Magnesium Depleted by Numerous Drugs

By Dr. Linda J. Dobberstein, DC, Board Certified in Clinical Nutrition

September 21, 2020

Magnesium Depleted by Numerous Drugs
Magnesium is a critical nutrient that impacts numerous systems through the body. Low quality diets, changes to nutrient content in the soil and foods, and high stress all reduce tissue stores of magnesium and produce a deficit situation that is unable to meet demand. This deficit takes a toll on health and can lead to long-term health issues. On top of these dietary and lifestyle challenges, there is the added issue in that several commonly used drugs significantly deplete nutrients including magnesium. With the added demands for magnesium in our life, we must be mindful on what helps or hinders this life essential mineral.

Why You Need Magnesium

Lack of adequate magnesium may cause fatigue, sleep problems, muscle cramps including foot and leg cramps, mood stress, irritability, weakness, and poor appetite.

Hundreds of processes in all your organs require magnesium. Here is a snapshot of some of these processes that depend upon adequate magnesium. Your heart and cardiovascular system require magnesium for its rhythm, quality of heartbeat, and blood vessel relaxation. Blood sugar metabolism, liver detoxification, immune cell functions and protection, gastrointestinal function and bowel movements require adequate magnesium.

Bones, joints and cartilage require magnesium for structure, but also to help other nutrients like calcium and vitamin D work synergistically together. Magnesium status even affects dental implants and restoration therapy because of bone health and tissue inflammation management.

Your energy producing mitochondria absolutely need magnesium. If mitochondria are not provided enough nutrients like magnesium, the very essence of energy production within each organ is compromised. This is particularly critical for your brain, immune system, thyroid and adrenal stress tolerance and exercise tolerance.

Prenatal development and pregnancy require adequate magnesium. Bone health in menopause is significantly influenced by magnesium status. Men need magnesium for prostate health and urine flow

Even the repair mechanisms for your DNA require magnesium. If you do not have enough magnesium, your DNA is more susceptible to oxidative stress and injury.

About 400 mg per day of magnesium is needed for adults to meet the RDA. Any of the factors listed above will increase your daily need. Further information about magnesium including food sources and lab test information are in the articles below.

Insufficient Magnesium – Public Health Crisis Declared

Magnesium: A Notable Mineral Essential for Life 

Vitamin D and Magnesium: Essential Partnership for Health

How to Choose a High Quality Magnesium Supplement

Magnesium Boosts Brain Function

Magnesium and Vitamin B1 – Team Players Needed for Brain, Muscles, Metabolism, and More

Magnesium Robbing Drugs

Medications are often taken without thought into how they impact your nutrient status. Many individuals are treated with polypharmacy or multiple medications, which leads to increasingly common drug-nutrient depletions. Patients are often left in the dark on these concerns and suffer further loss of health from the lack of adequate nutrients. Nutrient deficiency symptoms may be ignored or dismissed as side effects of the medications, stress, or simply a result of aging. Nutrient depletion symptoms may even be treated with another medication. Your body requires nutrients of many types to work. Stripping them out or hindering their function does not help your health. Here are some of the medications known to rob your body of magnesium

Acid-blocking Drugs

Acid-blocking drugs directly interfere with magnesium absorption and several other nutrients in your digestive tract. For magnesium to be absorbed, there must be adequate stomach acid and proper pH in the intestinal tract. This, however, is altered with the use of acid blocking drugs like proton-pump inhibitors. Rather than your intestinal tract absorbing the much-needed mineral, it ends up being eliminated via the kidneys into the urine.

Proton pump inhibitors are drugs with “prazole” in the drug-name. These include omeprazole (Prilosec, Zegerid), lansoprazole (Prevacid), pantoprazole (Protonix), rabeprazole (Aciphex), esomeprazole (Nexium), and dexlansoprazole (Dexilant).

Insulin and Insulin Mimicking Drugs

Certain medications affect how magnesium is transported into cells as they block magnesium-transporting proteins. Insulin is one such compound. When insulin levels are balanced and controlled, it helps magnesium move appropriately in cells. With elevated insulin levels, i.e. high dose insulin therapy, use of insulin-mimicking drugs or even insulin resistance, magnesium is moved out of cells and lost through the urine.

Insulin levels are greatly impacted by diet. Carbohydrate dominant foods, such as white flour, white sugar, and starches, contribute to higher release of insulin when these foods are ingested. Diets balanced with higher levels of protein, good fats and complex carbohydrates cause smaller amounts and slower release of insulin. Dietary choices can either aid or worsen the impact of insulin’s effect on magnesium balance even with drug-nutrient depletion.

Other diabetic medications, like Metformin may impact magnesium, but in a different manner. A case report showed that Metformin caused low magnesium levels because of diarrhea as a drug-induced side-effect. How many people are on Metformin or other medications that cause chronic diarrhea and poor absorption leading to magnesium insufficiency?

Antimicrobials, Asthma, and Heart Failure Meds

Various antibiotics, antifungals, and antiviral drugs interfere with magnesium as they cause loss through the kidneys and urine. Medications include antibiotics, such as gentamicin, tobramycin, amikacin, and quinolones (Cipro, Levaquin), and other antimicrobials, such as pentamidine, foscarnet, and amphotericin B.

Asthma and heart failure medications (beta adrenergic agonists) like fenoterol, salbutamol, and theophylline cause a shift of magnesium inside cells. This impacts magnesium function and ultimately leads to excretion of it in the urine. Your respiratory and cardiovascular systems depend on magnesium for normal function, bronchial and blood vessel dilation, heart muscle activity and mitochondrial energy production. Do you sense that something is wrong with this picture?!

Chemo Drugs

Bisphosphonate chemotherapy drug pamidronate/Aredia causes kidneys to excrete magnesium. Other chemotherapy drugs that cause magnesium loss include amsacrine, cetuximab, and cisplatin.

Water Pills

Certain water pills including loop and/or thiazide diuretics cause magnesium loss. These include the commonly used meds Lasix/furosemide and HCT/HCTZ or hydrochlorothiazide. Studies from thirty years ago showed that although blood levels of magnesium can be normal in patients treated with thiazide diuretics, yet cell levels are often markedly depleted.

The elderly are often put on these drugs for months or years and have a much higher likelihood to be severely depleted in magnesium. They are at a much higher risk of a life threatening event or death because of this, yet how many know of this concern and do something about it?

Birth Control Pills

Birth control pills or oral contraceptives strip numerous nutrients out of the body including magnesium. How many teenage girls get put on birth control for hormone management and then stay on them for decades for oral contraception, without any concern for their magnesium status or intake? How about girls and women who suffer from PMS related symptoms (mood, cramps, insomnia, etc) due to inadequate magnesium?

Steroids and Antidepressants

Steroid medications like prednisone and antidepressants like imipramine and Zoloft deplete magnesium. Bone health and blood sugar management are adversely impacted because of the steroid drugs themselves. It becomes even more harmful if your magnesium status is inadequate.

Imipramine, a tricyclic antidepressant, and Zoloft, a selective serotonin reuptake inhibitor (SSRI) deplete magnesium. In brain and mood health, if you do not have enough magnesium, serotonin levels in your brain suffer. In addition, high cortisol and stress hormones cause your brain cells to release magnesium into the blood stream leading to magnesium depletion inside cells. It becomes a vicious cycle with modern life stress and these medications that deplete magnesium necessary for serotonin production. Magnesium supports mood, stress tolerance, and more restful sleep.

Insufficient vitamin D, calcium, and potassium often coexist with inadequate magnesium levels. If you replenish magnesium levels, it helps improve levels of these other nutrients.

The British Medical Journal declared a public health crisis in 2018 due to inadequate intake of magnesium in the diet. Drug-induced magnesium depletion certainly creates another significant threat to health. The drugs listed above are a partial list known to affect magnesium status. Additional drug information may be found in the article Magnesium: A Notable Mineral Essential for Life

Take a moment to think about your diet and that antacid, diuretic, or birth control pill, etc that you or a family member have been on for years. Are you truly getting enough magnesium to manage the drug-depletion? Mineral levels within our food supply have been dwindling for several decades. High stress causes your cells to rapidly release magnesium to meet demands. Poor digestion and loss of stomach acid production related with age or autoimmune atrophy, gastric bypass surgery, gut inflammation, and numerous other factors contribute to further depletion. In addition to these factors, do not let drug-nutrient depletions rob you of this critical nutrient. Magnesium is a fundamental pillar of your nutritional health.

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