_agnesium _atters - Part 3 by Doorless Carp

Where is that missing Mg in medical treatment?

Doorless Carp has lots more to share on the wonders of _agnesium and wonders why M seems to be a missing letter in many pharma Journals. *me paraphrasing, not exact. Go see for yourself (Substack)

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I was recently writing about magnesium, and this reference makes my point - low magnesium levels will cause a complimentary drop in calcium and potassium levels. Giving the person more calcium isn’t the need however - it is the magnesium and maybe the potassium too. The average diet tends to be low in both and may be low in calcium too if dairy products aren’t used.

The body will control the level of electrolytes within the blood to keep them in balance with each other. If one is lacking in the diet, then others may be kept low in the blood serum even though the diet has enough of those minerals.

In a study on patients with acute renal failure treatment with magnesium and potassium to correct low serum levels helped correct the low serum calcium levels too. It also improved symptoms of irritability, agitation, tingling in the fingers or toes, dizziness, and muscle weakness causing difficulty with speaking. Why isn’t that the standard of care then?

This research article which asks that question or suggests that approach for treatment is published in the Indian Journal of Nephrology. Nephrologists do tend to understand electrolytes the best of any medical specialty from what I’ve read - my own opinion.

Hypomagnesemia was observed in 31 patients out of 50 during the recovery period of acute renal failure with symptomatic hypomagnesemia being seen in 23 patients. Serum magnesium levels on the day of admission and during the recovery phase were 2.11 ± 0.38 mg/dL and 1.64 ± 0.41 mg/dL respectively.

Symptoms seen in patients with low magnesium included:

• Paresthesia [pins and needles like tingling in the fingers or toes],

• irritability,

• agitation,

• dysartharia [difficulty speaking due to weak muscles needed for speech; alt. spelling],

• vertigo [dizziness],

• and associated hypokalemia [low serum potassium]

• and hypocalcemia [low serum calcium]

…were noted in symptomatic hypomagnesemic patients.

Treatment of the low magnesium and potassium levels improved all of the symptoms seen in the patients with acute renal failure — including the low calcium levels.

Treatment of hypomagnesaemia and hypokalemia ameliorated the symptoms. […]

In conclusion, hypokalemia and hypocalcemia were commonly seen with hypomagnesemia in recovering ARF patients in our study. Treating hypomagnesemia and associated electrolyte abnormalities ameliorated the symptoms. (Satish and Gokulnath, 2008)

Doorless Carp has lots more to share on the wonders of _agnesium and wonders why M seems to be a missing letter in many pharma Journals. *me paraphrasing, not exact. Go see for yourself (Substack)

Magnesium deficiency and associated pathologies: Part 3

From one of the links shared by Doorless Carp, we learn that increased intake of calcium can be a factor in low magnesium. This passage fails to note that magnesium deficiency can also be a causal factor of insulin resistance and Type 2 diabetes.

“An estimated 10% of older adults have a low plasma Mg level and 20% of them have a low concentration of erythrocyte Mg [14]. There are a few possible reasons for Mg deficiency in the elderly.

1. First, the intestinal absorption of Mg decreases with age [15].

2. Second, Mg deficiency is often observed in patients with type 2 diabetes mellitus (T2DM) or those taking diuretics, the anti-hypertension medication [16]. Two conditions often occurring in the elderly.

3. Finally, the Mg deficit is further intensified by an increased intake of calcium which is advised for osteoporosis prevention [17]. Low Mg, together with excessive calcium, predisposes an individual to cardiovascular diseases.

Not surprisingly, there is a growing body of evidence to indicate a link between a Mg deficiency and a plethora of age-related diseases, including OA [18,19], osteoporosis [20], metabolic syndrome (MetS) [21,22], stroke, cognitive impairment [23] as well as hypertension and T2DM [16]. (Kuang, Chiou, Lo, Wen, 2021)

To bypass point #1, I recommend topical soaks or products with Magnesium sulfate (Epsom salt) or Magnesium chloride salt flakes.

Point #2 means recognizing when increased urinary loss may be a factor, having diabetes and/or high blood sugar for whatever reason will increase urine output and that leads to increased loss of magnesium. That low magnesium may also precede the Type 2 diabetes is an additional point.

Pont #3 means we need to consider the overall balance of magnesium and calcium in our diet. A corollary I would add — and phosphorus levels play a factor in overall health, bone and tooth mineralization, and affects our calcium levels.

There is a paywall, so read more about that article in Part 3 of Doorless Carp’s novelette/novella on _agnesium. Perhaps a _agnum opus? (doorlesscarp.Substack)

“Magnesium means illness and death - of your cash flow model.” - Doorless Carp

Photo by kazuend on Unsplash

A caution — excess of magnesium, may add to arthritis risk in women too, possibly be effects on estrogen levels. (Hu, et al., 2020) Low magnesium definitely adds to the risk though as magnesium is needed to promote mesenchymal stem cells which could become bone cells or other cell types in the body. (Kuang, Chiou, Lo, Wen, 2021)

So why does a major arthritis patient support website have zero entries for ‘magnesium’ on its website? (versusarthritis.org/search?query=magnesium)

I can play that game too - US nonprofit Arthritis Foundation arthritis.org/search/results?query=magnesium I got an encouraging 26 results, however, on taking a closer look one is “Calcium Needs for People with Arthritis”. Zero are “Magnesium Needs for People with Arthritis”.

Others we could read:

• Alkaline Water - Miracle or Marketing? (arthritis.org) My betting money would guess their answer is “Marketing!” The article did suggest it might be expensive but likely not dangerous and might help some digestive symptoms and would be safer than taking PPIs - but diet improvement was the best choice in the study example.

• Naproxen and esomeprazole magnesium - Category: Drug, class NSAIDs. (arthritis.org) *the article never mentions the magnesium, it must be part of the tablet with the 20 mg of esomeprazole.

• Risks from Common Heartburn Drugs - “Proton pump inhibitors linked to fractures, infections, dementia and other health problems.” (arthritis.org/health-wellness/treatment/treatment-plan/disease-management/proton-pump-inhibitor-medication-risks)

The PPI article does include the word magnesium once but in an incidental way - suppressing stomach acid is bad because it might lead to reduced calcium and magnesium absorption (which I don’t think sounds correct - that is true of B vitamin absorption but minerals are absorbed later), rather than correctly explaining any of the disturbing research findings about PPIs. This article tells us about disturbing conditions that seem linked to PPIs but overall is fairly positive in tone ‘PPIs can really help people who need them but there may be some severe risks.’ Never does it bring up the government warning about a severe risk for magnesium deficiency (2011) - or that magnesium deficiency can be causal of the observed risks. Only stopping use of the PPI medication was able to reverse magnesium deficiency in a sizeable percent of people using PPIs. There seems to be a genetic susceptibility for that severe of magnesium loss. See this post - I had saved a copy: (denutrients/p/original-prilosec-warning-edited)

Vitamin and Mineral Guide for Arthritis - this one is doozy. Right at the top we learn that Calcium is really important for arthritis and while 1200 mg is the standard recommendation, 1500 mg might be needed for arthritis. The upper tolerable limit is 2500 mg. …………Farther down on the page we learn that magnesium deficiency is rare.

“What it does: 

• Magnesium strengthens bones [more flexible, less brittle and less fracture prone and needed to promote bone cell differentiation];

• maintains nerve and muscle function [lack of it and/or low B12 can cause the tingling or pain and numbness in fingertips and magnesium is needed to relax muscles. Deficiency will lead to muscle cramps and tension or migraine headaches];

• regulates heart rhythm and blood sugar levels [low magnesium is linked to arrhythmia and insulin resistance and Metabolic Syndrome and blood vessel plaques];

• and helps maintain joint cartilage. (20 words)

Let’s compare that blurb about the role of magnesium in arthritis with what they wrote about calcium: “Calcium is an essential mineral that maintains strong bones and teeth; regulates muscle contractions; transmits nerve impulses; and helps release essential hormones and enzymes. It also helps prevent osteoporosis (loss of bone density) and fractures, which are higher risks among people with rheumatoid arthritis (RA) and those taking corticosteroids.” (48 words) That blurb makes it seem like calcium, and lots of it, are all you need for strong bones - calcium does it all by itself, no vitamin D, K2, or magnesium needed! The article goes on to recommend 1500 mg for arthritis - an increased need for it above 1200 mg, and 2500 mg is the safe limit, so nothing to worry about from taking a mere 1500 mg.

We do seem to need more calcium than magnesium, but the safe ratio is closer to one than to three 1200/400 = 3.

A ratio of 800/500 = 1.6. That is not based on any one specific national goal, but just realize that not all nation’s replicate the US dietary recommendations, although the US is often used as a mode.

Magnesium blurb continued:

How much: Recommended dietary allowance (RDA) = 420 milligrams (mg) daily for men 31 and older; 320 mg for women. For best absorption, choose magnesium orotate, oxide or citrate. 

• [*Magnesium oxide is one of the least well-absorbed forms; orotate and citrate are better absorbed forms that are less likely to cause diarrhea.)

Too much: Tolerable upper limit (UL) = 350 mg. 

• [A sensible person might ask how the tolerable upper limit could be lower than the recommended amount for men age 31 and older. At least I asked that question and looked into how the guidelines were set - it was based on estimates/guesses for which more research was supposed to have happened later, and the fact that magnesium oxide type supplements do tend to cause watery stools / diarrhea but more watery and all day.]

Too little: Rare, but early symptoms include loss of appetite, nausea, vomiting, fatigue and weakness.”

• [Those are more likely symptoms of acute magnesium deficiency when the blood serum level of magnesium is low. This can occur after sweating a lot and may be related to pre-CoV era sudden deaths by athletes or student athletes. Or a heart attack after spending a weekend retreat where sweat lodges and little normal food were part of the program.]

Sixteen of the search results on the Arthritis Foundation website for “magnesium” were either recipes, or were about a diet type (Mediterranean) or a chef’s favorite, or ‘The top five or ten foods for arthritis’.

The recipes may all have similar blurbs as this one: “Beans are an excellent source of fiber and protein, which can help lower c-reactive protein (CRP), a measure of inflammation levels in the blood. They’re also rich in folic acid, magnesium, iron, zinc and potassium, which is good for heart health and immunity.” (arthritis.org/black-bean-salad-with-quinoa) *Beans are a natural food which makes them a source of folate, not a source of synthetic folic acid.

An article on Water Therapy mentions adding Epsom salt to your pain relieving bath - and that indeed might help. (arthritis.org)

The take home point might be that “patient support” websites and non-profit organizations are frequently just a front for a pharma funded entity that has a goal of promoting pharmaceuticals in a positive light and not providing much information about alternatives or may not present them fairly.

That depressed me, I should go back to Doorless Carp’s article, or get some sunshine.

Photo by Mark Koch on Unsplash

Disclaimer: This information is being provided for educational purposes within the guidelines of Fair Use and is not intended to provide individual health care guidance. However, Magnesium matters!

References

(Hu, et al., 2020) Hu C, Zhu F, Liu L, Zhang M, Chen G. Relationship between dietary magnesium intake and rheumatoid arthritis in US women: a cross-sectional study. BMJ Open. 2020 Nov 9;10(11):e039640. doi: 10.1136/bmjopen-2020-039640. PMID: 33168559; PMCID: PMC7654130. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7654130/

(Kuang, Chiou, Lo, Wen, 2021) Kuang, X., Chiou, J., Lo, K., Wen, C., Magnesium in joint health and osteoarthritis, Nutrition Research, Vol 90, 2021, pp 24-35, ISSN 0271-5317, https://doi.org/10.1016/j.nutres.2021.03.002. https://www.sciencedirect.com/science/article/pii/S0271531721000142

(Satish and Gokulnath, 2008) Satish R, Gokulnath G. Serum magnesium in recovering acute renal failure. Indian J Nephrol. 2008 Jul;18(3):101-4. doi: 10.4103/0971-4065.43688. PMID: 20142914; PMCID: PMC2813135. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2813135/