(More information), Severe magnesium deficiency can impede vitamin D and calcium homeostasis. Magnesium is required for the active transport of ions like potassium and calcium across cell membranes. Mineral water may contain large amounts of calcium, magnesium, and potassium, all of which promote blood circulation. In a cross-sectional study in patients with pre-dialysis CKD, higher serum magnesium concentrations were associated with lower coronary artery calcification density scores in those in the higher end of normal serum phosphorus concentrations (i.e., ≥3.4 mg/dL) (31). 4. Calcium is a chemical element with the symbol Ca and atomic number 20. (PubMed), 102. Mookadam F, Moustafa SE, Lester SJ, Warsame T. Subclinical atherosclerosis: evolving role of carotid intima-media thickness. (PubMed), 134. Rennenberg RJ, Kessels AG, Schurgers LJ, van Engelshoven JM, de Leeuw PW, Kroon AA. Meats and milk have an intermediate content of magnesium, while refined foods generally have the lowest. 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. Fang X, Wang K, Han D, et al. (PubMed), 19. Similar observations were reported in two additional meta-analyses, yet there was discrepancy regarding the ability of magnesium to alleviate pain (149, 150). (PubMed), 6. Mauskop A, Altura BM. Preliminary studies have shown that magnesium improved insulin sensitivity in individuals at risk for type 2 diabetes mellitus. Volpe SL. Hassan PF, Saleh AH. Pain Physician. 2009;5(1):185-197. Available at: https://naturalmedicines.therapeuticresearch.com/. Older adults have relatively low dietary intakes of magnesium (8, 9). 2016;95(50):e5406. 2013;57(1):84-91. (PubMed), 65. 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. 2017;16(1):26. PLoS One. Presently, a combination of all three markers — dietary, serum, and urinary magnesium — may be used to get a valid assessment of magnesium status (reviewed in 10). People who want to buy mineral water can find it in supermarkets or choose from brands online. Circulation. (PubMed), 72. (PubMed), 77. Here’s everything you need to know about this nutrient, along with what’s the best time of day to take it. (PubMed), 123. This can include adding or removing carbon dioxide (CO2) gas or eliminating toxic substances, such as arsenic. Angkananard T, Anothaisintawee T, Eursiriwan S, et al. 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. Association between density of coronary artery calcification and serum magnesium levels among patients with chronic kidney disease. (PubMed), 136. Catling LA, Abubakar I, Lake IR, Swift L, Hunter PR. I. Magnesium and nitrogen retention. Efficacy of magnesium sulfate added to local anesthetic in a transversus abdominis plane block for analgesia following total abdominal hysterectomy: a randomized trial. All living organisms need water to survive. 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 (137). In practice, magnesium status is usually determined through assessments of dietary magnesium intake, serum magnesium concentration, and/or urinary magnesium concentration (10). Magnesium hydroxide, oxide, or trisilicate salts are used as antacids to mitigate gastric hyperacidity and symptoms of gastroesophageal reflux disease (180). Implications and actions. MNT is the registered trade mark of Healthline Media. 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 (134). 2018;125(10):1304-1311. Nutrients. Surg Laparosc Endosc Percutan Tech. The use of nebulized, inhaled magnesium for treating asthma has also been investigated. Also, despite the efforts of public water suppliers, contaminants from rusted or leaking pipes can pollute drinking water. The most influential study was a randomized, placebo-controlled trial in 2,316 patients that found a significant reduction in mortality in the group of patients given intravenous magnesium sulfate within 24 hours of suspected myocardial infarction (7.8% all-cause mortality in the experimental group vs. 10.3% all-cause mortality in the placebo group) (125). Hendler SS, Rorvik DM. (PubMed), 32. Recent studies have examined the use of magnesium sulfate for pain control after other surgeries, including hysterectomy (152, 153), spinal surgery (154, 155), or during endoscopic sinus (156) or cochlear implantation (157) surgery. Sarcopenia as a risk factor for falls in elderly individuals: results from the ilSIRENTE study. Present Knowledge in Nutrition. (PubMed), 60. Clin J Am Soc Nephrol. Magnesium depletion has been associated with type 1 (insulin-dependent) and type 2 diabetes mellitus, as well as with gestational diabetes. 2016;111:272-282. 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). Sung KC, Lee MY, Kim YH, et al. Prospective study of nutritional factors, blood pressure, and hypertension among US women. (PubMed), 21. However, adverse effects from excessive magnesium have been observed with intakes of various magnesium salts (i.e., supplemental magnesium) (6). Finally, both meta-analyses reported no reduction in risk of post-operative nausea and vomiting with intravenous magnesium administration (148, 150). Corbo J, Esses D, Bijur PE, Iannaccone R, Gallagher EJ. (PubMed), 117. McDonald SD, Lutsiv O, Dzaja N, Duley L. A systematic review of maternal and infant outcomes following magnesium sulfate for pre-eclampsia/eclampsia in real-world use. 2012;32(2):135-140. Diabetes Obes Metab. 1998;136(3):480-490. Effects of magnesium supplementation on blood pressure: a meta-analysis of randomized double-blind placebo-controlled trials. 2013;33(9):663-669. Accessed 10/29/18. Oral magnesium oxide prophylaxis of frequent migrainous headache in children: a randomized, double-blind, placebo-controlled trial. 2002;89(5):711-714. Magnesium is required for a number of steps during synthesis of deoxyribonucleic acid (DNA), ribonucleic acid (RNA), and proteins. Transl Neurosci. Veronese N, Watutantrige-Fernando S, Luchini C, et al. A pooled analysis of three studies also suggested a higher risk of sepsis in ICU patients with hypomagnesemia (175). Cephalalgia. A small-scale 2004 study involving 70 adults with borderline hypertension and low magnesium levels found that drinking 1 liter of mineral water per day decreased their blood pressure. 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. 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). The efficiency of magnesium absorption varies with the type of oral magnesium complex, and this might explain the conflicting results. 08/04/2017 Available at: https://www.fda.gov/Drugs/DrugSafety/ucm245011.htm. A recent randomized controlled trial in 60 healthy women undergoing elective cesarean section confirmed that the addition of magnesium sulfate to a bupivacaine/opioid regimen increased the duration of spinal anesthesia and lowered the pain level, yet did not improve the potency of bupivacaine (146). Gastrointestinal disorders: Prolonged diarrhea. However, a larger placebo-controlled trial in more than 58,000 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 (127). Liability for individual actions or omissions based upon the contents of this site is expressly disclaimed. 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 (162). Conversely, endothelial dysfunction results in widespread vasoconstriction and coagulation abnormalities. Moreover, intravenous magnesium has been used in the management of several conditions. Tucker KL, Hannan MT, Chen H, Cupples LA, Wilson PW, Kiel DP. Manufacturers can also infuse their water with CO2 after extraction. 7. 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. 2009;22(3):151-156. Nutrients. J Nutr. 2015;102(2):376-384. 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) (131). Here’s our process. A recent systematic review of 25 randomized controlled trials, including adults, children, or both, found little evidence that inhaled magnesium sulfate alone or along with a β2-adrenergic receptor agonist and/or a muscarinic anticholinergic (e.g., ipratropium) could improve pulmonary function in patients with acute asthma (140). 2013;28(2):173-181. Han H, Fang X, Wei X, et al. (PubMed), 59. The efficacy of magnesium infusions was also investigated in a randomized, single-blind, placebo-controlled, cross-over trial of 30 patients with migraine headaches (167). 2013;167(6):3044-3047. Hard tap water has higher mineral contents, which some consider more healthful. 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 827 women who underwent cesarean section (145). Duley L. The global impact of pre-eclampsia and eclampsia. (PubMed), 133. (PubMed), 153. (PubMed), 148. The FDA prohibit these manufacturers from adding minerals to their products. Ma J, Folsom AR, Melnick SL, et al. Baratloo A, Mirbaha S, Delavar Kasmaei H, Payandemehr P, Elmaraezy A, Negida A. 2013;1:CD003611. Role of magnesium in the pathogenesis and treatment of migraines. 1995;345(8951):669-685. Serum magnesium and risk of incident heart failure in older men: The British Regional Heart Study. Pediatr Emerg Care. 2015;41(6):831-842. 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). Beasley R, Aldington S. Magnesium in the treatment of asthma. 2007(2):CD002755. It also regulates the rate and rhythm of the heartbeat. Efficacy of intravenous magnesium sulfate in the treatment of acute migraine attacks. Hruby A, O'Donnell CJ, Jacques PF, Meigs JB, Hoffmann U, McKeown NM. It is thought that pancreatic β-cells, which secrete insulin, could become less responsive to changes in insulin sensitivity in magnesium-deficient subjects (67). However, each of these indicators has limitations. Imani F, Rahimzadeh P, Faiz HR, Abdullahzadeh-Baghaei A. Oral magnesium supplementation in chronic kidney disease stages 3 and 4: efficacy, safety, and effect on serum calcification propensity-a prospective randomized double-blinded placebo-controlled clinical trial. Nutrients. Simental-Mendia LE, Rodriguez-Moran M, Guerrero-Romero F. Failure of beta-cell function for compensate variation in insulin sensitivity in hypomagnesemic subjects. Bisphosphonates (e.g., alendronate, etidronate), which are drugs used to treat osteoporosis, and magnesium should be taken two hours apart so that the absorption of the bisphosphonates is not inhibited (181, 182). How can diet help lower triglyceride levels? Magnesium intake and incidence of metabolic syndrome among young adults. Diabetes Care. Low magnesium levels in adults with metabolic syndrome: a meta-analysis. The pooled analysis of seven prospective studies showed an 8% lower risk of hypertension with higher versus lower dietary magnesium intakes (26). 2016;32(4):409-417. (PubMed), 86. (PubMed), 57. 1996;27(5):1065-1072. This might constitute a potential mechanism through which magnesium could play a role in the prevention of metabolic disorders. Pharmacol Res. Effect of magnesium supplementation on glucose metabolism in people with or at risk of diabetes: a systematic review and meta-analysis of double-blind randomized controlled trials. A more recent meta-analysis by Fang et al. Costello RB, Nielsen F. Interpreting magnesium status to enhance clinical care: key indicators. Clin Exp Allergy. (PubMed), 44. (PubMed), 140. 2003;33(10):1355-1359. Analgesic effects of methadone and magnesium following posterior spinal fusion for idiopathic scoliosis in adolescents: a randomized controlled trial. Wilhelm SM, Rjater RG, Kale-Pradhan PB. 2012;31(5):652-658. Adverse effects have not been identified from magnesium occurring naturally in food. Another placebo-controlled trial in 86 children with frequent migraine headaches found that oral magnesium oxide (9 mg/kg body weight/day) reduced headache frequency over the 16-week intervention (165). Hypertension. A 2018 meta-analysis of four randomized controlled trials in 263 patients also suggested that magnesium sulfate infusion may help reduce pain scores at 2 and 8 hours (but not 24 hours) after laparoscopic cholecystectomy (151). 2007;7(1):107-110. Oral supplementation with magnesium (mean dose of 410 mg/day; range of 120 to 973 mg/day) for a median period of 11.3 months significantly reduced systolic blood pressure by 2 to 3 mm Hg and diastolic blood pressure by 3 to 4 mm Hg (110); a greater effect was seen at higher doses (≥370 mg/day). 2017;10(1):16-25. Sci Rep. 2017;7(1):106. ATP, the molecule that provides energy for almost all metabolic processes, exists primarily as a complex with magnesium (MgATP) (3). Dibaba DT, Xun P, Fly AD, Yokota K, He K. Dietary magnesium intake and risk of metabolic syndrome: a meta-analysis. (National Academy Press). Sakaguchi Y, Hamano T, Nakano C, et al. J Neural Transm. 2016;15:22. Cunha AR, D'El-Rei J, Medeiros F, et al. Sibai BM. It is not intended as nutritional or medical advice for individual problems. (PubMed), 121. La SA, Lee JY, Kim DH, Song EL, Park JH, Ju SY. (PubMed), 62. J Asthma. The metabolism of carbohydrates and fats to produce energy requires numerous magnesium-dependent chemical reactions. Both bottled mineral water and tap water can be sources of magnesium. (More information), Inadequate dietary intakes and/or low serum concentrations of magnesium have been associated with increased risk of cardiovascular disease, osteoporosis, and metabolic disorders, including metabolic syndrome, hypertension, and type 2 diabetes mellitus. JAMA. Cochrane Database Syst Rev. In a meta-analysis of six (quasi) randomized controlled trials in 325 children with acute asthma treated with a short-acting β2-adrenergic receptor agonist (e.g., salbutamol) and systemic steroids, intravenous magnesium sulfate treatment improved measurements of the respiratory function and reduced the risk of hospital admission by 30% compared to control (138). Nutr Rev. J Anesth. 2009. BMC Cardiovasc Disord. Clin Nutr. Perils and pitfalls of long-term effects of proton pump inhibitors. 1999;69(4):727-736. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional, 250 parts per million of total dissolved solids, 1 milligram per liter (mg/l) to more than 120 mg/l. Modern Nutrition in Health and Disease. 2017;106(3):921-929. Delage N, Morel V, Picard P, Marcaillou F, Pereira B, Pickering G. Effect of ketamine combined with magnesium sulfate in neuropathic pain patients (KETAPAIN): study protocol for a randomized controlled trial. Some studies have found lower magnesium content and larger hydroxyapatite crystals in bones of women with osteoporosis compared to disease-free women (74). [Your name] is not affiliated or endorsed by the Linus Pauling Institute or Oregon State University. Hypomagnesemia after aneurysmal subarachnoid hemorrhage. The administration of 1 gram of intravenous magnesium sulfate ended the attacks, abolished associated symptoms, and prevented recurrence within 24 hours in nearly 90% of the subjects. Adelaide (AU): University of Adelaide Press; 2011. Blood contains less than 1% of total body magnesium. Magnesium. 2014;10(5):255-256. (PubMed), 28. Eur J Epidemiol. (PubMed), 175. Many plastic containers contain bisphenol A, or BPA. Pasch A, Block GA, Bachtler M, et al. (More information), About half of the US adult population may have insufficient magnesium intakes to support nutritional adequacy. Wu X, Wang C, Zhu J, Zhang C, Zhang Y, Gao Y. Meta-analysis of randomized controlled trials on magnesium in addition to beta-blocker for prevention of postoperative atrial arrhythmias after coronary artery bypass grafting. 1993;6(2):155-163. Proton pump inhibitor drugs (PPIs): drug safety communication - low magnesium levels can be associated with long-term use. Paleti S, Prasad PK, Lakshmi BS. 2018;9:99-105. Calcium and magnesium concentrations in the fluid surrounding cells affect the migration of a number of different cell types. Minerals that are often present in mineral water include: Unlike tap water, mineral water is bottled at the source. This live article covers developments regarding SARS-CoV-2 and COVID-19. 2017;14(10):e1002398. Oral magnesium treatment in patients with neuropathic pain: a randomized clinical trial. 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). 2014(8):Cd001060. Drexel University, Copyright 2001-2021  Linus Pauling Institute. 2001;41(2):171-177. Shechter M, Sharir M, Labrador MJ, Forrester J, Silver B, Bairey Merz CN. Am J Cardiol. Magnes Res. Mauskop A, Altura BT, Altura BM. Atherosclerosis. 2014;100(3):974-981. Cochrane Database Syst Rev. You may not copy, modify, distribute, display, transmit, perform, publish or sell any of the copyrightable material on this website. A number of early studies found lower cardiovascular-related mortality in populations who routinely consume "hard" water. A 2015 analysis of data from the US National Health and Nutrition Examination Survey (NHANES 2001-2010) in 9,148 adults (mean age, 50 years) found a 32% lower risk of metabolic syndrome in those in the highest versus lowest quantile of magnesium intake (≥355 mg/day versus <197 mg/day) (15). Ascherio A, Rimm EB, Giovannucci EL, et al. The health benefits of celery include the following: Anti-inflammatory Properties. Rodriguez-Moran M, Guerrero-Romero F. Oral magnesium supplementation improves insulin sensitivity and metabolic control in type 2 diabetic subjects: a randomized double-blind controlled trial. J Pediatr (Rio J). (PubMed), 110. While research on the combined supplement is lacking, studies on the individual minerals are clear and well established. At present, additional evidence is needed from prospectively designed studies to inform the potential relationship between dietary and circulating magnesium and the risk of metabolic syndrome. Oral magnesium therapy improves endothelial function in patients with coronary artery disease. Effect of magnesium supplementation on carotid intima-media thickness and flow-mediated dilatation among hemodialysis patients: a double-blind, randomized, placebo-controlled trial. About 50 to 60% of all the magnesium in the body is found in the skeleton and the remainder is found in soft tissue, primarily in muscle. Randomized controlled trials have also investigated the role of magnesium supplementation in the prevention of complications following stroke or heart surgery. (PubMed), 80. (PubMed), 143. 2017;55(3):56-67. Intravenous caffeine citrate vs. magnesium sulfate for reducing pain in patients with acute migraine headache; a prospective quasi-experimental study. The buildup of plaque inside arterial walls — a process called atherosclerosis — is an early event in the development of cardiovascular disease. Additionally, similar metabolic improvements have been reported following the supplementation of magnesium (382 mg/day for four months) to participants who were both hypomagnesemic and lean yet metabolically obese (i.e., with metabolic disorders usually associated with obesity) (70). J Emerg Med. Although no serious adverse effects were noted during these migraine headache trials, 19 to 40% of individuals taking the magnesium supplements have reported diarrhea and gastric irritation. In addition, oral magnesium supplementation is of no known value in the management of chronic asthma (141-143). According to a recent study, sparkling water manufactured by a soda carbonator significantly reduced enamel hardness on teeth in a laboratory setting. Serum calcification propensity predicts all-cause mortality in predialysis CKD. 2011;141(10):1847-1854. PDR for Nutritional Supplements. Microplastics, tiny plastic particles, are another potential concern. J Crit Care. Diabetes Care. 1998;47(9):1109-1113. Hypertension. Mineral water comes from natural underground reservoirs and mineral springs, giving it a higher mineral content than tap water. (PubMed), 90. (PubMed), 125. Qu X, Jin F, Hao Y, et al. Vascular calcifications as a marker of increased cardiovascular risk: a meta-analysis. The Magpie Trial: a randomised placebo-controlled trial. Accessed 10/22/18. Am J Clin Nutr. 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). 2017;18(1):517. 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) (61).
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