Supplements

Magnesium

Magnesium is essential to many metabolic reactions, including lipid metabolism, amino acid activation, the glycolytic cycle, and the citric acid cycle. Its primary function is as an enzyme cofactor, thus producing energy, synthesizing lipids and proteins, regulating calcium flow and parathyroid hormone (PTH) secretion, forming urea, and relaxing muscles. Vitamin B6 works with magnesium in many enzyme systems and assists in the body's accumulation of magnesium.

Magnesium is necessary to prevent the calcification of soft tissue. This essential mineral protects the arterial linings from stress caused by sudden blood pressure changes, and plays a role in the formation of bone and in carbohydrate and mineral metabolism.

A person with high blood pressure typically will have a lower level of the mineral compared with somebody who has a healthier blood pressure reading. Magnesium supplements work like a natural calcium channel blocker, another standard antihypertension drug, but without ill effects. Symptoms such as excess insulin in the blood, low potassium levels, and constricted blood vessels, are all addressed simultaneously by Magnesium.

The use of magnesium supplements can help in the prevention of cardiovascular disease by doing the following:

• Irregular heart rhythms become more stable.
• High blood pressure improves.
• The body keeps a better balance of potassium, another important cardiovascular mineral.
• The heart pumps a larger volume of blood with no extra demand for oxygen.
• Constricted blood vessels relax, allowing blood to flow more freely.
• The chest pains of angina pectoris strike less frequently.
• By not allowing platelets to clump together, the blood becomes less likely to form
  artery-blocking clots.
• HDL cholesterol rises and LDL cholesterol falls.

The metabolism of sugar is linked to magnesium, making the mineral essential to anyone with diabetes or insulin resistance. Poor sugar control raises the risk of magnesium deficiency, which then impairs sugar metabolism.

Persons with Type II diabetes can regulate blood sugar more easily. As a result their need for oral diabetes drugs usually diminishes and could disappear altogether. Persons with hypoglycemia, too, can stabilize the rise and fall of their blood sugar.

For pregnant women, magnesium supplements can frequently overcome several serious blood pressure disorders. Magnesium is the treatment of choice for preeclampsia, a common complication seen in the latter part of the pregnancy that raises blood pressure and causes water retention, and can lead to coma. Some 60 percent of all such hypertension-related complications could be avoided, researchers estimate, if pregnant women were to take supplements.

Mitral Valve Prolapes, which involves a weakness of a valve in the heart, increases magnesium excretion. Resupplying the mineral helps to correct low blood sugar, one of the main problems linked to mitral valve prolapes, and counteracts fatigue, which probably is the most frequently encountered symptom.

Taking magnesium orally is a good preventive for migraine sufferers. People who enjoy the most prolonged relief from migraines are usually those with the lowest blood levels of the mineral (magnesium).

Magnesium is an effective treatment for the muscle and joint pain related to Fibromyalgia. 300-600 mg, can help those suffering from chronic fatigue syndrome. It's especially powerful when combined with 1-2 grams of malic acid.

Magnesium readings are markedly lower than average in people who have multiple sclerosis, Parkinson's, and Alzheimer's or other types of dementia. Many of them have unusually high amounts of aluminum in their brains, and the metal is known to interfere with magnesium.

Magnesium is a key nutrient for preventing osteoporosis since it balances the body's calcium supply and keeps it from being excreted. Some scientists go so far as to say that the amount of magnesium we eat is a stronger predictor of bone density than calcium consumption. Without enough magnesium and other trace minerals, any additional calcium we ingest will be deposited not around our bones, but elsewhere, perhaps in the walls of our arteries.

Muscle growth and strength, especially from a weight-training program, depends on magnesium.

Magnesium supplements can help tame premenstrual migraines and yeast infections.

For better sleep magnesium, should be a part of any nutrient program. In addition to encouraging more restful sleep it works against bruxism, an involuntary grinding of the teeth while asleep.

The additional benefits of magnesium supplementation: help against chemical sensitivities, bacterial and viral infections, leg cramps, kidney stones, and intermittent claudication, an impairment in blood flow to the legs that causes pain upon exertion.

• Supplementary magnesium is available in several varieties of salts.
• Magnesium citrate, magnesium gluconate, and magnesium lactate are more soluble and bioavailable than magnesium oxide.
• Magnesium chloride is more soluble than magnesium oxide, gluconate, citrate, hydroxide, and sulfate, and does not require stomach acid for solubility, but its use is limited due to its hygroscopic properties.
• Magnesium hydroxide (milk of magnesia)
• Magnesium sulfate (Epsom salts)

Deficiency: Risk factors for depletion include gastrointestinal disorders, such as inflammatory bowel disease, pancreatitis, fatty acid malabsorption, ileal dysfunction, and gastrointestinal infections (viral, bacterial, or protozoan) that result in malabsorption or vomiting and diarrhea; renal dysfunction with excessive urine loss; nephrotoxic and diuretic drugs; and endocrine disorders, such as hyperthyroidism, diabetes mellitus, and hyperparathyroidism with hypercalcemia.

Depleting Agents: The consumption of alcohol, the use of diuretics, diarrhea, the presence of fluoride, and high levels of zinc and vitamin D all increase the body's need for magnesium.

The consumption of large amounts of fats, cod liver oil, calcium, vitamin D, and protein decrease magnesium absorption. Fat-soluble vitamins also hinder the absorption of magnesium, as do foods high is oxalic acid, such as almonds, chard, cocoa, rhubarb, spinach, and tea.

Sources: Rich sources: tofu, legumes, whole grains, green leafy vegetables, wheat bran, Brazil nuts, soybean flour, almonds, cashews, blackstrap molasses, pumpkin and squash seeds, pine nuts, black walnuts. Good sources: peanuts, whole wheat flour, oat flour, beet greens, spinach, pistachio nuts, shredded wheat, bran cereals, oatmeal, bananas, baked potatoes (with skin).

Herb Sources: Many herbs, spices, and seaweeds supply magnesium (e.g., agar seaweed, coriander, dill weed, celery seed, sage, dried mustard, basil, cocoa powder, fennel seed, savory, cumin seed, tarragon, marjoram, poppy seed).

Precautions: Individuals with severe heart disease (such as high-grade atrioventricular block) should take magnesium only on the advice of their physician.

Individuals with kidney disease should not take more than 3,000 mg per day.

Overuse of magnesium hydroxide (milk of magnesia) as a laxative or antacid, or magnesium sulfate (Epsom salts) as a laxative and tonic, may cause deficiencies of other minerals or lead to toxicity.

Dosage Ranges and Duration of Administration: Recommendations for adequate magnesium intake promulgated by the Food and Nutrition Board of the Institute of Medicine in 1997:

Infants:

• Birth to 6 months: 30 mg/day
• 6 months to 1 year: 75 mg/day

Children:

• 1 to 3 years: 80 mg/day
• 4 to 8 years: 130 mg/day
• 9 to 13 years: 240 mg/day

Adolescents:

• 14 to 18 years (boys): 410 mg/day
• 14 to 18 years (girls): 360 mg/day

Adults:

• 19 to 30 years (men): 400 mg/day
• 19 to 30 years (women): 310 mg/day
• 31+ years (men): 420 mg/day
• 31+ years (women): 320 mg/day

Pregnant women:

• Up to 18 years: 400 mg/day
• 19 to 30 years: 350 mg/day
• 31 to 50 years: 360 mg/day

Lactating women:

• Up to 18 years: 360 mg/day
• 19 to 30 years: 310 mg/day
• 31 to 50 years: 320 mg/day

These represent significant increases for adolescents and adults from the recommended dietary allowance promulgated by the National Academy of Sciences in 1989. Supplementation should be in small doses three to six times throughout the day with a full glass of water to reduce chance of diarrhea.

INTERACTIONS

Alendronate; Tiludronate
Magnesium salts or magnesium-containing antacids interfere with absorption of tiludronate, a bisphosphonate drug similar to alendronate. This interaction has not been reported with alendronate. However, calcium and other minerals should be taken at least two hours before or after alendronate administration to minimize interference with the absorption of the drug.

Calcium Channel Blockers
Magnesium sulfate may interact with calcium channel blockers and decrease cardiac function, particularly in pregnant women. However, another report indicates that using magnesium-enriched salt as a substitute for sodium enhances the cardiovascular effects derived from the combination of low dose felodipine and ramipril in rats.

Digoxin
Hypomagnesemia increases the risk of cardiac glycoside toxicity. Digoxin decreases the reabsorption of magnesium from the kidneys, which leads to increased excretion in the urine. However, adequate amounts of magnesium enhance the antiarrhythmic activity of this drug, particularly by diminishing the ventricular response during atrial fibrillation. One case report describes a patient with digoxin toxicity associated with ventricular tachycardia. Treatment with magnesium sulfate (two doses of 10 mmol IV) resulted in a more stable junctional rhythm. Normal magnesium levels should be maintained during digoxin treatment.

Estrogens; Progestins
In a controlled clinical study with 25 healthy women at or past menopause and 15 healthy women of child-bearing age, serum levels of magnesium were inversely related to the serum level of estrogen in both groups. Another group of postmenopausal women treated with conjugated estrogens and medroxyprogesterone for one year had reduced urinary excretion of zinc and magnesium. The clinical significance of this interaction is unknown.

Glipizide; Glyburide
Concomitant ingestion of magnesium hydroxide with both glipizide and glyburide has been shown to increase the rate and extent of absorption of these medications. The faster rate of absorption may result in increased early insulin and glucose responses. This effect was observed with magnesium hydroxide antacids, not dietary supplements.

Insulin Preparations
Supplementation with magnesium in patients with type II diabetes mellitus enhances insulin sensitivity and secretion. In rats predisposed to type II diabetes, supplementation with oral magnesium diminished the progression of the disease.

Nitrofurantoin
Magnesium salts decrease the rate and extent of absorption of nitrofurantoin. It is not known if dietary supplements containing magnesium will have a similar effect on nitrofurantoin absorption.

Penicillamine
Penicillamine can inactivate magnesium, particularly when high doses are used over a long period of time. However, supplementation with magnesium and other nutrients in over 50 patients on penicillamine therapy for the treatment of autoimmune disorders resulted in fewer adverse reactions than those commonly experienced in patients treated with the drug alone.

Quinolone Antibiotics
Quinolone antibiotics form chelates with metal cations, such as aluminum, magnesium, calcium, iron, zinc, copper, and manganese, which significantly reduces the absorption of these medications. Dietary supplements and antacids containing aluminum and magnesium should be taken two to four hours before or after administration of these antibiotics.

Tetracycline Derivatives
Tetracyclines form chelates with divalent and trivalent cations, including iron, aluminum, magnesium, and calcium. It has been reported that these chelates are poorly soluble and can significantly reduce the absorption and efficacy of tetracyclines. However, one study reports that magnesium-tetracycline complexes may be more bioavailable than uncomplexed tetracycline due to a higher degree of membrane diffusion.