Magnesium supplementation may be indicated when a specific health problem or condition causes an excessive loss of magnesium or limits magnesium absorption.1 2 3 4 5

Some medicines may result in magnesium deficiency, including certain diuretics, antibiotics, and medications used to treat cancer (anti-neoplastic medication).6 7 8 Examples of these medications are:

Individuals with poorly-controlled diabetes may benefit from magnesium supplements because of increased magnesium loss in urine associated with hyperglycemia.9

Magnesium supplementation may be indicated for persons with alcoholism. Low blood levels of magnesium occur in 30% to 60% of alcoholics, and in nearly 90% of patients experiencing alcohol withdrawal.10 11 Anyone who substitutes alcohol for food will usually have significantly lower magnesium intakes.

Individuals with chronic malabsorptive problems such as Crohn's disease, gluten sensitive enteropathy, regional enteritis, and intestinal surgery may lose magnesium through diarrhea and fat malabsorption.12 Individuals with these conditions may need supplemental magnesium.

Individuals with chronically low blood levels of potassium and calcium may have an underlying problem with magnesium deficiency. Magnesium supplements may help correct the potassium and calcium deficiencies.13

Older adults are at increased risk for magnesium deficiency. The 1999-2000 and 1998-94 National Health and Nutrition Examination Surveys suggest that older adults have lower dietary intakes of magnesium than younger adults.14 15 In addition, magnesium absorption decreases and renal excretion of magnesium increases in older adults.16 Seniors are also more likely to be taking drugs that interact with magnesium. This combination of factors places older adults at risk for magnesium deficiency.17 It is very important for older adults to get recommended amounts of dietary magnesium.

Anti-neoplastic medication: Cisplatin

Doctors can evaluate magnesium status when above-mentioned medical problems occur, and determine the need for magnesium supplementation.

Table 4 describes some important interactions between certain drugs and magnesium. These interactions may result in higher or lower levels of magnesium, or may influence absorption of the medication.

Table 4: Common and important magnesium/drug interactions

Drug Potential Interaction
  • Loop and thiazide diuretics (e.g. lasix, bumex, edecrin, and hydrochlorthiazide
  • Anti-neoplastic drugs (e.g. cisplatin)
  • Antibiotics (e.g. gentamicin and amphotericin)
 These drugs may increase the loss of magnesium in urine. Thus, taking these medications for long periods of time may contribute to magnesium depletion.18 19 20
Magnesium binds tetracycline in the gut and decreases the absorption of tetracycline.21
  • Magnesium-containing antacids and laxatives
    		•  Many antacids and laxatives contain magnesium. When frequently taken in large doses, these drugs can inadvertently lead to excessive magnesium consumption.22 23 and hypermagnesemia, which refers to elevated levels of magnesium in blood.

    Related Links: What is magnesium? | What foods provide magnesium? | How much magnesium do I need? | What happens if I do not get enough magnesium? | Do I need extra magnesium? | Can magnesium be harmful? | What are some of the current issues and controversies about magnesium?

    Disclaimer
    Reasonable care has been taken in preparing this document and the information provided herein is believed to be accurate. However, this information is not intended to constitute an "authoritative statement" under Food and Drug Administration rules and regulations.

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    Footnotes

    1. Wester PO. Magnesium. Am J Clin Nutr 1987;45:1305-12. PubMed abstract [↩]
    2. Vormann J. Magnesium: nutrition and metabolism. Molecular Aspects of Medicine 2003:24:27-37. [↩]
    3. Ladefoged K, Hessov I, Jarnum S. Nutrition in short-bowel syndrome. Scand J Gastroenterol Suppl 1996;216:122-31. PubMed abstract] [↩]
    4. Rude KR. Magnesium metabolism and deficiency. Endocrinol Metab Clin North Am 1993;22:377-95. [↩]
    5. Kelepouris E and Agus ZS. Hypomagnesemia: Renal magnesium handling. Semin Nephrol 1998;18:58-73. PubMed abstract [↩]
    6. Ramsay LE, Yeo WW, Jackson PR. Metabolic effects of diuretics. Cardiology 1994;84 Suppl 2:48-56. PubMed abstract [↩]
    7. Lajer H and Daugaard G. Cisplatin and hypomagnesemia. Ca Treat Rev 1999;25:47-58. PubMed abstract [↩]
    8. Shils ME. Magnesium. In Modern Nutrition in Health and Disease, 9th Edition. (edited by Shils, ME, Olson, JA, Shike, M, and Ross, AC.) New York: Lippincott Williams and Wilkins, 1999, p. 169-92. [↩]
    9. American Diabetes Association. Nutrition recommendations and principles for people with diabetes mellitus. Diabetes Care 1999;22:542-5. PubMed abstract [↩]
    10. Elisaf M, Bairaktari E, Kalaitzidis R, Siamopoulos K. Hypomagnesemia in alcoholic patients. Alcohol Clin Exp Res 1998;22:244-6. PubMed abstract [↩]
    11. Abbott L, Nadler J, Rude RK. Magnesium deficiency in alcoholism: Possible contribution to osteoporosis and cardiovascular disease in alcoholics. Alcohol Clin Exp Res 1994;18:1076-82. PubMed abstract [↩]
    12. Rude RK and Olerich M. Magnesium deficiency: Possible role in osteoporosis associated with gluten-sensitive enteropathy. Osteoporos Int 1996;6:453-61. PubMed abstract [↩]
    13. Shils ME. Magnesium. In Modern Nutrition in Health and Disease, 9th Edition. (edited by Shils, ME, Olson, JA, Shike, M, and Ross, AC.) New York: Lippincott Williams and Wilkins, 1999, p. 169-92. [↩]
    14. Ford ES and Mokdad AH. Dietary magnesium intake in a national sample of U.S. adults. J Nutr. 2003;133:2879-82. [↩]
    15. Bialostosky K, Wright JD, Kennedy-Stephenson J, McDowell M, Johnson CL. Dietary intake of macronutrients, micronutrients and other dietary constituents: United States 1988-94. Vital Heath Stat. 11(245) ed: National Center for Health Statistics, 2002:168. [↩]
    16. Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes: Calcium, Phosphorus, Magnesium, Vitamin D and Fluoride. National Academy Press. Washington, DC, 1999. [↩]
    17. Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes: Calcium, Phosphorus, Magnesium, Vitamin D and Fluoride. National Academy Press. Washington, DC, 1999. [↩]
    18. Ladefoged K, Hessov I, Jarnum S. Nutrition in short-bowel syndrome. Scand J Gastroenterol Suppl 1996;216:122-31. PubMed abstract [↩]
    19. Rude KR. Magnesium metabolism and deficiency. Endocrinol Metab Clin North Am 1993;22:377-95. [↩]
    20. Ramsay LE, Yeo WW, Jackson PR. Metabolic effects of diuretics. Cardiology 1994;84 Suppl 2:48-56. PubMed abstract [↩]
    21. Takahashi M, Degenkolb J, Hillen W. Determination of the equilibrium association constant between Tet repressor and tetracycline at limiting Mg2+ concentrations: a generally applicable method for effector-dependent high-affinity complexes. Anal Biochem 1991;199:197-202. [↩]
    22. Xing JH and Soffer EE. Adverse effects of laxatives. Dis Colon Rectum 2001;44:1201-9. [↩]
    23. Qureshi T and Melonakos TK. Acute hypermagnesemia after laxative use. Ann Emerg Med 1996;28:552-5. PubMed abstract [↩]

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