Magical Metal Magnesium 

Magical Metal Magnesium 

Magnesium with its atomic number (AN12) is sandwiched between sodium (AN11) and aluminum (AN13) on the periodic table.  It also sits above calcium (AN20).  All four elements are metals.  Magnesium and calcium have two “available” electrons in their outermost orbital ring, which can help explain some of the medicinal applications of magnesium.   

Magnesium is found in all cells in all organisms both plant and animal.  It is indispensable for health as it is an essential cofactor for ATP (adenosine triphosphate) the battery molecule that powers all of our cells.  It is also a cofactor for hundreds of cellular enzymes.  In addition, it regulates metabolism of sugars, fats and proteins, helps control nerve and muscle function, regulates cardiac rhythm, modulates blood vessel tone and regulates hormone secretion.   

Whew.  With all those important jobs you would think we would hear more about magnesium and that there might be more than three medical conditions where it is the drug of choice.   

There are a number of medical applications where it isn’t the drug of choice.  It has GI benefits as both an antacid and a laxative.  It can increase the seizure threshold for epileptics.  It can lessen the frequency of migraines.  It can help muscle spasms including tetany.  It is integral for good bone matrix formation.  One unwanted side effect of long use protein pump inhibitors is their impact on micronutrient absorption including magnesium and thereby reducing bone density.   

But, the three conditions where it is the treatment of choice are torsade de pointes, acute asthma exacerbation, and preeclampsia/eclampsia.   Torsade de pointe is a life-threatening form of ventricular tachycardia.  It is often resistant to treatment with standard Anti arrhythmias such as beta blockers.   

Eclampsia/preeclampsia is a condition in pregnant women that can threaten the woman’s life and the baby’s.  The mother experiences fluid retention and elevated blood pressure which if severe can cause a seizure or stroke for the women and death for the baby.  Preeclampsia is helped by oral magnesium.  Eclampsia is treated with intravenous magnesium.   

In severe hospitalized asthma, magnesium is used both intravenously and also by adding it to the albuterol used in nebulizer treatments.  

Its mechanism of action has been best understood in asthma but it probably applies to all the conditions just described.  It is a natural calcium channel blocker.  Calcium channels are portals of flow for calcium ions in many tissues.  In bronchial smooth muscle calcium channels can cause the constriction of these muscles which in turn narrows the airways.  Blocking the channel with magnesium allows the muscles to relax and the airways to open.  Remember in the introduction to this article the close proximity of calcium and magnesium and the two available electrons in the outer shell.  This allows magnesium to bump calcium out of the channel, kind of a “preferred passenger status”.   

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