MAGNESIUM

Less than half of the American adult population consumes adequate magnesium in the diet. 

Standard laboratory ranges are set too low.  Levels < 2.0mg/dL have been associated with increased cardiovascular risk such as sudden death. 

Benefit – Magnesium is the cofactor of at least 600 enzymatic reactions and the activator of another 200 enzymatic reactions in the human body.  It is essential for heart electrical function, metabolism and optimum nervous system function.  

Hypomagnesemia (low magnesium) can be attributed to alcohol abuse, gastrointestinal losses during diarrhea or chronic loose stools, kidney losses, and other conditions.  

Certain medications may cause hypomagnesemia such as:  proton pump inhibitors – Nexium (esomeprazole magnesium), Dexilant (dexlansoprazole), Prilosec (omeprazole), Zegerid (omeprazole and sodium bicarbonate), Prevacid (lansoprazole), Protonix (pantoprazole sodium), and AcipHex (rabeprazole sodium). Vimovo is a prescription combination drug product that contains a PPI (esomeprazole magnesium and naproxen). Over-the-counter (OTC) PPIs include Prilosec OTC (omeprazole), Zegerid OTC (omeprazole and sodium bicarbonate), and Prevacid 24HR (lansoprazole). 

Diuretics such as hydrochlorothiazide (HCTZ) and others produce hypomagnesemia in ⅓ of the patients taking them.

Sudden Cardiac Death–  the degree of low magnesium is directly related to the risk of sudden cardiac death. 

Hypertension – supplementation with oral magnesium 300 – 600 mg/day may have modest reductions in systolic blood pressure.

Hypomagnesemia – oral magnesium supplementation should be able to correct serum magnesium into the optimal range of 2.25 -2.5 mg/dL given that there are no underlying conditions such as chronic diarrhea, malabsorption or kidney wasting (particularly in the setting of diuretics).  Work closely with your health care provider to monitor your levels. 

Quality/Safety – The products listed below have been tested for contamination and have been shown to have the same amount as listed on the label by independent labs that have no financial ties to the manufacturer.   Excessive magnesium intake can cause diarrhea.  

How much should you take?  A safe dose for most people without lab monitoring is 300 mg daily.  In my practice I check serum magnesium in all my patients at least once/year and aim for a level of 2.25 – 2.5 mg/dL.  You should work closely with your health professional to monitor and determine the correct dose for you.