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Poll on magnesium

How does magnesium affect you?


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@zzz
Magnesium's function as a CNS depressant is widely known and can be easily verified. If you simply type "magnesium CNS" into Google, Google's first suggestion is "magnesium cns depressant." If you select this suggestion, you will get pages and pages of results, some more relevant than others.
There are many, many other such high quality references just among the first few pages of results.
And they almost all specify MAGNESIUM SULFATE, which, as I pointed out in my response to your second post, is potentially dangerous when taken internally and then, only very occasionally and in the smallest possible amounts. They should be administered internally, whether by IV or any other method, solely by professional, trained and educated medical personnel.

Some of them rather evasively state that “ ……magnesium is SAID to have a depressant effect on the central nervous system ….”, a clear, almost caviling, caveat.
Searching for "magnesium cns depressant NMDA" provides a number of relevant examples of how magnesium interacts with the NMDA receptor. For example, the journal article Magnesium as a Neuroprotective Agent states that magnesium "has a depressant effect at the postsynaptic membrane through the voltage-dependent block of N-methyl-D-aspartate (NMDA) receptors." Although the CNS is not mentioned explicitly here, NMDA receptors occur throughout the CNS in huge quantities, so when they do, the depressant effect mentioned at the NMDA receptors is a CNS depressant effect.
NMDA receptors are neurotransmitter receptors that are located in the post-synaptic membrane of neurons, existing both in the CNS and the brain, and apparently also in the kidneys, liver, spleen, lungs, reproductive system, ad infinitum. They are proteins embedded in the membrane of nerve cells that receive signals across the synapse from a previous nerve cell. While NMDA receptors reside within the CNS, they are not exactly the CNS as much as located within the CNS, any more than the car that is located inside your garage is your garage.
The previous quote from Magnesium—Essentials for Anesthesiologists applies to this question of yours as well, being even more specific. Once again, there are quite a few high quality search results connecting magnesium's CNS depressant effects with its actions at the NMDA receptor.
And once again, they almost ALL reference MAGNESIUM SULFATE, the only form of magnesium that should only be administered orally or intravenously by a professional medical tech, except in the smallest oral amounts, and hardly on a daily basis.

The article you hyperlinked, Magnesium --- Essentials for Anesthesiologists, addresses the difficulties presented pre- and post-operatively of both hyper- and hypo-magnesemia, amng other issues, so not sure how it applies to my question. Since you didn’t mention what that question was it’s a little hard to say.

The same article goes on to state: “At the beginning of last century, magnesium was proposed to induce anesthesia effectively. Although later studies could not support this hypothesis and seriously questioned sufficient blood–brain barrier penetration of intravenous magnesium (and thus a true central nervous system effect of the drug itself), magnesium has been suggested for reducing anesthetic requirements, attenuating cardiovascular effects from laryngoscopy and intubation, and exerting muscle- relaxing effects.” ….. and
“Although a number of studies suggest a clinically relevant effect of magnesium, its actual efficacy as an adjuvant to analgesics and anesthetics to induce and maintain general anesthesia remains unclear and requires evaluation in large clinical trials"
Certainly not. That's why I have provided the references you requested.
You offered references to a search page for mag sulfate, an article from the Karger Journal, which deals with embryonic and neo-natal brain development, or as it describes itself “ …. a multidisciplinary journal publishing papers covering all stages of invertebrate, vertebrate and human brain development….”, and to a lengthy directive and guidance for anesthesiologists, but no specific references that I could find to other, safer forms of magnesium meant to function as systemic magnesium, intended for oral use and to be taken on a daily basis as a nutritional support, and not as laxatives, intended for intermittent, occasional use.

While I found your link to the Karger publishing company’s article Magnesium As a Neuroprotective Agent, addressing Neonatal Encephalopathy in Term Infants, and Fetal Neuroprotection, pre-eclampsia, and mag sulfate interesting, it didn’t seem to be a citation specific to our discussions here.

There was also a brief entry on the use of mag sulfate as an emergency rescue therapy in adult neurological injuries, which includes warnings about the use of mag sulfate “…. due to possible adverse effects on neuronal cell architecture…”, and goes on to state that “ …. further preclinical evaluation is essential to ensure safety and efficacy of magnesium sulfate neuroprotection prior to further human clinical trials.”
This is indeed very possible. But as our underlying conditions are generally very hard to treat, warning people of magnesium side effects that may occur as a result of an interaction with these conditions seems reasonable to me. I have found that people tend to get rather upset (and understandably so) when they are blindsided by side effects that no one told them about, especially when such side effects are well known (e.g., described in the references I have cited).
Other than a reference to the rather impenetrable and very broad “channelopathies”, you offered no warnings attached to more specific underlying conditions, like, say, diabetes, or even the illness we’re all so preoccupied with here, ME, which isn’t necessarily a singular free-standing condition, but rather an agglomeration of multiple other conditions, all knitted together to produce the effects of ME. So I’m not sure how effective your warning was.
I beg to differ. The Wiktionary defines "drug" as:
A substance used to treat an illness, relieve a symptom, or modify a chemical process in the body for a specific purpose.
This is a somewhat specious argument, since I’m guessing pretty much everybody on these threads, myself included, knows that there’s a pronounced difference between what can be regarded as a drug, and what we regard as a supplement, whether herbal, vitamin, or mineral, or even a food.

Since serious interactions can exist between harmless substances like, say, grapefruit and certain classes of drugs, your logic would dictate that grapefruit is a drug. This is a logical syllogism.

The fact that they all are meant to treat some form of illness or dis-ease does not equate to their being a drug on the level of those I cited in my response, which, since I think they were left out of your response, I’ll repost here as examples of true anxiolytic drugs: Xanax, Ativan, Valium, Klonipin, Tranxene, just for starters.

Magnesium is anxiolytic in so far as its ability to possibly treat, and greatly reduce, the horrors of endless ongoing panic and anxiety attacks, which are a misery that’s almost impossible to describe to anyone who hasn’t endured them. Magnesium does so with minimal, if any, side effects, particularly if taken judiciously and with FULL information (like not taking Mag Sulfate orally or on a daily basis without medical supervision), unlike the prescription drug classes of anxiolytics, which can and actually have killed people. A lot of ‘em.
If you Google "magnesium drug," you will find many high quality references that refer to magnesium as a drug.
Yes, and they mostly seem to address magnesium as a supplement, not a drug, altho some of the listings are on specific drug sites like Drug Interactions, RXList, WebMD, and DrugRX, all of whose intentions are to indicate what cross-potentiations or vitiations exist between the mineral magnesium and the various prescription drugs that are taken by a large number of this nation’s, as well as other nations, patient population. These, again, do not equate magnesium to a drug, but rather warn readers against interactions, potentiations, etc., that exist between it, as a mineral, and what most of us more readily would define as drugs.

A small number of recent namings of Mg as a drug seems to stem from its multiple beneficial actions in the human brain and body, and the avid interest by various bodies, corporate and otherwise, to isolate it from its more humble mineral beginnings and elevate it to a position that would engage more research dollars and possibly take it from a readily available, inexpensive OTC supplement, to a prescription product which pharma companies could convert into huge amounts of money. Much as they did with tryptophan when its value in combating migraines was determined.
Strictly speaking, most sources consider magnesium to be "anxiolytic-like", although some do simply call it an anxiolytic. As for being carbon-based, magnesium doesn't fit into that category. But the NMDA and GABA systems are in many ways complementary, in that NMDA antagonists (such as magnesium) tend to have many similarities to GABA agonists, and vice versa. In the case of the benzodiazepines that you mentioned, although they are not GABA agonists, they are GABA receptor potentiators, which behave in a similar way.
“Anxiolytic-like” covers a lot of ground which would include various forms of tea, like chamomile, as well as wine, harder spirits, warm scented baths, many essential oils like frankincense and lavender, even foods like chocolate altho it contains caffeine, offset by theobromine, and certain kinds of lettuces And there are myriad other examples.

And yes, benzos ARE GABAa agonists. They amplify the GABAa receptor’s effects, the very definition of an agonist. It’s why they’re so hard to withdraw from, because in amplifying the GABAa receptors, they precipitate dangerous down-regulation of them. A short google search will support that.

But I’d prefer not to go off-topic and argue GABA potentiators, agonists, antagonists, and down-regulators, since this all started with your warnings about magnesium, which I was afraid would have a negative effect on members who might otherwise have tried it, and since, like you, I’m not in the best shape right now, I’m hesitant to pour too much more of my fleeting energy into this.

You have very strong opinions that you will not back down from as do I, so it’s a Mexican stand-off. But specious arguments and logical syllogisms can be seriously misleading.
My health is not all that great, and I don't want to stress it out too much by pushing myself too hard here. Also, I think at some point I have to take mercy on the poor readers (if there are any left after this post).
The readers of these threads are not children. In my experience, they're generally smart, well-informed, and extremely interested readers of the posts in the many threads on this site, and like me, and I suspect you, open to the exploration of any information that might help in their battle with this gaping, sharp-toothed maw of a horror of an illness in any way possible.


Further, they can skip reading these posts if they chose to. It’s really not up to us to decide for them.
When someone states something that surprises me, or that I don't believe, I'll first check out reliable resources on the Web before replying, as I am very aware that my medical knowledge is quite limited. If you have further questions about what I said, you might want to consider a similar course. Meanwhile, due to my low energy level and current health status, this is about as much as I can do on this topic. Feel free to reply (and I will read any replies), but I need to take a break from long posts for now.
“You might want to consider a similar course ….” feels a little snide, but I'm having a piss-poor day, so maybe that’s just me.

I’m well aware of the magic of the google machine, and I use it gratefully and judiciously, largely because along with solid fact-based information, there’s an awful lot of ridiculous tosh.

And yes, there are still a lot of unaddressed questions about what you posted, as I’m sure you feel about what I’ve posted, but as I’ve already stated, I have limited strength and energy, and, having done my best to set the record straight on magnesium and its actions and safety, have little interest in continuing with circular arguments regarding what you’ve said or what I’ve said.
I know we both want the best for everyone on this forum
Absolutely !!! And I particularly didn’t want readers of your original post to be warned off of or unnecessarily scared away from magnesium, as particularly a new member might have been, since, as I mentioned in my response to that post, it saved my @ss and probably my life. Your post made it seem both somewhat threatening and even possibly dangerous,

And that’s how this whole fandango started. Let’s end it here.

Feel better
!!! :):) :thumbsup::thumbsup:
 
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@pamojja
Thanks for asking. I feel guilty of having got rid of constant PEM 2 years ago, and therefore can't really contribute to its discussion that much anymore. Since mine could have been a different animal altogether.
I've never found any of your posts to be anything other than well-considered and highly informative, and I think that you still have a lot to contribute to these threads. There may be others who are dealing with similar circumstances without realizing what the root cause (sorry, unintentional pun, apologies) is who could profit from your input and experience.

Look forward to seeing you in these threads, yes? :woot::woot:
:thumbsup::thumbsup::thumbsup: :hug::hug:
 
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@Inara
I once tried Mg transdermally and had an instant bad reaction (weakness, tremor); by taking calcium orally it got better. Due to this reaction I do wonder if Mg is good or bad for me; I don't actually know.
Altho magnesium helps your body absorb and retain calcium, too much magnesium may prevent calcium from being adequately absorbed, and vice-versa. Taking large amounts of either calcium or magnesium could potentially create malabsorption and/or a magnesium or calcium deficiency, so approach this on a trialing basis, with the usual caveat heard so often in these threads, “Start low and go slow”.

If I’m remembering correctly, a 2:1 calcium-to-magnesium ratio is the way to go for optimum absorption. You might try balancing your transdermal mag with twice as much calcium and see if that helps :):):thumbsup:.
 

junkcrap50

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@YippeeKi YOW !! Why do you say Magnesium Sulfate (Epsom salt) is so dangerous? I'm looking at doing some Mag Sulfate enemas to replenish magnesium levels. As far as I can tell, the only danger is poses is that it is easy to overdose on it - a seeminlgy small amount can kill you (~1 tbsp) from the amount of magnesium it gives you. Is there any other reason?

If you calculated a precise dose of magnesium do deliver, say 400mg. I would think 400mg elemental magnesium as mag sulfate taken parateneal (enema, nebulization, etc) would be safe.
 

junkcrap50

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I also have a question regarding IV Magnesium. It seems like the dose usually given is quite small, and I'm having difficulty understanding how it can lead to raising tissue Mg levels. Typically, 1g 50% MgSO4 is given, which is ~100mg elemental magnesium. Or if given 1g MgS04 = 200mg elemental Mg.

Would this not be similar to taking 1,000mg elemental magnesium from Mag Citrate assuming 20% absorption?

So, I don't see how IV provides a better way to raise Mg2+ levels. Yet there are several anecdotes that ONLY IV has been effective in patients and that's the standard protocol by doctors & hospitals.

Is there something more complicated regarding Magnesium transport that would explain IV's more effectiveness?
 

pamojja

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Typically, 1g 50% MgSO4 is given, which is ~100mg elemental magnesium. Or if given 1g MgS04 = 200mg elemental Mg.
The packet insert of my Mg-sulfate ampoules say:

3. how to use Magnesium Verla® i.v. 50 %?

Always use this medicine exactly as described in this leaflet or according to the instructions of your doctor or pharmacist. Ask your doctor or pharmacist if you are not sure.

The dosage depends on the indication and the magnesium serum level.

The recommended dosage is

In pre-eclampsia, eclampsia: 4-6 g magnesium sulphate (16-24 mmol magnesium) i.v. in diluted form by perfusor or short infusion for 15-20 minutes. Maintenance dose 1-2 g magnesium sulphate/hour (4-8 mmol magnesium/hour) to 24-48 hours post partum.

In case of premature birth aspirations, as additional therapy to tocolysis with betamimetics: 4-8 mmol magnesium/hour.

For severe magnesium deficiency: 20 mmol magnesium/day.

Translated with www.DeepL.com/Translator (free version)
1 pampoule I usually get with 250 mgl salt-solution contains:

What Magnesium Verla® i.v. 50 % contains:

The active ingredient is: magnesium sulfate.

1 ampoule of 10 ml solution:

magnesium sulfate heptahydrate: 4930 mg

Magnesium content: 486.1 mg = 20 mmol = 40 mval

The other component is: Water for injection purposes
I think the fundamental difference of 486,1 mg of elemental magnesium IV to 1000mg of elemental magnesium from Mg-citrate orally is, that there is no other way than 100% being absorbed in the blood-stream by the former. Oral absorption only has been tested partially in humans (short-term urinary excretion) and absorbtion rates assumed despite too many unknowns.,

(I don't understand how they give a 20 mmol IVs in preclamsia within 15 minutes, I get the same amound and it always takes more than an hour. I always have to slow down the drip to not overheat)
 
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junkcrap50

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I think the fundamental difference of 486,1 mg of elemental magnesium IV
Yes. If that is the dose you are being given, 486.1mg of elemental Mg (5g MgSO4), I can see how it makes a difference in raising levels. However, in my research and review of papers, reports from CFS patients who went on IV/IM Mg, and other uses of IV Mg (say for migraines, etc.), the dose you are given does not seem to be typical (unless I am wrong) for subclinical magnesium deficiency. I thought 1g MgSO4 (100mg elemental) was typical; it is for IM at the very least. ~5g MgSO4 IS however the recommended dose for Hypomagnesemia, which is a bit different and a dangerous/serious condition, preclamsia, and other very serious conditions.

How often do you get the IV of 486mg Mg2+? Once per week?
 

pamojja

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5g MgSO4 IS however the recommended dose for Hypomagnesemia, which is a bit different and a dangerous/serious condition, preclamsia, and other very serious conditions.

How often do you get the IV of 486mg Mg2+? Once per week?
As you mention and according to the packet insert, 5g Mg-sulfate is the recommented dose for severe Mg-deficiency per day. Which is what I take it for (mind it, it took me many years to find a GP willing to give it to me, once in a hospital I was blundly told, 'sorry, we don't treat Mg-deficiencies'. Of course, most MDs don't know that even with a very severe deficiency serum levels can still be within normal. And that only RBC or whole blood tests can show the extent. Tests they never use here, and therefore don't trust.).
.
For pre-eclamsia the same within 15 min., and up to ~48g the next 24 hours as maintainance dose, condinued even for a second day. So in total that would amount up to a whooping 101g of Mg-sulfate in a hospital setting for pre-eclamsia within 2 days!!! On an other forum a health-care worker commented having withnessed this procedure routinely without any adverse effects.

However, I understand that for other conditions than Mg-deficiency, like you mention ME/CFS or migranes, the dose must of course be much smaller if not monitoring levels. Hypermagnesia could be potentially very dangerous. But even so, pre-eclamsia also doesn't has anything to do with severe Mg-deficiency..

Somewhere I read 8 of such IVs would usually correct a severe Mg-deficiency. In my case got it from my GP almost monthly. By the 6th IV very pain-ful muscle-cramps ceased, which before got alleviated only somewhat with up to 2.4g per day of oral elemental magnesium (1.7g in average for 11 years now; even on the higher oral doses serum-Mg only declined further within the range).

After the 10th IV I retested whole-blood Mg, showing it only raised about 3 mg/l since starting the IVs, still 2 short of normal between 34-36 mg/l. All the while continuing my high oral intake. By now I received my 18th IV within 2 years, and should get the next whole-blood Mg results taken just before the last IV in about a week.

For overdose the packet-inserts reads:

If you have used a larger amount of Magnesium Verla® i.v. 50% than you should:

Main symptoms and general signs of overdose are muscle weakness, disappearance of deep tendon reflexes, drop in blood pressure and heart rate, increase in skin circulation, ECG changes, vomiting, sedation and confusion.

If the plasma-magnesium concentration exceeds 2 mmol/l, the deep tendon reflexes are weakened, at about 5 mmol/l they are no longer present and respiratory depression occurs. At 6.0-7.5 mmol/l a coma occurs and from 8 mmol/l for respiratory paralysis and diastolic cardiac arrest.

Magnesium intoxication should be treated with intravenous calcium intake - as an antidote (e.g. slow i.v. administration of 10 ml of a 10 % calcium gluconate solution). In addition, the cholinesterase blocker Neostigmine should be administered as it increases the acetylcholine concentration and antagonizes the muscle relaxant effect of magnesium.
I never experienced any of the described overdose symptoms. However, it is very calming and warming.
 
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junkcrap50

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As you mention and according to the packet insert, 5g Mg-sulfate is the recommented dose for severe Mg-deficiency per day. Which is what I take it for (mind it, it took me many years to find a GP willing to give it to me, once in a hospital I was blundly told, 'sorry, we don't treat Mg-deficiencies'. Of course, most MDs don't know that even with a very severe deficiency serum levels can still be within normal. And that only RBC or whole blood tests can show the extent. Tests they never use here, and therefore don't trust.).
Yes, well you're lucky that you're MD recognized your low magnesium to be a severe deficiency.

By the 6th IV very pain-ful muscle-cramps ceased, which before got alleviated only somewhat with up to 2.4g per day of oral elemental magnesium (1.7g in average for 11 years now; even on the higher oral doses serum-Mg only declined further within the range).

After the 10th IV I retested whole-blood Mg, showing it only raised about 3 mg/l since starting the IVs, still 2 short of normal between 34-36 mg/l. All the while continuing my high oral intake. By now I received my 18th IV within 2 years, and should get the next whole-blood Mg results taken just before the last IV in about a week.
Holy crap. That's a lot of Mg for you. You must have been severely depleted. Or perhaps, you're wasting/excreting a lot of it all the time. Did your doctor check for any magnesium wasting for you? Or drugs you take that cause Mg loss? It seems unusual you're losing a ton of magnesium. Maybe that's why it's taken several years of monthly administration, because in the month between IVs, you're losing so much naturally/unnaturally.
 

pamojja

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My GPs (a couple) are very good-hearted. For years I told the male part, that all which probably really would help my multifacetious health-problems, would be Mg-sulfate IVs against my Mg-deficiency. He noded stoically. Only after years in his practice I spotted a brochure in the waiting-room from his wife (actually a homeopath too), advertising ascorbate IVs. I was immetiately curious and asked if she also would do Mg-sulfate IVs? She only asked to get the ampoules from a pharmacy myself (prescribtion-free here) and it was set up.

The reality is, there are up to 150 patients in 2 hours of ordination. They take on all patients with migrating background, GPs usually refuse to take beyond a certain quote. On asking why her husband never suggested her IV service upon being asked for it, she answered she already would be glad if he doesn't drops death from all the stress one day! During my 18 IVs till now I routinely got asked how much saline? How much ampoules in 1 IV again? That's how far their investigation goes, asking me. The whole-blood testing I have to get out of my pocket myself.

Hell, what do I know? 250ml saline with 1 ampoule worked fine till now. I wouldn't want to risk 2 at once. However, finally receiving Mg-sulfate IVs, I'm a happy camper anyway..

I don't take drugs. It however all started by getting my vitamin D3 serum levels up to healthy levels. Since magnesium is a co-factor in vitamin D3 metabolism, I have to assume a sub-clinical magnesium deficiency for my whole life. Which propably was just pushed to very severe by the higher vitamin D3 metabolism. There are probably additional reason for the huge loss, I'll never find out on my own.
 
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junkcrap50

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Thank for your answers.

During my 18 IVs till now I routinely got asked how much saline? How much ampoules in 1 IV again? That's how far their investigation goes, asking me. The whole-blood testing I have to get out of my pocket myself.
That sucks that you have to instruct the doctors on your care. That's just the way it is and the conclusion I've reache.
Basically for ME/CFS 1) you have to be your own doctor and basically ask MDs to do stuff that you want, because otherwise nothing would get done; and 2) every treatment is basically all trial and error, every patient responds differently to different things. So you just have to try various treatments yourself.
 

pamojja

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That sucks that you have to instruct the doctors on your care.
Truth is, years ago I moved and searched a new GP. But didn't found even one who wouldn't be offended by basically being handing over a list of blood-tests needed (my GP told he could do it only because I'm his only patient doing that, otherwise he would get problems with insurance too) and an own opinion. So now I have to travel an hour just to get there, and be very glad to have at least one considerate.
 

junkcrap50

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Don't know where to ask this question, so I figured I'd ask here.

What's the relationship between phosphorus (particullar low phosphorus) and magnesium deficiency or magnesium absorption?


I could have sworn I read that phosphorus is needed for intracellular magnesium absorption, but I can't find that reference anywhere. Does anyone know?