I must confess I am very reverential to magnesium. Life began on our planet Earth with conversion of solar energy into chemical bond energy. Chemical bond energy is the thread which holds together the posies of life form flowers.Chlorophyll converts solar energy into chemical bond energy and is a magnesium chelate. ATPase and Acetyl CoA are premium molecules in human energy dynamics. Magnesium is a cofactor for both. Methionine-homocysteine-cysteine-taurine and cysteine-glutathione sulfhydryl systems are essential life-preserving antioxidant defenses of the body. These pathways are magnesium dependent. The first step in glucose metabolism is conversion of glucose to glucose-6-phosphate. This reaction requires hexokinase which is a magnesium-dependent enzyme. Delta-6-desaturase is a critical enzyme in the conversion of fatty acids of plant and animal origin into longer chains and unsaturated fatty acids essential for human metabolism. Delta-6-desaturase is a magnesium dependent enzyme. Magnesium serves as a cofactor in diverse reactions involved in DNA and protein synthesis. Magnesium is essential for many enzymatic reactions that use vitamin B1 (thiamine) and vitamin B6 (pyridoxine). These vitamins, in turn, are required for biosynthesis of essential neurotransmitter such as serotonin, GABA (gamma-amino-butyric acid) and melatonin.
Magnesium is a cofactor for the metabolism of yet other neurotransmitter such as acetylcholine. Increased intracellular levels of calcium poison cellular enzymes, hence the fascination of our drug industry with calcium channel blockers. Magnesium is nature’s calcium channel blocker.
Magnesium serves as a cofactor in many biochemical reactions that are involved the maintenance of intracellular
concentration of other cations such as potassium, sodium and calcium. Magnesium is also a cofactor for a large number of enzymes such as kinases.
Acutely ill hospitalized patients almost always become magnesium-poor within a few days. Such deficiency almost always goes unrecognized because we continue to insist that a deficiency state must be documented with blood tests before embarking upon magnesium replacement therapy. The fact that only less than 1% of total body magnesium exists in the blood does not seem important to us (skeletal and intracellular compartments contain approximately 53% and 46% of magnesium respectively). We fail to see the obvious: Increased oxidant stress on cell membranes associated with illness and resulting in hospitalization leads to leakage of magnesium out of the cell and into the extracellular space. In addition, it masks the intracellular magnesium deficiency. The ideal test for functional magnesium deficiency, in my judgment, is an intravenous therapeutic trial It is my clinical observation that oral magnesium supplements frequently fail to replenish magnesium stores within the cells.
In patients with chronic fatigue, myalgia, fibromyositis, and persistent muscle spasms and pain, oral magnesium supplements often give poor results while intravenous magnesium therapy almost always gives rapid and satisfactory clinical benefits. The same holds for patients with asthma, irregular heart rhythm, and severe backache. I once used intravenous magnesium along with other micronutrients for one of my patients with severe depression in a desperate — and fortunately successful — attempt to avoid hospitalization (this patient had very traumatic memory of previous hospital admission for depression). Indeed, there is extensive evidence that disorders of mood, memory and mentation, and psychiatric symptoms such as confusion, disorientation, agitation and depression are common in magnesium-deficient patient (JAMA 224:1749; 1973).
Magnesium is often poorly absorbed; clinical studies indicate absorption rate ranging from 50% to 70% in healthy
subjects on normal diet (Shils, M.E. in Modem nutrition in health and disease Philadelphia: Lea & Fibiger, pp. 159-192).
The intestinal absorption of magnesium is further decreased in magnesium-deficient states ( Intern. J. Neuroscience 61:87; 1991). Indeed, correction of magnesium deficiency in many patients is so problematic that a genetic basis for reduced magnesium absorption has been considered (Cecil Textbook o f Medicine 1988).
I know my advice to use intravenous magnesium drip as a test for functional magnesium deficiency in states of accelerated oxidative stress will rankle many of my colleagues in mainstream medicine. I stand by my recommendation. It is one of the most valuable diagnostic tool for the clinician caring for people with unremitting suffering. I refer the professional reader to my review article Magnesium and Oxidative Cell Membrane Injury that appeared in the spring 1992 issue of The Environmental Physician published by the American Academy of Environmental Medicine, Denver, Colorado.
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