortunately, testing for magnesium levels is difficult. The 1% of your magnesium that floats around in your bloodstream is the only magnesium level we can test, called the serum magnesium level. However, it is tightly regulated so that whenever your blood levels decrease, your body releases magnesium from the bones and muscles.

So you can have very little magnesium in your body, but still have normal serum levels of magnesium, making blood tests for this micronutrient not very reliable. Most healthcare providers rely on a combination of lab tests and clinical assessments to get an accurate idea of what your magnesium levels are and if you need supplementation.

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Normal magnesium levels may benefit the heart and cardiovascular system in several ways:

• Keeps the heart pumping regularly: Muscle cells in your heart and blood vessels have ion transport channels that move ions like sodium, potassium, and calcium into and out of cells, causing muscle contractions (Severino, 2019). Magnesium is necessary for this ion pump to work and helps keep the heart pumping with a regular rhythm; magnesium deficiency leads to abnormal heart rhythms (arrhythmias), which can sometimes be fatal. 
• May help decrease blood pressure:  Magnesium competes with calcium for many of the same ion transport channels; a magnesium deficiency leads to a buildup of calcium, which in turn causes spasms of the heart and blood vessels and can result in elevated blood pressures. The presence of magnesium decreases the amount of calcium in the cells and allows the heart and blood vessels to relax, thereby potentially reducing blood pressure. One study showed a small decrease in blood pressure in people taking magnesium (an average of 368 mg/day). However, magnesium supplementation is not considered standard high blood pressure treatment; more studies are needed to better understand the role of magnesium in managing blood pressure (Zhang, 2016). 
• May decrease the risk of type 2 diabetes: Magnesium helps the pancreas release insulin and move glucose out of the bloodstream, thereby keeping the overall amount of glucose in the blood under control (Severino, 2019). Diets with higher levels of magnesium have a lower risk of type 2 diabetes (NIH, 2019). However, according to the American Diabetes Association, there is not enough evidence to recommend the routine use of magnesium supplementation to improve blood sugar control in people with type 2 diabetes (Evert, 2013). Diabetes is a known risk factor for heart disease.
• May decrease the risk of heart disease (cardiovascular disease): There are several different ways that magnesium may reduce the risk of heart disease. One pathway is via its antioxidant and anti-inflammatory effects; a magnesium deficiency increases inflammation and damage to blood vessel walls, along with cholesterol deposits (atherosclerosis) in the coronary blood vessels. All of these changes increase your risk of a heart attack or stroke. Another way that magnesium may protect your heart is by decreasing the ability of platelets to clump up and form a clot, as happens in a heart attack or stroke. Magnesium deficiency is associated with an increased risk of heart disease and heart attacks (Severino, 2019).

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In addition to all of the ways that magnesium can potentially improve your heart health, it can also have beneficial effects in other conditions.

• Migraines: Studies show that some people who suffer from migraines have low magnesium levels (Gröber, 2015). However, the exact role that magnesium plays in migraines is not well understood. Magnesium affects some of the receptors in the brain pathways that can lead to headaches, like serotonin and N-methyl-D-aspartate (NMDA) receptors. One study shows an improvement in migraine symptoms and a trend towards decreasing migraine frequency with magnesium supplementation, although this trend was not statistically significant (Gaul, 2015). While it is not considered the mainstay of migraine treatment, the Academy of Neurology and American Headache Society state that magnesium supplementation is “probably effective” for migraine prevention (Holland, 2012).  
• Sleep: Sleep problems are widespread, especially as we get older. The brain chemicals (neurotransmitters) NMDA and gamma-aminobutyric acid (GABA) play an important role in sleep regulation, and both of these neurotransmitters interact with magnesium. How magnesium affects sleep is unclear; however, one trial showed that people taking magnesium supplements subjectively reported falling asleep faster and staying asleep longer (Abbasi, 2012). More research needs to be done in this area.
• Depression: Since magnesium affects brain chemistry (through neurotransmitters), it may also help improve depression symptoms. Studies have shown an association between magnesium deficiency and depression, and several show an improvement in depression after taking magnesium supplements. However, others show no benefit. More information is needed to better understand how magnesium and depression are related (Wang, 2018).
• Osteoporosis: Magnesium interacts with bone cells and affects the balance of creating new bone versus removing old bone. Studies have found that women with osteoporosis have lower magnesium levels than those without osteoporosis (NIH, 2019). One small study even found that a group of postmenopausal women who took magnesium supplements (290 mg/day) had decreased bone turnover, which translates to reduced bone loss (Aydin, 2010). It is clear that magnesium promotes bone health, but its role in preventing and treating osteoporosis needs to be explored further.

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Dietary surveys of Americans have shown that overall, approximately 50% of people aged 19–50 years don’t get their estimated average requirement of magnesium from their food; this number climbs to 70–80% if you focus on people over 71 years old (Moshfegh, 2009).

The recommended dietary allowance (RDA) is 400–420 mg/day for men and 310–320 mg/day for women (NIH, 2019). Where can you get magnesium? It is in many different foods—especially green leafy vegetables (like spinach), legumes, nuts, seeds, and whole grains. Most foods that are high in fiber also have high levels of magnesium as do fortified foods, like breakfast cereal, and bottled water.

Here is a list of some magnesium-rich foods (NIH, 2019):

Almonds, dry roasted, 1 ounce	80
Spinach, boiled, ½ cup	78
Cashews, dry roasted, 1 ounce	74
Peanuts, oil roasted, ¼ cup	63
Cereal, shredded wheat, 2 large biscuits	61
Soymilk, plain or vanilla, 1 cup	61
Soymilk, plain or vanilla, 1 cup	60
Edamame, shelled, cooked, ½ cup	50
Peanut butter, smooth, 2 tablespoons	49
Bread, whole wheat, 2 slices	46
Avocado, cubed, 1 cup	44
Potato, baked with skin, 3. 5 ounces	43
Rice, brown, cooked, ½ cup	42
Yogurt, plain, low fat, 8 ounces	42
Breakfast cereals, fortified	40

If you are not able to get enough magnesium from your diet, you can turn to supplements. Magnesium in supplements comes in several forms: magnesium aspartate, magnesium carbonate, magnesium chloride, magnesium lactate, magnesium oxide, magnesium sulfate, and magnesium citrate. Some studies have shown that the absorption of the aspartate, citrate, lactate, and chloride forms are better than the oxide and sulfate formulations (NIH, 2019).

Even though most Americans do not eat enough magnesium, healthy people generally don’t get symptoms from low magnesium; this is because the kidneys limit how much magnesium gets excreted in the urine when levels are low. However, people with medical conditions like Crohn’s disease, alcoholism, type 2 diabetes, and older adults can have a magnesium deficiency (hypomagnesemia). Hypomagnesemia can cause a loss of appetite, nausea, vomiting, fatigue, and weakness in the early stages (NIH, 2019). As this condition worsens, you can develop numbness, tingling, muscle cramps, seizures, and irregular heart rhythms.

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Likewise, too much magnesium can be harmful as well. Again, since the kidneys manage how much magnesium is removed in the urine, most healthy people can excrete the excess magnesium from their diet. However, if you have impaired kidney function or take too much supplemental magnesium, you can accumulate unhealthy levels of magnesium; this leads to diarrhea, nausea, and abdominal cramping. Some antacids and laxative contain very high doses (more than 5,000 mg) and have been associated with magnesium toxicity, which can cause the following symptoms (NIH, 2019):

• Low blood pressure
• Nausea/vomiting
• Facial flushing
• Difficulty urinating (urinary retention)
• Lethargy
• Muscle weakness
• Irregular heartbeat
• Death

Before starting magnesium supplements, talk to your healthcare provider about other medicines you are taking; magnesium interacts with several types of medications, and this can potentially affect the ability of the drug to work or change your magnesium levels. Some of the medicines that interact with magnesium supplements include (NIH, 2019):

• Bisphosphonates (e.g., alendronate, risedronate): These drugs are typically used to treat osteoporosis; magnesium supplements can decrease their absorption. Bisphosphonates and magnesium should be taken at least two hours apart from each other to avoid this interaction. 
• Quinolone antibiotics (e.g., ciprofloxacin, levofloxacin) and tetracycline antibiotics (e.g., tetracycline, doxycycline): Taking these drugs with magnesium makes them less absorbable in your gut, and thereby less effective at treating your infection. To avoid this, take the antibiotic at least two hours before or at least four to six hours after your magnesium supplement.
• Loop diuretics (e.g., bumetanide, furosemide), thiazide diuretics (e.g., hydrochlorothiazide): Diuretics, also known as “water pills,” are typically used to treat high blood pressure and heart failure. Taking them may cause the body to excrete too much magnesium in the urine, which can decrease the levels of magnesium in the body. Know the symptoms of magnesium deficiency and alert your healthcare provider if you start to experience any of them; early recognition may help prevent health problems.
• Potassium-sparing diuretics (e.g., amiloride, spironolactone): Unlike the other diuretics, this type decreases the amount of magnesium removed in the urine and can potentially cause an excess of magnesium. Talk to your provider if you have any symptoms of high magnesium.
• Proton pump inhibitors (e.g., omeprazole, pantoprazole): Proton pump inhibitors (PPIs) are used to treat heartburn or acid reflux. Using PPIs for more than a year can lead to low magnesium levels. Your provider may check your magnesium levels before starting a PPI and then monitor them periodically while you are on the medication.

Although magnesium affects many aspects of your health, you should strive to get most of your magnesium from your diet. A diet with a variety of fruits, vegetables, whole grains, nuts, etc. is ideal. If you need to supplement your diet with magnesium pills, be sure to discuss your options with your healthcare provider to avoid any adverse effects.

1. Abbasi, B., Kimiagar, M., Sadeghniiat, K., Shirazi, M. M., Hedayati, M., & Rashidkhani, B. (2012). The effect of magnesium supplementation on primary insomnia in elderly: A double-blind placebo-controlled clinical trial. Journal of Research in Medical Sciences, 17(12), 1161–1169. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23853635
2. Aydın, H., Deyneli, O., Yavuz, D., Gözü, H., Mutlu, N., Kaygusuz, I., & Akalın, S. (2010). Short-Term Oral Magnesium Supplementation Suppresses Bone Turnover in Postmenopausal Osteoporotic Women. Biological Trace Element Research, 133(2), 136–143. doi: 10.1007/s12011-009-8416-8, https://pubmed.ncbi.nlm.nih.gov/19488681/
3. Gaul, C., Diener, H.-C., & Danesch, U. (2015). Improvement of migraine symptoms with a proprietary supplement containing riboflavin, magnesium and Q10: a randomized, placebo-controlled, double-blind, multicenter trial. The Journal of Headache and Pain, 16(1), 32. doi: 10.1186/s10194-015-0516-6, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4393401/
4. Gröber, U., Schmidt, J., & Kisters, K. (2015). Magnesium in Prevention and Therapy. Nutrients, 7(9), 8199–8226. doi: 10.3390/nu7095388, https://pubmed.ncbi.nlm.nih.gov/26404370/
5. Holland, S., Silberstein, S., Freitag, F., Dodick, D., Argoff, C., & Ashman, E. (2012). Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: [RETIRED]. Neurology, 78(17), 1346–1353. doi: 10.1212/wnl.0b013e3182535d0c, https://pubmed.ncbi.nlm.nih.gov/22529203/
6. Moshfegh, A., Goldman, J., Ahuja, J., Rhodes, D., & LaComb, R. (2009). What We Eat In America, NHANES 2005-2006: Usual Nutrient Intakes from Food and Water Compared to 1997 Dietary Reference Intakes for Vitamin D, Calcium, Phosphorus, and Magnesium. U.S. Department of Agriculture, Agricultural Research Service. Retrieved from https://www. ars.usda.gov/ARSUserFiles/80400530/pdf/0506/usual_nutrient_intake_vitD_ca_phos_mg_2005-06.pdf
7. National Institutes of Health (NIH), Office of Dietary Supplements – Magnesium. (2019, October 11). Retrieved November 10, 2019, from https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/
8. Schwalfenberg, G. K., & Genuis, S. J. (2017). The Importance of Magnesium in Clinical Healthcare. Scientifica, 2017, 1–14. doi: 10.1155/2017/4179326, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5637834/
9. Severino, P., Netti, L., Mariani, M. V., Maraone, A., D’Amato, A., Scarpati, R., … Fedele, F. (2019). Prevention of Cardiovascular Disease: Screening for Magnesium Deficiency. Cardiology Research and Practice, 2019, 1–10. doi: 10.1155/2019/4874921, https://www.hindawi.com/journals/crp/2019/4874921/
10. Wang, J., Um, P., Dickerman, B., & Liu, J. (2018). Zinc, Magnesium, Selenium and Depression: A Review of the Evidence, Potential Mechanisms and Implications. Nutrients, 10(5), 584. doi: 10.3390/nu1005058410, https://pubmed.ncbi.nlm.nih.gov/29747386/

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How Magnesium Help With The Heart Conditions?

Cardiovascular disease remains the leading cause of death in the US.¹

With nearly half the US population consuming less than the recommended amount of magnesium in their diets,² this widespread magnesium deficiency is a commonly overlooked risk factor for cardiovascular disease.³ Studies demonstrate that the lower your
intake of magnesium, the greater your risk of succumbing to cardiovascular disease.⁴

Research has shown that magnesium supplementation can be therapeutic for a range of cardiac factors including arrhythmias, hypertension, atherosclerosis,
and endothelial dysfunction.^3,5

Even a moderate magnesium deficiency can cause profound changes in how the heart, blood vessels, blood cells, intestinal tract, and other tissues
function. ⁶ This is because magnesium is critical for tissues that have electrical or mechanical activity, such as nerves, muscles (including the
heart), and blood vessels.^5,7,8

Experiencing a heart attack or stroke because of a simple magnesium deficiency does not need to happen. In this article we provide important information to
protect yourself from unnecessary cardiac events.

Are You At Risk Of Magnesium Deficiency?

Nearly half of the US population consumes less than the recommended amount of magnesium in their diet.²

Inadequate dietary intake is one reason why magnesium deficit is so prevalent in the elderly. Older people have reduced magnesium absorption in their
intestines, reduced stores of magnesium in their bones, and increased magnesium losses in their urine.⁹ This correctable deficiency
exposes the aging population to an entirely preventable cardiovascular risk factor. ¹⁰

Magnesium deficit is also responsible for inflammation, endothelial dysfunction, type II diabetes, excessive platelet “clumping,” and other changes that
put your heart—and your life—at risk.^5,9

Magnesium Deficit Increases Cardiovascular Risk

Because magnesium is essential for healthy control of blood vessel function, blood pressure regulation, and normal heart contractions, a deficiency in
magnesium increases risk of conditions such as endothelial dysfunction, hypertension, and cardiacarrythmias.³

Arrhythmias

Low magnesium levels raise the risk of developing potentially fatal disorders of heart rhythm, known as cardiac arrhythmias.^4,11-13

There are many different kinds of arrhythmias, but all have one thing in common: They involve abnormal conduction of the electrical impulses that govern
heartbeat and heart rate. Such electrical disturbances in turn result in a heart rate that is irregular, or too fast or too slow. ¹⁴

Mild arrhythmias may simply cause discomfort when the heartbeat can be felt in palpitations, while ones that are more serious can cause cardiac arrest or
fibrillation, in which the beating chambers of the heart either stop entirely or result in an irregular heartbeat.¹⁴

The deadliest arrhythmias involve the major pumping chambers of the heart, the ventricles, while milder, more chronic arrhythmias involve the upper
chambers, or atria.¹⁴ Atrial arrhythmias can also degenerate into dangerous atrial fibrillation or flutter, in which slow blood flow can produce
clots that travel to the brain, lungs, or other vulnerable areas.¹⁴

Many arrhythmias are managed by drug therapies aimed at restoring normal electrical activity in the heart. These drugs, however, by their very nature can
be dangerous and can easily overshoot their goals, resulting in actual increases or changes to more dangerous arrhythmias. ¹⁴

This cause-and-effect can be particularly dangerous in people with congestive heart failure, who may take diuretic drugs (“water pills”) that cause them to
lose magnesium at a high rate,¹⁵ raising their already high risk for arrhythmias.¹² Similarly, coronary artery bypass surgery, a
procedure still used for many people with severe atherosclerosis of the heart’s blood vessels, is known to lower magnesium levels and raise the risk of
arrhythmias.¹⁶

In one study, 13 women consumed an experimental diet low in magnesium.¹⁷ Three of the women (23%) developed arrhythmias
(atrial fibrillation and atrial flutter), in which the upper pumping chambers of the heart lose their normal beating
pattern, and four (31%) had to begin magnesium repletion by supplementation earlier than scheduled.

Fortunately, magnesium supplementation readily corrects drug-induced or other low magnesium-related arrhythmias. ¹⁸ Supplementation is now
routinely used before many kinds of heart surgery that are known to induce postoperative arrhythmias, and is also recommended for people with
chronic arrhythmias having known low magnesium levels.^19-22

Research suggests magnesium supplementation can combat that risk by restoring healthy heart cell electrical functions, fighting the development of
arrhythmias at its source.²³

Emergency departments have used intravenous magnesium infusions to reduce dangerously rapid heart rates in patients with a common arrhythmia called rapid atrial fibrillation.²⁴ In addition, giving oral magnesium supplements in the days before surgery has proven to have
similar benefits to infusion of magnesium during surgery in preventing dangerous arrhythmias in patients undergoing open heart surgery.²⁵

A recent study evaluated the use of oral magnesium supplements in preventing premature ventricular contractions (often called PVCs), which
have been described as feeling like a “punch in the chest” and have the potential of converting into serious, life-threatening arrhythmias. ^26,27
For the study, patients with known PVCs were randomly assigned to receive a placebo or 3 grams of magnesium pidolate delivering 260 mg of magnesium daily. After 30 days, 76.6% of the supplemented group showed a significant reduction in daily
arrhythmia episodes, while only 40% of placebo recipients showed slight improvement.²⁶

These are exciting results for a condition in which the medical establishment has struggled to find adequate treatment.

Hypertension

Having low blood magnesium levels increases risk for hypertension, the dangerous persistent rise in blood pressure that leads to
congestive heart failure, strokes, and other catastrophes.^28,29

Lower magnesium levels are associated with higher blood pressure readings.^30,31 In fact, you are nearly twice as likely to develop
“prehypertension” (blood pressures of 120-139/80-89 mmHg) if your magnesium levels are below the safe lower limit ( 1. 7mg/dL).³² Epidemiologic research shows that people in areas where drinking water is higher in magnesium tend to have lower
blood pressure.³³ Certain common blood pressure medications, paradoxically, can also deplete your body of magnesium.³⁴

Supplementation with magnesium has a beneficial effect on blood pressure. A large meta-analysis demonstrated an average decrease in blood pressure of 3 to 4 mmHg systolic (top number), and 2 to 3 mmHg diastolic, a change that increased
further when intake of magnesium topped 370 mg/day.³⁵ A subsequent meta-analysis of people with existing high blood pressure,
with a mean starting systolic pressure of greater than 155 mmHg, reported a highly significant 18.7 mmHg mean reduction
in systolic, and a similarly significant 10.9 mmHg mean reduction in diastolic blood pressures. ³⁶ In a group of patients with
type II diabetes, a major cardiovascular risk factor, systolic blood pressure fell by an average of 7.4 mmHg after supplementation with 384 mg magnesium chloride a day.³⁷

Enlarged Heart

Hypertension is also a leading risk factor for the development of dangerous enlargement of the heart, specifically the left ventricle, which is the heart’s
main pumping chamber.³⁸ Preclinical and human studies reveal that a deficiency in dietary magnesium and low magnesium levels are associated with
such enlargement, producing a condition known as hypertrophic cardiomyopathy, in which the heart muscle becomes so enlarged that
it can no longer pump bloodeffectively.^39,40

Atherosclerosis

Endothelial dysfunction leads to thickening and stiffening of the arterial walls (“hardening of the arteries,” or atherosclerosis). ⁵ While
arterial stiffening drives up blood pressure, magnesium supplementation not only lowers blood pressure, but also sharply decreases the resistance against
which the heart must pump; this is especially notable in the smaller arteries that provide blood flow to major organs and help improve the amount of
nutrient-rich blood they receive.⁴¹

Magnesium supplementation can also improve the quality of life for those suffering from cardiovascular disease. For instance, in people with known coronary
artery disease, magnesium supplementation improved exercise tolerance and reduced exercise-induced chest pain.⁴² And in a six-month study of
patients with known ischemic heart disease (poor blood circulation to heart muscle), magnesium supplementation led to an impressive decrease in
angina attacks and a decrease in the use of antianginal drugs such as nitroglycerin.⁴³

In patients on dialysis for kidney failure, thickening of arterial walls occurs much faster than in healthy patients. However, magnesium can provide
important reduction of this condition.⁴⁴ In one study, supplementation with 440 mg of magnesium oxide three times weekly for
six months was found to be effective at reducing that thickening among dialysis patients, while placebo recipients had increased thickening over the same
period.⁴⁵ Another study of dialysis patients observed similar results when supplementing with 610 mg of magnesium citrate every
other day for two months.⁴⁴

Metabolic Syndrome And Diabetes

Magnesium is vital for normal metabolic function, including glucose metabolism and insulin action. This is why magnesium supplementation in type II
diabetics appears to reverse much of the damage wrought by low levels. Magnesium is an essential “co-factor” for more than 300 enzymes and is vital to the
ways your body manages its energy.^46,47

In one study, a daily dose of 2. 5 grams of magnesium chloride significantly reduced insulin resistance, fasting blood sugar levels, and
hemoglobin A1c, a measure of chronic exposure to high sugar.⁴⁸ In another study, 12 weeks of supplementation with 360 mg/day of
magnesium produced a 10 mg/dL drop in fasting glucose levels.⁴⁹

Magnesium supplementation also directly counteracts metabolic syndrome. In a group of type II diabetics, treatment with 600 mg/day of
magnesium oxide produced significant drops in total and LDL (“bad”) cholesterol and triglycerides, with a rise in HDL (“good”) cholesterol.⁵⁰
Similar results were seen in another study when healthy volunteers supplemented with magnesium oxide, enough to deliver 520 mg/day of
elemental magnesium.⁵¹ Magnesium oxide and magnesium citrate have been shown to reduce platelet aggregation, and thereby reduce the risk of a
dangerous blood clot. ⁵¹

In a study representative of today’s typical middle-aged person (namely, people who were overweight and insulin resistant, but not yet diabetic), six
months of magnesium supplementation significantly improved fasting blood sugar and insulin sensitivity, compared to placebo.⁵² Intriguingly,
none of the patients had detectably low blood magnesium at the study’s outset, suggesting that it’s possible to be total-body deficient in magnesium, while
still maintaining normal blood levels. According to the authors, this study emphasized “the need for an early optimization of magnesium status to prevent
insulin resistance and subsequently type II diabetes.”⁵² Subsequent preclinical research has confirmed that type II diabetes can be delayed by
magnesium supplementation.⁵³

People with lower magnesium levels or low magnesium intake may be at an increased risk for developing metabolic syndrome, the combination of central
obesity with at least two of the following: hypertension, lipid disorders, impaired glucose tolerance, or diabetes. ^33,46,51,52

As is the case with other health problems, the lower your magnesium intake, the greater your risk of obesity, excess body fat percentage, and high
triglycerides.⁵⁴ In fact, as magnesium levels decrease, the number of metabolic syndrome components increase, as does an important marker of
inflammation C-reactive protein (CRP).^46,55,56

People with existing diabetes, or with “pre-diabetes” (impaired fasting glucose or impaired glucose tolerance) have significantly lower magnesium levels
than do those with normal metabolism.⁵⁷ In one study, 88.6% of type II diabetics had magnesium intake less than the dietary
recommendations, and 37.1% had low blood magnesium levels.⁵⁴

Magnesium deficiency is especially dangerous for diabetics. In one study of diabetic patients with heart failure, 73.3% were found to have
low serum magnesium. ⁵⁸ Low magnesium levels in red blood cells are strongly associated with increased incidence of cardiac events and poor
outcomes.⁴³

Some of these observations may be explained by the fact that low magnesium levels appear to raise insulin resistance through a variety of biochemical
mechanisms.^59,60 In addition, low magnesium levels make platelets “stickier,” increasing the risk of a destructive or fatal blood clot forming,
and thereby increasing the likelihood of a dangerous heart attack or stroke.⁶¹

Summary

Magnesium is an element critical to multiple vital functions in the human body, yet even people interested in optimizing their nutritional health
frequently ignore it. Low magnesium levels trigger problems in the heart muscle, blood vessel walls, and blood vessel linings that can lead to heart
attacks, heart failure, atherosclerosis, and cardiac arrhythmias.

Magnesium deficiency also contributes to metabolic syndrome and type II diabetes, two epidemic conditions that themselves lead to cardiovascular disease
and other chronic, age-related conditions.

But nearly half of all Americans (and more than that among the elderly) fail to get enough magnesium in their diets, and therefore have suboptimal blood
levels of this vital mineral.

Magnesium supplementation is an easy, inexpensive, and effective way to restore magnesium to your whole body, and studies show that boosting your magnesium
levels sooner rather than later offers the best protection. Indeed, people with the highest blood levels of magnesium, and/or the highest dietary intake of
magnesium, are at lower risk for dying of both cardiac and noncardiac conditions.

If you are an older adult concerned about the possibility of a premature death from cardiovascular or metabolic diseases, you should begin a regular
magnesium supplement today.

If you have any questions on the scientific content of this article, please call a Life Extension^® Health Advisor at
1-866-864-3027.

Editor’s Note

Science continues to evolve, and new research is published daily. As such, we have a more recent article on this topic:
Magnesium Deficit and Hypertension

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Treating arrhythmias with adjunctive magnesium: identifying future research directions | European Heart Journal – Cardiovascular Pharmacotherapy

Magnesium is the fourth most abundant cation in the human body and is the second most prevalent cation in intracellular tissues. Myocardial cell action potentials are mediated by voltage-dependent Na⁺, K⁺, and Ca²⁺channels which, when their function is altered, can lead to the genesis of cardiac dysrythmias. Magnesium regulates the movement of ions through these channels within myocardial tissues. The potential ability of magnesium supplementation to prevent and/or treat arrhythmias has been recognized in clinical medicine for years. This includes termination of torsade de pointes, prevention of post-operative atrial fibrillation, acute treatment of atrial fibrillation, and improving the efficacy and safety of antiarrhythmic drugs. Despite what is currently known about magnesium’s therapeutic potential, a number of limitations and gaps to the literature exist. This includes an unclear link between correction of intracellular magnesium concentrations and both mechanistic and clinical outcomes, small sample sizes, varying routes of administration and doses, as well as short follow-up periods. This review highlights these gaps and recommends areas of need for future research.

Introduction

Magnesium is the fourth most abundant cation in the human body and is the second most prevalent cation in intracellular tissues.¹ Its primary physiologic roles involve enzyme activity and protein transport, including being an essential component of all adenosine triphosphate-utilizing systems.² As such, magnesium plays an integral role in a variety of functions related to cardiovascular disorders.³ Reduced dietary intake of magnesium has been linked with a higher risk of hypertension,⁴ atrial fibrillation (AF),⁵ ischaemic heart disease,⁶ and new-onset heart failure and heart failure-related hospitalization.^7,8 Similarly, a low serum magnesium level is associated with up to a 50% higher incidence of new AF,^9,10 left ventricular hypertrophy,¹¹ and is an important predictor of sudden cardiovascular death and overall mortality. ^12–14

The potential ability of magnesium supplementation to prevent and/or treat arrhythmias has been recognized in clinical medicine for years.^15–17 This includes prevention of AF following cardiac surgery,¹⁸ acute treatment of rapid AF,^19,20 new-onset and treatment-refractory supraventricular tachycardia (SVT),^21,22 refractory ventricular fibrillation,²³ and a variety of drug-induced arrhythmias most notably torsade de pointes (TdP).^24–28 As a result, the American Association for Thoracic Surgery and European Society of Cardiology have incorporated magnesium into their recent guidelines for preventing and managing certain arrhythmias.^29,30

Despite what is currently known about magnesium’s therapeutic potential, a number of limitations and gaps to the literature exist. Examples include the true incidence and impact of intracellular magnesium deficiency, target serum and intracellular magnesium concentration targets, the most efficacious magnesium salt form (Table 1),³¹ and the optimal dose and timing of magnesium administration. The purpose of this review is to critically evaluate the current literature base supporting the use of magnesium supplementation for preventing and/or treating clinical arrhythmias and to subsequently identify the key future research directions needed to better inform clinical decision making. Pertinent clinical investigations (randomized controlled trials, observational studies, and meta-analyses) as well as mechanistic studies were identified by searching MEDLINE from its inception through 31 August 2016. Medical Subject Heading and key words used included: Magnesium, Arrhythmias, Cardiac, Cardiac Surgical Procedures, and Cardiac Electrophysiology. Citation lists from identified studies and review articles were also examined for pertinent citations.

Table 1

Comparison of oral magnesium supplements³¹

Magnesium salt .	Elemental Mg++ dose, mg (mEq) .	Bioavailability .	Oral absorption, % .	Dosage form .	Recommended daily dose .	Adverse effects .
Carbonate	232 (19.0)	Very low	N/A	Tablet	70 mg elemental Mg (each tablet)	GI distress, diarrhoea
Chloride	64 (5.26)	Good	19.7	Enteric-coated tablets	640 mg/day (1–2 tablets TID)	GI distress, diarrhoea
Citrate	N/A	Good	29.6	Liquid, tablets	25 mEq Mg, 2–5 tablets	Laxative, evacuant
Gluconate	27 (tablets), 54 (liquid)	Good	19.3	Liquid, tablets	645 mg/day, 2–4 tablets t.i.d.	GI distress, diarrhoea
Hydroxide	10.3	Very low	N/A	Tablet	Two tablets	GERD, diarrhoea
l-Aspartate	5	Excellent	41. 7	Tablet	One tablet	GI distress, diarrhoea
l-Lactate	84	Excellent	42.3	Sustained-release caplet	1–2 caplets b.i.d.	GI distress, diarrhoea
Oxide	241	Good	22.8	Tablets, capsules	2–4 tablets t.i.d.	Emesis, diarrhoea

Magnesium salt .	Elemental Mg++ dose, mg (mEq) .	Bioavailability .	Oral absorption, % .	Dosage form .	Recommended daily dose .	Adverse effects .
Carbonate	232 (19.0)	Very low	N/A	Tablet	70 mg elemental Mg (each tablet)	GI distress, diarrhoea
Chloride	64 (5.26)	Good	19. 7	Enteric-coated tablets	640 mg/day (1–2 tablets TID)	GI distress, diarrhoea
Citrate	N/A	Good	29.6	Liquid, tablets	25 mEq Mg, 2–5 tablets	Laxative, evacuant
Gluconate	27 (tablets), 54 (liquid)	Good	19.3	Liquid, tablets	645 mg/day, 2–4 tablets t.i.d.	GI distress, diarrhoea
Hydroxide	10.3	Very low	N/A	Tablet	Two tablets	GERD, diarrhoea
l-Aspartate	5	Excellent	41.7	Tablet	One tablet	GI distress, diarrhoea
l-Lactate	84	Excellent	42.3	Sustained-release caplet	1–2 caplets b.i.d.	GI distress, diarrhoea
Oxide	241	Good	22.8	Tablets, capsules	2–4 tablets t. i.d.	Emesis, diarrhoea

Table 1

Comparison of oral magnesium supplements³¹

Magnesium salt .	Elemental Mg++ dose, mg (mEq) .	Bioavailability .	Oral absorption, % .	Dosage form .	Recommended daily dose .	Adverse effects .
Carbonate	232 (19.0)	Very low	N/A	Tablet	70 mg elemental Mg (each tablet)	GI distress, diarrhoea
Chloride	64 (5.26)	Good	19.7	Enteric-coated tablets	640 mg/day (1–2 tablets TID)	GI distress, diarrhoea
Citrate	N/A	Good	29.6	Liquid, tablets	25 mEq Mg, 2–5 tablets	Laxative, evacuant
Gluconate	27 (tablets), 54 (liquid)	Good	19. 3	Liquid, tablets	645 mg/day, 2–4 tablets t.i.d.	GI distress, diarrhoea
Hydroxide	10.3	Very low	N/A	Tablet	Two tablets	GERD, diarrhoea
l-Aspartate	5	Excellent	41.7	Tablet	One tablet	GI distress, diarrhoea
l-Lactate	84	Excellent	42.3	Sustained-release caplet	1–2 caplets b.i.d.	GI distress, diarrhoea
Oxide	241	Good	22.8	Tablets, capsules	2–4 tablets t.i.d.	Emesis, diarrhoea

Magnesium salt .	Elemental Mg++ dose, mg (mEq) .	Bioavailability .	Oral absorption, % .	Dosage form .	Recommended daily dose .	Adverse effects .
Carbonate	232 (19.0)	Very low	N/A	Tablet	70 mg elemental Mg (each tablet)	GI distress, diarrhoea
Chloride	64 (5.26)	Good	19.7	Enteric-coated tablets	640 mg/day (1–2 tablets TID)	GI distress, diarrhoea
Citrate	N/A	Good	29.6	Liquid, tablets	25 mEq Mg, 2–5 tablets	Laxative, evacuant
Gluconate	27 (tablets), 54 (liquid)	Good	19.3	Liquid, tablets	645 mg/day, 2–4 tablets t.i.d.	GI distress, diarrhoea
Hydroxide	10.3	Very low	N/A	Tablet	Two tablets	GERD, diarrhoea
l-Aspartate	5	Excellent	41.7	Tablet	One tablet	GI distress, diarrhoea
l-Lactate	84	Excellent	42. 3	Sustained-release caplet	1–2 caplets b.i.d.	GI distress, diarrhoea
Oxide	241	Good	22.8	Tablets, capsules	2–4 tablets t.i.d.	Emesis, diarrhoea

Physiologic and pharmacologic role of magnesium in the cardiovascular system

Magnesium is primarily an intracellular cation with 99% of total body concentrations found in bone, muscles, and non-muscular soft tissue.³² The remaining 1% is located extracellularly within serum and red blood cells. Of this 1%, a small proportion (1–5%) is ionized with the remainder being protein bound. Magnesium is absorbed primarily within the small intestine through paracellular mechanisms with the remainder excreted in the feces.³³ Homeostasis is maintained by the kidneys where it is filtered in the glomerulus and ∼95% is reabsorbed mostly within the proximal tubule and thick ascending limb of the loop of Henle.

The recommended daily allowance of magnesium is 4.5 mg/kg/day.² Foods known to be rich in magnesium include grains, nuts, and green vegetables, amongst others. Around 24–76% of dietary magnesium intake is absorbed.³⁴ Studies have suggested that the relationship between magnesium absorption and intake is curvilinear and may be a saturable process.³⁴ Known causes of low magnesium include inadequate dietary intake, malabsorption states, gastrointestinal losses (diarrhoea and vomiting), bowel resection surgery, and drugs (diuretics, laxatives, and insulin).² An additional challenge of diuretic-induced hypomagnesaemia is that potassium levels can also be lowered with these drugs; this means that simultaneous administration of magnesium and potassium supplements may be required to normalize serum levels of each.³⁵

A major challenge when using oral magnesium preparations as a means of repletion is their generally poor bioavailability, as well as lack of consensus. Firoz and Graber³⁶ showed the fractional bioavailability of magnesium oxide to be ∼4% with magnesium lactate, aspartate, and chloride averaging 9–11%. Other studies suggest magnesium acetate to have greater absorption than magnesium chloride, whereas others have reported higher bioavailability values.^31,34 This is an important consideration when evaluating the results of trials using oral magnesium supplements. The difference in total absorption between exogenous magnesium supplements and dietary sources could be due to either larger fractions of ingested magnesium being unabsorbed or slow-release mechanisms.³⁴ No evidence is currently available showing which of the commercially available products is most likely to correct either a serum or intracellular magnesium deficiency.

Given that a majority of magnesium is found within the cell, it is not surprising that disparities between intracellular and serum (reference range 0.65–1. 05 mmol/L) magnesium concentrations have been seen in clinical studies.^37,38 Shah et al.³⁸ showed that 89% of patients undergoing radiofrequency catheter ablation of AF had intracellular magnesium deficiencies, despite serum values within the reference range for all participants. This suggests that routine screening and monitoring of serum magnesium concentrations are unlikely to represent a patient’s true magnesium status. Accurate determination of intracellular magnesium concentrations is a recognized challenge in the field. Measurement of magnesium content within lymphocytes or erythrocytes has correlated to intramyocardial muscle magnesium and is likely the most accurate.^39,40 However, commercial labs do not currently run assays to determine these concentrations and are only available for research purposes. Other tests that measure intraepithelial cell magnesium content (reference range 33.9–41.9 mEq/International Units) from buccal tissue samples are available, although only a single site within the USA performs the test. ³⁷ This validated, non-invasive test can be performed in 60 s in any clinic situation and is available to both practitioners and researchers.³⁷

Magnesium is a cofactor for a large number of adenosine triphosphate-mediated reactions.^41,42 This includes control of plasma and intracellular ion transport pumps responsible for movement of sodium (Na⁺), calcium (Ca²⁺), potassium (K⁺), and intracellular pH.^43,44 Within the vasculature, magnesium is involved with the exchange of various smooth muscle vasodilators, such as nitric oxide and prostatyclin, as well as various thrombogenic and inflammatory mediators (Figure 1).^3,44,45 This promotes vasodilation, reduced vascular resistance, and lower systemic and coronary blood flow and pressure.^5,46 In myocardial tissues, the ability of magnesium to antagonize Ca²⁺activity during ischaemia limits infarct size, reduces coronary artery spasm, and limits post-infarction oxidative damage.⁴⁷ However, evidence from clinical trials does not support the routine use of intravenous (i.v.) magnesium during an acute myocardial infarction.⁴⁸

Figure 1

Effects of magnesium on the heart and vasculature. Reprinted with permission from reference 3. AV, atrioventricular; IL-1, interleukin-1; IL-6, interleukin-6; MVO_2, myocardial oxygen consumption; NO, nitric oxide; PAI1, plasminogen activator inhibitor-1; PGI_2, prostacyclin; PVR, peripheral vascular resistance; VCAM-1, vascular cell adhesion molecule-1.

Figure 1

Effects of magnesium on the heart and vasculature. Reprinted with permission from reference 3. AV, atrioventricular; IL-1, interleukin-1; IL-6, interleukin-6; MVO_2, myocardial oxygen consumption; NO, nitric oxide; PAI1, plasminogen activator inhibitor-1; PGI_2, prostacyclin; PVR, peripheral vascular resistance; VCAM-1, vascular cell adhesion molecule-1.

Electrophysiologic properties of magnesium

Myocardial cell action potentials are mediated by voltage-dependent Na⁺, K⁺, and Ca²⁺channels which, when their function is altered, can lead to the genesis of cardiac dysrythmias. Magnesium regulates the movement of ions through these channels within myocardial tissues.^15,49 The cellular membrane sodium gradient is maintained by a magnesium-dependent Na⁺-K⁺-ADPase enzyme. The outward flow of Na⁺through these channels is highly dependent on intracellular magnesium and is blocked with increasing concentrations.⁵⁰ Intracellular magnesium also plays an integral role in the physiologic regulation of the voltage-gated Ca²⁺current.⁵¹ Increases in both intra- and extracellular magnesium concentrations have inhibitory effects on T- and L-type Ca²⁺channels.^52,53 In addition to Na⁺and Ca²⁺channel blockade, increasing magnesium concentrations decrease the activity of the rapid inward component of the delayed-rectifier K⁺channel (I_Kr).^54,55

These channel-blocking properties result in a variety of electrocardiographic changes that play vital roles in the genesis of cardiac dysrythmias. In patients undergoing routine electrophysiologic assessment, infusion of i.v. magnesium resulted in prolonged atrioventricular (AV)-nodal conduction times as well as PR and QRS durations.⁵⁶ Similar findings of AV-nodal slowing have been seen in other studies,^57–59 although only one saw this effect in male participants.⁵⁶ Stiles et al.⁵⁹ observed that conduction was affected more prominently through the slow pathway in patients’ dual AV-nodal physiology. Both atrial and ventricular refractory periods are also prolonged with magnesium use.^58,60

One of the more common uses of i.v. magnesium is for the treatment of TdP.²⁸ In fact, low tissue magnesium concentrations is associated with increased QT dispersion, potentially representing a risk factor for the development of triggered arrhythmias such as TdP.⁶¹ Torsade is thought to occur as a result of early after-depolarizations (EADs) resulting in triggered automaticity, unidirectional block, and intramural re-entry circuit development.⁶² Magnesium suppresses the EADs and automaticity by decreasing I_Kr current and L-type Ca²⁺activity (which is thought to be responsible for the triggered automaticity), thereby terminating the rhythm.^63–65 A canine model showed the ability of magnesium to homogenize the transmural dispersion of ventricular repolarization, which also aids in the termination of polymorphic ventricular tachycardias (VTs).⁶⁶

Prevention of post-operative atrial fibrillation

Approximately 25–40% of patients undergoing cardiac surgery develop post-operative AF, resulting in prolonged hospital length of stay, increased risk of stroke, and higher hospital costs.^67,68 Studies show a significant association between low pre-operative intracellular magnesium concentrations and an elevated risk of post-operative atrial fibrillation (POAF).^69,70 Low serum magnesium levels are also common following cardiac surgical procedures that utilize cardiopulmonary bypass.^71,72 Thus, prophylactic use of magnesium has the potential to correct these deficiencies and reduce POAF risk.

A large number of clinical trials and meta-analyses have been published evaluating the impact of perioperative magnesium supplementation on rates of POAF with mixed results (Table 2).^18,73–81 The literature base is limited by studies with small sample sizes, varying magnesium doses and timing of administration, and differing study designs and quality. Not surprisingly, many meta-analyses found significant statistical and methodological heterogeneity in their analyses. Many of the clinical trials did not use a blinded design or intention-to-treat, did not adequately define AF, or reported POAF as a secondary outcome. When Cook et al.⁸¹ performed a subgroup analysis of only those trials they deemed to be of high methodologic quality, no benefit or prophylactic magnesium on POAF risk was seen [odds ratio (OR) 0.94, 95% confidence interval (CI) 0.61–1.44].

Table 2

Published meta-analyses of magnesium for prevention of post-operative atrial fibrillation^18,73–81

Table 2

Published meta-analyses of magnesium for prevention of post-operative atrial fibrillation^18,73–81

The areas of uncertainly related to prophylactic magnesium supplementation in patients undergoing cardiothoracic surgery include the optimal timing and duration of treatment, most appropriate dose, and concomitant medication administration. The administration of i.v. magnesium sulfate during the operative procedure has not resulted in a reduction in POAF risk.^76,82 When studies of between 2 and 6 days duration of magnesium use were pooled, significant reductions in POAF risk were seen.⁷⁵ However, meta-regressions performed by duration of magnesium treatment have not showed a significant relationship with POAF risk (P = 0.56).⁸¹ There is similar uncertainty surrounding the optimal dose of magnesium to provide, with no association between dose and POAF risk seen upon meta-regression.⁸¹ Henyan et al.⁷⁶ suggested that lower doses of magnesium reduced POAF risk (OR 0.36, 95% CI 0.23–0.56) whereas moderate-high doses did not (OR 0.99, 95% CI 0.70–1.42). No trials have directly compared the impact of either timing or various magnesium dosing strategies on POAF risk and represent a significant gap in knowledge.

The last area of uncertainty is whether magnesium, when used in combination with other proven pharmacologic agents, provides additional POAF risk reduction. Behmanesh et al.⁸³ showed that patients randomized to receive i.v. magnesium in combination with mandatory beta-blocker use with bisoprolol compared with control (continuation of pre-operative β-blocker only) significantly reduced the incidence of POAF (P < 0.001). However, when Cook et al.⁸² randomized patients to receive either i.v. magnesium or placebo in addition to mandatory β-blocker use (atenolol), no difference in atrial arrhythmia incidence was seen. No trials have specifically studied the use of magnesium in addition to amiodarone, or in comparison with these other strategies. The guidelines published by the American Association for Thoracic Surgery in 2014 recommend i.v. magnesium supplementation to prevent POAF in patients with low serum magnesium levels, although only as a class IIb recommendation.²⁹ However, trials providing evidence of the optimal timing, dose, duration, and concomitant therapies are needed to better inform the clinical use of i.v. magnesium in patients undergoing cardiothoracic surgery to lower POAF risk.

Treatment of acute atrial and ventricular arrhythmias

Atrial fibrillation is the most common supraventricular arrhythmia and significantly increases stroke and mortality risk.⁸⁴ Patients with AF have been shown to have lower serum magnesium levels compared with healthy controls;⁸⁵ one in five patients with symptomatic AF is also hypomagnesaemic.⁸⁶ Management of AF includes either control of the ventricular response (rate-control) or conversion to normal sinus rhythm (rhythm-control) in addition to antithrombotic therapy.⁸⁷ Given the known effects of magnesium on voltage-dependent Na⁺, K⁺, and Ca²⁺channels, it is plausible for it to have a beneficial impact as part of either a rate- or rhythm-control strategy.

Trial evidence shows i.v. magnesium to be effective for controlling the ventricular response in patients with AF. Early investigations showed significant reductions in pulse rates when i.v. magnesium was used in combination with digoxin for managing acute AF.^88,89 A trial of 190 patients with rapid AF presenting to the emergency department showed that i.v. magnesium sulfate use resulted in pulse rates of <100 b.p.m. more often than placebo (P < 0.001).⁹⁰ Similar reductions in pulse rates have also been shown when comparing i.v. magnesium sulfate with diltiazem.⁹¹ Meta-analyses of clinical trial data show that magnesium is superior to placebo (when added to digoxin) for getting the pulse rate below 100 b.p.m., but is inferior to calcium channel blockers or amiodarone.^19,20

In addition to ventricular rate control, studies have evaluated the role of magnesium for aiding in the successful conversion of AF to normal sinus rhythm. A small clinical trial by Moran et al.⁹² showed that i.v. magnesium use (administered via continuous infusion) resulted in a greater number of conversions of atrial tachyarrhythmias (including AF) to normal sinus rhythm than amiodarone at 24 h (P < 0.05). Meta-analysis of clinical trial data shows that magnesium-treated patients are more likely to regain sinus rhythm than other agents, including placebo or calcium channel blockers (OR 1.60, 95% CI 1.07–2.39).²⁰ The findings related to magnesium use in patients undergoing direct current cardioversion of AF are mixed. Although one study showed that pre-treatment with a magnesium and potassium solution significantly improved cardioversion success rates vs. control (96.4% vs. 86.0%; P = 0.005),⁹³ 1-week pre-treatment with oral magnesium (either alone or in combination with sotalol) did not appreciably affect cardioversion success or AF recurrence rates.⁹⁴ The relation between serum and intracellular magnesium concentrations and efficacy remains unknown. In the study by Frick et al.,⁹⁴ relatively few patients (4 of 170) had a baseline serum magnesium deficiency with no differences seen in serum levels between patients in sinus rhythm or with AF recurrence. Intracellular magnesium determinations have not been performed in any of the AF studies to date. Thus, more mechanistic evaluations of the role that magnesium has with AF pathogenesis and outcomes are needed before it can be definitely recommended as a treatment strategy.

A weak body of evidence also supports the ability of magnesium to terminate SVT. Case reports²¹ and case series²² show that i.v. magnesium can terminate SVT or, at a minimum, slows the pulse rate; the effect is most noticeable when the AV node is part of the reentrant circuit. Not all studies have supported these findings, however. Viskin et al.⁹⁵ did not show any difference in SVT conversion rate, despite repeated dosing of i.v. magnesium. They did, however, suggest potential efficacy of magnesium for terminating SVT via blocking retrograde conduction in accessory pathways. Conversely, a single-blind study by Gullestad et al.⁹⁶ showed that patients with recent-onset SVT receiving i.v. magnesium were more likely to convert to sinus rhythm within 4 h than those receiving verapamil. However, verapamil was more efficacious from 4 to 24 h, and no difference was found between groups beyond 24 h. Taken together, the current data (most of which is more than 20 years old) do not support the routine use of i.v. magnesium for the rapid termination of SVT. No studies to date have evaluated oral magnesium preparations for managing SVT.

Studies have shown that up to 38% of patients with sustained ventricular arrhythmias have a serum magnesium deficiency and 72% have an excessive magnesium loss.⁹⁷ Correction of this deficiency with i.v. magnesium resulted in a decrease in ventricular ectopic beats (P < 0.0001), couplets (P < 0.003), and episodes of non-sustained VT (P < 0.01) vs. placebo.⁹⁷ Oral supplementation with magnesium and potassium also reduced ventricular premature beats (P = 0.001) vs. placebo over a 3-week period.⁹⁸ A number of case reports have also showed magnesium to be effective for terminating various drug-induced ventricular arrhythmias.^24–27

The primary use of magnesium is for the termination of polymorphic VT/TdP.^24,30 In fact, hypomagnesaemia has been associated with polymorphic VT and TdP following an acute myocardial infarction.^99,100 As mentioned earlier, magnesium suppresses the EADs and automaticity by decreasing I_Kr current and L-type Ca²⁺activity (which is thought to be responsible for the triggered automaticity), thereby terminating TdP (Figure 2).^{3,63–65,101} Guidelines recommend immediate administration of i.v. magnesium as first-line management of TdP.¹⁰² The initial data supporting this recommendation came from a case series of 12 patients who developed TdP, mostly (75%) due to antiarrhythmic drug use with QTc intervals ranging from 540 to 720 ms.²⁸ The TdP resolved following a single 2 g dose of i.v. magnesium sulfate in 9 of the 12 patients (75%). An additional dose was required in the other three patients and for three others who had a recurrence of TdP. Additional evidence comes from investigations of paediatric populations with TdP resulting from congenital or acquired long QT syndrome.^103,104

Figure 2

Mechanism of benefit of magnesium in treating torsade de pointes. Reprinted with permission from references 3 and 101.

Figure 2

Mechanism of benefit of magnesium in treating torsade de pointes. Reprinted with permission from references 3 and 101.

Use of adjunctive magnesium with antiarrhythmic drugs

The adjunctive use of magnesium supplementation added to antiarrhythmic drugs has received the most research focus in recent years. The theory behind this usage stems from the ability of magnesium to not only treat drug-induced TdP (as was discussed in the previous section) but also prevent it as well. Animal models show that addition of magnesium to antiarrhythmic drugs prevents EADs and lessens TdP risk without appreciable affecting QTc.⁶⁵ A clinical trial of 20 patients undergoing chemical cardioversion of AF or atrial flutter showed that the QTc interval increased by 29% from baseline when patients received the ibutilide (P = 0.007) but did not change when 2 g of i.v. magnesium sulfate was given immediately before ibutilide administration (P > 0.05).¹⁰⁵ A number of subsequently published observational studies supported and extended these findings.^106–109

A multicentre cohort study of three large, tertiary care centres by Kalus et al.¹⁰⁶ showed that AF or flutter patients who received magnesium within 2 h of ibutilide administration had a 19% higher rate of successful cardioversion to normal sinus rhythm vs. those who did not receive magnesium (P = 0.040). The need for subsequent direct current cardioversion was also reduced by 34% in the magnesium group. Interestingly, the cardioversion success rates with concomitant magnesium appeared to increase in a dose-related fashion (Figure 3). A significantly lower rate of TdP has also been seen when magnesium was used along with ibutilide (0%) vs. ibutilide alone (3.5%; P = 0.009).¹⁰⁹ The strategy of administering i.v. magnesium within 2 h of ibutilide in AF or flutter patients is also a cost-effective strategy, from a US hospital-payer prospective.¹¹⁰ Similar results were seen in a retrospective cohort evaluation of patients receiving dofetilide for chemical cardioversion of AF or flutter where concomitant magnesium increased the rate of successful conversion two-fold.¹⁰⁸

Figure 3

Dose–response relation of magnesium for cardioversion of atrial fibrillation/flutter in combination with ibutilide. Originally published in 2003, American Society of Health‐System Pharmacists, Inc. All rights reserved. Reprinted with permission from reference 106 (R1609).

Figure 3

Dose–response relation of magnesium for cardioversion of atrial fibrillation/flutter in combination with ibutilide. Originally published in 2003, American Society of Health‐System Pharmacists, Inc. All rights reserved. Reprinted with permission from reference 106 (R1609).

Clinical trial data supporting these findings are limited. Steinwender et al.¹¹¹ randomized 117 patients with persistent atrial flutter to receive either 4 g of i.v. magnesium or placebo immediately preceding ibutilide administration for chemical cardioversion. The primary endpoint or successful conversion to sinus rhythm within 4 h of the procedure occurred in 85% of the magnesium patients vs. 59% of the placebo patients (P = 0.017). This difference was most notable in patients with typical (P = 0.017) vs. atypical atrial flutter (P = 0.189). Interestingly, although the QTc interval significantly increased from baseline following ibutilide administration, no post-dose differences were seen between the magnesium and placebo groups (P= 0.139). These findings are inconsistent with the pilot and observational data previously discussed. A number of questions remain regarding the role of adjunctive magnesium in AF/flutter patients undergoing chemical cardioversion. The optimal dosage of magnesium, route of administration (i.v. or oral), and duration of therapy all remain unanswered in this population. Given the promise of the current body of evidence, there is a critical need for both mechanistic as well as clinical outcome-based trials to help inform this practice.

Studies have also evaluated whether chronic oral magnesium improves the efficacy and safety of antiarrhythmic agents. McBride et al.¹¹² randomized 34 patients with either atrial or ventricular tachyarrhythmias receiving sotalol or dofetilide to receive twice-daily magnesium l-lactate (504 mg elemental magnesium daily) or placebo for 48 h. The intracellular magnesium concentration, which was low in 63% of participants regardless of the experimental group, significantly increased in the magnesium group (P = 0.002) and was unchanged with placebo (P = 0.32). Magnesium significantly reduced the QTc interval from baseline at both 3 and 51 h vs. placebo (P = 0.015 and P = 0.001, respectively). The investigators also calculated the Tpeak–Tend interval which is a marker of transmural dispersion of repolarization.¹¹³ Decreases in dispersion within the myocardium have been suggested to reduce TdP risk.¹¹⁴ A non-significant reduction in Tpeak–Tend was seen in the magnesium group (P = 0.293). Taken together, this pilot study showed that giving three tablets twice daily of magnesium l-lactate (providing 504 mg elemental magnesium daily) to arrhythmia patients receiving sotalol or dofetilide corrected the intracellular magnesium concentration and shortened their QTc interval.

Despite the positive findings, not all trials have revealed beneficial effects. Baker et al.^46,115 randomized 70 patients with an implantable cardioverter defibrillator (as either primary or secondary prevention) to receive either magnesium l-lactate (six tablets daily, providing 504 mg of elemental magnesium) or placebo for 12 months. Similarly to previous investigations, 86% of individuals in this trial (regardless of randomization) had a baseline intracellular magnesium deficiency. Twenty (28.6%) dropped out before the 12-week follow-up timepoint, mostly due to excessive pill burden (six tablets per day) or diarrhoea. No difference in either intracellular or serum magnesium concentrations was seen between the magnesium and placebo groups. Not surprisingly, the primary endpoint of the cumulative incidence of implantable cardioverter defibrillator therapy did not differ between the groups (HR 0.84, 95% CI 0.33–2.12; P = 0.706).¹¹⁵ Quality-of-life measures were also similar between the magnesium and placebo groups. Magnesium did, however, significantly lower systolic blood pressure at 12 weeks vs. placebo (117.7 ± 11.8 vs. 126.3 ± 16.7 mmHg, respectively; P = 0.04).⁴⁶

Conclusions

Magnesium has a number of potential beneficial effects on the cardiovascular system, most notably antiarrhythmic properties. This includes control of intracellular ion transport pumps responsible for movement of sodium (Na⁺), calcium (Ca²⁺), and potassium (K⁺) as well as reductions in EADs and slowed AV nodal conduction times. These physiologic properties provide promise of the therapeutic benefits that magnesium may have in managing various tachyarrhythmias. These benefits may stem from correcting the intracellular magnesium deficiency that has been found in many patient populations.

Taken together, a number of important clinical questions remain unanswered by this evidence base. The relationship between normalization of intracellular magnesium concentrations and improvements in clinical outcomes remains unknown. This includes pharmacologic investigations such as thorough QTc studies, correlations between magnesium levels and both surrogate and clinical outcomes, and dose-ranging studies. The most appropriate route (i.v. vs. oral), salt (oxide vs. lactate, etc.), dose, and duration of therapy for magnesium supplementation are also not available to clinicians. These gaps in evidence make incorporating the potentially important research findings into practice a challenge for clinicians caring for high-risk patients. They also represent critical need of study to allow the large body of evidence with magnesium to be translated to clinical practice.

Funding

Connecticut Institute for Clinical and Translational Science (CICATS) at the University of Connecticut to W.B. The content is solely the responsibility of the authors and does not necessarily represent the official views of CICATS.

Conflict of interest: none declared.

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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For Permissions, please email: [email protected].

Magnesium Could Help COVID-19 Patients with Pre-Existing Heart Conditions | Medical School

Jin O-Uchi, MD, PhD, FAHA, FCVS, has always been interested in magnesium (iron) and its effects on the human heart. 

Hypertension, commonly known as high blood pressure, is a pre-existing cardiovascular disease prominent in patients who suffer from serious cardiac damage during their fight against COVID-19. Researchers at the University of Minnesota are studying whether magnesium can make a difference in high-risk patients.

“When we looked at the situation, we realized that this was something that we could do to help—even without being virologists. We asked, ‘How can we resolve the issue that people with cardiovascular disease have a higher death rate for COVID-19?’” said Dr. O-Uchi, an assistant professor in the U of M Medical School’s Department of Medicine, Division of Cardiology.

Magnesium’s known cardioprotective effects include anti-arrhythmic, anti-oxidative and anti-apoptotic effects. For instance, it has been suggested to reduce risk for atrial fibrillation, which is one type of common cardiac arrhythmia. Cardiac arrhythmia refers to a group of conditions that cause the heart to beat irregular, too slowly or too quickly.

Early data shows that COVID-19 produces ion channels, thus changing the function of the infected human cells. Magnesium has a profound impact as it blocks the “viral ion channel” in the body while protecting against oxidation. Oxidation is another well-known cause of risk for abnormal cardiovascular function.

With the help of a CO:VID (Collaborative Outcomes: Visionary Innovation & Discovery) grant, Dr. O-Uchi and colleagues across the U of M are analyzing whether the viral ion channels encoded by SARS-CoV-2 genes in the heart increases the risk of sudden cardiac death and cardiac damage in COVID-19 patients.

“We are working to protect the people who are highly vulnerable and hope that we can breach the gap until a vaccine is available,” Dr. O-Uchi said.

According to the prior studies from University researchers, most people may require around 400 milligrams of magnesium oxide per day to efficiently increase the magnesium concentration in their blood. Although the use of magnesium oxide is approved by the Federal Drug Administration, additional approval must be given to take a higher amount every day. 

Researchers hope to establish efficacy. That way, those who are at risk from COVID-19 can obtain the dosage they need. Previous trials provided data regarding how much magnesium concentration could be increased in a person’s blood. The safety of the research was already well established, making it easy for researchers at the U of M to get approval.

Dr. O-Uchi recently received a new grant from the University’s Institute for Engineering in Medicine and will now collaborate with epidemiologists and the bioengineering team at the University to validate the effect of magnesium and bring it to market. 

Magnesium

Other name(s):

magnesium carbonate, magnesium citrate, magnesium hydroxide, magnesium oxide, magnesium sulfate

General description

Magnesium is an essential mineral. It helps more than 300 enzymes work. It’s needed for nerve and muscle activity. It also controls the electrical and muscle activity of the heart. Magnesium is in many antacids and laxatives. It’s found in many foods. Because of this, magnesium deficiency is rare.

Magnesium is needed for many functions in the body. These include:

Magnesium helps bone and tooth enamel form. It’s needed to convert protein, carbohydrates, and lipids into energy. It also helps make protein, RNA, and DNA. Magnesium helps break down (metabolize) of many substances in the body.

Medically valid uses

Magnesium is used as a laxative. This is often done in the form of magnesium sulfate or magnesium citrate. Magnesium citrate is given to cleanse the bowel before taking X-rays, CT scans, or MRIs of the abdomen.

It’s used in some treatments for heartburn and upset stomach due to acid indigestion

Magnesium is also used to prevent and treat low magnesium levels. This is called hypomagnesemia. In hospitals, magnesium is used to treat preeclampsia and eclampsia. These issues can happen in pregnancy and right after childbirth.

Magnesium works with calcium, vitamin D, and parathyroid hormone to make healthy bone tissue and tooth enamel.

Your healthcare provider may prescribe magnesium to treat certain heart problems. These include: 

• Heart attack

• Heart rhythm problems

• Heart failure

• Digitalis poisoning

It may also be used during cardiac surgery.

Unsubstantiated claims

There may be benefits that have not yet been proven through research.

Magnesium may:

• Help maintain health of muscles, bone, and nerve tissues

• Help with anxiety and depression

• Induce sleep in people with insomnia

• Relieve premenstrual syndrome (PMS)

• Prevent muscle cramps, muscle weakness, and fatigue

• Prevent heart disease

• Prevent hardening of the arteries (arteriosclerosis)

• Prevent high triglyceride levels

Recommended intake

Magnesium is measured in milligrams (mg). The Recommended Dietary Allowance is RDA.

*Adequate Intake (AI)

Magnesium supplements come in many forms. Each form has a different amount of magnesium. Magnesium oxide and magnesium hydroxide have the highest amounts of it. Magnesium gluconate and magnesium gluceptate have the lowest.

Dose may be noted as the amount of magnesium. Or it may be noted as the percentage. Read the label to see how it is noted. You can learn the amount of elemental magnesium in a food. To do this, multiply the percentage of magnesium by 10. One (1) gram of magnesium oxide has 60.3% of magnesium or 603 mg.

You should take magnesium supplements with food. This can help prevent diarrhea.

You may need more magnesium if you have any of these:

• Diabetes

• A malabsorption syndrome

• Kidney disease

• Take water pills (diuretics) regularly

• Having vomiting or diarrhea

• Have burns over large areas of the body

• Extreme athletic activity

• Moderate-to-heavy alcohol use

You may also need more magnesium if you are an athlete who restricts calories.

Magnesium is in nearly all foods. Because of this, it’s rare to have a diet low in magnesium. Signs of deficiency may include:

Side effects, toxicity, and interactions

Taking too much magnesium can cause diarrhea. This is the most common side effect. It can also cause:

Magnesium supplements may be dangerous for some people. This includes:

Women who are pregnant or breastfeeding should talk to their healthcare providers before taking any supplements.

Magnesium is used in many antacid forms. These can cause diarrhea. Taking magnesium with food may help prevent this side effect.

Magnesium may change the effects of some medicines. These include:

• Bisphosphonates

• Antibiotics

• Diuretics

• Proton pump inhibitors

Tell your healthcare provider about all medicines you take before you take magnesium.

5 Mind-Blowing Benefits of Magnesium

The magical mineral magnesium is essential to human life. It plays a central role in almost every bodily process and is a cofactor in more than 300 enzyme systems, making it a key player in numerous biochemical reactions in the body, including muscle and nerve function; reproduction; blood pressure regulation; DNA, RNA, and protein synthesis; and cellular energy production. We cannot survive without it, yet around 50 percent of the population has an inadequate intake, putting a considerable number of people at risk for deficiency. 

According to research published in the BMJ Journal, hunter and gatherer societies of the Paleolithic era consumed a diet containing about 600 milligrams of magnesium per day, a number that far exceeds the average daily magnesium intake of today, which is approximately 270 milligrams a day for a 150-pound person. Not only is the modern intake of magnesium much lower than those of our ancestors, but it’s also lower than the recommended daily allowance (RDA) of magnesium, which is between 300 and 420 milligrams for most people (and many experts believe these amounts simply prevent an outright deficiency and are not adequate for optimal health).

Magnesium’s Health Benefits

Stress And Anxiety Relief 

Are stress and anxiety recurring themes in your life? Magnesium may be the “chill pill” you need. Magnesium plays a role in regulating the hypothalamic-pituitary-adrenal axis (HPA axis), our stress response system, and deficiencies in the mineral have been shown to induce anxiety and HPA axis dysregulation in an animal model. Indeed, anxiety is one of the physical symptoms of a magnesium deficiency. In humans, magnesium can suppress the release of the stress hormones cortisol and adrenaline and work at the blood-brain barrier to possibly prevent stress hormones from entering the brain. 

Neuroplasticity

The brain’s ability to change is neuroplasticity. This flexibility allows our brains to forge new neural connections (synapses) and affects learning, memory, behavior, and general cognitive function. Neuroplasticity plays a fundamental role in how well our brains age, with a loss of plasticity resulting in a loss of cognitive function. Research on neuroplasticity is growing and scientists are discovering that increasing neuronal cell magnesium levels can increase synapse density and plasticity, improving overall cognitive function. It is also showing promise to help “rewire” the brain in cases of traumatic brain injury and anxiety disorders. But not just any magnesium supplement will do—magnesium L-threonate is the form used in studies because it has the ability to cross the blood-brain barrier to effectively increase magnesium levels in the brain. 

Attention and Focus

As you’re probably coming to understand, magnesium is essential for healthy brain and nervous system function; this also includes attention and focus. Some of the symptoms of magnesium deficiency can manifest as irritability, restlessness, a lack of concentration, and fatigue, also symptoms associated with attention deficit hyperactivity disorder (ADHD). Studies have consistently found that children diagnosed with ADHD are deficient in magnesium and that supplementation improves behavior, impulsivity, and hyperactivity. Magnesium also interacts with gamma-aminobutyric acid (GABA) receptors, helping to maintain normal transmission of this calming neurotransmitter, while balancing levels of glutamate, an excitatory neurotransmitter. 

Anti-Inflammatory

Research shows that increasing magnesium intake may also reduce inflammation, an immune response that can contribute to a laundry list of health problems and chronic diseases, including anxiety and depression. Studies have shown that both children and adults who consume less than the RDA of magnesium are, on average, twice as likely to have elevated levels of C-reactive protein (CRP), a strong indicator of inflammation, compared to those who consume the RDA. A study published in The Journal of Immunology found that magnesium has a modulatory effect on the immune system and is able to reduce inflammatory cytokine production. This means that consuming more magnesium can help to reduce the inflammatory factors that can lead to disease. 

Cardiovascular Health

Magnesium plays a multitude of important roles in maintaining cardiovascular health, and many of the more severe symptoms of magnesium deficiency are cardiovascular in nature, including sudden cardiac death. Magnesium supports healthy blood pressure, reduces the risk of atherosclerosis, maintains healthy endothelial function and vasodilation, and is required for normal heart contraction and energy production in the heart. The authors of a review published earlier this year in the journal Open Heart, concluded that, “subclinical magnesium deficiency likely leads to hypertension, arrhythmias, arterial calcifications, atherosclerosis, heart failure, and an increased risk for thrombosis. This suggests that subclinical magnesium deficiency is a principal, yet under-recognized, driver of cardiovascular disease. A greater public health effort is needed to inform both the patient and clinician about the prevalence, harms, and diagnosis of subclinical magnesium deficiency.”

Some Of The Best Magnesium-Rich Food Options Include:

• Cooked spinach
• Cooked Swiss chard
• Broccoli
• Brussels sprouts
• Pumpkin seeds
• Cashews
• Almonds
• Avocado
• Black beans
• Yogurt or kefir
• Bananas
• Dark chocolate 

Magnesium Deficiency Is Widespread

There are so many people in the U.S. and around the world suffering from magnesium deficiency, and even worse, they don’t even know it. Magnesium deficiency can be present despite normal serum magnesium levels because only one percent of magnesium in your body is found in your bloodstream— most are found in your bones, muscles, and inside cells. So even though your magnesium levels may appear “normal” on paper, you may, in fact, be dealing with a deficiency. 

Causes 

There are a number of reasons why magnesium deficiency is a widespread problem today: Soil degradation has drastically lowered the magnesium content in our food; the modern Western diet is loaded with processed foods that contain little to no magnesium and other important micronutrients; the heavy consumption of phosphorous-containing soft drinks depletes magnesium; common digestive issues hinder the absorption of minerals; and medication use also reduces the absorption of magnesium. These reasons make it necessary for most people to supplement their diets with magnesium. 

Best Supplemental Forms 

Magnesium supplements in citrate, chelate, glycinate, and chloride forms are better absorbed than those in oxide or sulfate forms. It’s important to note that taking magnesium supplements in high doses can have a laxative effect, so aim to have no more than 300 to 400 milligrams in one dose.  As previously mentioned, if your goal is to increase brain plasticity, magnesium L-threonate is the best choice.

Magnificent Magnesium Oil & Bath Salts 

Another option for increasing your magnesium levels is to use magnesium oil. Magnesium oil is applied topically so that it can be absorbed into the skin. There are a few ways to use magnesium oil: It can be sprayed directly on the skin after you take a shower, massaged into the skin to reduce muscle cramps and soreness, or added to your bath water. 

Another form of magnesium that you can easily use at home is Epsom salt, which is a mineral compound of magnesium and sulfate. I recommend adding Epsom salt to warm bath water and soaking in it for at least 20 minutes. This will help to boost magnesium levels, reduce inflammation, ease stress, and relieve constipation. 

Magnesium is one of the most important minerals in the body and is needed to maintain optimal health, but an alarming number of people are at risk of a deficiency. If necessary, I suggest increasing your intake of magnesium-rich foods and turning to supplements—oral and/or topical—to ensure that you are getting enough of this vital nutrient and enjoying the health benefits that come with optimal levels

Maintinaining Cardiac Health with Magnesium

Video Interview of Dr. William McAuliffe

Dr. William McAuliffe explains the importance of magnesium in our significantly magnesium deficient society.

(See transcript below.)

Video Transcript

Dr. William McAuliffe, DC, CN discusses just how far we as a society have fallen into magnesium deficiency, and the difficulty of trying to reverse it through food alone. Through his work and research, he’s discovered a myriad of issues resolved through simply adding this crucial mineral to your system. From heart disease, to blood pressure, to the absorption of other nutrients, magnesium is essential to overall health.

However, as Dr. McAuliffe describes, adequate intake of magnesium via oral supplements is very difficult to achieve.

Dr. McAuliffe:

The prevalence magnesium deficiency is pandemic in this country.  I can’t speak for the world, but in this country it is pandemic, primarily because of the lack of magnesium in the types of foods people are eating.

Magnesium is Essential for Whole Body Health

Magnesium is essential for the absorption of calcium.

It’s essential for maintaining proper blood pressure.

It’s essential for cardiovascular problems.

It’s essential for a whole myriad of things going on in the body.

Magnesium & CoQ

¹⁰ for Heart Disease

I spoke with a biochemist at the University of Texas not too long ago.

He said, “We have eliminated heart disease at the University of Texas by increasing magnesium as well as CoQ10 into the diet of people down there, and in every case people responded.

No Laxative Effect With Topical Magnesium

However, you are limited as to how much magnesium you can give somebody from an oral point of view because of the laxative effect.

You are not limited in a topical form of how much magnesium people take because you can give them – have them put magnesium just sprayed on their entire bodies three or four times a day, if it’s necessary in unusual cases, and they will absorb most of it.

High Dosages of Magnesium Absorbed Through Skin

And at least eight sprays of magnesium will give you at least 100 mg of magnesium in a chloride form.  So, if you’re spraying the entire body, you’re getting maybe 50 sprays, and you’ll be getting almost 1,000 mg of magnesium each time you spray the entire body.

If you can do that a couple of times a day, then you’re getting 2,000 mg or two grams of magnesium that way.  There is no way you can get that much magnesium in an oral intake.

90,000 Choosing Magnesium. Admission courses and daily rates

Magnesium is an essential mineral that is essential for the full and healthy functioning of all organ systems in the human body. Scientific facts and studies have proven that this trace element takes part in most biological processes in the body. So, it helps to produce hormones, ensures the correct transmission of impulses, and controls muscle contractions.

In 2010, the German Medical Society conducted a large-scale study aimed at studying the behavior of the body in conditions of lack and deficiency of minerals.As it turned out, the topic of the importance of magnesium is very serious and relevant, since 33.7 percent of the working-age population in Germany had a serious lack of a trace element in the body.

Next, let us consider in detail how important magnesium is and what role it plays in ensuring the healthy functioning of the body, what the consequences of its deficiency can be and from what food to get it. We will also pay attention to natural supplements with magnesium and the peculiarities of taking such dietary supplements.

Why does the human body need magnesium

About 60 percent of the total volume of the mineral is contained in bone tissue, and the rest is in muscles, blood and other working fluid, as well as in soft tissues.

Among the main functions of a trace element, it is important to note the following:

• helps to generate cellular energy through the formation of ATP molecules;
• takes part in the metabolic reactions of vitamin C and B-groups, otherwise, without magnesium, these nutrients are useless for the human body;
• accelerates the recovery reactions of the affected tissues, in particular the epithelium.

In addition, magnesium is important for health in the following aspects of action:

• Strengthens the strength and resistance of the cell walls;
• interacts with calcium, thereby regulating vascular and muscle tone, is responsible for improving coordination of movements;
• helps insulin to enter cells faster;
• prevents extraordinary contractions of the myocardium;
• promotes healthy teeth and bones.

What happens in the body with a lack of magnesium

Turning to modern medicine, there is a specific list of symptoms that indicate a chronic mineral deficiency:

• attacks of nausea in the morning followed by vomiting;
• normal appetite is disturbed, I do not want to eat more than one small amount of food during the day;
• permanent fatigue for no apparent reason, which has no connection with lack of sleep, physical exertion or stress.Explained as “just fatigue”;
• there are muscle twitching of the fingers, eyelids, frequent cramps in the arms and shoulder girdle;
• there is numbness in the limbs, a state of trembling in the body, the feeling of warmth and coldness in the body changes dramatically;
• coordination is impaired, in particular, fine motor skills of the hands are affected.

Magnesium for the female body

As statistics show, women tend to experience micronutrient deficiencies 20-30 percent more often than men. This is due to the specifics of the body and the production of the hormone aldosterone, which accumulates water. The mineral from the blood gradually migrates into the water reserves concentrated outside the cells, then it is simply excreted from the body in a natural way.

During menstrual bleeding, an additional loss of magnesium is observed, since aldosterone is produced in large quantities. In case of hemorrhage due to trauma and wounds, the loss of the mineral also occurs.

Magnesium for the male body

Men are also susceptible to a lack of magnesium, which is manifested by characteristic symptoms.Despite the fact that they account for fewer cases compared to the female audience, in men with high blood pressure, when the reading is above 140 mmHg, a large amount of the mineral is excreted through the urinary tract.

Natural sources of magnesium

In the bowels of the Earth, magnesium inorganic compounds are present, and scientists have also discovered large accumulations in plants and sea water. The mineral is characterized by a low degree of assimilation, which is why it is important to regularly consume foods with its content, as well as exclude spicy and fatty foods from the diet.

Magnesium is found in the following popular products:

• Walnuts;

90,023 spinach;

90,023 soybeans;

• cocoa beans;

90,023 arugula;

• anise;

90,023 bananas;

• sage;
• coriander.

Nutrient Tracker helps you find the magnesium you need

If you want to quickly and easily find out the top magnesium products, or want to know the entire composition of your meal, then try the PREPRO mobile app.

In addition to making meal plans and checking which vitamins and minerals are missing in your diet, there is a great feature that looks for anything among foods and supplements that, for example, contains magnesium.

You can get acquainted with the application on the website

How to choose the right magnesium supplements

Each person needs their own individual dose of the mineral, which is due to the influence of various factors, in particular:

• sports activity;

90,023 level of physical labor;

• the quality of night sleep, whether there is a deficit;

90,023 cases of intoxication;

• periods of increased mental activity;
• frequency of infectious diseases.

If symptoms of a micronutrient deficiency appear, it is recommended to undergo a prophylactic course to replenish the body’s needs, using the following food additives:

• Magnesium citrate – is a combination of a trace element with citric acid.This product has high bioavailability and digestibility, which allows you to take it in small dosages and saturate the body with the necessary nutrients;
• Magnesium Chelate – is a special magnesium form, since the mineral itself is in the structure of amino acids, thus, the body completely absorbs the additive and no additional synthesis reactions are required. Due to the large size of the molecule, one cannot be limited to only one capsule of administration, however, it is important to follow the instructions with the rules for taking this drug;
• Magnesium chloride is an easily assimilated salt that is absorbed by the walls of the small intestine, after which it is rapidly distributed in the body.However, you cannot use this supplement if you have chronic diseases of the urinary system;
• Magnesium Aspartate – This supplement is based on a combination of a magnesium salt with aspartic acid and thus has a high absorption rate;
• Magnesium Carbonate – Considered the simplest form of the mineral and is available for purchase at any pharmacy. Combines a favorable price and good properties to saturate the body with a trace element.

Supplements are often prescribed when magnesium and vitamin B6 are taken at the same time, since each component complements the other.

Rules for the intake of magnesium

By adhering to the following rules, you can always use supplements safely and effectively for your health:

• Divide the daily dose into several doses, take them evenly throughout the day.At least two doses – in the morning and in the evening;
• magnesium is well absorbed if taken 15 minutes before meals;
• Do not use the supplement on an empty stomach or if you do not eat, otherwise it will provoke nausea and pain in the stomach;
• it is better to avoid combining magnesium supplements with tea, coffee and alcoholic beverages, and should not be combined with foods and dishes that increase diuresis, otherwise it will contribute to the rapid removal of the mineral from the body in a natural way;
• In order for the body to receive the required amount of magnesium, it is important to provide it with other nutrients, nutrients, in particular calcium.Scientists were able to establish that with an imbalance of the latter, magnesium is absorbed worsens.

This substance is one of the seven key macronutrients required by the body every day and in relatively large quantities (at least 100 milligrams).Next, let’s take a look at the best magnesium supplements on the market.

Recommended reading:

The most beneficial properties of magnesium for human health

10 interesting types of magnesium and what is each for

Date of publication of the article 07.09.2018
Update date 15.07.2021

90,000 Asparkam for heart failure, ischemia, myocardial infarction

Hypersensitivity to the drug, metabolic disorders of amino acids, arterial hypotension, acute and chronic renal failure, hyperkalemia, hypermagnesemia, atrioventricular conduction disorder (atrioventricular block I-III degree), severe myasthenia gravis, hemolysis, adrenal cortex insufficiency, age up to 18 years (efficacy and security not established).

Side effects

Possible nausea, vomiting, diarrhea, discomfort or burning sensation in the epigastric region (in patients with anacid gastritis or cholecystitis), hyperkalemia (nausea, vomiting, diarrhea, parasthesia), hypermagnesemia (facial flushing, thirst, decreased blood pressure, hyporeflexia, muscle , paresis, coma, areflexia, respiratory depression, convulsions).

Caution

During pregnancy and during breastfeeding, lactation.

Overdose

Symptoms: impaired conduction (especially with previous pathology of the cardiac conduction system).
Treatment: intravenous administration of calcium chloride; if necessary, hemodialysis and peritoneal dialysis.

Interaction with other medicinal products

Combined use with potassium-sparing diuretics (triamterene, spironolactone), beta-blockers, cyclosporine, heparin, angiotensin-converting enzyme inhibitors, nonsteroidal anti-inflammatory drugs increases the risk of hyperkalemia up to the development of arrhythmia and asystole.The use of potassium preparations together with glucocorticosteroids eliminates the hypokalemia caused by the latter. Due to the content of potassium ions, the undesirable effects of cardiac glycosides are reduced. Due to the content of magnesium ions, it reduces the effect of neomycin, polymyxin B, tetracycline and streptomycin.

* see details in the instructions for medical use of the medicinal product LS-002168

What they are treating us with: Cardiomagnyl’s path to the heart is through the stomach

Of course, heart muscle cells also have their own characteristics that allow the heart to contract automatically and continuously.For example, there calcium, coming from outside the cell, triggers the release of intracellular calcium from special stores (in mitochondria and endoplasmic reticulum) – as if the underground workers hiding for the time being came out to meet the soldiers-liberators of a friendly army.

But what place in this whole story is magnesium, which does not greatly affect the membrane potential? He has several roles in this bead swing game. First, it is a cofactor (a non-protein substance that is required for enzyme proteins to work) and is involved in the synthesis of ATP.This happens at the “substation” – in the mitochondria. Magnesium can do this in two ways – either in combination with ATP, participating in the reaction of converting creatine phosphate and ADP into creatine and ATP, or directly.

Secondly, magnesium often interferes with the work of calcium: it inhibits sodium-dependent expelling of calcium, and under some conditions magnesium prevents calcium from hiding back into storage. If there are a lot of calcium ions, the bond between actin and myosin increases, and if magnesium predominates, it weakens. Also, magnesium helps to split off phosphates in the myosin head.In general, in the heart he does many useful things, but in the Cardiomagnyl he is not needed for that.

From what, from what

But the most interesting thing in the preparation is not even this, but in its composition. The main active ingredients are indicated on the packaging, and they are called “acetylsalicylic acid + magnesium hydroxide”. Doesn’t it look like anything?

In fact, these substances have already become the main (or additional) heroes of our stories. Acetylsalicylic acid is simply aspirin, which we have already considered as a non-steroidal anti-inflammatory drug in the story about Nurofen, where aspirin “married” cyclooxygenases associated with inflammation (however, he kept the aromatic ring with him and gave his wife an acetyl tag).

What is the risk of a lack of magnesium in the body and what foods does it contain?

The trouble crept up imperceptibly: what is the threat of a lack of magnesium in the body and what products does it contain?

June 6, 2019

Why is magnesium needed?

It participates in the most important functions, namely:
• normalizes the pulse, dilates blood vessels, lowers blood pressure, regulates the level of oxygen and blood sugar;
• thanks to magnesium, the risk of blood clots is reduced;
• magnesium has an anti-stress effect, normalizes your sleep, reduces fatigue and irritability;
• this microelement relieves muscle spasms and relaxes them, especially after stress;
• it improves the functioning of the digestive and genitourinary systems;
• he participates in the respiratory processes;
• full formation of bones and teeth is impossible without magnesium;
• magnesium contributes to a favorable course of pregnancy.
In addition, without magnesium, the body will not fully assimilate B vitamins, calcium, vitamin C, phosphorus, potassium and sodium.
What causes magnesium levels to fall and what are the symptoms of magnesium deficiency?
The daily intake of magnesium is 400-500 mg per day. This indicator can fall due to malnutrition and lack of foods with magnesium, due to high physical exertion, due to severe stress and alcohol abuse. Also, the absorption of magnesium decreases with an excess in the diet of fats, calcium, certain metals, coffee, alcohol and antibiotics.
How is the lack of magnesium in the body manifested?
First of all, alarming symptoms are constant fatigue and mood swings, dizziness and poor coordination, loss of appetite, nausea and vomiting, constipation, headache, muscle cramps and numbness of the arms and legs, hair loss and brittle nails, etc. As you can see, a lack of magnesium affects all body systems and invariably leads to chronic diseases.
The most obvious way to avoid a lack of magnesium in the body is to eat well.Of course, ideally, you do not need to stress and drink too much coffee, but we understand that in the modern pace of life it is difficult. Therefore, let’s focus on nutrition to rule out the root cause of magnesium deficiency.
So, which foods contain magnesium?
First of all, these are cereals, cereals and legumes. It is from them that half of the daily value of magnesium should enter the body. Magnesium is also found in leafy vegetables, avocados, berries (raspberries, blackberries, strawberries), bananas, lemons, grapefruit, apples, dried apricots, sesame seeds, and wheat germ.Also rich in magnesium are dairy products, nuts, sunflower seeds, gelatin, soy and buckwheat honey. Other sources of magnesium are fish such as sea bass, herring, cod, mackerel, carp, flounder and shrimp.

Since we found out which foods contain magnesium, now it’s up to you! Adjust your diet by introducing the daily intake of cereals and grains, dairy products, nuts, as well as vegetables and fish. If the above symptoms of magnesium deficiency appear, then run to the therapist! In the meantime, to anticipate the problem – eat right, enrich your diet with foods containing magnesium, do not overuse coffee and learn

resist stressful situations!
Polymed Medical Center offers the widest range of analyzes, including magnesium analysis.
Detailed information by phone: +375 (29) 388-30-30 or +375 (33) 388-60-70

Perga – description of the ingredient, instructions for use, indications and contraindications

Description of bee bread

Perga is a beekeeping product made from pollen preserved with a honey-enzymatic composition. Insects collect pollen as a backup food source for the winter. Arriving in the hive, the bee cleans off the adhering pollen from the hairs on its body, folds it into honeycombs, covers it on top with honey, and then wax.Bee saliva is used as an enzyme. In order for the product to begin to ferment, insects will have to create special conditions: to completely isolate it from oxygen.

Both in structure and in taste, bee bread is similar to sweet bread made from rye flour with honey. Therefore, it is called “bee bread”.

Composition of bee bread

The unique chemical composition of bee bread has led to its use in preventive, stimulating and restorative therapy. The product contains 16 amino acids, carotenoids, fructose, sucrose, glucose and 13 fatty acids, including omega-3 and omega-6. The mineral complex is represented by magnesium, iron, phosphorus, zinc, potassium, manganese. Vitamin – B₁, B₂, B₃, B₆, K, C, P, D.

Pharmacological properties

Perga strengthens the immune system, reduces the risk of colds, increases the supply of physical and mental resources, significantly improving the general condition of the body and well-being.

A beekeeping product is good for the heart and blood vessels. It stimulates the myocardium, lowers cholesterol levels, increases the concentration of red blood cells in the blood, prevents the development of anemia and arrhythmias and eliminates vasospasm.Aspartic acid and magnesium normalize metabolic processes in the heart muscle. Retinol, zinc, arginine and lysine prevent the progression of atherosclerosis.

The benefits of bee bread for the digestive system are manifested in improving appetite, accelerating metabolism, normalizing intestinal microflora, stimulating the secretion and outflow of bile. It has a beneficial effect on the liver, cleansing it of toxins and helping to restore damaged cells.

The product is used as an adjuvant in the treatment of influenza, tonsillitis, bronchitis.It normalizes nervous activity, stimulates brain activity, promotes tissue regeneration, suppresses inflammatory processes, and improves memory.

Attention! For women, bee bread is useful in that it restores the menstrual cycle, increases the chances of conception, and eliminates the symptoms of toxicosis. In men, with its regular use, the composition of the seminal fluid improves, the vitality of spermatozoa increases, erectile function improves, and libido increases.

Perga prevents premature aging. Its antioxidants stimulate collagen synthesis and deactivate free radicals that destroy cells.

Contraindications and side effects

The powerful stimulating properties of bee bread make it illegal for people with serious illnesses. Restrictions can be removed by a doctor.

Application rules and standards

Perga dissolve in the mouth like a lollipop without drinking. Since it has strong stimulant properties, it should not be consumed in the evening and at night.

The optimal dosage of the product for prophylaxis is 10-15 g. You can take it in 1 tsp. half an hour before meals three times a day. For treatment, use 15-30 g of bee bread: 1 tbsp. l. 30 minutes before meals three times a day.

Attention! Add honey to extend the shelf life of bee pollen and improve its taste at the same time.

The optimal duration of the treatment course is 3 weeks.