(PubMed), 159. Despite magnesium being plentiful in foods, it is considered a shortfall nutrient (see the article on Micronutrient Inadequacies in the US Population). (43) included six studies and reported a 10% lower risk of CHD with higher versus lower dietary magnesium intakes. (PubMed), 121. Sojka JE, Weaver CM. Crit Care Med. 2018;9:99-105. Serum magnesium and risk of incident heart failure in older men: The British Regional Heart Study. (PubMed), 97. Only the free, ionized form of magnesium (Mg2+) is physiologically active. (PubMed), 99. 2009;5(1):185-197. Bjog. 2017;11(4):1064-1069. 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 (124). Barbara Delage, Ph.D. J Am Heart Assoc. Metabolic syndrome refers to the concomitant presentation of several metabolic disorders in an individual, including dyslipidemia, hypertension, insulin resistance, and obesity (11). The relationship between magnesium sulfate and risk of cerebral damage in premature infants has been assessed in observational studies. Simental-Mendia LE, Sahebkar A, Rodriguez-Moran M, Guerrero-Romero F. A systematic review and meta-analysis of randomized controlled trials on the effects of magnesium supplementation on insulin sensitivity and glucose control. (PubMed). Linus Pauling Institute Br J Nutr. The effect of magnesium on neuropathic pain has been examined in some clinical studies. Urinary magnesium concentration fluctuates rapidly with dietary intakes, but measurements of 24-hour urinary magnesium can be used in addition to other indicators to assess population status. (PubMed), 107. Magnesium at the surface of bones is also available for dynamic exchange with blood (73). Only two prospective studies have examined the risk of heart failure in relation to magnesium intakes. 2012;31(5):652-658. Available at: https://naturalmedicines.therapeuticresearch.com/. The Linus Pauling Institute's Micronutrient Information Center provides scientific information on the health aspects of dietary factors and supplements, food, and beverages for the general public. 2011;34(9):2116-2122. Intravenous and nebulized magnesium sulfate for treating acute asthma in children: a systematic review and meta-analysis. (PubMed), 22. (PubMed), 67. Baltimore: Lippincott Williams & Wilkins; 2006:223-247. Intrathecal magnesium sulfate does not reduce the ED50 of intrathecal hyperbaric bupivacaine for cesarean delivery in healthy parturients: a prospective, double blinded, randomized dose-response trial using the sequential allocation method. As hypermagnesemia progresses, muscle weakness and difficulty breathing may occur. Arsenault KA, Yusuf AM, Crystal E, et al. Naturally carbonated water gets its CO2 from the source. Abd-Elsalam KA, Fares KM, Mohamed MA, Mohamed MF, El-Rahman AMA, Tohamy MM. 1999;9(3):159-165. 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, 58). Oral magnesium supplementation reduces insulin resistance in non-diabetic subjects - a double-blind, placebo-controlled, randomized trial. These annual reports contain information about water sources, levels of contaminants, and mineral contents. (PubMed), 78. (PubMed), 126. Ascherio A, Rimm EB, Giovannucci EL, et al. (PubMed), 102. Mauskop A, Varughese J. Role of magnesium in the pathogenesis and treatment of migraines. Am J Clin Nutr. Cochrane Database Syst Rev. Occurrence of hypomagnesemia has been reported in patients who suffered from a subarachnoid hemorrhage (a type of stroke) caused by the rupture of a cerebral aneurysm (53). 2012;122(9):397-407. Both bottled mineral water and tap water can be sources of magnesium. * OVERALL HEALTH. Mooren FC, Kruger K, Volker K, Golf SW, Wadepuhl M, Kraus A. 2011;41(4):405-410. 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 (103). Calcium is a chemical element with the symbol Ca and atomic number 20. 2003;26(4):1147-1152. 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 (60). Cephalalgia. 2017;42:69-77. (PubMed), 144. A study in postmenopausal women who were taking estrogen replacement therapy and a multivitamin supplement found that supplementation with an additional 400 mg/day of magnesium and 600 mg/day of calcium resulted in increased BMD at the heel compared to postmenopausal women receiving estrogen replacement therapy only (83). Corvallis, Oregon 97331, phone: 541-737-5075 | fax: 541-737-5077 However, each of these indicators has limitations. 2015;114(6):924-935. Am J Clin Nutr. Barbagallo M, Dominguez LJ, Galioto A, Pineo A, Belvedere M. Oral magnesium supplementation improves vascular function in elderly diabetic patients. (PubMed), 63. WHO recommendations for prevention and treatment of pre-eclampsia and eclampsia. (PubMed), 108. A 2014 meta-analysis of 37 trials found that intravenous infusion of magnesium sulfate was no more efficacious than commonly used tocolytics (e.g., β-adrenergic receptor agonists, calcium channel blockers, prostaglandin inhibitors) in delaying delivery or preventing serious infant outcomes (105). Diagnosis, prevention, and management of eclampsia. The most recent pooled analysis of 14 studies found a 12% lower risk of stroke with higher versus lower magnesium intakes and estimated a 7% risk reduction of stroke associated with each 100-mg increment in daily magnesium intake (43). Diabetes Care. While they acknowledge that more research is needed, the authors report that microplastics in bottled mineral water do not appear to pose a safety risk. Begin MJ, Ste-Marie LG, Coupal L, Ethier J, Rakel A. Hypomagnesemia during teriparatide treatment in osteoporosis: incidence and determinants. Magnesium is required for the active transport of ions like potassium and calcium across cell membranes. (National Academy Press). (PubMed), 16. 2004;17(2):126-136. (PubMed), 13. Other metabolic markers, including serum triglycerides, HDL-cholesterol, and a measure of insulin resistance, also improved in magnesium- versus placebo-treated individuals (69). A randomized clinical trial of intrathecal magnesium sulfate versus midazolam with epidural administration of 0.75% ropivacaine for patients with preeclampsia scheduled for elective cesarean section. By definition, mineral water must contain a minimum quantity of microbes. (PubMed), 166. Few multivitamin/mineral supplements contain more than 100 mg of magnesium due to its bulk. Anesth Essays Res. Dietary magnesium intakes: Several large prospective cohort studies, including the Health Professionals Follow-up Study (HPFS) and the Nurses’ Health Study (NHS), have examined magnesium intakes in relation to cardiovascular outcomes. (PubMed), 124. J Am Coll Nutr. 2014; 21(1):2-9. (PubMed), 177. (More information). 1995;48(7):927-940. (PubMed), 84. 1998;5(1):24-27. Hashimoto Y, Nishimura Y, Maeda H, Yokoyama M. Assessment of magnesium status in patients with bronchial asthma. (PubMed), 69. Eur J Clin Invest. 2013;1:CD003611. Oral magnesium oxide prophylaxis of frequent migrainous headache in children: a randomized, double-blind, placebo-controlled trial. A meta-analysis of four small (145 participants in total) and heterogeneous intervention studies found no effect of magnesium supplementation (98.6 to 368 mg/day for 2 to 6 months) on CIMT (116). In contrast, there was no evidence of an effect of magnesium supplementation on FMD in three trials conducted in hemodialysis patients (120) or healthy participants with normal (121) or high body mass index (BMI) (122). 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 (95). The most recent meta-analysis of five randomized, double-blind, controlled trials reported no beneficial effect of magnesium infusion for migraine in adults (171). (PubMed), 12. J Anesth. While mild magnesium deficiency may not elicit clinical symptoms, it may be associated with an increased risk of developing chronic diseases (see Disease Prevention) (1). 2014;6(12):6005-6019. The benefits of drinking aloe vera juice first thing in the morning include reducing inflammation, speeding healing, and stimulating digestion.It also helps in improving liver function which detoxifies the body, boosting immunity, and protecting the heart.Aloe juice is also used for increasing hydration, treating sunburn, soothing the skin, hair care, and relieving heartburn, among others. Additionally, meta-analyses of prospective studies have found no associations between magnesium intake and cardiovascular (50) or all-cause mortality (43). Trials. (PubMed), 109. An evaluation of the adding magnesium sulfate to ropivacaine on ultrasound-guided transverse abdominis plane block after abdominal hysterectomy. Hypomagnesemia is not uncommon in patients admitted to intensive care units (ICU). (PubMed), 87. For more information on the nutrient content of foods, search USDA's FoodData Central. However, the fact that foods high in magnesium (fruit, vegetables, whole grains) are frequently high in potassium and dietary fiber has made it difficult to evaluate the independent effect of magnesium on blood pressure. Increased serum calcification propensity has been associated with greater risk of mortality in patients with impaired kidney function (33, 34). Lancet. 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). According to the findings of a randomized controlled study, drinking mineral water containing magnesium sulfate and sodium sulfate led to more frequent bowel movements and an improved quality of life among people with constipation. The Magpie Trial: a randomised placebo-controlled trial. 1995;345(8951):669-685. 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 (148). 2017;14(10):e1002398. (PubMed), 141. Liability for individual actions or omissions based upon the contents of this site is expressly disclaimed. 2007;7(1):107-110. Studies suggest that drinking mineral water may have health benefits, though little research directly suggests that it is better for a person’s health than tap water. Atherosclerosis. Vasc Health Risk Manag. Surg Laparosc Endosc Percutan Tech. 2017;17(1):8. 8. 2017;16(1):26. Kass L, Weekes J, Carpenter L. Effect of magnesium supplementation on blood pressure: a meta-analysis. CO2 helps prevent oxidation and limits bacterial growth in mineral water. BMC Med. 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. In: Erdman Jr. JW, Macdonald IA, Ziegler EE, eds. 2016;31(2):317-325. Circulation. 1992;86(5):1475-1484. Another two more recent intervention studies suggested that magnesium sulfate infusion could be more effective and faster than dexamethasone/metoclopramide (172) or caffeine citrate (173) to relieve pain in patients with acute migraine. Crowther CA, Brown J, McKinlay CJ, Middleton P. Magnesium sulphate for preventing preterm birth in threatened preterm labour. Eur J Clin Nutr. (PubMed), 162. (PubMed), 68. 1998;47(9):1109-1113. Efficacy of intravenous magnesium in neuropathic pain. The use of magnesium sulfate also resulted in lower pain score (3 studies) and in lower postoperative consumption of analgesics (4 studies). 2011;305(11):1119-1127. Magnesium. 2017;12(2):315-322. Imani F, Rahimzadeh P, Faiz HR, Abdullahzadeh-Baghaei A. Endothelial cells and magnesium: implications in atherosclerosis. 2018;34(1):23-28. Intervention trials on treated participants showed a reduction in hypertension with magnesium doses from 243 mg/day to 486 mg/day, whereas untreated patients required doses above 486 mg/day to achieve a significant decrease in blood pressure. Beasley R, Aldington S. Magnesium in the treatment of asthma. 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). Corbo J, Esses D, Bijur PE, Iannaccone R, Gallagher EJ. Chen T, Carter BS. US Food and Drug Administration. Castiglioni S, Cazzaniga A, Albisetti W, Maier JA. Pediatr Emerg Care. The efficiency of magnesium absorption varies with the type of oral magnesium complex, and this might explain the conflicting results. (PubMed), 50. The Food and Nutrition Board (FNB) of the US Institute of Medicine set the tolerable upper intake level (UL) for magnesium at 350 mg/day; this UL represents the highest level of daily supplemental magnesium intake likely to pose no risk of diarrhea or gastrointestinal disturbance in almost all individuals. (PubMed), 62. Bressendorff I, Hansen D, Schou M, et al. 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 (62). Woods KL, Fletcher S, Roffe C, Haider Y. Why all migraine patients should be treated with magnesium. 2014;10(5):255-256. 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 (106). (PubMed), 152. Guerrero-Romero F, Simental-Mendia LE, Hernandez-Ronquillo G, Rodriguez-Moran M. Oral magnesium supplementation improves glycaemic status in subjects with prediabetes and hypomagnesaemia: A double-blind placebo-controlled randomized trial. The relationship between magnesium intake and risk of hypertension suggests that improving diet quality or using magnesium supplements might play a role in the prevention of hypertension in those with inadequate dietary intakes. In a small group of postmenopausal women with osteoporosis, magnesium supplementation of 750 mg/day for six months followed by 250 mg/day for 18 more months resulted in increased BMD at the wrist after one year, with no further increase after two years of supplementation (82). (PubMed), 28. 2014;45(5):388-393. Shock. (PubMed), 30. Choi H, Parmar N. The use of intravenous magnesium sulphate for acute migraine: meta-analysis of randomized controlled trials. Hypomagnesemia usually describes serum magnesium concentrations less than 0.74 millimoles/liter (mmol/L) or 1.40 milliequivalents/liter (mEq/L) or 1.70 milligrams/deciliter (mg/dL). Over time, serum calcium concentration also began to decrease (hypocalcemia) despite adequate dietary calcium. We discuss the differences between tap water and mineral water below. Br J Anaesth. Zhang X, Li Y, Del Gobbo LC, et al. The scientists also noted that producing glass bottles consumed the largest amount of raw material and required the most energy. Cho HK, Park IJ, Yoon HY, Hwang SH. (PubMed), 175. Maximizing bone health--magnesium, BMD and fractures. It naturally contains a range of minerals, including magnesium and calcium. Tucker KL, Hannan MT, Chen H, Cupples LA, Wilson PW, Kiel DP. Is there benefit to continue magnesium sulphate postpartum in women receiving magnesium sulphate before delivery? 181. The daily recommended allowance for magnesium is as follows: According to the Office of Dietary Supplements, most people in the U.S. consume less than the recommended amount of magnesium. PLoS One. (PubMed), 128. Zhang X, Xia J, Del Gobbo LC, Hruby A, Dai Q, Song Y. Serum magnesium concentrations and all-cause, cardiovascular, and cancer mortality among U.S. adults: Results from the NHANES I Epidemiologic Follow-up Study. Clin Nutr. (More information), The tolerable upper intake level (UL) for supplemental magnesium is 350 mg/day. Clin Sci (Lond). In 2018, researchers published a systematic review of current data on plastic toxicity. Hayhoe RP, Lentjes MA, Luben RN, Khaw KT, Welch AA. Nutr J. 307 Linus Pauling Science Center 2012;118(2):90-96. Adelaide (AU): University of Adelaide Press; 2011. The most recent meta-analysis of 25 prospective cohort studies, including 637,922 individuals and 26,828 new cases of type 2 diabetes mellitus, found that higher magnesium intakes were associated with a 17% lower risk of type 2 diabetes mellitus (63). 2013;23(3):169-176. (PubMed), 119. (PubMed), 133. 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. BMJ Open. Public water suppliers move water from its source to treatment plants, where it undergoes chemical disinfection. (PubMed), 57. A number of early studies found lower cardiovascular-related mortality in populations who routinely consume "hard" water. 2018;273:98-105. Oral magnesium and vitamin C supplements in asthma: a parallel group randomized placebo-controlled trial. (PubMed), 137. Microplastics, tiny plastic particles, are another potential concern. Irazuzta JE, Chiriboga N. Magnesium sulfate infusion for acute asthma in the emergency department. Also, despite the efforts of public water suppliers, contaminants from rusted or leaking pipes can pollute drinking water. Hypomagnesemia in patients with type 2 diabetes. Carbonated mineral water contains carbonic acid, which can cause hiccups or bloating. Adv Pharm Bull. 2013;57(1):84-91. In addition to hypomagnesemia, signs of severe magnesium deficiency included hypocalcemia, low serum potassium concentrations (hypokalemia), retention of sodium, low circulating PTH concentrations, neurological and muscular symptoms (tremor, muscle spasms, tetany), loss of appetite, nausea, vomiting, and personality changes (3). ", Linus Pauling Institute | Oregon State University In particular, elevated blood phosphorus concentration and increased deposition of calcium phosphate within the vasculature are thought to promote vascular calcification. All rights reserved. Pregnancy benefits; When you’re pregnant, magnesium helps build and repair your body’s tissues. Stella L. Volpe, Ph.D., RDN, ACSM-CEP, FACSM Nutrients. A more recent meta-analysis of randomized controlled studies with 2,028 participants found that supplemental magnesium at a median dose of 368 mg/day (range: 238-960 mg/day) for a median duration of three months (range: 3 weeks-6 months) increased serum magnesium concentration by 0.05 mmol/L (27 trials) and reduced systolic blood pressure by 2 mm Hg and diastolic blood pressure by 1.78 mm Hg (37 trials) (112). Xiao F, Xu W, Feng Y, et al. (43), there was no association between dietary magnesium intake and risk of total cardiovascular disease. Ju SY, Choi WS, Ock SM, Kim CM, Kim DH. 2017;20(6):504-511. Yarad EA, Hammond NE, Winner ABNRPsbE. Mortazavi M, Moeinzadeh F, Saadatnia M, Shahidi S, McGee JC, Minagar A. Rude RK. (More information), The use of magnesium supplementation is currently being explored in the management of various conditions, including hypertension, cardiovascular disease, type 2 diabetes mellitus, asthma and pain. Lancet. Mineral water refers to bottled spring water. Association between density of coronary artery calcification and serum magnesium levels among patients with chronic kidney disease. Curr Opin Allergy Clin Immunol. 2017;93 Suppl 1:19-25. 2015;48(1):69-76. Accessed 10/9/18. Volpe SL. Schwartz R, Walker G, Linz MD, MacKellar I. Metabolic responses of adolescent boys to two levels of dietary magnesium and protein. Usually, increased PTH secretion quickly results in the mobilization of calcium from bone and normalization of blood calcium concentration. Martin DP, Samora WP, 3rd, Beebe AC, et al. Diabetes Care. Neurosurgery. Gastrointestinal disorders: Prolonged diarrhea. Based on the current evidence, the differences are not very significant. However, adverse effects from excessive magnesium have been observed with intakes of various magnesium salts (i.e., supplemental magnesium) (6). 2016;8(11). Endocrine and metabolic disorders: Several conditions, such as diabetes mellitus, parathyroid gland disorders, phosphate depletion, primary aldosteronism, and even excessive lactation, can lead to magnesium depletion.

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