This article originally appeared in Amazing Wellness magazine.
You may have a near-perfect battery of supplements to support everything from your bones to your blood to your heart, and more. But when and how you take your vitamins, fish oil, and probiotics may be as important as what you’re taking. Get the most out of seven popular supplements with this comprehensive guide to timing, combining, and dosing.
- 1. Calcium
- 2. Iron
- 3. Vitamin D
- 4. B Complex
- 5. Vitamin C
- 6. Fish Oil
- 7. Probiotics
- Calm-Aid Side Effects
- For the Consumer
- For Healthcare Professionals
- More about Calm-Aid (diphenhydramine)
- The Side Effects of Adderall Are Real. But These Powerful Supplements Can Help.
- The Facts About Adderall Side Effects
- Recoop Balance
- Recoop Recovery
- Best Tranquilene Total Calm Side Effects of 2020 – Top Rated & Reviewed
- Our Promise to Readers
- What Is Magnesium Citrate?
- Magnesium Citrate vs. Chelate, Chloride Oil and Other Forms
- Health Benefits (Including for Constipation)
- Recommended Dosage (and How to Use It)
- Risks, Side Effects and Interactions
- Magnesium Supplements: Benefits, Side Effects, and Dosage
- What You Need to Know About Magnesium and Your Sleep
- Mg Water
- Medications, Alcohol Consumption, and Magnesium: Ensuring Adequate Intake of Oral Magnesium
In doses higher than 250 milligrams, calcium and magnesium tend to compete for absorption. But both are critical for bone health, and the extra convenience of taking them in a combined supplement may outweigh the relatively small percentage of each that may not get absorbed. A 1:1 to 2:1 ratio of magnesium to calcium is best.
Take calcium with food (to boost absorption and reduce the risk of kidney stones) and in split doses (the body absorbs smaller doses better than large ones). If you can, take calcium at a different time of day than zinc and iron. Chelated forms tend to be better absorbed and easier on the stomach. New Chapter Bone Strength Take Care is a whole-food supplement that delivers bone-strengthening calcium.
For maximum absorption, it’s best to take iron on an empty stomach. Unless you have a sensitive stomach, take it first thing in the morning and wash it down with orange juice. (The caffeine in coffee and the calcium in dairy can interfere with its absorption, while vitamin C can enhance it.) To prevent constipation, avoid the ferrous sulfate form, and be sure to drink plenty
of water and eat ample fiber. If you have a sensitive stomach, try iron bisglycinate.
Take 60 to 120 milligrams of iron with a vitamin C-containing food (like an orange) before breakfast, at least two hours before taking vitamin E or a multivitamin. Flora Floradix Iron + Herbs is an easily-absorbed liquid formula that’s rich in iron and B vitamins.
3. Vitamin D
Like other fat-soluble vitamins (A, E, and K), vitamin D is better absorbed if taken with a meal that contains fat. (One study found that taking vitamin D with dinner—usually our heaviest meal—increased blood levels by 50 percent.) Don’t take D at dinner if you eat late, though, since it interrupts the body’s production of melatonin and can disrupt sleep.
Take up to 2,000 IUs of vitamin D with lunch or early dinner that contain healthy fats, like avocado, olives, salmon, or nut butter. The Vitamin Shoppe Vitamin D3 delivers 2,000 IUs in each easy-to-swallow softgel.
4. B Complex
B complex vitamins are water-soluble, so the body can only absorb so much at a given
time (unlike fat-soluble vitamins, which are stored until they’re needed). Splitting the dose can ensure steady blood levels. B vitamins tend to boost energy, so take them in the morning; at night, they can lead to restlessness and insomnia. They’re best absorbed on an empty stomach, but if you have a sensitive tummy, take them with a little food.
Split B vitamins into morning and afternoon doses—before breakfast and lunch—and take them on an empty stomach, if possible. Look for a formula that contains well under 100 milligrams of B6. Irwin Naturals Mega-B Complex softgels provide all of the essential B vitamins.
5. Vitamin C
Like B vitamins, vitamin C is water-soluble and doesn’t require dietary fat to be effective. Splitting the dosage improves absorption, keeps blood levels elevated all day, and prevents the gastrointestinal distress some people experience with large doses (1,000 milligrams or more). Buffered forms of vitamin C are best if you have a sensitive stomach. Vitamin C enhances calcium absorption, but may interfere with the absorption of vitamin B12, so take them separately if possible.
Take 250 milligrams twice a day, with breakfast and lunch. Plnt’s Whole-Food Vitamin C offers 250 milligrams per capsule.
6. Fish Oil
Fish oil can cause gastric distress (like nausea and indigestion), so it should always be taken with food. Plus, the fat in your meal will also help its absorption. Because it can be hard to digest, take fish oil in divided doses, and never right before physical exercise or bed; the increased activity or prone position can interfere with digestion and cause heartburn or reflux. If you really struggle with digesting fish oil supplements, try an emulsified version, which may be easier to digest and absorb. Fish oil mixes well with most other supplements, but don’t take it with ginkgo biloba or other blood-thinning herbs. If you’re on a prescription blood-thinner, talk to your doc before adding fish oil to your routine.
Take 500 to 600 milligrams of fish oil twice a day, with breakfast and lunch or with lunch and an early dinner. Nordic Naturals Lemon Omega-3 softgels offer 690 milligrams of omega-3 fatty acids.
Harsh stomach acids may destroy probiotics, so they’re best taken when digestive enzymes, bile salts, and stomach acids are low—in other words, on an empty stomach. Some studies suggest probiotics survive in the largest numbers when taken 30 minutes before a meal that contains some fat (which buffers stomach acids and helps probiotics survive to reach the intestines). However, some evidence also exists that food buffers stomach acid, so taking probiotics with a meal may offer increased protection for the microorganisms. (Keep in mind that probiotics were traditionally taken via cultured foods like yogurt or sauerkraut.) Additionally, different strains may have different tolerances to stomach acids. Since the jury’s still out, try taking some of your daily probiotics before meals and some with meals, and see what works best for you. Just don’t take them post-meal: Several studies show probiotic survival tends to be lowest when taken 30 minutes after eating. Choose a probiotic with a variety of strains, especially L. acidophilus, B. Longum, B. bifidum, L. rhamnosus, and L. fermentum.
Take anywhere between five and 25 billion CFUs of a broad-spectrum formula, half an hour before or with breakfast, lunch, or dinner. Garden of Life Primal Defense Ultra delivers 15 billion CPU per three-capsule serving.
Keep your supplement schedule straight with this handy infographic:
Calm-Aid Side Effects
Generic Name: diphenhydramine
Medically reviewed by Drugs.com. Last updated on Oct 3, 2019.
- Side Effects
Note: This document contains side effect information about diphenhydramine. Some of the dosage forms listed on this page may not apply to the brand name Calm-Aid.
For the Consumer
Applies to diphenhydramine: oral capsules and tablets, parenteral injection
Side effects include:
Sedation, sleepiness, dizziness, disturbed coordination, epigastric distress, thickening of bronchial secretions.
For Healthcare Professionals
Applies to diphenhydramine: compounding powder, injectable solution, oral capsule, oral disintegrating strip, oral liquid, oral tablet, oral tablet chewable, oral tablet disintegrating
The most commonly reported side effects included somnolence, dizziness, and incoordination.
Common (1% to 10%): Sedation/somnolence/sleepiness, drowsiness, unsteadiness, dizziness, headache, attention disturbance
Rare (0.01% to 0.1%): Extrapyramidal effects, tremor, convulsions
Frequency not reported: Paresthesia, dyskinesia/muscle dyskinesia, vertigo, neuritis, incoordination, psychomotor impairment, activation of epileptogenic foci
Drowsiness usually diminishes after a few days.
Common (1% to 10%): Dry mouth
Frequency not reported: Gastrointestinal disturbance, nausea, vomiting, constipation, diarrhea, dyspepsia, epigastric distress
Common (1% to 10%): Fatigue
Frequency not reported: Lassitude, tinnitus, acute labyrinthitis, asthenia, chills, impaired performance (including impaired driving, work, and/or information processing)
Rare (0.01% to 0.1%): Confusion, depression, sleep disturbances
Frequency not reported: Paradoxical excitation/excitation, agitation, increased energy, restlessness, nervousness, euphoria, anxiety, hallucinations, insomnia, irritability
Rare (0.01% to 0.1%): Palpitations, hypotension, arrhythmia
Frequency not reported: Tachycardia, chest tightness, extrasystoles
Rare (0.01% to 0.1%): Blood disorders
Frequency not reported: Hemolytic anemia, thrombocytopenia, agranulocytosis
Rare (0.01% to 0.1%): Hypersensitivity reactions
Frequency not reported: Angioedema, anaphylactic shock
Rare (0.01% to 0.1%): Liver dysfunction
Frequency not reported: Rash, urticaria, skin rashes, erythema, photosensitivity, pruritus, drug rash, excessive perspiration
Frequency not reported: Dyspnea, thickening of bronchial secretions, throat tightening, wheezing, nasal stuffiness, dry nose or throat
Frequency not reported: Urinary hesitancy/difficulty/retention, dysuria, early menses
Frequency not reported: Blurred vision, dry eyes, diplopia
Frequency not reported: Increased appetite, anorexia
Frequency not reported: Muscle twitching/weakness
1. Cerner Multum, Inc. “Australian Product Information.” O 0
2. “Product Information. Benadryl (diphenhydramine).” Parke-Davis, Morris Plains, NJ.
4. Cerner Multum, Inc. “UK Summary of Product Characteristics.” O 0
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Some side effects may not be reported. You may report them to the FDA.
- What is the difference between diphenhydramine hydrochloride and diphenhydramine citrate?
More about Calm-Aid (diphenhydramine)
- During Pregnancy or Breastfeeding
- Dosage Information
- Drug Interactions
- Drug class: anticholinergic antiemetics
Other brands: Benadryl, Banophen, Benadryl Allergy, ZzzQuil, … +26 more
- Diphenhydramine Hydrochloride (AHFS Monograph)
- … +1 more
- Allergic Reactions
- Allergic Rhinitis
- Cold Symptoms
- … +5 more
The Side Effects of Adderall Are Real. But These Powerful Supplements Can Help.
October is ADHD Awareness month. And if you’re one of the millions of Americans who rely on prescription stimulants like Adderall to boost concentration, alertness, and energy, but you’re worried about possible long term damage the drug might be doing to your brain, here’s some very good news. A new company called Recoop has created the world’s first science-based supplement system specifically designed to counteract Adderall side effects as well as the unwanted effects of other common prescription stimulants.
According to a 2018 survey conducted by the American Journal of Psychiatry, at least 16 million Americans over the age of 18 use prescription stimulants such as Adderall. That includes an estimated 25 to 50 percent of college students. So if you’re one of the millions of people with an Adderall prescription, it’s important to understand that the drug often comes with some serious unwanted baggage.
The Facts About Adderall Side Effects
Adderall side effects may include anxiety, irritability, and insomnia, just to name a few. For a long time, doctors tried to counteract Adderall side effects by prescribing benzodiazepines. This is a class of prescription depressants that has sedative, anti-anxiety, and muscle relaxant properties – the most famous example of which is diazepam, or Valium. However, new laws created in response to the ongoing opioid crisis limit doctors’ ability to prescribe stimulants alongside benzodiazepines.
Of course, even if doctors could still prescribe benzodiazepines alongside prescription stimulants, that wouldn’t completely eliminate the danger. Recent studies have shown that long term Adderall use can result in neurotoxicity, which is when a chemical substance damages the structure or function of the central and/or peripheral nervous system. Specifically, the excess levels of dopamine triggered by the amphetamines in Adderall can cause neuron damage as the brain actually strips itself of dopamine receptors in order to restore balance. Which is very bad.
Unfortunately, for most people who use them, giving up prescription stimulants like Adderall is not an option. That’s why Recoop set out to eliminate their side effects. And after extensive research, their team of scientists and researchers came up with two different formulas—one to control the side effects of stimulants throughout the day, and another to deactivate those stimulants at night.
As its name suggests, Recoop Balance is designed to balance out the effects of stimulants, claiming to give you all the focus without the anxiety. Two caplets in the morning before you take any stimulants have been shown to improve impulse control, combat irritability, lift mood, and boost productivity.
So what, exactly, is in Recoop Balance? Here’s a rundown of the key ingredients:
Curcumin for Detoxification
Curcumin, which is found in the spice tumeric, has been used in India for medicinal purposes for thousands of years. It contains natural polyphenol compounds called curcuminoids that have antioxidant, anti-inflammatory, and neuroprotective properties. Recent evidence also suggests that curcumin can increase cognitive performance and enhance neurogenesis. Curcumin is used in Recoop Balance for detoxification and neurogenesis.
Vitimin B for Cognitive Function
Elevated levels of the homocysteine serum can result in the loss of cognitive function, as well as various cardiovascular problems. Studies have also shown that coffee consumption raises homocysteine levels. Luckily, Vitamin B helps prevent loss of cognitive function by reducing levels of homocysteine. Vitamin B is used in Recoop Balance to promote DNA regeneration, regulate mood, and build healthy brain cells.
Ashwagandha for Stress Relief
Ashwagandha is an herb used in Ayurveda, a traditional Indian medicine. But recent scientific studies have found that it may fight anxiety by reducing cortisol levels. Cortisol is your body’s main stress hormone. Produced by the adrenal glands, it interacts with parts of your brain to control mood, motivation, and fear. Ashwagandha is used in Recoop Balance to reduce stress, improve focus, and reduce cravings.
L-Theanine for Focus
L-theanine is an amino acid found in green tea that is structurally similar to glutamate, another amino acid that helps transmit nerve impulses to the brain. L-theanine has long been known to improve focus and attention, and actually has a synergistic effect with stimulants such as caffeine. We now know this is because it modulates inhibitory neurotransmitters, selective serotonin, and dopamine to bring about anxiolytic and calming effects. L-theanine is used in Recoop Balance for deep concentration, reduced stress, and stimulant enhancement.
Coenzyme Q10 for Organ Function
Coenzyme Q10 is a molecule found in mitochondria that plays a critical role in producing energy for the body. It is also a powerful antioxidant that has a well-documented impact on cardiovascular health. Coenzyme Q10 is used in Recoop Balance to reduce headaches, detoxify, and promote heart health.
Whereas Recoop Balance is designed to balance the effects of stimulants so you can stay focused and productive throughout the day, Recoop Recovery is designed to flush stimulants from your system so you can fall into a deep regenerative sleep and wake up feeling more refreshed. Two caplets 30 minutes before bed can help your body and your brain repair itself overnight so you are 100-percent ready to take on the next day.
Some of the key ingredients in Recoop Balance are also found in Recoop Recovery. Turns out a calm mind is good for work and relaxation.
Vitamin C for Cleansing
Vitamin C, or L-ascorbic acid, is a water-soluble essential vitamin found in citrus fruits. Well known for its antioxidant properties and immunity benefits, Vitamin C sequesters free radicals in the body, which helps promote blood flow and neurogenesis. Vitamin C is used in Recoop Recovery to trigger the natural elimination of stimulants from the system and provide immune support.
Magnesium to Reduce Tolerance
Magnesium is an essential mineral that serves as a cofactor in the biochemical reactions performed by enzymes. These include converting food into energy, creating and repairing DNA, and regulating neurotransmitters. Magnesium is used in Recoop Recovery for heart health, neuroprotection, and to reset the body’s neural pathways on a cellular level.
NALT to Lift Mood
NALT is a form of L-Tyrosine, an amino acid that is used to produce noradrenaline and dopamine. Research shows that taking tyrosine reduces anxiety and improves cognitive function during stressful conditions. NALT is used in Recoop Recovery to boost dopamine levels and reduce anxiety.
L-Theanine to Cause Restfulness
The same calming effects of L-theanine that help you stay focused during the day also help you relax at night, once stimulants are out of your system. That’s why L-theanine is used in Recoop Recovery to reduce anxiety, melt away stress, and improve sleep quality.
Melatonin to Regulate Sleep Rhythms
Melatonin is a neurohormone secreted by the pineal gland that tells your brain when it’s time to power down for the night. Light—including the kind emitted from the cell phone that’s almost always a foot away from your face—suppresses melatonin production, interfering with your natural circadian rhythm. That’s why Melatonin is used in Recoop Recovery to promote natural sleep patterns by telling your brain it’s time for bed.
Recoop Balance and Recoop Recovery were designed to be taken together, and Recoop maintains that this is the best way to combat the side effects of stimulants. However, you don’t have to take them together, and if you’re going to take just one, Recoop recommends the Balance formula.
So if you’re worried about Adderall side effects or those caused by other common stimulants, .
Futurism fans: To create this content, a non-editorial team worked with an affiliate partner. We may collect a small commission on items purchased through this page. This post does not necessarily reflect the views or the endorsement of the Futurism.com editorial staff.
Best Tranquilene Total Calm Side Effects of 2020 – Top Rated & Reviewed
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Magnesium is the fourth most-abundant mineral in the body, and it’s mostly stored inside our bones. Because our bodies can’t make magnesium, we must get this mineral from our diets or supplements. Magnesium supplements are available in a variety of forms, one of which is magnesium citrate.
What is magnesium citrate good for?
The No. 1 reason to use any magnesium supplement is to help maintain adequate levels of this mineral in order to prevent deficiency. Believe it or not, some research shows that nearly two-thirds of the population in the western world does not achieve the recommended daily allowance for magnesium.
Magnesium deficiency is believed to be one of the most prevalent nutrient deficiencies that affects adults, for reasons including poor soil quality, issues with absorption, and a lack of fruits or vegetables in people’s diets. Not only can magnesium citrate help defend against deficiency symptoms like fatigue, muscle aches and trouble sleeping, but it’s also commonly used by doctors to alleviate constipation. That’s not all. Read on learn more about magnesium citrate.
What Is Magnesium Citrate?
Magnesium citrate is an over-the-counter magnesium preparation made with a combination of salt and citric acid. Magnesium citrate is sometimes described as a “saline laxative” because it effectively works to relieve constipation and clear out the intestines, thanks to its ability to increase water and fluids in the small intestine. However, treating occasional constipation is not the only use for magnesium citrate supplements — they are also taken for nutritional support.
What does magnesium citrate do for the body?
Magnesium itself is an essential, multipurposed mineral involved in over 300 enzymatic reactions in the body. About 99 percent of the total magnesium found in the human body is located in bones, muscles and non-muscular soft tissue. The main purpose of using magnesium citrate and other forms of magnesium is to maintain healthy levels, since magnesium deficiency can contribute to a wide variety of symptoms and conditions. These include trouble sleeping, headaches, fatigue, and muscle aches or spams.
Magnesium citrate benefits and uses include:
- Cleaning stool from the intestines, which is why magnesium citrate is sometimes used before surgery or certain bowel procedures like a colonoscopy
- Relieving constipation, gas and bloating
- Helping regulate muscle and nerve functions
- Supporting higher energy levels/preventing fatigue
- Supporting bone and dental health
- Helping with maintenance of normal blood pressure, heartbeat rhythms and blood glucose levels
- Helping maintain a positive outlook and calmness
- Supporting healthy immune system function
Other names for magnesium citrate can include Citrate of Magnesia or the brand name Citroma.
The absorption rate and bioavailability of magnesium supplements differs depending on the kind you use. Research shows that usually types that dissolve in liquid are better absorbed in the gut than less soluble forms. Some research suggests that magnesium citrate, chelate and chloride forms are typically absorbed better than magnesium supplements in oxide and magnesium sulfate forms.
Here’s a bit about the different types of magnesium citrate supplements that are available:
- Magnesium citrate powder — This is a popular form of magnesium that is stirred into water or another fluid and taken for nutritional support. The powder is combined with water. This causes the two to bind together, creating “ionic magnesium citrate,” which is absorbed in the gastrointestinal tract.
- Magnesium citrate liquid — This form is the type usually taken for its laxative effects. A liquid magnesium citrate product usually has a magnesium content of about 290 mg per 1 fl oz (30 mL) serving. Other ingredients might also be added to enhance the taste and effects, such as potassium, lemon oil, polyethylene glycol, sodium and sugar/sucrose. Because liquid products are usually used as saline laxatives, they are typically taken about two or more hours before or after other drugs.
- Magnesium citrate capsules — Capsules are a convenient way to take magnesium citrate. They are usually taken just like powder forms, with at least a glass of water.
Magnesium Citrate vs. Chelate, Chloride Oil and Other Forms
Magnesium citrate is only one of a number of magnesium supplement options. Here is how different forms of magnesium compare:
- Magnesium Chelate — highly absorbable by the body and the kind found in foods like fruits and vegetables naturally. This type is bound to multiple amino acids (proteins) and often used to restore magnesium levels and prevent deficiency.
- Magnesium Chloride Oil — an oil form of magnesium that can be applied to skin. It’s also given to people who have digestive disorders that prevent normal absorption of magnesium from their food. Athletes sometimes use magnesium oil to increase energy and endurance, dull muscle pain, and heal wounds or skin irritation. It can also be used to soothe skin issues like dermatitis, eczema and acne.
- Magnesium Oxide — typically used as a laxative and remedy for acid reflux. This type may be taken in higher doses than other forms since its not absorbed as well. Another name for this type is hydroxide, which is the ingredient in milk of magnesia that is taken for heartburn symptoms.
- Magnesium Sulfate — a combination of magnesium, sulfur and oxygen that is sold as Epsom salt. This type is usually added to baths as it seeps through the skin, relieving sore muscles and promoting relaxation.
- Magnesium Glycinate — highly absorbable. This is recommended for anyone with a known magnesium deficiency and less likely to cause laxative effects than some other magnesium supplements.
- Magnesium Threonate — has a high level of absorbability/bioavailability since it can penetrate the mitochondrial membrane. This type is not as readily available, but as more research is conducted, it may become more widely used.
- Magnesium Orotate — have orotic acid. Magnesium orotate is beneficial to the heart.
Health Benefits (Including for Constipation)
1. Can Help Treat Constipation and Clear Out the Intestines
Does magnesium citrate make you poop?
Yes, it usually results in a bowel movement within 30 minutes to eight hours, depending on the type you take and the dosage. Lower doses are recommended for daily use to help with regularity, in addition to sticking with other healthy diet and lifestyle habits. Higher doses are used only once or for several days if being used for medical reasons, such as for a colonoscopy. If a high dose is taken you can expect to have a bowel movement within about three hours.
Magnesium citrate pulls water into the intestines due to its chemical structure. Magnesium and citric acid have oppositely charged atoms, which causes an osmotic effect to take place in your digestive tract when you consume them together. This means that water enters the intestines and becomes absorbed by the stools. This helps lubricate the GI tract and soften stools, making it easier to pass a bowel movement.
2. Can Help Prevent Magnesium Deficiency Symptoms
Taking magnesium citrate is one way to increase magnesium levels, especially since it has higher bioavailability than some other types of magnesium supplements. Preventing magnesium deficiency is important because magnesium is needed for hundreds of different bodily functions, plus for warding off common symptoms like anxiety, trouble sleeping, aches, spasms, headaches and blood pressure changes.
3. Can Help Support Muscle and Nerve Functions
Because magnesium is an electrolyte that is particularly important for the muscles and nerve cells, using magnesium citrate may provide benefits like enhancing relaxation, increasing sleep quality. and helping with stress relief. It also can help fight muscle spasms, aches and pains since magnesium helps contracted muscles relax.
That said, other forms of magnesium tend to be more popular for these effects, including magnesium glycinate, magnesium sulfate or magnesium chloride oil.
4. May Help Protect Against Kidney Stones
High calcium levels in the urine can contribute to kidney stones. In fact, it’s estimated that high urinary calcium is the cause of kidney stones in upward of 80 percent of cases. Calcium and magnesium work together to balance each other out, and magnesium may be able to decrease accumulation of calcium, thereby supporting good kidney health. While magnesium citrate is useful for this prevention of kidney issues, magnesium oxide may work even better for this purpose. (It’s frequently recommended at doses of approximately 400 milligrams per day.)
5. Beneficial for Cardiovascular and Bone Health
Magnesium is an essential mineral for maintaining bone density, normal cardiac rhythmicity, pulmonary function and healthy blood glucose levels. Having adequate levels is important for maintaining normal blood pressure and heartbeat rhythms, protecting against issues like hypertension and arrhythmia (irregular heartbeats). This is why deficiency in magnesium may lead to metabolic and circulatory changes that increase the risk of developing chronic conditions like cardiovascular disease, type 2 diabetes, osteoporosis and others.
Magnesium is also needed to help with proper absorption of vitamin D, which has been associated with better protection against osteoporosis/weak bones, a weakened immune system and a number of illnesses. Vitamin D and magnesium, along with calcium and vitamin K, can help regulate bone metabolism and maintenance of bone density.
Related: Most Supplements Contain Magnesium Stearate — Is It Safe?
Recommended Dosage (and How to Use It)
The magnesium dosage that is right for you is based on factors like your medical condition, age, any symptoms you’re experiencing and how sensitive to this product you are. It’s important to always read the directions on the label of the product you use, since each product works a bit differently.
Below are general recommendations for magnesium citrate dosages:
- If you’re taking magnesium citrate as a nutritional supplement, a general recommendation for adults is to take between 200 and 400 milligrams per day orally in a single daily dose, or in divided doses, with a full glass of water.
- If you’re taking magnesium citrate for the purpose of constipation relief or bowel evacuation, the standard dose is 195–300 mL of liquid magnesium in a single daily dose or in divided doses with full glass of water, or two to four tablets before bedtime.
- Adult men should generally stick with the recommended daily allowance of 400 to 420 mg/day, while adult women should stick with 310 to 320 mg/day. However, sometimes a patient may take higher doses, up to 900 milligrams daily, if working with a health care provider.
- In liquid form, the standard dosage recommendation is 290 mg/5ml daily, unless your doctor tells you otherwise.
- In tablet form, the the standard dosage recommendation is 100 mg/day, which might be taken in two to three divided doses.
- Pregnant and breastfeeding women need about 320 to 350 mg/day.
- Children should take between 60 to 195 milligrams per day, depending on their age (it’s best to check with your pediatrician first).
Here are tips for taking magnesium citrate:
- If using a magnesium citrate powder, start with a low dose, about half a teaspoon daily or 200 milligrams or less, and increase as needed to the full or recommended amount as stated on the product label.
- Take this product with a full glass of water (at least eight ounces), since it works by pulling water into the intestines.
- Magnesium can usually be taken with or without food. However, depending on the reason you’re taking magnesium citrate, your doctor might tell you to take it on an empty stomach, at least one hour before or two hours after a meal.
- Magnesium can be taken at any time of day. Trying picking a time of day to take magnesium and stick with it, since daily use of a moderate dosage may have the best effects.
- Many people find the taste of magnesium citrate to be unpleasant, so if you’d like to improve the taste, try chilling the mixture first or mixing it with a small amount of juice. Just don’t freeze magnesium citrate. This can change how it works.
- Some magnesium citrate products work by dissolving in water first, which usually works fastest when you use warm water, although cold water will work too (effects will just take slightly longer to kick in).
- Don’t forget to also aim to get magnesium naturally from a nutrient-dense diet full of anti-inflammatory plant foods.
How long does it take for magnesium citrate to kick in?
If you’re taking magnesium citrate for constipation or prior to bowel procedure, it should have an effect within about six to eight hours and sometimes in as little as 30 minutes. If you’re taking a low dose daily, such as before bed, it may kick in within 30 minutes but not encourage a bowel movement until the next morning. The length of time it takes to kick in depends on how much you take and how sensitive you are.
Is magnesium citrate safe to take daily?
Yes, as long as you take a low to moderate amount and not a high dose that causes loose stools repeatedly.
Ideally you want to maintain healthy digestion and normal bowel function by drinking plenty of water and fluids and by eating a diet that includes enough fiber and magnesium-rich foods — such as dark leafy greens, beans, avocado and bananas. Exercising, sleeping enough, managing stress, and avoiding too much caffeine and alcohol are also important for staying “regular” and reducing reliance on laxatives.
Is magnesium citrate not working for you?
You may need to increase the dosage you’re taking or try splitting the dose in two parts. If you’re looking for other benefits besides constipation relief, consider trying another form of magnesium or getting your doctor’s advice.
Risks, Side Effects and Interactions
Magnesium citrate may have a laxative effect in some cases when taken in high doses but is otherwise considered safe for most people.
That said, it’s possible for magnesium citrate side effects to occur, especially if you take a high dose for an extended period of time. Magnesium citrate side effects may include:
- Dehydration symptoms/loss of too much body water
- Abdominal pain, gas and nausea
- Decreased weight
- Rarely, serious side effects like slow/irregular heartbeat, mental/mood changes, persistent diarrhea, severe/persistent stomach/abdominal pain, bloody stools, rectal bleeding, decreased urination and allergic reactions
You don’t want to use magnesium citrate too often because this can wind up causing “dependence” on the product and loss of normal bowel function. People who abuse laxatives, including magnesium citrate, may not be able to have normal bowel movement without using the product after some time.
You also shouldn’t take magnesium citrate or other laxatives if you’re taking antibiotics, especially tetracycline/quinolone. If you need to take both, take them at least two hours apart. If you have any of the following medical conditions, talk to your doctor before you start taking magnesium citrate: kidney disease, GI issues that last longer than two weeks, frequent stomach pains, nausea, vomiting, or if you’ve been told to follow a low-magnesium or low-potassium diet.
When it comes to using magnesium supplements during pregnancy or giving magnesium to your child, it’s recommended that you check with your doctor first, although both are usually safe and can be beneficial.
- Magnesium citrate is an over-the-counter magnesium supplement made with a combination of salt and citric acid. It is sometimes described as a “saline laxative” because it effectively works to relieve constipation and clear out the intestines. It does this by drawing water and fluids into the intestines, which lubricates stools.
- Other magnesium citrate benefits include helping increase magnesium levels and prevent deficiency and supporting bone, nerve, muscle and heart health.
- If you take a high dosage of magnesium citrate you might experience side effects, including diarrhea/loose stools. Other magnesium citrate side effects can include dehydration, weakness, abdominal pains and weight loss.
- Always follow magnesium citrate dosage recommendations carefully, since each type of product (powder, liquid and pills) works a bit differently.
Read Next: You Probably Have Low Potassium — Start Eating These 12 Foods
Magnesium Supplements: Benefits, Side Effects, and Dosage
Getting enough magnesium is important for keeping your body functioning optimally.
Though it’s possible to get adequate amounts of this mineral from your diet, taking a supplement may be helpful if you struggle to meet your needs through food or if you’re deficient.
Taking a magnesium supplement and correcting a deficiency has been linked to health benefits. These include a lower risk of conditions like heart disease and improved blood pressure, mood, and blood sugar control.
Can Reduce Blood Pressure
Taking magnesium supplements may help reduce blood pressure levels (5).
Studies show that people with high blood pressure may experience improvements when supplementing with this mineral (6, 7).
In fact, one review of 22 studies found that supplementing with an average of 410 mg of magnesium daily was associated with a 3–4 mm Hg drop in systolic blood pressure (the top number) and a 2–3 mm Hg drop in diastolic blood pressure (the bottom number) (8).
Similarly, a recent review of 34 studies concluded that taking around 350 mg per day of magnesium for an average of 3 months significantly reduced systolic blood pressure by 2.00 mm Hg and diastolic blood pressure by 1.78 mm Hg (9).
May Improve Mood
Some studies link low levels of magnesium with depression, which has led researchers to wonder whether supplementing with this mineral could help treat this condition (10).
One 12-week randomized controlled trial in older adults with type 2 diabetes, magnesium deficiency, and depression found that 450 mg of magnesium daily was as effective as a 50 mg dose of the antidepressant Imipramine at improving depressive symptoms (11).
Another 6-week study in 126 people with mild or moderate depression observed that those who took 248 mg per day of the mineral, alongside their normal treatment, reported a significant improvement in depression scores (12).
However, these studies were not blinded, meaning that the participants knew that they received the mineral, which could skew the results.
Ultimately, larger and longer studies in this area are needed.
May Benefit Blood Sugar Control
Magnesium plays a crucial role in insulin and glucose metabolism. Many people with type 2 diabetes — a condition impacting blood sugar control — are deficient in this nutrient (2).
In part, this is because high blood sugar or insulin levels can increase how much of this nutrient you lose through your urine (13).
It’s been suggested that taking magnesium supplements may improve insulin resistance, a metabolic problem in which your cells don’t respond to insulin.
Insulin is an important hormone that helps regulate your blood sugar levels. Thus, improving insulin resistance can promote better blood sugar control — especially in people with diabetes.
In a 3-month study, people with type 2 diabetes who took 300 mg per day of magnesium experienced significant reductions in fasting and post-meal blood sugar levels compared to the placebo group (14).
Additionally, a review found that taking magnesium supplements for more than four months had a beneficial effect on insulin sensitivity and blood sugar control (15).
Though more research is needed, magnesium supplements seem to be effective at helping control blood sugar in people with type 2 diabetes (13).
May Reduce Heart Disease Risk
Low levels of magnesium have been linked to an increased risk of heart disease (16, 17).
This may be because low levels of this mineral negatively affect risk factors for heart disease like blood sugar control and blood pressure (17).
A recent review of 28 studies concluded that magnesium supplements positively affected some heart disease risk factors in people with type 2 diabetes by lowering blood pressure, cholesterol levels, and fasting blood sugar (18).
This means that taking magnesium supplements may help reduce heart disease risk factors, especially in people who are deficient (19).
While these results are promising, more studies in this area are needed.
May Improve Migraine
Low levels of magnesium have been linked to migraine, a condition characterized by intense, recurring headaches (20).
One 12-week study found that people with migraine who took a daily supplement containing 600 mg of magnesium experienced 42% fewer migraine attacks, and the attacks were less intense (21).
Another review of 5 studies showed that treating migraine with 600 mg of magnesium — a high-level dose — was safe and effective (22).
Still, more studies are needed before firm dosage recommendations can be made for treating migraine.
Summary Magnesium supplements may improve a number of health markers, such as blood pressure and blood sugar control. It may also reduce your risk of health conditions such as heart disease, migraine, and depression.
What You Need to Know About Magnesium and Your Sleep
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Terri Orbuch, Ph.D.
Terri Orbuch Ph.D.
The Love Doctor
How Much Do You Trust Your Partner?
Expert tips to help identify deception, and to plan what to do afterward.
Posted Aug 24, 2009
Honesty with your partner builds trust and intimacy—and we all value honesty in our relationships. We also expect that in trusting relationships, both partners are totally honest and open with each other. When one partner has secrets or withholds information from the other, it violates those expectations of trust.
And yet studies show that most of us tell at least one lie per day. These lies may be small and harmless or they may be big and serious, but even minor ones can destroy a relationship if they become sufficiently frequent.
To start, it’s important to know why we might lie to a partner. Most of the time, it’s because we don’t feel safe telling the truth. We fear their disapproval or rejection, so we think it’s easier just to avoid the truth. We may also lie out of embarrassment or guilt at having done something wrong, especially something we know violated their expectations of trust and commitment in our relationship.
How Can You Tell?
Is your partner telling you lies? There isn’t one sign that always indicates that a person isn’t telling the truth, but there are some identifiable behavior patterns. No one is telltale, and most of us are not as adept at spotting liars as we think. If you discover one or two of the signs below in your partner, for example, it’s as likely as not meaningless. But if you see enough of them, and repeatedly, it may be a significant pattern. (Some studies show that women are better at detecting lies than men, as they tend to be more likely to pick up on the nonverbal messages or signs of deception.)
Here are some signs that your partner might be lying to you:
Evasiveness. At first, your partner may avoid outright lying and just become evasive. If this is not how your partner typically behaves, it can be a signal that something is up. It may feel like pulling teeth to have a conversation, and when you ask direct questions, your partner may avoid answering, or just repeat, “I don’t know.”
Speech Patterns. When people are lying, they often speak hesitantly or in a higher pitch, and they make more grammatical errors and slips of the tongue than when they are telling the truth. Also, when people are lying, there are discrepancies or mismatches between their tone of voice and their facial expressions. Your partner may even cover his or her mouth while talking. It’s as if they’re subconsciously repressing the untruths they’re saying. It may be as blatant as completely concealing the mouth or as subtle as a single finger placed in front of the lips.
Body Talk. On many occasions, when people are lying, their mouth and the body are not in sync. The words sound convincing, but everything else about their body language sends a very different message. If your partner can’t look you straight in the eye, it may also that mean he or she has something to hide. (Of course, if it’s not their habit to look you in the eye when speaking, this may be less of a sign.) Also, when people are lying, their pupils dilate and they blink more often.
What should you do if you suspect that your partner is lying? First, try to understand the possible reason behind the lie. Most of the time, this is at least as important as the content of the secret or the fact of the deception itself.
Then, have a conversation with your partner—a “trust chat.” Pick a good moment, without the distractions of children, television, or work. Go to your partner without judgment or shame, and talk to him or her about honesty, trust, and secrecy. Share your concerns and see your partner responds. His or her reactions could speak volumes.
That is partially true.
Submitted by Anonymous on October 10, 2009 – 12:35pm
That is partially true.
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Submitted by Anonymous on March 5, 2013 – 8:39pm
Okay well I have realized a lot of things within the past few months. To start out with, I have medical issues that my spouse is well aware of and knows the life threatening consequences. He use to be a smoker and he quit knowing it effected my health! Well here and there he would come home from work smelling like smoke and his lips tasting like smoke. Just a month ago he smelt like he was out partying, smelling like heavy smoke and weed. I have been in the hospital for days because of a infection. I was asked multiple times from doctors if my spouse smoked and I told them no. Well when I came home, my spouse ended not coming straight home from work. He ate breakfest with a “Guy friend” from work. Well he never told me until I found out through the bank two months later. He said he didnt think it was imporant enough to tell me. That is being deceitful, I mean come on your wife just spent four days in the hospital and you rather eat breakfest with your friend than come home to your wife! He got defensive when I asked him and when I asked him about smoking. He knows that he can kill me because I am highly allergic to smoke and whats in it, I have a immune problem on top of having multiple sclerosis. He def has changed since when we 1st got together. It breaks every part of me as well because im no happy with how things are. He talks to drug dealers that work with him and lies about the people he talks too. Since I have caught him in lies hes acted different. Like the smoking deal, all I have is himself and cloths smelling like heavy smoke but yet I am in the wrong because I dont have phsyical proof! All he said was he goes in a smoking tint that is OUTSIDE! Okay for you to smell like a smoking bar mixed with weed, you’d have to be in a inclosed building or car. Not a outside tint. I just dont know what to do because I love him with all my heart but I dont trust him. I mean I keep on getting sick week after week and doctors questioning me. My own mother thought I was smoking cigs and weed when I havent done it! ADVICE PLEASE! I want phsyical proof so I can get the truth from his lips and maybe he’ll want to show me he wants to fix things and help me to trust him again. I dont know i think I sound pathetic! Maybe I do but I dont want to give up on my married or the promise I not just made to him and myself but God!
Submitted by Anonymous on June 26, 2014 – 8:43am
Maybe just maybe he is having trouble coping with your illness, and this is how he is coping. It also sounds like there are other issues there. Its hard to have MS and other health problems especially when you are immunocompromised. Does he still want to be in the marriage? Why the avoidant behavior. I would also suggest therapy for health problems and to manage stress for yourself, and maybe couples counseling. I would just focus more on yourself, and try treating yourself to a massage ( if your white count is up/ immune system allows). Branch out, find different people family and friends who will support you. He might just be stressed out, and smoking weed and drinking is a way for him to cope. Have you discussed his concerns? Being sick especially with a disease with MS is incredibly difficult. It is also difficult to have a spouse with health issues, especially if they are chronic. Think of what would happen if he lost both of his legs, went into a deep depression and complained constantly. This would impact his desirability, perhaps you would question your future with him? reach out to your husband and try theray, try seeing things from his perspective. try not to talk about your illness as much- or save it for your therapist. Your husband should be supportive of you. But sometimes we can’t ask for love no matter what- unfortunately love is not always unconditional. It takes work, and perseverance. However if he has abandoned you already emotionally, and does not seem interested in fixing things and becoming and active husband, then you need to think about what you need. Life is to short to be unhappy especially when battling MS. You need to surround yourself with people who uplift and support you, who radiate life. 🙂 Best of wishes to you, and I hope your marriage improves.
Submitted by Anonymous on June 26, 2014 – 7:35am
Just week there was an article in Psychology Today which refuted Dr. Orbuch indicators of lying. Eye contact. The dishonest know this misbelief and ensure eye contact and body movements are in sync to cloak their deception. Furthermore, those telling the truth where more apt to exhibit the signs of lying listed in this cliche ridden article. I believe this to be true.
In southeast Asia, May 2007,
Submitted by Kontiki man on September 19, 2014 – 12:00pm
In southeast Asia, May 2007, after my wife gave birth we agreed that I take care of our son as she was working as hospital nurse. When she entered Auckland NZ for bridging school in Oct 2012 I was left to look after our son. She was employed in a local district health board hospital in April 2013. Things went downhill for me in January 2014 when I saw in my wife’s FB her ex as FB friend. I messaged her nicely, asking what’s still up with her FB “friendship” with that other person. She replied with “what’s wrong with that” tone. I didn’t reacted violently, but I started doubting. In July 2014 she went back home for a vacation. I secretly checked her chats with her ex in her FB. She flirted, shared cheesy talk and even hinted on seeing each other if they had the chance. Their FB chats lasted for about 9 months. I was devastated. In August 2014, me and our 7 year old son were reunited with my wife here in Auckland. I still secretly open her FB account. The chats have stopped, but I still maintain my vigilance. Every waking hour I could see her world – a world where she is still longing for someone she couldn’t have anymore. I could understand her troubles with her past. But her behaviour is slowly inching away from her tenderness for me. I’ve had thoughts of leaving her because of her infidelity. But I couldn’t. She sticks in me. And stubbornly, I really wanted to be able to ease her mind and ultimately prove that she is home with me. Indeed, there are reasons why people lie to each other. My goal is to win her back. Win her over. I am in love with my wife and I want her out of her troubles. Mercy and wisdom comes from God that I trust.
Is my hubby lying again? Advice please
Submitted by marsha on July 22, 2015 – 4:28pm
About 4 yrs ago I caught out my husband had been chatting to women online & having filthy conversations with them whilst I was at work. I found out when he said I could use his phone when we were abroad as I couldn’t use my own phone. I saw conversations on a social media site with several women. I was devastated . I immediately flew at him & he denied it. I showed him what I’d seen & he just said he loved me & he didn’t know why he did it. This made me more suspicious & when we were home I delved into his emails & found he’d been going on dating sites & had other women on his Hotmail MSN messenger. When I approached him about it he denied it at first but then I told him what I’d seen & again, he said he didn’t know why he went on the dating sites but he was ‘just looking’. He’d actually joined a couple of these sites too. I was going to leave him but he said he knew how much he’d hurt me & had stopped doing it. His facebook account was deleted & also his Hotmail account. Since then I said he could use my Facebook to keep in contact with his daughter & I then found he’d searched for a family members female friend & searched for another woman. Again, he said he didn’t know why he did it. Now something has been niggling me since we were abroad 9 months ago. We were out with a family member, all having a nice time & we were in a bar & we had words over something I’ve forgotten about. Next thing he said he was going to the loo but was gone for absolutely aged. …he was only going for a wee! Now I’m pretty sure that the bar owner disappeared also & reappeared as he did. We had a conversation about ‘BJ’s’ & he said he’d not been given one by a Russian girl YET. I asked what the hell he meant & he ‘didn’t know’. I asked him why he was so long in the loos & he said it was coz I was in a huff with him & he wanted to keep out of my way….he NEVER keeps out of my way if we have words. He always gets defensive when I question him stuff too. I’m thinking he was up to no good with this woman in the loo but I’m unsure about confronting him again coz he’ll just fly off the handle. I don’t trust him & I’m always watching him. Can anyone advise please? Thanks
How to change behavior of lying for insignificant things
Submitted by Shivani on June 7, 2016 – 12:42am
Me and my husband have a very healthy and happy relationship Exept for the fact that he has a problem of lying or manipulating the truth when it comes to topics which are basically of no significance. Many times he lies just to keep his pride intact. but when I come to know later about lying for such insignificant things which I would never bother to care, I feel hurt. I feel that we don’t have trust and start doubting the existence of our relationship. I want him to be open about everything but due to his nature he always avoids confrontation of unpleasant topics between us. I need serious help because I am afraid this may ruin our lovely relationship.
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THE MAGNESIUM REPORT
CLINICAL, RESEARCH, AND LABORATORY NEWS FOR CARDIOLOGISTS
Second Quarter 2000
Medications, Alcohol Consumption, and Magnesium: Ensuring Adequate Intake of Oral Magnesium
TIMOTHY J. MAHER, PHD
The importance of adequate magnesium intake is documented by scientific and clinical data that justify the consumption of magnesium-rich foods and the use of oral magnesium supplements for good health. When intake or retention of magnesium is inadequate, magnesium deficiency can take either of 2 forms—clinical hypomagnesemia or chronic latent magnesium deficiency. Clinical hypomagnesemia is easier to recognize because it is associated with specific clinical manifestations (Table 1), but chronic latent magnesium deficiency is more common.
The consequences of chronic latent magnesium deficiency are extremely prevalent, and some are potentially very serious (please see The Magnesium Report, First Quarter 2000, in which Drs. Ronald J. Elin and Robert K. Rude discuss chronic latent magnesium deficiency and the role of magnesium in preventive medicine). Chronic latent magnesium deficiency increases the risk for cardiac arrhythmias, coronary artery disease, diabetes mellitus, hypertension, migraine, osteoporosis, and premenstrual syndrome (Table 2).
There are clinically significant interactions between magnesium and a number of medications that may alter magnesium status and affect medication efficacy (Table 3). Some commonly used medications, including certain antibiotics, loop and thiazide diuretics, cisplatin, and cyclosporine can lead to decreased absorption or increased elimination of magnesium, as can ethanol consumption. In addition, antacids that contain magnesium can decrease the bioavailability of some medications by interfering with intestinal absorption.
Mg absorption and excretion
Magnesium, the second most common intracellular cation in the body, is a crucial cofactor for more than 300 enzymatic reactions involved in normal physiologic processes. These include pathways in metabolism of carbohydrates, fats, and proteins. Magnesium is required in every enzymatic reaction of ATP and in many of the steps involved in the synthesis of DNA and RNA, and it stabilizes these macromolecules as well.
The gut and kidney control the magnesium content of the body. Magnesium absorption occurs primarily in the small intestine, and may be impaired by gastrointestinal infections, inflammatory bowel disease, radiation-induced gastroenteritis, steatorrheic states, severe diarrhea, and familial malabsorption syndromes. Of more significance in the gut, however, may be the effect of magnesium on the absorption or availability of medications.
Normal kidney function is essential to the body’s ability to retain magnesium. As part of the normal filtration-reabsorption process, most calcium, magnesium, and sodium in plasma are filtered through the glomerular membrane. Unlike calcium and sodium, which are largely reabsorbed in the proximal convoluted tubule, most magnesium reabsorption takes place in the loop of Henle—specifically, in the thick ascending limb of the cortical segment. Some reabsorption also occurs in the distal. tubule.
Use of diuretics is the most frequent reason for hypomagnesemia. Magnesium reabsorption in the thick ascending limb of the loop of Henle is decreased significantly by loop diuretics, and in the distal tubule by thiazide diuretics. In addition, patients taking diuretics are at increased risk when gut absorption of magnesium is compromised by inflammatory bowel disease, a bout of severe diarrhea, or during an episode of “stomach flu.” The magnesium-wasting effect of diuretics is especially important in patients who have cardiac arrhythmias or risk factors for arrhythmias.
Hypokalemia, which also occurs with use of loop or thiazide diuretics, may lead to renal magnesium wasting. Cellular potassium depletion is associated with diminished magnesium reabsorption within the loop of Henle and the distal tubule and may lead to increased magnesium excretion. Long-term use of loop or thiazide diuretics may deplete potassium and promote renal magnesium wasting.
Most patients who take loop diuretics such as furosemide or bumetamide or a thiazide diuretic such as chlorothiazide will become hypomagnesemic unless they augment their magnesium intake with oral supplements or magnesium-rich foods (Table 4). For these patients, it is reasonable to emphasize the need for the recommended daily intake of magnesium—that is, 420 mg/d for adult men or 320 mg/d for non-pregnant women. A single 400 mg tablet of magnesium oxide contains 241.3 mg of elemental magnesium, so 1 or 2 tablets daily is appropriate.
Cancer patients undergoing chemotherapy with regimens containing cisplatin are at significant risk for hypomagnesemia. Cisplatin impairs renal reabsorption of magnesium because it is directly toxic to the ascending limb of the loop of Henle and the distal tubule. Approximately 90% of patients who receive this nephrotoxic antineoplastic drug will become hypomagnesemic unless corrective pretreatment measures are initiated. Adequate dietary magnesium intake before chemotherapy will not prevent cisplatin-associated magnesium deficiency.
While there is general agreement that oral or intravenous (IV) supplementation of magnesium is appropriate with cisplatin therapy, there is no consensus on the ideal dosage or mode of administration. In 4 randomized trials and 2 nonrandomized studies, a statistically significant benefit for oral or IV magnesium supplementation has been found. Evans and colleagues randomized 28 patients receiving cisplatin, 5-fluorouracil, and epirubicin for upper gastrointestinal cancers to either scheduled or “as needed” IV magnesium supplementation, with oral supplementation given if necessary. They found that IV supplementation alone was not fully protective against hypomagnesemia during cisplatin chemotherapy but concluded that patients should receive 1V supplementation with each cycle of chemotherapy.
Martin and associates found that both oral and IV supplementation significantly reduced the decline in serum magnesium levels after the first two or three courses of chemotherapy. Patients with tumors of the head and neck, ovary, and bladder were randomized to receive 7.15 mmol of magnesium (as magnesium pidolate) orally q8h on days 2 through 21 of each chemotherapy cycle, 12 mmol of magnesium (as magnesium sulfate) IV in the prehydration fluid given before each cycle, or no magnesium supplementation (control group). Compared to the control group, statistically significant differences in serum magnesium levels were seen after the second cycle in patients receiving oral supplementation and after the third cycle in patients receiving IV supplementation.
Persons with alcoholism represent the second largest group of people with hypomagnesemia. This is due in part to the inherent effects of alcohol on magnesium homeostasis and in part to the consequences of the poor diet typical of alcohol abusers. Acutely, alcohol increases urinary magnesium excretion by as much as 260% above baseline values; this occurs within minutes of ingestion or parenteral administration.
With chronic alcohol intake, body stores of magnesium become depleted. Reasons include inadequate intake, starvation ketosis, vomiting and diarrhea, and urinary excretion. In advanced alcoholism, however, urinary magnesium excretion may decline in response to reduced intake and depleted stores. Among the effects of chronic alcoholism are a negative magnesium balance, decreased plasma levels of magnesium, decreased magnesium concentration in cerebrospinal fluid and in muscle biopsies, and the development of a magnesium-responsive hypocalcemia.
The increased cancer risk associated with alcoholism may be partly explained by alcohol-induced magnesium deficiency. According to Richard Rivlin, MD, of New York’s Memorial Sloan-Kettering Cancer Center, there are several lines of evidence suggesting that abnormalities in magnesium metabolism are associated with cancer development. Among them are the observations that magnesium inhibits carcinogenesis and may affect oncogene amplification, and that magnesium deficiency favors tumor formation by leading to impaired immune surveillance and enhanced susceptibility of cell membranes to oxidant injury.
Magnesium repletion by mouth is recommended for patients known to be heavy drinkers. It is also appropriate to give magnesium parenterally during alcohol withdrawal. Many of the manifestations of advanced or chronic alcoholism, such as personality changes, neuromuscular irritability, seizures, and delirium tremens, are probably aggravated by magnesium deficiency. The recalcitrant hypocalcemia frequently seen in patients with alcoholism usually becomes amenable to treatment when magnesium is given.
A number of antacids contain magnesium, including AmphojelTM, MaaloxTM, MylantaTM, and RiopanTM. The liquid formulation of bismuth subsalicylate, used in the treatment of Helicobacter pylori infections, also contains magnesium (in the form of magnesium aluminum silicate, an inactive excipient). These will not cause hypermagnesemia in the individual with normal renal function. In the face of renal impairment, however, there can be significant accumulations of magnesium.
Magnesium, as a divalent cation, can bind with certain drugs, decreasing their bioavailability (Table 3). Such an effect has been shown for quinidine, quinolone antibiotics (especially the older ones such as ciprofloxacin and norfloxacin), tetracycline and related antibiotics, and certain nonsteroidal antiinflammatory drugs (specifically diclofenac, diflunisal, indomethacin, and naproxen). Moreover magnesium loading in the gut may cause diarrhea, which can adversely affect absorption of a number of drugs.
Hypomagnesemia, with concomitant hypocalcemia and hypokalemia, can develop after less than a week of gentamicin use. A number of instances of reversible hypomagnesemia secondary to gentamicin use have been reported. Although the mechanism is unknown, nephrotoxicity has been suggested, and several investigators have suggested that gentamicin contributes to renal magnesium and potassium wasting.
In 1 case report, a 68-year-old woman hospitalized for acute myelomonocytic leukemia (2 years after being treated with radiation and chemotherapy for ovarian carcinoma) was given gentamicin (80 mg q6h) IV when she became febrile. After 7 days of antibiotic therapy (including penicillin and cefazolin), she developed Chvostek’s sign and was found to be hypomagnesemic, hypocalcemic, and hypokalemic. IV administration of 10 g magnesium sulfate and 120 mmol potassium over 48 hours was associated with normalization of electrolyte levels and the disappearance of Chvostek’s sign.
In another instance, a 65-year-old man with diabetes and peripheral vascular disease was given gentamicin (80 mg q8h) IV, along with clindamycin and metronidazole, after amputation of a gangrenous leg. After 6 days of gentamicin therapy he developed Chvostek’s sign and was hypomagnesemic, hypocalcemic, and hypokalemic. Gentamicin therapy was continued while the patient was given IV magnesium and potassium replacement. At the end of the 13-day course of gentamicin, his electrolyte levels were normal and Chvostek’s sign had disappeared.
Magnesium replacement may be appropriate in the treatment and prevention of hypertension associated with cyclosporine use. In a case-controlled study, June and colleagues observed that hypomagnesemia developed in a group of 32 bone marrow transplant recipients who developed hypertension after cyclosporine treatment but hypomagnesemia did not develop in 32 cyclosporine-treated controls matched for age, sex, and disease who remained normotensive. These investigators concluded that either hypomagnesemia and hypertension were coincident toxic effects of cyclosporine or that magnesium derangement contributed to hypertension. Using an animal model, Rob and associates found that oral magnesium reduced the toxicity of cyclosporine even when dietary intake of magnesium was normal.
The intestinal absorption of magnesium is decreased in persons taking oral zinc preparations. Zinc is a divalent cation found in certain cold medication lozenges arid is also taken by some men for prostate health. Spencer and colleagues studied magnesium absorption and magnesium and zinc metabolic balance in 142 men taking high, low, and intermediate levels of calcium. They found that high zinc intake caused a highly significant decrease in magnesium absorption and a negative magnesium balance regardless of calcium intake.
Healy DP, Dansereau RJ, Dunn AB, Clendening CE, Mounts AW, Deepe GS Jr. Reduced tetracycline bioavailability caused by magnesium aluminum silicate in liquid formulations of bismuth subsalicylate. Ann Pharmacother. 1997;31:1460-1464.
June CH, Thompson CB, Kennedy MS, Loughran TP Jr, Deeg HJ. Correlation of hypomagnesemia with the onset of cyclosporine-associated hypertension in marrow transplant patients. Transplantation. 1986;41:47-51.
Lajer H, Daugaard G. Cisplatin and hypomagnesemia. Cancer Treat Rev. 1999;25:47-58.
Nanji AA, Denegri JF. Hypomagnesemia associated with gentamicin therapy. Drug Intell Clin Pharm. 1984;18:596-598.
Quamme GA. Renal magnesium handling: new insights in understanding old problems. Kidney Int. 1997;52:1180-1195.
Rivlin RS. Magnesium deficiency and alcohol intake: mechanisms, clinical significance and possible relation to cancer development (a review). J Am Coll Nutr. 1994;13:416-423.
Sadowski DC. Drug interactions with antacids. Mechanisms and clinical significance. Drug Saf. 1994;11:395-407.
Schaafsma G. Bioavailability of calcium and magnesium. Eur J Clin Nutr. 1997;51(Suppl 1):S13-S16.
Spencer H, Norris C, Williams D. Inhibitory effects of zinc on magnesium balance and magnesium absorption in man. J Am Coll Nutr. 1994;13:479-484.
The above article is from the “The Magnesium Report”, Second Quarter 2000. Blaine Pharmaceuticals is the manufacturer of Mag-Ox 400 and Uro-Mag magnesium supplements.
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This page was first uploaded to The Magnesium Web Site on September 18, 2002
Gold nanoparticles have shown excellent activity for selective oxidation of alcohols; such catalytic systems are highly dependent on the initial activation of the substrates, which must occur on the catalyst surface in heterogeneous catalysts. In many cases, an extra base addition is required, although the basicity of the support may also be of significant importance. Here, we explored the intrinsic basicity of magnesium-based enrichments on CoFe2O4 magnetic nanoparticles for the oxidation of benzyl alcohol using molecular oxygen as oxidant. The MgO and Mg(OH)2 enrichments enabled gold impregnation, which was not possible on the bare CoFe2O4 nanoparticles. The Au/MgO/CoFe2O4 and Au/Mg(OH)2/CoFe2O4 catalysts reached 42% and 18% conversion, respectively without base promotion, in 2.5 hour and 2 bar of O2. When the catalysts were tested with sub-stoichiometric amounts of base, they became more active (>70% of conversion) and stable in successive recycling experiments without metal leaching, under the same reaction conditions. We also showed the oxide phases of the enrichments performed using Rietveld refinements and how the Mg(OH)2 phase interferes with the activity of MgO-based materials.