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Clinician’s Corner: MAGNESIUM


We’re all done with the vitamins, now time to start discussing the minerals, starting with magnesium. We all know that potassium gets most of the attention when we think of diuretic use, but magnesium is becoming equally important.  Magnesium is also important for:

  • managing bone metabolism
  • nerve transmission, cardiac excitability, neuromuscular conduction, muscular contraction, vasomotor tone, and blood pressure
  • Insulin and glucose metabolism

Sources of magnesium

  • Food sources of magnesium include green leafy vegetables, nuts, legumes, and whole grains
  • 50% stored in bone, the other half in soft tissues, less than 1% in blood.

Uses for magnesium

  • Intravenous magnesium is used for treatment of rhythm disturbances of the heart.
  • Treatment of high blood pressure of pregnancy
  • Headache: cluster and migraine sufferers generally have low magnesium levels..
  • Severe asthma exacerbations
  • Constipation- Citroma and Milk of Magnesia are examples.

Patients most susceptible to magnesium deficiency:

  • Patients with diabetes: will have lower magnesium levels due to the diuresis caused by high urine glucose levels. Low magnesium levels might worsen insulin resistance.
  • Patients with alcoholism (30%) substitute alcohol for food as well as malabsorption syndrome
  • Potent diuretic therapy, especially loop diuretics like Lasix, will wash out magnesium.
  • Chronic diarrhea
  • Proton pump inhibitors (omeprazole, pantoprazole etc.) if used over a year, especially if on diuretic therapy.

Rx Treatment:

Drug Interactions: Magnesium can greatly reduce the absorption of tetracyclines, fluoroquinolones (Cipro, Levaquin), and most important Levothyroxine (Synthroid).  Be sure to separate by 4 hours.

Sustained-release preparations (Slow-Mag) have the advantage that they are slowly absorbed and thereby minimize excretion by the kidney of the administered magnesium.

Your Thompson Pharmacist is a great resource when you need help selecting any vitamin or mineral supplement like magnesium. Go Ahead and ASK… at Thompson Pharmacy it’s all for YOU!