Without enough magnesium, these areas malfunction. This is summarized in research, which finds that a magnesium deficiency or low magnesium diet leads to health problems.

Although epidemiological studies show that higher magnesium diets are associated with lower rates of disease, results are mixed from clinical trials showing that magnesium supplementation can correct these conditions. It may be because a magnesium-rich diet is often higher in other nutrients, which collectively work together in disease prevention as opposed to a supplement containing a single nutrient.

For disease prevention, a good rule of thumb is to eat a daily diet that includes some magnesium-rich foods and take a supplement if directed by a physician to correct a deficiency if blood levels are low.

It is also involved with the activity of bone-building cells and the parathyroid hormone, which regulates calcium levels. Population studies have found an association of greater bone mineral density in men and women with higher magnesium diets.

More research is needed to see if and how much of a supplement can reduce fracture risk. Magnesium is sometimes prescribed as a complementary treatment for migraine headaches, as clinical studies have found low magnesium levels in people suffering from this condition.

The study found the magnesium to be more effective and faster-acting than the typical treatment. This was a one-time administration in an acute setting, so studies with longer follow-up are needed to confirm this benefit.

The National Headache Foundation suggests a daily dose of mg of magnesium to reduce the frequency of migraine attacks; however because this is greater than the RDA, it may lead to side effects e. They recommend discussing the use of high-dosage magnesium supplements with a physician.

Magnesium assists with neurological pathways that, when not functioning correctly, are believed to lead to mood disorders like depression and anxiety.

Several observational studies have linked lower magnesium levels with increased depression. The trials also tended to have a small number of participants with a short duration, ranging from weeks. Longer trials with standardized depression rating scales are needed to better assess this connection.

High blood pressure is a risk factor for cardiovascular disease CVD , and magnesium helps to regulate blood pressure. Studies have shown an association with magnesium deficiency and high blood pressure.

However, the results of clinical studies are mixed on using magnesium supplements to lower blood pressure. Epidemiological studies have found an association of the DASH diet including magnesium-rich fruits, vegetables, and low-fat dairy products with decreased blood pressure, but DASH is also rich in potassium and calcium that may lower blood pressure, so it is not clear if magnesium or a combination of nutrients is protective.

However, the FDA has concluded that the evidence is inconsistent and inconclusive. Magnesium assists enzymes that regulate blood sugar and insulin activity.

Prospective cohort studies show an association of diets low in magnesium with an increased risk of type 2 diabetes. Results are also mixed on the effectiveness of supplements in improving overall blood sugar control.

Part of the reason may be differences in the study design of these clinical trials. The American Diabetes Association reports a lack of evidence at this time to recommend magnesium supplements to improve blood sugar control in people with diabetes.

Magnesium is found in plant foods like legumes, dark green leafy vegetables, nuts , seeds, whole grains , and fortified cereals. It is also in fish, poultry, and beef. A magnesium supplement may be prescribed if the body is having problems absorbing the nutrient. Over-the-counter magnesium supplements come in different forms; liquid types like magnesium citrate or chloride may be better absorbed than solid tablets like magnesium oxide and sulfate.

Magnesium can have a laxative effect at high doses; in fact, it is sold as a laxative in the form of magnesium hydroxide. Magnesium hydroxide is also an ingredient in some popular antacids to treat heartburn and upset stomach; it is important to be aware of the laxative effect when using magnesium hydroxide tablets for an upset stomach.

Research from the National Health and Nutrition Examination Survey NHANES data show that higher intakes of magnesium from food or supplements is associated with significantly reduced risks of vitamin D deficiency.

Although magnesium is naturally found in a variety of foods and some fortified foods, some research suggests that magnesium levels may be lower in soils than in prior years, and food processing can reduce magnesium content from plant foods containing the mineral.

The body also helps to preserve magnesium levels when stores are low by limiting the amount excreted in urine and absorbing more magnesium in the gut. Certain types of magnesium deficiency show a normal blood level. Severe deficiency occurs with a long-term low magnesium diet, malabsorption, and large losses from alcohol abuse or use of medications that deplete magnesium some diuretics, proton pump inhibitors, and antibiotics.

Toxicity is rare from food sources because the kidneys will remove excess magnesium in the urine. However toxic levels may occur with long-term use of high-dosage supplements. People with kidney disease have a higher risk of toxicity because their kidneys are not working properly and cannot flush out extra magnesium.

Magnesium supplements are a popular remedy for leg and foot cramps, a bothersome condition that may jolt you awake in the middle of the night or during exercise. A deficiency of magnesium can certainly cause muscle cramping, but these supplements are often used whether or not people know they are truly deficient.

Evidence so far does not support this treatment for muscle cramps. A Cochrane review of seven randomized controlled trials looking at the effects of magnesium supplements on muscle cramps did not find a significant difference in intensity or duration of cramps in people using the supplements versus a placebo for one month.

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Home Nutrition News What Should I Eat? The post-hoc analysis of a small randomized controlled trial suggested that maintaining magnesium sulfate infusion for 10 days post-aSAH or until signs of vasospasm disappear might protect against secondary cerebral infarction when markers of vasoconstriction and reduced brain perfusion are present 57, Current evidence does not support the use of magnesium supplementation in clinical practice for aSAH patients beyond magnesium status normalization.

Atrial arrhythmia also called atrial fibrillation is a condition defined as the occurrence of persistent heart rate abnormalities; such arrhythmias often complicate the recovery of patients after cardiac surgery.

The use of magnesium in the prophylaxis of postoperative atrial arrhythmia after coronary artery bypass grafting has been evaluated as a sole or adjunctive agent to classical antiarrhythmic molecules namely, β-blockers and amiodarone in several prospective, randomized controlled trials.

A meta-analysis of 21 intervention studies showed that intravenous magnesium infusions could significantly reduce postoperative atrial arrhythmia in treated compared to untreated patients The results of a more recent meta-analysis of 22 placebo -controlled trials suggested that magnesium may effectively reduce atrial arrhythmia when administered post-operatively, as a bolus, and for more than 24 hours However, another meta-analysis of four trials found that magnesium was no more effective than other antiarrhythmic agents Moreover, the meta-analysis of five randomized controlled trials also suggested that intravenous magnesium added to β-blocker treatment did not decrease the risk of atrial arrhythmia compared to β-blocker alone and was associated with more adverse effects bradycardia and hypotension Presently, high-quality evidence is still lacking to support the use of magnesium in the prophylaxis of post-operative atrial fibrillation and other arrhythmias in patients with contraindications to first-line antiarrhythmic agents Public health concerns regarding the epidemics of obesity and type 2 diabetes mellitus and the prominent role of magnesium in glucose metabolism have led scientists to investigate the relationship between magnesium intake and type 2 diabetes mellitus.

However, inclusion of this study in a meta-analysis of eight cohort studies showed that the risk of type 2 diabetes was inversely correlated with magnesium intake Insulin resistance , characterized by alterations in both insulin secretion by the pancreas and insulin action on target tissues, has been linked to inadequate magnesium status.

A cross-sectional analysis of the Cohorts for Heart and Aging Research in Genomic Epidemiology CHARGE consortium, which included 15 cohorts with a total of 52, diabetes-free participants, showed that magnesium intakes were inversely associated with fasting insulin concentrations after multiple adjustments, including various lifestyle factors, body mass index BMI , caffeine intake, and fiber intake It is thought that pancreatic β-cells, which secrete insulin, could become less responsive to changes in insulin sensitivity in magnesium-deficient subjects Other metabolic markers, including serum triglycerides , HDL -cholesterol, and a measure of insulin resistance, also improved in magnesium- versus placebo-treated individuals This latter study suggests that magnesium might have additional effects on glucose tolerance and insulin sensitivity that go beyond the normalization of serum magnesium concentrations in hypomagnesemic individuals.

Although decreased bone mineral density BMD is the primary feature of osteoporosis , other osteoporotic changes in the collagenous matrix and mineral composition of bone may result in bones that are brittle and more susceptible to fracture Magnesium at the surface of bones is also available for dynamic exchange with blood As the magnesium content of bone mineral decreases, hydroxyapatite crystals of bone may become larger and more brittle.

Some studies have found lower magnesium content and larger hydroxyapatite crystals in bones of women with osteoporosis compared to disease-free women Inadequate serum magnesium concentrations are known to result in low serum calcium concentrations, resistance to parathyroid hormone PTH action, and resistance to some of the effects of vitamin D calcitriol , all of which can lead to increased bone loss see the articles on Vitamin D and Calcium.

Lower serum magnesium concentrations may not be unusual in postmenopausal women with osteoporosis 75 , and hypomagnesemia has been reported as an adverse effect of using the prescription drug teriparatide Forteo in the treatment of osteoporosis Higher dietary magnesium intakes have been associated with increased site-specific 77 and total-body BMD 78 in observational studies , including studies of older adults.

More recently, a large cohort study conducted in almost two-thirds of the Norwegian population found the level of magnesium in drinking water to be inversely associated with the risk of hip fracture In a case-cohort study nested within the European Prospective Investigation into Cancer and Nutrition EPIC -Norfolk study, which included 5, individuals, total magnesium and potassium intakes were found to be inversely associated with heel bone calcaneus broadband ultrasound attenuation BUA measurements — which are predictive of the risk of incidental fracture — and with the risk of hip fractures Few studies have addressed the effect of magnesium supplementation on BMD or osteoporosis in humans.

Evidence is not yet sufficient to suggest that supplemental magnesium in excess of the RDA could be effective in the prevention of osteoporosis unless normalization of serum magnesium concentration is required Sarcopenia is a condition characterized by a loss of skeletal muscle mass that increases frailty and risk of falls in older adults Several cross-sectional studies have reported a positive association between dietary magnesium intakes and proxy measures of skeletal muscle mass in middle-age and older adults A randomized controlled study in physically active and healthy older women mean age, More research is needed to examine further the effect of magnesium supplementation on body composition, muscle strength, and physical performance in older adults, whether physically active or sedentary, and with normal or inadequate magnesium status.

The use of pharmacologic doses of magnesium to treat specific disorders is discussed below. Because of the potential side effects of high doses of magnesium, especially in the presence of impaired kidney function, any disease treatment trial using oral magnesium doses higher than the UL should be conducted under medical supervision.

Moreover, intravenous magnesium has been used in the management of several conditions. Preeclampsia is defined as the presence of elevated blood pressure hypertension , protein in the urine, and severe swelling edema during pregnancy Eclampsia occurs with the addition of seizures to the triad of preeclamptic symptoms and is a significant cause of perinatal and maternal mortality 93, Although cases of preeclampsia are at high risk of developing eclampsia, one-quarter of eclamptic women do not initially exhibit preeclamptic symptoms Although lower magnesium concentrations have been reported in the blood and brain of women with preeclampsia than in healthy pregnant women, there is no evidence that magnesium imbalance may cause adverse pregnancy events.

A meta-analysis of 10 randomized controlled trials found no effect of oral magnesium salt administration during normal and at-risk pregnancies on the risk of preeclampsia, perinatal mortality, and small-for-gestational age infants For many years, high-dose intravenous magnesium sulfate has been the treatment of choice for preventing eclamptic seizures that may occur in association with severe preeclampsia in pregnancy or during labor 97, A systematic review of seven randomized trials in 1, women with eclampsia compared the effect of magnesium sulfate administration with diazepam a known anticonvulsant treatment on perinatal outcomes.

Risks of recurrent seizures and maternal death were significantly reduced by the magnesium regimen compared to diazepam. Moreover, the use of magnesium for the care of eclamptic women resulted in newborns with higher Apgar scores ; there was no significant difference in the risk of preterm birth and perinatal mortality Additional research has confirmed that infusion of magnesium sulfate should always be considered in the management of severe preeclampsia and eclampsia to prevent initial and recurrent seizures Moreover, the World Health Organization WHO recommends the use of magnesium sulfate — administered either intramuscularly or intravenously — as first-line treatment for the prevention of eclampsia in women with severe preeclampsia, in preference to other anticonvulsants Further research is needed to evaluate the efficacy of magnesium salt infusion in eclampsia prophylaxis in women with mild preeclampsia In addition, it is unclear whether prolonging magnesium use post-partum in women who presented with severe preeclampsia during pregnancy is necessary to lower the risk of eclampsia after delivery While intravenous magnesium sulfate is included in the medical care of preeclampsia and eclampsia , the American College of Obstetricians and Gynecologists ACOG and the Society for Maternal-Fetal Medicine support its use in two additional situations: specific conditions of short-term prolongation of pregnancy and neuroprotection of the fetus in anticipated premature delivery Preterm birth, which is defined by the premature delivery of an infant between the 20 th and 37 th weeks of estimated gestation , is associated with an increased risk of perinatal mortality and both short- and long-term morbidity.

The ACOG approves the use of different classes of drugs — known as tocolytics — that are meant to delay delivery for long enough so that antenatal corticoids can be used to accelerate lung maturation in the fetus of women at imminent risk of preterm labor A meta-analysis of 37 trials found that intravenous infusion of magnesium sulfate was no more efficacious than commonly used tocolytics e.

Very limited evidence also suggested that high- versus low-dose magnesium infusion may reduce the length of hospital stays in neonates admitted to intensive care units The relationship between magnesium sulfate and risk of cerebral damage in premature infants has been assessed in observational studies.

A meta-analysis of six case-control and five prospective cohort studies showed that the use of magnesium significantly reduced the risk of cerebral palsy, as well as mortality However, the high degree of heterogeneity among the cohort studies and the fact that corticosteroid exposure which is known to decrease antenatal mortality was higher in the cases of children exposed to magnesium compared to controls imply a cautious interpretation of the results.

Another meta-analysis conducted on five randomized controlled trials found that intravenous magnesium administration to newborns who suffered from perinatal asphyxia could be beneficial in terms of short-term neurologic outcomes, although there was no effect on mortality Additional trials are needed to evaluate the long-term benefits of magnesium in pediatric care.

While results from intervention studies have not been entirely consistent 2 , the latest review of the data highlighted a therapeutic benefit of magnesium supplements in treating hypertension.

A meta-analysis examined 22 randomized , placebo -controlled trials of magnesium supplementation conducted in 1, individuals with either normal blood pressure normotensive or hypertension treated with medication or untreated.

The results of 19 of the 22 trials included in the meta-analysis were previously reviewed together with another 25 intervention studies The systematic examination of these 44 trials suggested a blood pressure-lowering effect associated with supplemental magnesium in hypertensive but not in normotensive individuals.

Magnesium doses required to achieve a decrease in blood pressure appeared to depend on whether participants with high blood pressure were treated with antihypertensive medications, including diuretics. A meta-analysis restricted to trials in participants with underlying preclinical insulin resistance or prediabetes or clinical conditions type 2 diabetes mellitus or coronary heart disease found a 4.

For example, adherence to the DASH diet — a diet rich in fruit, vegetables, and low-fat dairy and low in saturated and total fats — has been linked to significant reductions in systolic and diastolic blood pressures See the topic page: High Blood Pressure.

Vascular endothelial cells line arterial walls where they are in contact with the blood that flows through the circulatory system. Normally functioning vascular endothelium promotes vasodilation when needed, for example, during exercise, and inhibits the formation of blood clots. Conversely, endothelial dysfunction results in widespread vasoconstriction and coagulation abnormalities.

In cardiovascular disease , chronic inflammation is associated with the formation of atherosclerotic plaques in arteries. Atherosclerosis impairs normal endothelial function, increasing the risk of vasoconstriction and clot formation, which may lead to heart attack or stroke reviewed in A recent systematic review identified six randomized controlled trials that examined the effect of pharmacologic doses of oral magnesium on vascular endothelial function Three out of six trials, which included individuals with coronary artery disease , diabetes mellitus , or hypertension , reported an improvement in flow-mediated dilation FMD with supplemental magnesium compared to control.

In other words, the normal dilation response of the brachial arm artery to increased blood flow was improved. In contrast, there was no evidence of an effect of magnesium supplementation on FMD in three trials conducted in hemodialysis patients or healthy participants with normal or high body mass index BMI The measurement of the thickness of the inner layers of the carotid arteries is sometimes used as a surrogate marker of atherosclerosis Higher serum magnesium concentrations have been associated with reduced carotid intima-media thickness CIMT in all women and in Caucasian men participating in the Atherosclerosis Risk in Communities ARIC study A meta-analysis of four small participants in total and heterogeneous intervention studies found no effect of magnesium supplementation Results from several randomized , placebo -controlled trials have suggested that an intravenous magnesium administered early after a suspected myocardial infarction could decrease the risk of death.

The most influential study was a randomized, placebo-controlled trial in 2, patients that found a significant reduction in mortality in the group of patients given intravenous magnesium sulfate within 24 hours of suspected myocardial infarction 7.

However, a larger placebo-controlled trial in more than 58, patients found no significant reduction in five-week mortality in patients treated with intravenous magnesium sulfate within 24 hours of suspected myocardial infarction, resulting in controversy regarding the efficacy of this treatment A systematic review of 26 clinical trials , including 73, participants, concluded that intravenous magnesium administration does not appear to reduce post-myocardial infarction mortality and thus should not be utilized as a treatment Thus, the use of intravenous magnesium sulfate in the therapy of acute myocardial infarction remains controversial.

Magnesium depletion has been associated with type 1 insulin -dependent and type 2 diabetes mellitus , as well as with gestational diabetes. Low serum concentrations of magnesium hypomagnesemia have been reported in One cause of the depletion may be an increased urinary loss of magnesium caused by an increased urinary excretion of glucose that accompanies poorly controlled diabetes.

Magnesium depletion has been shown to increase insulin resistance in a few studies and may adversely affect blood glucose control in diabetes mellitus see also Diabetes mellitus under Disease Prevention The most recent meta-analysis of nine randomized, double-blind, controlled trials concluded that oral supplemental magnesium lowered fasting plasma glucose concentrations in individuals with diabetes However, magnesium supplementation did not improve other markers of glucose homeostasis , such as glycated hemoglobin HbA1c concentration, fasting and post-glucose load insulin concentrations, and measures of insulin resistance Another meta-analysis of trials that included participants either at-risk of diabetes mellitus or with diabetes mellitus suggested that evidence to support a benefit of magnesium supplementation on measures of insulin resistance was stronger in subjects who were magnesium deficient than in those with normal serum concentrations of magnesium Correcting existing magnesium deficiencies may improve glucose metabolism and insulin sensitivity in subjects with diabetes, but it remains uncertain whether magnesium supplementation can have any therapeutic benefit in patients with adequate magnesium status.

The occurrence of hypomagnesemia may be greater in patients with asthma than in individuals without asthma Several clinical trials have examined the effect of intravenous magnesium infusions on acute asthmatic attacks in children or adults who did not respond to initial treatment in the emergency room.

Indeed, magnesium can promote bronchodilation in subjects with asthma by interfering with mechanisms like the activation of N-methyl D-aspartate NMDA receptors that trigger bronchoconstriction through facilitating calcium influx in airway smooth muscle cells In a meta-analysis of six quasi randomized controlled trials in children with acute asthma treated with a short-acting β 2 -adrenergic receptor agonist e.

Another meta-analysis of randomized controlled trials primarily conducted in adults with asthma exacerbations indicated that single infusions of 1. The use of nebulized, inhaled magnesium for treating asthma has also been investigated.

In addition, oral magnesium supplementation is of no known value in the management of chronic asthma The potential analgesic effect of magnesium is attributed in particular to its capacity to block NMDA receptors , which are located in the brain and spinal cord and are involved in pain transduction Several intervention studies have examined the role of magnesium on pain control and analgesic requirement in patients during the immediate post-surgery period.

After cesarean section: Pain management strategies after cesarean section usually involve the injection of an analgesic into either the epidural space for epidural analgesia or the subarachnoid space for spinal [intrathecal] analgesia.

A recent meta-analysis of nine randomized controlled trials summarized the evidence regarding the potential use of magnesium sulfate to control or relieve postoperative pain in women who underwent cesarean section All the trials evaluated the effect of a first-line analgesic regimen i.

The results suggested that the anesthesia 8 studies and sensory blockade 6 studies lasted longer in women who received the additional magnesium sulfate. The use of magnesium sulfate also resulted in lower pain score 3 studies and in lower postoperative consumption of analgesics 4 studies.

Additionally, there was no difference in occurrence of side effects between regimens In another study in women with mild preeclampsia who received an epidural injection of ropivacaine after cesarean section, spinal infusion of magnesium sulfate increased the duration of sensory and motor blockade, as well as the time before patients requested an analgesic, compared to midazolam After a variety of other surgeries: The efficacy of intravenous magnesium has also been examined for local, regional, or systemic pain control following a range of different surgeries.

A review of four small randomized controlled studies suggested that, when added to local analgesics, magnesium infusion to patients undergoing tonsillectomy might decrease pain and incidence of laryngospasm , extend the time to first post-operative analgesic requirement, and reduce the number of post-operative analgesic requests Similar observations were reported in two additional meta-analyses , yet there was discrepancy regarding the ability of magnesium to alleviate pain , Indeed, the review of eight trials by Xie et al.

Finally, both meta-analyses reported no reduction in risk of post-operative nausea and vomiting with intravenous magnesium administration , A meta-analysis of four randomized controlled trials in patients also suggested that magnesium sulfate infusion may help reduce pain scores at 2 and 8 hours but not 24 hours after laparoscopic cholecystectomy Recent studies have examined the use of magnesium sulfate for pain control after other surgeries, including hysterectomy , , spinal surgery , , or during endoscopic sinus or cochlear implantation surgery.

Despite conflicting results or reports of limited benefits of magnesium, further research is needed before any conclusions can be drawn. The effect of magnesium on neuropathic pain has been examined in some clinical studies.

The intravenous administration of magnesium sulfate was found to partially or completely alleviate pain in patients with postherpetic neuralgia, a type of neuropathic pain caused by herpes zoster infection shingles , In a more recent randomized controlled trial in 45 patients with either postherpetic neuralgia or neuropathic pain of traumatic or surgical origin, oral supplementation of magnesium failed to improve measures of pain and quality of life compared to a placebo Another trial is underway to examine the impact of intravenous magnesium with ketamine on neuropathic pain Lower intracellular magnesium concentrations in both red blood cells and white blood cells have been reported in individuals who suffer from recurrent migraine headaches compared to migraine-free individuals Additionally, the incidence of hypomagnesemia also appeared to be greater in women who experience migraines with menstruation compared to women without menstrual migraines A few intervention studies have examined whether an increase in intracellular magnesium concentration with supplemental oral magnesium could help decrease the frequency and severity of migraine headaches in affected individuals.

The efficiency of magnesium absorption varies with the type of oral magnesium complex, and this might explain the conflicting results. The efficacy of magnesium infusions was also investigated in a randomized , single-blind, placebo-controlled, cross-over trial of 30 patients with migraine headaches While this promising result was confirmed in another trial , two additional randomized, placebo-controlled studies found that magnesium sulfate was less effective than other molecules e.

The most recent meta-analysis of five randomized, double-blind , controlled trials reported no beneficial effect of magnesium infusion for migraine in adults The efficacy of magnesium should be examined in larger studies that consider the magnesium status of migraine sufferers Hypomagnesemia is not uncommon in patients admitted to intensive care units ICU.

A pooled analysis of three studies also suggested a higher risk of sepsis in ICU patients with hypomagnesemia However, evidence is currently unavailable to suggest that magnesium administration could improve outcomes in critically ill or severely injured patients Considering all sources of magnesium intakes i.

Yet, the long-term consequences of inadequate dietary intakes remain unclear 1. Since magnesium is part of chlorophyll , the green pigment in plants, green leafy vegetables are good sources of magnesium.

Unrefined grains whole grains and nuts also have high magnesium content. Meats and milk have an intermediate content of magnesium, while refined foods generally have the lowest. Water is a variable source of intake; harder water usually has a higher concentration of magnesium salts 2.

Some foods that are relatively rich in magnesium are listed in Table 2 , along with their magnesium content in milligrams mg. For more information on the nutrient content of foods, search USDA's FoodData Central.

Magnesium supplements are available as magnesium oxide, magnesium hydroxide, magnesium gluconate, magnesium chloride, and magnesium citrate salts, as well as a number of amino acid chelates like magnesium aspartate.

Magnesium hydroxide, oxide, or trisilicate salts are used as antacids to mitigate gastric hyperacidity and symptoms of gastroesophageal reflux disease Adverse effects have not been identified from magnesium occurring naturally in food. However, adverse effects from excessive magnesium have been observed with intakes of various magnesium salts i.

The initial symptom of excess magnesium supplementation is diarrhea — a well-known side effect of magnesium that is used therapeutically as a laxative. Individuals with impaired kidney function are at higher risk for adverse effects of magnesium supplementation, and symptoms of magnesium toxicity have occurred in people with impaired kidney function taking moderate doses of magnesium-containing laxatives or antacids.

Elevated serum concentrations of magnesium hypermagnesemia may result in a fall in blood pressure hypotension. Some of the later effects of magnesium toxicity, such as lethargy, confusion, disturbances in normal cardiac rhythm, and deterioration of kidney function, are related to severe hypotension.

As hypermagnesemia progresses, muscle weakness and difficulty breathing may occur. Severe hypermagnesemia may result in cardiac arrest 2, 3. The FNB cautions that individuals with renal impairment are at higher risk for adverse effects from excess supplemental magnesium intake.

However, the FNB also notes that there are some conditions that may warrant higher doses of magnesium under medical supervision 2. Magnesium interferes with the absorption of digoxin a heart medication , nitrofurantoin an antibiotic , and certain anti- malarial drugs, which could potentially reduce drug efficacy.

Bisphosphonates e. Magnesium has also been found to reduce the efficacy of chlorpromazine a tranquilizer , penicillamine, oral anticoagulants , and the quinolone and tetracycline classes of antibiotics , Intravenous magnesium might inhibit calcium entry into smooth muscle cells and lead to hypotension and muscular weakness if administered with calcium channel blockers e.

Because intravenous magnesium has increased the effects of certain muscle-relaxing medications used during anesthesia, it is advisable to let medical staff know if you are taking oral magnesium supplements , laxatives, or antacids prior to surgical procedures.

Moreover, long-term use three months or longer of proton-pump inhibitors drugs used to reduce the amount of stomach acid may increase the risk of hypomagnesemia , High doses of furosemide Lasix and some thiazide diuretics e.

Many other medications may also result in renal magnesium loss 3. Despite magnesium being plentiful in foods, it is considered a shortfall nutrient see the article on Micronutrient Inadequacies in the US Population. Eating a varied diet that provides green vegetables, whole grains , and nuts daily should provide the rest of an individual's magnesium requirement.

Originally written in by: Jane Higdon, Ph. Linus Pauling Institute Oregon State University. Updated in April by: Jane Higdon, Ph. Updated in August by: Victoria J. Drake, Ph.

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