A summary of normal magnesium homeostasis, and an overview of the manifestations, etiologies, diagnostic evaluation, and treatment of both hypomagnesemia and hypermagnesemia.
This video is fantastically and educationally informative. If it has been getting an unusually large number of thumb down, it is due to its very technical language which may not go down with some large numbers of RU-vid viewers. The content is, even, hard for medical students to take in, never mind the average viewer wanting to know some simple facts about Magnesium Disorder. I have A GP friend 56 years old, we both watched this video together and she was taken in by the depth of its medical analysis. Good luck and thank for this highly informative and well presented video.
Thanks for your feedback! The video was getting a ton of thumbs down because RU-vid had featured it for a month or so 2 years on their education channel, so it was getting many more views from non-health-care-professionals than usual.
I initially thought the 15mins were going to be long. Every minute of it was useful and filled with important information needed for me (pharmacy student), probably not for laymen. Thank you so much :)
Magnesium made my calf cramps go away!! Havent had a single one since starting daily magnesium supplement at the suggestion of my OB when I was pregnant with my first kid 6 years ago. Also I have less foggy brain :).
My attending pimped me on this subject a couple of days ago and I couldn't find much information on the it at all. I did see your video on RU-vid's education channel and decided to venture a view. I'm glad I did! Thanks for an easy understanding of Magnesium's role in the body!
I've had paroxysmal a-fib for ten years and obviously electrolyte balance is important in maintaining sinus rhythm in my case. Blood Mg levels are a poor indicator of intracellular Mg levels; rather a cheek cell test will give a more accurate intracellular level, indicative of that in the heart myocytes. Since Mg supplementation so often causes diarrhoea, or at least the potential for a "shart" (always a danger at my age, lol) I find chelated Mg supplements to be way more effective in getting the balance right without side (or should that be bottom?) effects of other forms of Mg supplements. Oh, and a seemingly healthy diet in Australia sometimes can have low Mg content, due to our poor soils.
Yes I agree it's about diet and nutrition and exercise you can do a lot with that if you know what foods are bad for you and you don't eat them all calories are created equal not even close don't eat sugar don't eat bread don't eat vegetable seed oil tomatoes don't eat tomatoes watch them they got to be tomato sauce or they got to be very fresh potatoes aren't good for you but I love scalloped potatoes or potatoes au gratin with the cream cheese
Excellent video and very informative . Got 2 full pages of notes and will be doing some further study with the GI correlation in acute and chronic GI issues. Magnesium is the most underrated and least discussed electrolyte and needs more attention. Lots of people I am hearing are taking massive amounts PO for muscle pain and I fight to inform them only to take if a doctor reccomends it. Thank you again, will be subscribing and investing more time watching your videos and look forward to learning more!
Helped me to understand why most of the people I know who take high blood pressure meds are ending up on dialysis. Physicians are not checking their patients who are on meds for years at a time.
@@Fomites : U r a Bully w/the name calling. like u don’t know these guys in the white lab 🥼 kick back from these drug companies. Honey I have family and friends that work in these doctors office ,spare me!
@Ines Cruz (sorry RU-vid is not letting me directly link to your comments): While I can't offer you specific, individualized medical advice on here, I will say that it is not standard of care in the US for a physician to prescribe an electrolyte supplement without first checking the serum chemistries. While serum magnesium does not correlate well with total body magnesium stores, supplemental magnesium should be used very cautiously if significant renal dysfunction were also present. Also, palpitations related to electrolyte deficiencies could easily be from potassium depletion - though both low magnesium and low potassium only cause palpitations via their possible contribution to abnormal heart rhythms - specifically atrial fibrillation, ventricular tachycardia, and multifocal atrial tachycardia (the last of which is very uncommon).
In my opinion, you should explore the role that magnesium has in birth. This situation provides a very clear physiological response pattern to magnesium.
I know this has been done long time ago but I wonder if you wanted to put hypocalcaemia in 3:54 - as Mg helps to produce PTH so low Mg generally leads to low Ca (it's possible to have low Mg secondary to high Ca but not the other way around). Then it would make sense, as the examples of symptoms you described are due to low calcium and not high (calcium is Na channel stabilizer so low levels cause increase na influx into cell hence easier depolarisation hence tetatni etc).
I'm amazed at your finding of magnesium I have a ruptured discs L4 and L5 and magnesium and B12 have been my best pain Killers if this information helps you please use it and pass it on I've manged without surgery but plenty of therapy thank you for your findings I was worried of any future side effects of magnesium, but with this information I can see I can over due it I'll value now more my yearly (Medical) physical
hi eric, please dont remove this video, i see there are no like/dislike numbers... im hoping you can clear up the serum mag test, rbc mag test, mag loading test, and any other lab tests to evaluate magnesium, there is a lot on the web about having the active/rcbmag test done,..there is a great deal of information by carolyne dean i was wondering if you are familiar with her work, also i appreciate being clear in the clarification of the limits of clinical use of magnesium in standard care and evaluation, it is important to make the distinction between what is known and what is used in regular medical care, as usual there is a great discrepancy gap....
Don't worry, I'm not planning on removing the video. I just blocked the like/dislike buttons ever since RU-vid placed this as a featured video on their general education channel. Because it's relatively technical, and because there are many people now clicking on it without necessarily having a strong desire to learn the technical details of magnesium balance, it was getting many dislikes that was hurting my ego... I'm not remotely an expert on alternative ways to diagnose magnesium deficiency (i.e. tests other than the unreliable standard serum magnesium test). All I can say is that none of the alternatives have entered into routine clinical practice in conventional medical settings. In the scientific literature, the magnesium loading test appears to be the most studied, but as I said, using it hasn't become standard practice. It's interesting that something like the mag loading test, which has a small and limited amount of data suggesting it's useful doesn't have widespread acceptance, whereas the typical serum magnesium level, for which there is a strong consensus that it is a flawed measure of total body mag stores, is used all the time without second thought. I suspect the apparent discrepancy is because routine serum mag tests probably correlate relatively well with the risk of complications from acute hypomagnesemia in critically ill patients (i.e. risk of arrhythmias from magnesium depletion during active diuresis of a patient in severe heart failure). Doctors then make the leap that the conventional serum mag test is also appropriate for assessment of chronic mag deficiency, which, as implied above, is probably largely false. Medical science is incomplete, and unfortunately, an accurate, reproducible, practical, and clinically useful means of assessing chronic magnesium deficiency has so far eluded us.
Eric's Medical Lectures i wasnt aware that the rbc mag test, was alternative, i thought it was a test to measure with more accuracy the active level of magnesium similar to intracellular b12 vs serum... im one of those you can freely bore away with detail : ) what is the best assays for assessing magnesium? serum is fairly useless, ( but i find it interesting that serum calcium is fairly good, as well if known albumin can estimate ionized,.. is there some formula comparable for assessing magnesium?
Dogmaof Oodles The RBC Magnesium test is best described as investigational. In 10 years of practice, I've literally never seen anyone order it or attempt to order it, and Stanford on-site labs doesn't offer the test at all. The bottom line is that there is no established, reliable test for assessing total body magnesium stores. Unfortunately, there is no formula for magnesium as there is for calcium.
ah, i think it would be great if you would address the role magnesium plays in enzymatic reactions, ie pth, calcidiol, calcitriol .... (of course every enzymatic rx needs a vit and a mineral,.. so it is a very large topic) in addition dr osborne has a good short magnesium overview: Signs and Symptoms of Magnesium Deficiency
Thanks for the suggestions. This video was originally created primarily with medical students in mind, who have limited attention spans when it comes to electrolytes, so I wanted to keep it relatively concise. Unfortunately, some important details may have been left out. I am familiar with Dr. Osborne's video that you've linked to. The only thing I'd say about it is that some of the consequences of mag deficiency that he mentions are speculative and/or don't (yet) have a huge amount of solid data behind them. Hopefully with time, larger and better studies will be conducted and published so that unresolved questions can be answered.
Eric's Medical Lectures hi eric! first thank you for your efforts and videos. i kept my comment a bit open, so narrowing it down, if you could i would like if you went over the role magnesium plays in the enzymatic conversions in numerous activation in the body, just for example because of this video pth, calcidiol, calcitriol, and any other you would like to add, (there are a few hundred), the purpose of that being to put emphasis on a not very well emphasized role, basically at which steps is magnesium needed and which anatomical structure....
Kristy, closed captioning is now available for this video (not sure why it wasn't before), and I just proofread the subtitles for accuracy. (RU-vid really needs to add more medical terms to their voice recognition software!)
My Gi tract does not take kindly to Mag of any type, so, I use spray on mag oil from mag chloride and mag sulfate from ES. Is there any likelihood of hyper mag from this method of application on a daily basis. sleep patterns are greatly improved with my application of mag to date. cheers and thanks, great learning with your style and presentation.
If I feel terrible every time I take magnesium what could be the issue? What route would be good to take? Have told a few doctors and there’s always a blank stare. Have tested this out many times past three years. Every time I take magnesium glycinate I feel awful; neck becomes extra stiff and headache comes on.
I'm sorry but I can't give specific, individualized medical advice on here, and you should always discuss any concerns about your medications with your own physicians and other healthcare providers. However, there are more than one type of magnesium supplementation (e.g. magnesium oxide, magnesium chloride, etc...).
@@StrongMed Every doc you talk too have no clue on this stuff so that's why most are here to get advise I hate when people say talk to your doc when then don't have a clue lol
Hi, Thank you for video! I've learned that hyperglycemia would cause the intracellular movement of magnesium but I cannot understand how it works in the systems. Would you please provide some guidance here? Thank you so much!
Hi, can you please talk about why magnesium supplements (no matter what form) causes me to have anxiety, restlessness, sleep disturbances, and sweaty hands and feet? It makes me paranoid if I take it for a while...its so bad...but magnesium RBC is only 4.6 (range is 4.2-6.8) and I get PVCs...so I think I need more magnesium. So frustrating.
I'm sorry, but I can't give specific, individualized medical advice here and I recommend speaking with your own physician about your concerns. Having said that, the symptoms you've described are not common side effects of oral magnesium supplements - although taking magnesium at the same time as *some* other medications can affect their absorption, so one might experience effects related to that kind of interaction. Depending on where you live, there may be more than one form of oral magnesium available; one could try a different formulation. I also always make sure other electrolytes (e.g. potassium, calcium) are checked at the same time as magnesium. Last, despite direct-to-consumer labs loving RBC magnesium testing, it hasn't been sufficiently validated as an accurate enough method of diagnosing magnesium depletion to recommend as a screening test. As I said - not medical advice, and you should speak to your own doctors about this. Hope you get it figured out!
Very educated video! Thanks for uploading them. My 10 year old son was diagonosed with Gitelman's Syndrome 2 years ago and ever since he takes Mg oxide and Potassium supplements every day. What is the ideal Mg level for his age. I know the norm is >2.0 mg accordingly to USA. What is the lower threshold which can be harmful? It is a challenge to maintain his Mg and K levels. Do you recommend any alternatives for better absorption of these minerals. I heard Dermal Mg oil,epsom salts etc, will they help to store Mg or it does not matter as Kidney will not re-absord them ? Thanks again!
Amudha Reddy I'm glad you found the video helpful. Unfortunately, I'm not able to give specific advice about your son, both for legal reasons, as well as the fact that advice about treating his Gitelman syndrome (a rare disorder) is best to come from a pediatric nephrologist (or adult nephrologist, if a pediatric nephrologist is not available in your area). I am able to say that, to the best of my knowledge, no specific formulation of magnesium supplementation is more effective than others, but would discuss whichever supplement you prefer to use with your son's doctor. Unfortunately, none of the supplements really help the body to hold on to magnesium; they only replace what is lost in the kidneys. As I'm sure you know, keeping magnesium and potassium in the normal range in Gitelman syndrome can be very challenging. Only other piece of advice I can offer is to be sure when you are looking at reports or tests of magnesium levels in the blood that you don't mix up the units: magnesium levels can be reported in either mg/dL, mEq/L, or mmol/L (and these are not the same); the first 2 types of units are commonly used in the US, the last is more common in other parts of the world.
Some organs are noted with a certain enzyme like the pancreas we like to associate that with insulin in the liver is making bio to digest food fat in the kidneys kind of filter the water from the blood and it's recycled sometimes some of it
Thank you for this interesting and informative video. i have two suggestions and one question, - you didn;t cover transdermal Mg absorbtion (Mg chloride also known as Mg Oil) = Mg serum levels are a very poor indicator of overall Mg levels - source on the Mg and loop of Henle please?
I appreciate that transdermal application of magnesium is used in complementary/alternative medicine, but the peer-reviewed scientific literature has just 1 study on it, published in 2015, which was a non-randomized, non-controlled study of 24 patients with fibromyalgia in whom magnesium levels (serum or intracellular) weren't even measured (www.ncbi.nlm.nih.gov/pubmed/26343101) - it's the kind of paper that is meant to generate hypotheses leading to more research; it is not enough to actually recommend a change in practice. This isn't to say that transdermal magnesium isn't effective, but rather, there is no significant evidence of its effectiveness. Since there is no specific reason to think it's superior to oral magnesium, with which we have greater experience, I personally advise patients to stick with oral mag supplements. I totally agree that the correlation between serum magnesium levels and total body magnesium levels is not great. (Same holds true for potassium, calcium, and phosphate) If I didn't explicitly state that in the video, I meant to - thanks for pointing it out. Unfortunately, we don't have a good alternative to serum magnesium levels. Although there are websites that promote measurement of intracellular magnesium, this test is not currently accepted by the medical community as an appropriate alternative. There is more research being done though, and hopefully someday there will be a way to more accurately assess total body magnesium stores. Regarding the reference for magnesium and loop of Henle, was there a specific fact that you were interested in? (i.e. effect of pH on reasborption, rapid administration of IV mag leads to increase renal tubular mag wasting, etc...)
Thanks for all of your positive comments over the last few days! Sorry I haven't been able to reply to them individually! A funny story about the down votes on this video... about a year after it was posted, some automatic RU-vid algorithm selected it to be featured for 2-3 months on RU-vid's Featured Education Channel (I don't think the channel even exists any more). So a huge volume of non-medical people clicked on it expecting a video made for laypersons, and seeing it was clearly not what they expected, down voted it and quit watching after 30 seconds. It has the most extreme analytics, by far, of any video I've made. It was kind of ironic to have been selected like that since it was one of the least layperson-friendly videos I had made up until that point.
I've had dangerously low levels of potassium and magnesium most of my life, I've also had UC since I was 6. I started having chronic kidney stones at 19. Although many of my friends who have UC also have had chronic Calcium kidney stones the Doc's say it's not related. Perhaps the low absorption of magnesium and potassium from UC is also causing an access of calcium?
Mandilyn, while I can't give you any specific advice regarding your own medical situation, I can tell you that IBD (both UC and Crohn's) is associated with higher risk of kidney stones. It's not a widely discussed problem, so it's not surprising that most doctors don't know about it. The reasons for the association between IBD and stones are complicated and not completely understood, though the risk appears highest in patients with the worst disease (worst in terms of both anatomic extent of intestinal inflammation, and disease activity). Related to this is that low serum potassium is also a risk factor for the development of calcium stones, though the mechanism of this is unknown. I honestly don't know of any association between magnesium and calcium stones, but since balance of each electrolyte is intertwined with the others, it's not hard to believe there is one waiting to be discovered. Finally, another consideration for stones in a patient with IBD is whether the stones are actually not primarily composed of calcium but rather uric acid, since uric acid stones can be caused by the systemic acidemia (i.e. acid in the blood) and mild volume depletion that can be seen in IBD characterized by severe, chronic diarrhea.
Magnesium gives me massive zits. Deep and painful zits, often interfering with blood wessels and give horrible swellings. Two to three days after taking a magnesium supplement.
For 2 years now I am very weak in the body every muscle is weak i can't even barely walk down the street ring in ears nervousness before . Never got this in my whole life 40 years old please i need so much health the doctors think i'm depressed and psychic that i am not even weak but i am. l magnesium deficiency?? What magnesium to take their so many out there??
I'm very sorry, but I can't give specific, individualized medical advice on here. But I will say that generalized weakness and ringing in the ears are not common manifestations of magnesium deficiency. I would seek a second opinion from another physician, if you haven't already.
Because the thyroid plays a large part in calcium regulation, and because hypermagnesemia presents similarly to hypercalcemia, wouldn't one look to the thyroid/parathyroid as a player in Mg regulation?
mitch0310, you make a great point, one which I should have made clearer in the video. Calcitonin (produced by the thyroid) and PTH (produced by the parathyroids) have both been shown to affect renal handling of magnesium (among other hormone). And derangements of magnesium have been shown to impact PTH secretion. What hasn't been shown yet, is whether primary derangements of any hormone (including calcitonin and PTH) can lead to a clinically relevant (i.e. significant enough to cause symptoms) alteration in the body's magnesium balance. My guess it that we simply still have much to learn about human physiology. I've embedded an annotation into the video mentioning the above. Thanks!
uofagrad2009 That's a great question. First, what I've discussed regarding mg repletion is more my opinion, and not official guidelines - since there aren't any official guidelines on the general management of hypomagnesemia. Most importantly, no one knows to what level magnesium should be repleted in either acute medical illness, chronic medical illness, or in an asymptomatic presumably healthy person. Thus, we have the common practice by which medical/surgical residents and hospitalists insist on repleting magnesium to 2.0 mEq/L in hospitalized patients, despite the normal range frequently being something like 1.8-2.2 mEq/L (i.e. they are unsatisfied with low normal levels, and insist on repleting to high normal levels). This is probably not necessary in asymptomatic patients who are without active cardiovascular/arrhythmogenic disease or prolonged QT syndrome. Related to that is the practice of almost always repleting magnesium via IV route in the hospital, when this may not always be necessary, and may be counterproductive (significant spikes in serum magnesium leads to renal magnesium wasting before cellular uptake can occur - thus patients may immediately lose in the urine a significant portion of the infused magnesium). For a review of magnesium repletion in patients who are hypomagnesemic, I'd recommend starting with UpToDate's article "Evaluation and Treatment of Hypomagnesemia" by Alan Yu - but given limited literature, much of the treatment section is presumably his opinion (albeit, a relatively well-informed opinion). Also, although it's more recent than my video (i.e. it wasn't a source I used), another relevant paper is: Ayuk J, Gittoes N. "Treatment of Hypomagnesemia" Am J Kidney Diseases. 2014: 63;691-695. PMID: 24100128.
I have mg deficiency since 4 years i took supplements through 4 years and none of them helped to raise the amount of mg in my body please tell me what is the problem with my body Ps my potassium and calcium are normal in my body I really dont know what to do ?
Consult a doctor (especially one with an interest in this topic). In the meantime, consider any medications you are taking - especially proton pump inhibitors (PPIs).
@@Fomites you won’t believe it if i told u that i visited a lot of doctors for this issue and none of them knew what is the problem, and the PPI’S medications i stopped all of them a year ago and still have the same issue
Alberto HERNANDEZ MARTINEZ Ahh!!! How embarrassing! Thanks you, you are correct: Hypomagnesemia causes HYPOcalcemia. I added an annotation into the video pointing out the mistake. I wish I knew someone willing to "proofwatch" these before I posted them!
