Magnesium in Prevention and Therapy
Abstract
:1. Introduction
2. Functions of Magnesium
Magnesium is involved in more than 300 essential metabolic reactions (e.g., all Adenosine Triphosphate (ATP)-dependent reactions). |
Energy production (→ ATP production) |
Breakdown and energetic utilization of carbohydrates, proteins and fats in intermediate metabolism (e.g., glycolysis, respiratory chain phosphorylation). ATP exists primarily as a complex with magnesium (MgATP). |
Enzyme activation (examples) |
Mitochondrial ATP synthase, Na+/K+-ATPase, Hexokinase, Creatine kinase, Adenylate cyclase, Phosphofructokinase, tyrosine kinase activity of the insulin receptor. |
Calcium antagonist/NMDA-receptor antagonist |
Control of calcium influx at the cell membrane (course of contractions, regulation of vascular muscle tone): muscle contraction/relaxation, neurotransmitter release, action potential conduction in nodal tissue, neuromuscular impulse conduction (inhibition of calcium-dependent acetylcholine release at the motor end plate), maintenance and stabilization of membrane physiology, muscle contraction. |
Cardiovascular system |
Economization of cardiac pump function, regulation of potassium movement in myocardial cells, protection against stress, vasodilation of the coronary and peripheral arteries, reduction of platelet aggregation. |
Membrane function |
Transmembrane electrolyte flux, active transport of potassium and calcium across cell membranes, regulation of cell adhesion and cell migration. |
Structural roles |
Component of mineralized bone (structure, microarchitecture), multiple enzyme complexes, mitochondria, proteins, polyribosomes, and nucleic acids. |
Nutrient metabolism |
Metabolic activation and utilisation of vitamin D, B-vitamins (e.g., thiamine) and glutathione. |
3. Magnesium and Nutrition
4. Magnesium Absorption and Excretion
5. Magnesium Status
6. Magnesium Deficiency
General: Anxiety, lethargy, weakness, agitation, depression, dysmenorrhea, hyperactivity, headache, irritability, dysacusis, low stress tolerance, loss of appetite, nausea, sleep disorders, impaired athletic performance. |
Musculature: Muscle spasm, cramps in the soles of the feet, leg cramps, facial muscles, masticatory muscles, and calves, carpopedal spasm, back aches, neck pain, urinary spasms, magnesium deficiency tetany. |
Nerves/CNS: Nervousness, increased sensitivity of NMDA receptors to excitatory neurotransmitters, migraine, depression, nystagmus, paraesthesia, poor memory, seizures, tremor, vertigo. |
Gastrointestinal tract: Constipation. |
Cardiovascular system: Risk of arrhythmias, supraventricular or ventricular arrhythmias, hypertension, coronary spasm, decreased myocardial pump function, digitalis sensitivity, Torsade de pointes, death from heart disease. |
Electrolytes: Hypokalaemia, hypocalcaemia, retention of sodium. |
Metabolism: Dyslipoproteinemia (increased blood triglycerides and cholesterol), decreased glucose tolerance, insulin resistance, increased risk of metabolic syndrome, disturbances of bone and vitamin D metabolism, resistance to PTH, low circulating levels of PTH, resistance to vitamin D, low circulating levels of 25(OH)D, recurrence of calcium oxalate calculi. |
Miscellaneous: Asthma, chronic fatigue syndrome, osteoporosis, hypertension, altered glucose homeostasis. |
Pregnancy: Pregnancy complications (e.g., miscarriage, premature labor, eclampsia). |
Drug Group (Drug Substance) | Mechanism/Effect |
---|---|
Aminoglycosides (e.g., gentamicin, tobramycin, amikacin) | increased renal magnesium loss, secondary hyperaldosteronism |
Antimicrobial medication (Pentamidine) | increased renal magnesium loss |
Antiviral medication (foscarnet) | nephrotoxicity, increased renal magnesium loss |
Beta adrenergic agonists (e.g., Fenoterol, salbutamol, theophylline) | increased renal magnesium excretion, metabolic abnormalities (magnesium shift into cells) |
Bisphosphonates (pamidronate) | renal impairment, magnesium excretion |
Chemotherapeutic agents (e.g., amsacrine, cisplatin) | nephrotoxicity, cisplatin accumulates in renal cortex, increased renal magnesium loss |
Immunosuppressants (cyclosporine, sirolimus) | 2- to 3-fold increased urinary magnesium excretion (→ magnesium wasting) |
Loop diuretics, esp. long-term use | increased renal magnesium loss, secondary hyperaldosteronism |
Monoclonal antibody (e.g. cetuximab, panitumumab) | EGFR blockade in the nephron impairs the active transport of magnesium (→ magnesium wasting) |
Polyene antifungals (amphotericin B) | nephrotoxicity |
Proton pump inhibitors | loss of active magnesium absorption via transient receptor potential melastatin-6 and -7 (TRPM6/7) |
Thiazide diuretics, esp. long-term use (e.g., hydrochlorothiazide) | increased renal magnesium loss, secondary hyperaldosteronism |
7. Magnesium in the Treatment and Prevention of Diseases
7.1. Magnesium, Type 2 Diabetes and Metabolic Syndrome
7.2. Cardiovascular Disease
7.2.1. Hypertension
7.2.2. Coronary Heart Disease, Myocardial Infarction and Stroke
7.3. Pre-Eclampsia and Eclampsia
7.4. Migraine Headaches
7.5. ADHD
7.6. Alzheimer’s Disease
7.7. Asthma
7.8. Miscellaneous
8. Dosage and Supplements
9. Adverse Effects and Interactions
10. Conclusions
Conflicts of Interest
References
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Gröber, U.; Schmidt, J.; Kisters, K. Magnesium in Prevention and Therapy. Nutrients 2015, 7, 8199-8226. https://doi.org/10.3390/nu7095388
Gröber U, Schmidt J, Kisters K. Magnesium in Prevention and Therapy. Nutrients. 2015; 7(9):8199-8226. https://doi.org/10.3390/nu7095388
Chicago/Turabian StyleGröber, Uwe, Joachim Schmidt, and Klaus Kisters. 2015. "Magnesium in Prevention and Therapy" Nutrients 7, no. 9: 8199-8226. https://doi.org/10.3390/nu7095388