Magnesium Health Article

Dietary supplements

Naturopaths generally recommend supplemental magnesium for people with high blood cholesterol, post-menopausal women, women taking birth control pills, diabetics, people who eat a lot of fast food or other highly processed food, and people who drink alcohol. Many nutrition experts recommend supplements that contain a balanced ratio of calcium to magnesium, usually two parts of calcium to one of magnesium. People who increase their calcium intake should increase their dose of magnesium (and phosphate) as well, because they work together and complement each other.

Some naturopaths recommend taking magnesium in the form of an aspartate or a citrate, arguing that these compounds are more easily absorbed by the body than magnesium carbonate or magnesium oxide. Others prefer magnesium chelated (combined with a metallic ion) with amino acids. Magnesium can also be obtained from herbal sources, such as red raspberries.

Standard medical preparations

Magnesium hydroxide is a common over-the-counter antacid, available as either a tablet or liquid. Most antacid tablets contain about 200 mg of magnesium hydroxide; liquid magnesium hydroxide is sometimes called milk of magnesia. Magnesium carbonate works as a cathartic or laxative when combined with citric acid to produce magnesium citrate; it is often flavored with lemon or cherry to make it more pleasant to swallow. Magnesium sulfate (in the form of Epsom salts) is available over the counter, usually in half-pound or pound boxes. Epsom salts are small whitish or colorless crystals that dissolve easily in water and have a bitter or salty taste.

Magnesium for intravenous dosage is prepared as a sulfate in a 50% solution. In general, intravenous administration of magnesium is reserved for patients with such serious symptoms as seizures, preeclampsia or eclampsia of pregnancy, acute asthma attacks, or severe cardiac arrhythmias. Magnesium sulfate can also be given by intramuscular injection.

Precautions

Preparations containing magnesium should not be given as laxatives to patients with kidney disease, nausea and vomiting, diarrhea, abdominal pain, rectal bleeding, symptoms of appendicitis, or symptoms of intestinal obstruction or perforation. In addition, these preparations should not be used routinely to relieve constipation, as the patient may become dehydrated, lose calcium from the body, or develop a dependence on them. Antacids containing magnesium should be used with caution in patients with kidney disease.

Side effects

Magnesium preparations taken internally may cause hypermagnesemia, especially with prolonged use; electrolyte imbalance; and abdominal cramps when taken as a laxative. Milk of magnesia occasionally produces nausea or diarrhea. There are no known side effects of Epsom salts when used externally.

Interactions

Milk of magnesia will decrease the patient's absorption of chlordiazepoxide, digoxin, isoniazid, quinolones, or tetracycline antibiotics. Because it increases the gastrointestinal tract's mobility, magnesium can also decrease the absorption (and thereby the effectiveness) of many other drugs and supplements as well. Magnesium sulfate, if given intravenously, is incompatible with calcium gluceptate, clindamycin, dobutamine, polymyxin B sulfate, procaine, and sodium bicarbonate.

BOOKS

Baron, Robert B., MD, MS. "Nutrition." In Current Medical Diagnosis & Treatment 2000. Edited by Lawrence M. Tierney, Jr., MD, et al. New York: Lange Medical Books/McGraw-Hill, 2000.

Beers, Mark H., MD, and Robert Berkow, MD, eds. The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck Research Laboratories, 1999.

Burton Goldberg Group. Alternative Medicine: The Definitive Guide. Fife, WA: Future Medicine Publishing, Inc., 1995.

Murray, Michael, ND, and Joseph Pizzorno, ND. Encyclopedia of Natural Medicine. Rocklin, CA: Prima Publishing, 1991.

Okuda, Toshihiro, MD, PhD, Kiyoshi Kurokawa, MD, MACP, and Maxine A. Papadakis, MD. "Fluid & Electrolyte Disorders." In Current Medical Diagnosis and Treatment 2000, edited by Lawrence M. Tierney, Jr., MD et al. New York: Lange Medical Books/McGraw-Hill, 2000.

Russell, Percy J., and Anita Williams. The Nutrition and Health Dictionary. New York: Chapman & Hall, 1995.

PERIODICALS

"Help for Eclampsia." American Medical News (June 17, 2002): 32.

ORGANIZATIONS

American Association of Naturopathic Physicians. P. O. Box 20386. Seattle, WA 98112.

Committee on the Scientific Evaluation of Dietary Reference Intakes. Institute of Medicine (1997) Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: National Academy Press, 1997.

Homeopathic Pharmacopoeia of the United States. P. O. Box 2221. Southeastern, PA 19399-2221. (610) 783-5124. Fax: (610) 783-5180. Publishes and distributes the Homeopathic Pharmacopoeia of the U.S., which defines the contents of homeopathic remedies and other preparations.

Rebecca J. Frey, PhD

Teresa G. Odle