Signs of low Magnesium (heart problems in this case) – Jan 2018

Subclinical magnesium deficiency: a principal driver of cardiovascular disease and a public health crisis

Open Heart 2018;5:e000668. doi:10.1136/ openhrt-2017-000668n 13 January 2018.
James J DiNicolantonio,1jdinicol@gmail.com James H O’Keefe,1 William Wilson2
’Department of Preventive Cardiology, Saint Luke's Mid America Heart Institute, Kansas City, Missouri, USA 2Hospital Medicine, Lahey Hospital & Medical Center, Burlington, Massachusetts, USA

 Download the PDF from VitaminDWiki

Because serum magnesium does not reflect intracellular magnesium, the latter making up more than 99% of total body magnesium, most cases of magnesium deficiency are undiagnosed. Furthermore, because of chronic diseases, medications, decreases in food crop magnesium contents, and the availability of refined and processed foods, the vast majority of people in modern societies are at risk for magnesium deficiency. Certain individuals will need to supplement with magnesium in order to prevent suboptimal magnesium deficiency, especially if trying to obtain an optimal magnesium status to prevent chronic disease. Subclinical magnesium deficiency increases the risk of numerous types of cardiovascular disease, costs nations around the world an incalculable amount of healthcare costs and suffering, and should be considered a public health crisis. That an easy, cost-effective strategy exists to prevent and treat subclinical magnesium deficiency should provide an urgent call to action.

Clipped from PDF

• ...magnesium balance decreases when calcium intake is over 10mg/kg/day. 21
• patients with diabetes appear to be magnesium-deficient and magnesium deficiency likely increases the risk of diabetes.
• Dietary aluminium may lead to magnesium deficit by reducing the absorption of magnesium by approximately fivefold
• Just 42–64 days on a diet low in magnesium (~101 mg/day) produced atrial fibrillation and flutter in three of five postmenopausal women (ages 47–75 years). Moreover, the arrhythmias responded quickly to magnesium supplementation.
• In a randomised, double-blind, placebo controlled study on 350 patients with acute myocardial infarction, intravenous magnesium sulfate given immediately after completion of thrombolytic therapy significantly reduced all-cause mortality (3.5% vs 9.9%, P<0.01) and ventricular arrhythmias (13% vs 48.6%, P=0.00001).135
• "One study found that 10 out of 11 apparently healthy women were magnesium-deficient based on the oral magnesium load test. "

Since 1940 there has been a tremendous decline in the micronutrient density of foods.
In the UK for example, there has been loss of magnesium in

• beef (−4 to −8%),
• bacon (−18%),
• chicken (−4%),
• cheddar cheese (−38%),
• parmesan cheese (−70%),
• whole milk (−21%) and
• vegetables (−24%).61
  • The loss of magnesium during food refining/processing is significant:
• white flour (−82%),
• polished rice (−83%),
• starch (−97%) and
• white sugar (−99%).12

Since 1968 the magnesium content in wheat has dropped almost 20%,
Principal Clinical signs of Magnesium Deficiency
Gastrointestinal disorders190
  —malabsorption syndromes
   (coeliac disease, non-tropical sprue, bowel resection,Crohn's disease, ulcerative colitis, steatorrhoea),
  prolonged diarrhoea or vomiting.
Liver disease 191 (acute or chronic liver disease, including cirrhosis).
Metabolic acidosis167 192 193 (latent or clinical).
Pancreatitis194-197 (acute and chronic).
Parathyroidectomy.
Pentamide.179
Peritoneal dialysis.198
Porphyria with inappropriate secretion of antidiuretic hormone.
Pregnancy.
Proton pump inhibitors.199 200
Strenuous exercise.201
Tacrolimus.179
Vitamin B6 (pyridoxine) deficiency.71 202
Vitamin D excess or deficiency 85 152 184 203
  (chronic kidney disease and liver disease can prevent the activation of vitamin D).2 Causes of magnesium deficiency
Acetaminophen toxicity.146
Alcoholism.
Aluminium 8 (environmental and dietary).
Aldosteronism.3 147
Alcohol.148
Ageing149 (hypochlorhydria, ie, decreased acid in the stomach).
Antacids149 150 (including ranitidine and famotidine).
Bariatric surgery (small intestinal bypass surgery).151
Calcium supplements (or a high calcium to magnesium diet).
Caffeine.152
Cancer.153
Coeliac disease.154
Colon removal.155
Chronic stress.156
Cisplatin.157-161
Crohn's disease.162
Ciclosporin.163-166
Type 1 and type 2 diabetes 83 167 (uncontrolled glucose levels).
Diarrhoea.
Diet high in fat or sugar.152 168
Digoxin.169
Diuretics170-172—non-potassium-sparing diuretics (thiazide and loop diuretics).
Excessive ingestion of poorly absorbable magnesium 173 (such as magnesium oxide), leading to diarrhoea and magnesium loss.
Emotional and/or psychological stress174 (overactivation of the sympathetic nervous system).
Enzymatic dysfunction175 (impaired magnesium distribution).
Oestrogen therapy176 (shifts magnesium to soft and hard tissues lowering serum levels).
Excessive or prolonged lactation.177
Excessive menstruation.152
Fasting178 (or low magnesium intake).
Foscarnet.179
Gentamicin180 and tobramycin.181
Hyperparathyroidism and hypoparathyroidism.
Hyperthyroidism.
Kidney diseases182-184 (glomerulonephritis, pyelonephritis, hydronephrosis, nephrosclerosis and renal tubular acidosis).
Heart failure.185
Haemodialysis.186
High phosphorus in the diet152 (soda, inorganic phosphates contained in many inactive ingredients in processed foods).
Hyperinsulinaemia187 (and insulin therapy).179
Insulin resistance188 (intracellular magnesium depletion).
Laxatives.23
Low salt intake.189
Low selenium intake.152
Less severe signs
Aggression.152
Anxiety.
Ataxia.
Chvostek sign80 (twitching of the facial muscles in response to tapping over the area of the facial nerve).
Confusion.
Cramps (spontaneous carpopedal spasm or painful cramps of the muscles in your hands and feet).
Disorientation.
Fasciculations (‘a brief, spontaneous contraction affecting a small number of muscle fibres, often causing a flicker of movement under the skin.
   It can be a symptom of disease of the motor neurons)'.91
Hyperreflexia.
Irritability.
Muscular weakness.
Neuromuscular irritability.
Pain or hyperalgesia206 (decreases the nociceptive threshold).
Photosensitivity.207
Spasticity.
Tetany204 (involuntary muscle spasms).
Tinnitus208 (ringing in the ears).
Tremors.
Trousseau sign.
Vertigo.
Vitamin D resistance.
Severe signs
Arrhythmias (caused by overexcitation of the heart due to enhanced depolarisation susceptibility,
  especially torsades de pointes or ventricular tachycardia with a prolonged QT interval).
Calcifications (soft tissue).
Cataracts.209
Convulsions.
Coronary artery disease.
Depressed immune response.210
Depression. 11
Hearing loss.152 212
Heart failure.
Hypertension.
Migraines/headaches.
Mitral valve prolapse.213
Osteoporosis.
Parathyroid hormone resistance and impaired parathyroid hormone release/function.214
Psychotic behaviour.
Seizures 215 (overexcitation of the nervous system (nerve cells),
   which are more likely to fire due to a reduced electric potential difference between the outer and inner surfaces of the membrane).
Sudden cardiac death.
Tachycardia.
Hypomagnesaemia.
Hypocalcaemia.
Hypokalaemia.
Prolonged QTc. ST segment depression 115 (in animals).