Friday, September 29, 2017

High, Low Levels of Magnesium Linked to Dementia Risk

Having magnesium levels that are too high or too low may put you at risk for Alzheimer’s and other dementias, Dutch researchers report.

In a study of more than 9,500 men and women, the highest or lowest levels of magnesium appeared to increase the chances for dementia by as much as 30 percent.

“At this moment, magnesium levels are not routinely measured in daily clinical practice,” said lead researcher Dr. Brenda Kieboom, of Erasmus University Medical Center in Rotterdam. “If our study results are replicated, magnesium levels could be used to screen for dementia, especially in people at risk for low magnesium levels.”

Kieboom said she also wants to study whether low magnesium levels also associate with a decline in mental function over time. “Mental function can be seen as a precursor stage of dementia, and if we find similar associations with dementia this will support our theory for a causal association,” she said.

“We already found that proton pump inhibitors [acid reflux drugs such as Nexium and Prilosec] are associated with a higher risk for abnormally low magnesium levels, but we continue looking into other drugs,” she said.

Those at risk for low levels of magnesium include people who use proton pump inhibitors or diuretics, or people who have a diet low in magnesium, Kieboom said.

Foods that are good sources of magnesium include spinach, almonds, cashews, soy and black beans. Whole grains, yogurt and avocados, she said.

The report was published online Sept. 20 in the journal Neurology.

My Take:
My lab measures serum magnesium as a routine test in the comprehensive metabolic profile (CMP). Magnesium was a routine test thirty years ago, was dropped and now has returned.

PPIs (proton pump inhibitors) have been the subject of several of my blogs. Along with diuretics, they are some of the most commonly prescribed drugs. PPIs are first on a long list of medications that have been targeted to be discontinued in our elderly population.

I think Dr. Kieboom is on the right track, looking at drugs as a major factor in the onset of dementia.

Magnesium is a cofactor facilitating proper function of the nervous system. Clinically, I use magnesium to reduce excess neurological stimulation to the heart. It is a vital supplement in the treatment of Afib (atrial fibrillation).

Magnesium is also frequently used as a laxative. Excess magnesium intake ends up in the bowel where it stimulates peristalsis. While I disagree with this use, I often titrate magnesium doses based on bowel tolerance. We start with 100mg per day and increase until the stool becomes loose, then reduce until the bowel is again well formed.

The Bottom Line:
It’s too early to tell if magnesium levels in the body have a causal relationship with dementia. However, I highly recommend you avoid the use of drugs known to reduce magnesium levels, like diuretics and PPIs. Additionally, avoid excess magnesium levels caused by using magnesium as a long-term laxative.

Source: September 20, 2017 National Institutes of Health

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