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Volume 80, Number 2 www.aafp.org/afp American Family Physician 157

Therapeutic Uses of Magnesium
MARY P. GUERRERA, MD, University of Connecticut School of Medicine, Farmington, Connecticut
STELLA LUCIA VOLPE, PhD, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania
JUN JAMES MAO, MD, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
M
agnesium is the fourth most
abundant essential mineral
in the body. It is distributed
approximately one half in the
bone and one half in the muscle and other
soft tissues; less than one percent is in the
blood.
1
Studies estimate that 75 percent of
Americans do not meet the recommended
dietary allowance of magneisum,
2
which
has raised concern about the health effects
of magnesium deciency. Lifestyle factors
(e.g., poor nutrition, excess alcohol intake),
some medications (e.g., diuretics), and
lower mineral content in commonly eaten
foods (e.g., fruit, vegetables) have led to an
increase in studies evaluating the potential
link of magnesium deciency to a number of
diverse medical conditions, and magnesiums
possible effectiveness in supplementation.
3-5
Early signs of magnesium deciency
include loss of appetite, nausea, vomiting,
fatigue, and weakness. Persons may experi-
ence numbness, tingling, muscle contractions
and cramps, seizures, personality changes,
abnormal heart rhythms, and coronary
spasms as magnesium levels decrease. Severe
deciency may lead to hypocalcemia and
hypokalemia.
1
Conditions that may lead to
hypomagnesemia include poorly-controlled
diabetes mellitus; chronic malabsorptive
problems (e.g., Crohn disease, gluten-sensitive
enteropathy, regional enteritis); medication
use (e.g., diuretics, antibiotics); alcoholism;
and older age (e.g., decreased absorption of
magnesium, increased renal exertion).
1
There are challenges in diagnosing mag-
nesium deciency because of its distribution
in the body. Magnesium is an intracellular
cation and its blood concentrations may not
accurately mirror magnesium status.
6
How-
ever, reductions in normal serum magnesium
concentrations (1.8 to 2.3 mg per dL [0.74 to
0.95 mmol per L]) signify deciency. Therefore,
serum magnesium concentrations are specic,
but not sensitive, to magnesium deciency.
7

Magnesium homeostasis is related to calcium
and potassium status, and should be evaluated
in combination with these two cations.
7
There
are other methods to assess magnesium status,
but the serum level is the most common and
practical test in the clinical setting.
8
Pharmacology
Magnesium is the second most abundant
intracellular divalent cation and is a cofactor
for more than 300 metabolic reactions in
the body.
9,10
These processes include pro-
tein synthesis, cellular energy production
and storage, cell growth and reproduction,
DNA and RNA synthesis, and stabilization
of mitochondrial membranes.
11-14
Magne-
sium is one of the minerals responsible for
managing bone metabolism, nerve trans-
mission, cardiac excitability, neuromuscular
Magnesium is an essential mineral for optimal metabolic function. Research has shown that the mineral content of
magnesium in food sources is declining, and that magnesium depletion has been detected in persons with some chronic
diseases. This has led to an increased awareness of proper magnesium intake and its potential therapeutic role in a
number of medical conditions. Studies have shown the effectiveness of magnesium in eclampsia and preeclampsia,
arrhythmia, severe asthma, and migraine. Other areas that have shown promising results include lowering the risk of
metabolic syndrome, improving glucose and insulin metabolism, relieving symptoms of dysmenorrhea, and alleviat-
ing leg cramps in women who are pregnant. The use of magnesium for constipation and dyspepsia are accepted as
standard care despite limited evidence. Although it is safe in selected patients at appropriate dosages, magnesium may
cause adverse effects or death at high dosages. Because magnesium is excreted renally, it should be used with caution
in patients with kidney disease. Food sources of magnesium include green leafy vegetables, nuts, legumes, and whole
grains. (Am Fam Physician. 2009;80(2):157-162. Copyright 2009 American Academy of Family Physicians.)
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Magnesium
158 American Family Physician www.aafp.org/afp Volume 80, Number 2

July 15, 2009

conduction, muscular contraction, vasomotor tone, and
blood pressure.
11-14
Magnesium also plays a signicant
role in glucose and insulin metabolism, mainly through
its impact on tyrosine kinase activity, phosphorylase b
kinase activity, and glucose transporter protein activ-
ity.
15-19
Because of these vital roles, magnesium levels may
be affected by stressors to the body, such as in certain
disease states. Supplementation with magnesium may
have therapeutic effects in these situations.
Uses and Effectiveness
Magnesium has been used for numerous conditions. The
most common indications are discussed here in order of
most supported to least supported in the literature.
ECLAMPSIA AND PREECLAMPSIA
Magnesium sulfate (intravenous and intramuscu-
lar) has been shown to be relatively effective for treat-
ing eclampsia and preeclampsia, although it has been
considered the standard of care for decades.
20
In 2003,
two Cochrane reviews showed that magnesium use in
patients with eclampsia was superior to that of phenyt-
oin (Dilantin) and lytic cocktail,
21,22
with another study
showing magnesium to be more effective than nimodip-
ine (Nimotop).
23
A different 2003 Cochrane review
showed that 1 to 2 g of intravenous magnesium sulfate
per hour reduced the risk of eclampsia in patients with
preeclampsia by more than one half.
24
The use of mag-
nesium does not appear to have harmful effects on the
mother or infant in the short term.
25
ARRHYTHMIA
A well-known use of intravenous magnesium is for
correcting the uncommon ventricular tachycardia of
torsade de pointes.
26
Results of a meta-analysis suggest
that 1.2 to 10 g of intravenous magnesium sulfate is also
a safe and effective strategy for the acute management of
rapid atrial brillation.
27
A six-week randomized, double-
blind crossover trial showed that oral magnesium sup-
plementation reduced the frequency of asymptomatic
ventricular arrhythmia in patients with stable congestive
heart failure secondary to coronary artery disease.
28
ASTHMA
A 2000 Cochrane review of magnesium sulfate for exac-
erbations of acute asthma in the emergency department
found that evidence does not support routine use of intra-
venous magnesium in all patients with acute asthma;
however, it appears safe and benecial for severe acute
asthma by improving peak expiratory ow rate and forced
expiratory volume in one second.
29
In a meta-analysis of
acute asthma in children, intravenous magnesium dem-
onstrated probable benet in moderate to severe asthma
in conjunction with standard bronchodilators and ste-
roids
30
; however, a randomized controlled trial showed
that oral magnesium added no clinical benet to standard
outpatient therapy for chronic stable asthma in adults.
31
In
a 2005 Cochrane review of inhaled magnesium sulfate in
acute asthma, nebulized magnesium in addition to a beta
2

agonist were shown to improve pulmonary function and
trend toward benet in fewer hospital admissions.
32
HEADACHE
Studies have found that patients with cluster headaches
and classic or common migraine, especially menstrual
migraine, have low levels of magnesium.
33,34
A prospective,
multicenter, double-blind randomized study conducted in
Germany showed that a single daily dosage of 600 mg oral
trimagnesium dicitrate signicantly reduced the frequency
of migraine compared with placebo, whereas a lower twice
daily dosage was found ineffective.
35,36
For acute treatment
of migraine, intravenous magnesium sulfate showed a sta-
tistically signicant improvement in the treatment of all
symptoms in patients with aura, or as an adjuvant therapy
for associated symptoms in patients without aura.
37
DYSPEPSIA
Another common condition with several self-treatment
options is dyspepsia, a key symptom of gastroesopha-
geal reux disease (GERD). Antacids are widely used
SORT: KEY RECOMMENDATIONS FOR PRACTICE
Clinical recommendation
Evidence
rating References
Magnesium is effective for treating eclampsia and preeclampsia. A 20-25
Intravenous magnesium is effective for treating torsade de pointes and managing rapid atrial brillation. A 26, 27
In severe acute asthma, parenteral magnesium supplementation improves peak expiratory ow rate and
forced expiratory volume in one second, and reduces hospital admissions.
B 29, 32
Oral and parenteral magnesium is possibly effective in improving symptoms of migraine. B 33-37
Magnesium is a widely accepted and effective approach to treat dyspepsia. B 38
Magnesium is accepted as a standard treatment for constipation, but there are few rigorous studies to
prove its effectiveness.
B 40
A = consistent, good-quality patient-oriented evidence; B = inconsistent or limited-quality patient-oriented evidence; C = consensus, disease-oriented
evidence, usual practice, expert opinion, or case series. For information about the SORT evidence rating system, go to http://www.aafp.org/afpsort.xml.
Magnesium
July 15, 2009

Volume 80, Number 2 www.aafp.org/afp American Family Physician 159

for dyspepsia; however, studies comparing antacids
with histamine H
2
receptor antagonists (H
2
blockers)
have been limited. A randomized, double-blind, cross-
over study showed that on-demand treatment with the
antacid hydrotalcite (aluminum hydroxide, magnesium
hydroxide, carbonate, and water) was more effective
than famotidine (Pepcid) or placebo.
38
An editorial on
these ndings questioned the standard use of H
2
block-
ers, and recommended shifting to more individualized
treatment of mild or intermittent GERD.
39
CONSTIPATION
Patients often self-treat constipation with over-the-
counter products, such as magnesium hydroxide (Milk
of Magnesia) or magnesium citrate. However, there are
few studies demonstrating effectiveness, as shown in a
systematic review of chronic constipation.
40
Despite this,
many physicians and patients have found these treat-
ments helpful, which indicates that a lack of evidence is
not necessarily synonymous with a lack of effect.
41
OTHER
Magnesium is associated with maintaining or improv-
ing bone mineral density as a dietary component in
combination with potassium, fruits, and vegetables, or as
an oral supplement.
42,43
One study suggested that adults
18 to 30 years of age with higher magnesium intake have a
lower risk of developing metabolic syndrome.
44
Another
study demonstrated a positive association between
hypomagnesemia and metabolic syndrome in adults.
45

A 2002 Cochrane review showed that magnesium lac-
tate or citrate twice a day was effective for leg cramps
in pregnant women.
46
A 2001 Cochrane review of three
small trials showed that in patients with dysmenorrhea,
magnesium was more effective than placebo for pain
relief and the need for additional medication was less.
47

Studies have linked magnesium deciency to myocardial
infarction, congestive heart failure, primary hyperten-
sion, and angina pectoris,
48
but evidence is still limited
to recommend its use for these conditions.
Contraindications, Adverse Effects,
and Interactions
Although oral magnesium supplementation is well-
tolerated, magnesium can cause gastrointestinal symp-
toms, including nausea, vomiting, and diarrhea.
49
Over-
dose of magnesium may cause thirst, hypotension,
drowsiness, muscle weakness, respiratory depression,
cardiac arrhythmia, coma, and death.
49
Concomitant use of magnesium and urinary excretion
reducing drugs, such as calcitonin, glucagon (Glucagen),
and potassium-sparing diuretics, may increase serum
magnesium levels, as may doxercalciferol (Hectorol).
50

Concomitant oral intake of magnesium may inuence
the absorption of uoroquinolones, aminoglycosides,
bisphosphonates, calcium channel blockers, tetracyclines,
and skeletal muscle relaxants. Because of this, concomi-
tant use should be monitored or avoided when possible.
51
Additionally, because magnesium is cleared renally,
patients with renal insufciency (creatinine clearance of
less than 30 mL per minute [0.50 mL per second]) may
be at increased risk of heart block or hypermagnesemia;
therefore, magnesium levels should be monitored. As
with any dietary supplement, the quality of the product
is important. Some magnesium products were found to
contain lead.
52
Dosages
Oral magnesium supplementation is safe in adults when
used in dosages below the upper intake level of 350 mg
per day (elemental magnesium).
51
However, higher dos-
ages have been studied and may be used for specic med-
ical problems. Table 1 provides selected food sources of
magnesium and the amount of magnesium per serving
1
;
there is no upper intake level for dietary magnesium.
Table 1. Selected Food Sources of Magnesium
Food
Magnesium
(in mg)
Halibut, cooked, 3 oz 90
Almonds, dry roasted, 1 oz 80
Cashews, dry roasted, 1 oz 75
Spinach, frozen or cooked, one half cup 75
Cereal, shredded wheat, two rectangular biscuits 55
Oatmeal, instant, fortied, prepared with water,
1 cup
55
Potato, baked with skin, one medium 50
Peanuts, dry roasted, 1 oz 50
Wheat bran, crude, 2 tablespoons 45
Yogurt, plain, skim milk, 8 oz 45
Bran akes, three fourths cup 40
Rice, brown, long-grained, cooked, one half cup 40
Avocado, California, one half cup pureed 35
Kidney beans, canned, one half cup 35
Banana, raw, one medium 30
Milk, reduced fat (2%) or fat free, 1 cup 27
Bread, whole wheat, commercially prepared,
one slice
25
Raisins, seedless, one fourth cup packed 25
Whole milk, 1 cup 24
NOTE: There is no upper intake level for dietary magnesium.
Adapted from the National Institutes of Health Ofce of Dietary Sup-
plements. Magnesium. http://ods.od.nih.gov/factsheets/magnesium.
asp. Accessed January 12, 2009.
Magnesium
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July 15, 2009

Magnesium is safe in children when used in dosages
below the tolerable upper intake level of 65 mg per day
for children one to three years of age, 110 mg per day for
children four to eight years of age, and 350 mg per day
for children older than eight years.
8
Table 2 lists some
common forms and dosages of magnesium.
Bottom Line
Magnesium is an essential mineral with evidence of
effectiveness in treating eclampsia and preeclampsia,
arrhythmia, severe asthma, and migraine (Table 3). The
National Center for Complementary and Alternative
Medicine is currently investigating the role of magne-
sium supplementation in mild to moderate persistent
asthma.
53
There are few studies to support wide use of
magnesium for treating constipation and dyspepsia.
Some of the potential indications that require further
investigation include lowering the risk of metabolic
syndrome, treating leg cramps in pregnant women, pre-
venting osteoporosis, and alleviating dysmenorrhea.
Diagnosis of mild to moderate magnesium deciency
is challenging because patients may be asymptomatic,
and usual diagnostic testing is specic but not sensi-
tive. Magnesium testing and supplementation should be
considered in at-risk patients, especially those on diuret-
ics, with poor nutritional intake, or with malabsorptive
states. Supplementation of magnesium should generally
not exceed the age-adjusted tolerable upper intake level
and should be used with caution in patients with kidney
dysfunction or in those taking certain medications.
Table 2. Common Magnesium Formulations and Dosages
Supplement Elemental magnesium content Dosage schedule for adults*
Magnesium oxide
(MagOx)
61% elemental magnesium
242 mg in 400-mg tablet
Two tablets per day with food
Magnesium hydroxide
(Milk of Magnesia)
42% elemental magnesium
167 mg in 400 mg per 5 mL oral suspension
5 to 15 mL as needed up to four times per day
Magnesium citrate 16% elemental magnesium
48 mg elemental magnesium and 13 mg potassium
in 290 mg per 5 mL oral solution
One half to one full bottle (120 to 300 mL)
Magnesium gluconate
(Mag-G)
5% elemental magnesium
27 mg in 500-mg tablet
One or two divided tablets per day
Magnesium chloride
(Mag-SR)
12% elemental magnesium
64 mg in 535-mg tablet
Two tablets once per day
Magnesium sulfate 10% elemental magnesium
1 g per 100 mL solution for injection
Atrial brillation: IV 1.2 to 5 g initial dose over one
to 30 minutes
Asthma: IV 25 to 75 mg per kg single dose (study
of children younger than 18 years)
Eclampsia, preeclampsia: IV 4 to 6 g over
15 to 20 minutes, then 1 to 2 g per hour
Magnesium sulfate
(Epsom salts)
10% elemental magnesium
98.6 mg in 1 g salts
Cathartic: mix 2 to 4 teaspoons in 8 oz water; take
up to twice per day
Magnesium lactate
(Mag-Tab SR)
12% elemental magnesium
84 mg in 84 mg tablet
One to two tablets every 12 hours
Magnesium aspartate
hydrochloride
(Maginex DS)
10% elemental magnesium
122 mg in 1,230 mg dietary supplement granules
Mix in 4 oz water; take up to three times per day
IV = intravenous.
*Recommended dietary allowance for adults 19 to 30 years of age: 310 mg per day for women and 400 mg per day for men; for adults older than
30 years: 320 mg per day for women and 420 mg per day for men.
Magnesium
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Volume 80, Number 2 www.aafp.org/afp American Family Physician 161

Members of various family medicine departments develop articles for
Complementary and Alternative Medicine. This is one in a series coor-
dinated by Sumi Sexton, MD, and Benjamin Kligler, MD, MPH.
The Authors
MARY P. GUERRERA, MD, FAAFP, is an associate professor and director of
integrative medicine in the Department of Family Medicine at the University
of Connecticut School of Medicine in Farmington. She also serves on the
steering and education committees of the Consortium of Academic Health
Centers for Integrative Medicine.
STELLA LUCIA VOLPE, PhD, RD, LDN, FACSM, is an associate professor
and the Miriam Stirl Term Endowed Chair in Nutrition at the University
of Pennsylvania School of Nursing, Division of Biobehavioral and Health
Sciences in Philadelphia.
JUN JAMES MAO, MD, MSCE, is an assistant professor in the Department
of Family Medicine and Community Health at the University of Pennsyl-
vania School of Medicine, and practices primary carebased integrative
medicine.
Address correspondence to Mary P. Guerrera, MD, FAAFP, Department
of Family Medicine, University of Connecticut School of Medicine, 99
Woodland St., Hartford, CT 06105 (e-mail: Mguerrer2@stfranciscare.
org). Reprints are not available from the authors.
Author disclosure: Nothing to disclose.
REFERENCES
1. National Institutes of Health Ofce of Dietary Supplements. Magne-
sium. http://ods.od.nih.gov/factsheets/magnesium.asp. Accessed Janu-
ary 12, 2009.
2. Alaimo K, McDowell MA, Briefel RR, et al. Dietary intake of vitamins,
minerals, and ber of person ages 2 months and over in the United
States: Third National Health and Nutrition Examination Survey, Phase 1,
1988-91. Adv Data. 1994;(258):1-28.
3. Marier JR. Magnesium content of the food supply in the modern-day
world. Magnesium. 1986;5(1):1-8.
4. Thomas D. A study on the mineral depletion of the foods available
to us as a nation over the period 1940 to 1991. Nutr Health. 2003;
17(2):85-115.
5. LaValle JB. Hidden disruptions in metabolic syndrome: drug-induced
nutrient depletion as a pathway to accelerated pathophysiology of
metabolic syndrome. Altern Ther Health Med. 2006;12(2):26-31.
6. Guerrero-Romero F, Rodrguez-Morn M. Hypomagnesemia is linked
to low serum HDL-cholesterol irrespective of serum glucose values.
J Diabetes Complications. 2000;14(5):272-276.
7. Gropper SS, Smith JL, Groff JL. Magnesium. In: Advanced Nutrition and
Human Metabolism. 4th ed. Belmont, Calif.: Wadsworth Publishing;
2005.
8. Food and Nutrition Board, Institute of Medicine. Dietary Reference
Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride.
Washington, DC: National Academy Press; 1997.
9. Elin RJ. Magnesium: the fth but forgotten electrolyte. Am J Clin Pathol.
1994;102(5):616-622.
10. Takaya J, Higashino H, Kobayashi Y. Intracellular magnesium and insulin
resistance. Magnes Res. 2004;17(2):126-136.
11. Newhouse IJ, Finstad EW. The effects of magnesium supplementation
on exercise performance. Clin J Sport Med. 2000;10(3):195-200.
12. Bohl CH, Volpe SL. Magnesium and exercise. Crit Rev Food Sci Nutr.
2002;42(6):533-563.
13. Rude RK, Shils ME. Magnesium. In: Shils, ME, Shike M, Ross AC, Cabal-
lero B, Cousins RJ, eds. Modern Nutrition in Health and Disease. 10th
ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2005:223-248.
14. Chubanov V, Gudermann T, Schlingmann KP. Essential role for TRPM6
in epithelial magnesium transport and body magnesium homeostasis.
Pugers Arch. 2005;451(1):228-234.
15. Paolisso G, Barbagallo M. Hypertension, diabetes mellitus, and insulin
resistance: the role of intracellular magnesium. Am J Hypertens. 1997;
10(3):346-355.
16. Barbagallo M, Dominguez LJ, Galioto A, et al. Role of magnesium in
insulin action, diabetes and cardio-metabolic syndrome X. Mol Aspects
Med. 2003;24(1-3):39-52.
17. Surez A, Pulido N, Casla A, Casanova B, Arrieta FJ, Rovira A. Impaired
tyrosine-kinase activity of muscle insulin receptors from hypomagne-
saemic rats. Diabetologia. 1995;38(11):1262-1270.
18. Yu JS, Lee SC, Yang SD. Effect of Mg2+ concentrations on phosphory-
lation/activation of phosphorylase b kinase by cAMP/Ca(2+) -indepen-
dent, autophosphorylation-dependent protein kinase. J Protein Chem.
1995;14(8):747-752.
19. Arner P, Pollare T, Lithell H, Livingston JN. Defective insulin receptor tyro-
sine kinase in human skeletal muscle in obesity and Type 2 (non-insulin-
dependent) diabetes mellitus. Diabetologia. 1987;30(6):437-440.
20. Witlin AG, Sibai BM. Magnesium sulfate therapy in preeclampsia and
eclampsia. Obstet Gynecol. 1998;92(5):883-889.
Table 3. Key Points About Magnesium
Effectiveness Effective: eclampsia and preeclampsia, arrhythmia, severe asthma, migraine, dyspepsia, constipation
Possibly effective: lowering risk of metabolic syndrome, improving glucose and insulin metabolism, preventing
osteoporosis, improving symptoms of leg cramps in pregnant women, dysmenorrhea
Adverse effects Oral supplementation generally is safe and well-tolerated; some reports of nausea, vomiting, diarrhea; overdose
may lead to hypotension, muscle weakness, and coma
Contraindications Patients with renal impairment (creatinine clearance of less than 30 mL per minute [0.5 mL per second]) may be at
risk of heart block or hypermagnesemia
Oral dosage and
tolerable upper
intake level
Adults: 350 mg per day of elemental magnesium
Children: 65 mg per day for children one to three years of age; 110 mg per day for children four to eight years of
age; 350 mg per day for children older than eight years
Cost Less than $20 for 30 tablets
Food sources Green leafy vegetables, sh, almonds, legumes, whole grains (see Table 1)
Magnesium
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21. Duley L, Henderson-Smart D. Magnesium sulphate versus phenytoin for
eclampsia. Cochrane Database Syst Rev. 2003;(4):CD000128.
22. Duley L, Gulmezoglu AM. Magnesium sulphate versus lytic cocktail for
eclampsia. Cochrane Database Syst Rev. 2001;(1):CD002960.
23. Belfort MA, Anthony J, Saade GR, Allen JC Jr, for the Nimodipine Study
Group. A comparison of magnesium sulfate and nimodipine for the pre-
vention of eclampsia. N Engl J Med. 2003;348(4):304-311.
24. Duley L, Glmezoglu AM, Henderson-Smart DJ. Magnesium sulphate
and other anticonvulsants for women with pre-eclampsia. Cochrane
Database Syst Rev. 2003;(2):CD000025.
25. Altman D, Carroli G, Duley L, et al. Do women with pre-eclampsia, and
their babies, benet from magnesium sulphate? The Magpie Trial: a ran-
domised placebo-controlled trial. Lancet. 2002;359(9321):1877-1890.
26. Banai S, Tzivoni D. Drug therapy for torsade de pointes. J Cardiovasc
Electrophysiol. 1993;4(2):206-210.
27. Onalan O, Crystal E, Daoulah A, Lau C, Crystal A, Lashevsky I. Meta-
analysis of magnesium therapy for the acute management of rapid atrial
brillation. Am J Cardiol. 2007;99(12):1726-1732.
28. Bashir Y, Sneddon JF, Staunton HA, et al. Effect of long-term oral mag-
nesium chloride replacement in congestive heart failure secondary to
coronary artery disease. Am J Cardiol. 1993;72(15):1156-1162.
29. Rowe BH, Bretzlaff JA, Bourdon C, Bota GW, Camargo CA Jr. Magne-
sium sulfate for treating exacerbations of acute asthma in the emer-
gency department. Cochrane Database Syst Rev. 2000;(2):CD001490.
30. Cheuk DK, Chau TC, Lee SL. A meta-analysis on intravenous magnesium
sulphate for treating acute asthma. Arch Dis Child. 2005;90(1):74-77.
31. Fogarty A, Lewis SA, Scrivener SL, et al. Oral magnesium and vita-
min C supplements in asthma: a parallel group randomized placebo-
controlled trial. Clin Exp Allergy. 2003;33(10):1355-1359.
32. Blitz M, Blitz S, Beasely R, et al. Inhaled magnesium sulfate in the
treatment of acute asthma. Cochrane Database Syst Rev. 2005(4):
CD003898.
33. Mauskop A, Altura BT, Cracco RQ, Altura BM. Intravenous magnesium
sulfate relieves cluster headaches in patients with low serum ionized
magnesium levels. Headache. 1995;35(10):597-600.
34. Mauskop A, Altura BT, Altura BM. Serum ionized magnesium levels and
serum ionized calcium/ionized magnesium ratios in women with men-
strual migraine. Headache. 2002;42(4):242-248.
35. Peikert A, Wilimzig C, Khne-Volland R. Prophylaxis of migraine with oral
magnesium: results from a prospective, multi-center, placebo-controlled
and double-blind randomized study. Cephalalgia. 1996;16(4):257-263.
36. Pfaffenrath V, Wessely P, Meyer C, et al. Magnesium in the prophylaxis of
migrainea double-blind placebo-controlled study. Cephalalgia. 1996;
16(6):436-440.
37. Bigal ME, Bordini CA, Tepper SJ, Speciali JG. Intravenous magnesium
sulphate in the acute treatment of migraine without aura and migraine
with aura. A randomized, double-blind, placebo-controlled study.
Cephalalgia. 2002;22(5):345-353.
38. Holtmeier W, Holtmann G, Caspary WF, Weingrtner U. On-demand
treatment of acute heartburn with the antacid hydrotalcite compared
with famotidine and placebo: randomized double-blind cross-over
study. J Clin Gastroenterol. 2007;41(6):564-570.
39. DeVault KR. Treatment of intermittent reux symptoms: one size does
not t all [editorial]. J Clin Gastroenterol. 2007;41(6):546-547.
40. Ramkumar D, Rao SS. Efcacy and safety of traditional medical therapies
for chronic constipation: systematic review. Am J Gastroenterol. 2005;
100(4):936-971.
41. Andrews CN, Bharucha AE. Review: good evidence supports polyethyl-
ene glycol and tegaserod for constipation. ACP J Club. 2005;143(2):47.
42. Stendig-Lindberg G, Tepper R, Leichter I. Trabecular bone density in a
two year controlled trial of peroral magnesium in osteoporsis. Magnes
Res. 1993;6(2):155-163.
43. Tucker KL, Hannan MT, Chen H, Cupples LA, Wilson PW, Kiel DP. Potas-
sium, magnesium, and fruit and vegetable intakes are associated with
greater bone mineral density in elderly men and women. Am J Clin Nutr.
1999;69(4):727-736.
44. He K, Liu K, Daviglus ML, et al. Magnesium intake and incidence of
metabolic syndrome among young adults. Circulation. 2006;113(13):
1675-1682.
45. Guerrero-Romero F, Rodrguez-Morn M. Hypomagnesemia, oxidative
stress, inammation, and metabolic syndrome. Diabetes Metab Res Rev.
2006;22(6):471-476.
46. Young GL, Jewell D. Interventions for leg cramps in pregnancy. Cochrane
Database Syst Rev. 2002;(1):CD000121.
47. Proctor ML, Murphy PA. Herbal and dietary therapies for primary and
secondary dysmenorrhoea. Cochrane Database Syst Rev. 2001;(3):
CD002124.
48. Gums JG. Magnesium in cardiovascular and other disorders. Am
J Health Syst Pharm. 2004;61(15):1569-1576.
49. Martindale W, Partt K, eds. Martindale: The Complete Drug Reference.
32nd ed. London: Pharmaceutical Press; 1999.
50. Shils ME, Olson JA. Modern Nutrition in Health and Disease. 8th ed.
Philadelphia, Pa.: Lea & Febiger; 1994.
51. McKevoy GK, ed. AHFS Drug Information. Bethesda, Md.: American
Society of Health-System Pharmacists; 1998.
52. ConsumerLab.com. Multivitamin/multimineral supplements. http://
www.consumerlab.com/results/multivit.asp. Accessed January 13, 2009.
53. National Center for Complementary and Alternative Medicine. Mag-
nesium and asthmaclinical trials. http://clinicaltrials.gov/ct2/show/
NCT00029510?term=%28NCCAM%29+%5BSPONSOR%5D+%28
magnesium%29+%5BTREATMENT%5D&rank=1. Accessed January
13, 2009.