Magnesium deficiency is common and deadly. Diuretics, heart conditions, exercise, and the ECA stack influence magnesium status.

The processing of food results in large losses of vital nutrients. For example, white bread contains about 40% less magnesium than whole wheat bread. In addition, since World War II, the amount of magnesium in our food has steadily declined due to farming methods and the use of fertilizers that only replenish nitrogen, phosphorus, and potassium (9-BK). Thus, there is reason to doubt whether even the best diet can provide an optimum amount of magnesium.

In light of all this, it is amazing that Big Brother actually tells people NOT to take supplements. Lets face it, Big Brother can tell people to eat 3,000 servings of fresh vegetables a day till he”s blue in the face, but how many people are going to choose broccoli over pizza? Thus, most of the people who listen to the official party line about supplements are left in the following predicament:

“In developed countries, the Mg [magnesium] intake [from food] is often marginal and the Mg intake coming from drinking water represents the critical factor through which the Mg intake is deficient or satisfactory . . . all [Mg studies have] shown a reverse correlation between cardiovascular mortality [death] and the Mg level” (1).

Isn”t that amazing? Unless you take supplements or eat an extraordinarily good diet, you are participating in the magnesium lottery — gambling your life on the quality of the WATER in your town. Yikes! When you hear some “expert” parroting the old line about how we *can* get all the nutrients that we need from food, what they are really saying — to the vast majority of people — is that instead of taking supplements (the dangerous practice of “self-medication”magnesium, mineral), we should just hope and/or pray that there is enough magnesium in the water. If you listen to these clowns, you are playing the magnesium lottery. And if you get a losing ticket in THIS lottery, you die.

A Bunch Of Scary Studies

OK, now I know it”s easy to criticize epidemiological studies. Actually, there is also quite a bit of clinical and laboratory  research supporting the need for magnesium supplementation. However, since the magnesium lottery is a global water quality  game, we really should dive in a little deeper (sorry):

“A consistent pattern has emerged, indicative of a global phenomenon, which illustrates the importance of waterborne magnesium in protecting against cardiovascular trauma and other ailments” (2).

Here are the lottery results from Sweden: “The odds ratios for death from acute myocardial infarction in the groups were inversely related to the amount of magnesium in drinking water” (4). Scientists in Taiwan studied over 17,000 cerebrovascular deaths and found that the unlucky people who lived in low magnesium areas were more likely to die of strokes: “there is a significant protective effect of magnesium intake from drinking water on the risk of cerebrovascular disease” (5). The scientists in Taiwan have been quite busy. They also found that low magnesium levels in drinking water are related to the risk of death from hypertension (6), diabetes mellitus (8), and an astonishing “42% excess risk of mortality from esophageal cancer” (7).

In light of the uncertainties of the magnesium lottery, it should not be too big of a surprise to find that magnesium deficiency has been found in a large percentage of hospital patients (I”ll spare you the joke about hospital food) — and this has been linked to “cardiovascular abnormalities, ranging from cardiac arrhythmias and atrial fibrillation to hypertension” (12). In addition, low serum magnesium levels are associated with thickening of the carotid wall and high fasting insulin levels (13). The elevated insulin levels reflect an attempt to compensate for impaired insulin receptor function caused by magnesium deficiency (14). Proper insulin function requires a LOT more than popping a chromium pill everyday.

I could go on and on, but Altura et al. did a good job of summing up the overwhelming evidence of the health problems that are related to magnesium deficiency:

“It is now becoming clear that a lower than normal dietary intake of Mg [magnesium] can be a strong risk factor for hypertension, cardiac arrhythmias, ischemic heart disease, atherogenesis and sudden cardiac death. Deficits in serum Mg appear often to be associated with arrhythmias, coronary vasospasm and high blood pressure” (15).

Big Brother To The Rescue (sort of)

The California Department of Health Services is aware of this research and they are calling for an “integrated program of laboratory and epidemiologic research” (3). They even describe how the use of a magnesium/potassium table salt substitute reduced hypertension in Finland. However, when it comes time to reach the obvious conclusion — that people should take supplements — they COMPLETELY wimp out: “Future research must provide better answers about low level waterborne magnesium before recommendations to the public can be made” (3).

Of course, the bureaucratic idea is to study this and — maybe — eventually add magnesium to the water supply. The elitists seem to think that they are SO much smarter than us common folks that, instead of self medicating (taking supplements), we should wait — despite the obvious dangers — until our wise rulers decide to monkey around with the water supply.

Personally, all this messing around with our water and food (irradiation, bioengineering) worries me because — if a mistake is made — we will have a MAJOR disaster on our hands. This sort of thing seems like a modern version of the doctrine of the infallibility of the Pope. I would be much happier if — whenever possible — Big Brother made recommendations and left us free to make up our own minds.

Dieters, Athletes, And ECA

Lets put this in perspective. Scientists have found that “In developed countries, the Mg [magnesium] intake is often marginal” (1). Thus, people who follow restricted diets are VERY likely to have a magnesium deficiency — even if they luck out and get a decent amount of magnesium from their water. Winning the magnesium lottery is definitely not enough — especially if you diet, exercise, or take the ECA stack.

Obviously, if you follow a restricted diet, it would be nuts not to take magnesium supplements. However, you should also take potassium supplements because they work together to protect your health (16, 17). Less well known is the fact that exercise lowers magnesium levels (10, 25, 27). One study found that strenuous exercise lowers magnesium levels for 3 months (27), and a rat study found that even a minor magnesium deficiency caused a large reduction in exercise capacity (26).

Dr. Michael Colgan works with a lot of athletes and he has found that athletes are likely to test normal even though they are really magnesium deficient:

“Magnesium status is difficult to measure in athletes in training. Red blood cells contain three times the magnesium of blood serum, and hemolysis (destruction of red cells) in athletes caused by exercise, falsely elevates serum magnesium levels” (9-BK).

The beta 2 adrenergic agonist, salbutamol, has been found to lower plasma magnesium levels (20). Thus, athletes that take clenbuterol are also likely to have low magnesium levels. In addition, people who take the ECA stack should know that caffeine increases urinary excretion of magnesium and calcium (11) and adrenaline infusion lowers plasma magnesium levels (10). By the way, unlike obese people, competitive athletes usually have normal, responsive sympathetic nervous systems (SNS). Thus, athletes that take thermogenic supplements are actually using TWO methods to boost their catecholamine output (ECA and exercise).

Although magnesium and potassium offer significant protection from catecholamines, I would also recommend that athletes take taurine and avoid supplements that contain iron. (Personally, I would not take iron supplements unless a clear need has been established.) Here”s the scoop: the amino acid taurine protects against free radicals — and inhibits the formation of cytotoxic quinones — generated by iron-stimulated autoxidation of catecholamines (18-NA).

Because of FDA regulations, multivitamins do not contain enough potassium. In addition, there are VERY few multivitamins that contain an adequate amount of bioavailable magnesium. Thus, in addition to a multivitamin, an ideal supplement (for dieters and athletes that take the ECA stack) would contain magnesium, potassium, and taurine. Interestingly, Twinlab already makes this combo, but I have never seen it promoted for this purpose.

Cellmins Potassium, Magnesium, & Taurine3 capsules contain:

* Magnesium Aspartate hcl . . . . 200 mg

* Potassium Aspartate hcl . . . . . 200 mg

* Taurine . . . . . . . . . . . . . . . 500 mg

In my opinion, these nutrients are a MUCH better addition to the ECA stack than anything that I have seen in the herbal stacks and this Cellmins formula costs less than $5 a month.

HEY TWINLAB!  Here is a thermogenic formula with a synergistic combination of nutrients designed to greatly reduce the risk of obesity-related diseases. This formula makes up for the low levels of potassium and folic acid in multivitamins (FDA regulations) and the common practice of putting poorly-absorbed magnesium oxide in multivitamins. You can even call it “DrumLib Fuel” — if you send me a check once in a while.magnesium oxide, mineral

DrumLib Fuel

One serving contains:

* 20 mg Ephedrine.

* 200 mg Caffeine (entirely from green tea extract).

* 100 mg Magnesium Aspartate hcl.

* 100 mg Potassium Aspartate hcl.

* 200 mg Taurine.

* 800 mcg Folic Acid.

* 25 mg B-6.

* 500 mcg B-12.

Diuretics And Magnesium

My mother has congestive heart failure. Although I told her (many times) about the benefits of supplements, she did not want to take them: “I have to take a handful of drugs everyday and I don”t want to take ANY more pills” was her usual response. Trips to the emergency room occurred frequently. And, as if that wasn”t bad enough, the diuretics (water pills) that she was getting from her doctor were depleting her potassium and endangering her life.

The best that several doctors and a heart specialist could do was to give her potassium-sparing diuretics and higher doses of potassium. This did no good because she was not retaining the potassium. Eventually, her potassium got so low that she almost died — I found her on the floor unable to move. Another trip to the emergency room.

This traumatic experience convinced my mother that the doctors were unable to get a handle on this potassium problem. She didn”t want to end up paralyzed again, so she agreed to take whatever I thought would help this potassium problem — as long as it involved a “reasonable” amount of pills (I take a LOT of supplements).magnesium, mineral, congestive heart failure

That night I did a MEDLINE computer search of the medical literature. For the life of me, I can”t imagine why the doctors and the specialist (expensivist?) couldn”t figure the problem out — the reason why my mother was unable to retain potassium was easy to find. In fact, there is so much research on this that it”s hard not to trip over it. You do NOT have to be Sherlock Holmes, dig? Here are a few clues:

A medical article titled “Refractory potassium repletion. A consequence of magnesium deficiency” explains how diuretics flush a lot more than potassium out of your system — and if (when) you get low in magnesium, you will be unable to retain potassium:

“Patients with hypertension and with congestive heart failure appear to be at special risk for magnesium depletion because diuretics are commonly prescribed in treatment . . .  Experimental and clinical observations support the view that uncorrected magnesium deficiency impairs repletion of cellular potassium . . . consideration should be given to treating hypokalemic [low potassium] patients with both magnesium as well as potassium to avoid the problem of refractory potassium repletion due to coexisting magnesium deficiency” (19). [emphasis added]

Consideration???  I nominate that for the understatement of the year award. Lets see . . . hmm . . . If the patient doesn”t take magnesium supplements, she will die. Hmm . . . Maybe we should give them thar suppulments some “consideration.” What do you think, Jethro?

I realize that medical professionals are busy and abstracts contain up to 250 words,magnesium, mineral, congestive heart failure but just the TITLE of this article should have given the doctors and the highly paid specialist a clue: “Potassium/magnesium depletion in patients with cardiovascular disease” explains how 43% of heart patients are at risk of dying (sudden death) from magnesium deficiency:

“below normal muscle magnesium levels have been found in 43 percent of congestive heart failure patients receiving diuretics. Magnesium is important for maintenance of cell potassium . . . an increased risk of sudden death demands that potassium and magnesium deficiencies be treated promptly and that repletion of both electrolytes be considered” (21). [emphasis added]

They said “demands.” Right on! Oops, just as I was about to say that it”s nice to see scientists with the guts to say it straight, they wimp out and use the word “considered.” Hey guys, get real — it”s death or magnesium. What”s to consider?”

Introduction: magnesium — coming of age” discusses how the patients serum magnesium level can be misleading. Do the research scientists have to hit doctors over the head with sledgehammers? Every heart patient with sound kidneys should be taking magnesium supplements:

“Clinical and research evidence continues to accumulate that magnesium deficiency likewise contributes to triggering ventricular ectopic activity and sudden cardiac death … magnesium depletion can coexist with a low-normal to normal serum magnesium level … The most frequent causes of magnesium depletion in cardiovascular medicine are diuretic drugs” (22-NA).

So, obviously, I gave my mother magnesium supplements and (SURPRISE, SURPRISE) her potassium level went up and the problem was solved. This has over a decade of documentation in the medical literature. Why is magnesium STILL underutilized? If I were not self-educated, my mother probably would not have survived. In addition to fixing her potassium problem, the magnesium supplements also made my mother feel better — which is not too surprising since magnesium also improves left ventricular function and exercise tolerance (28).

Fortunately, this experience changed her attitude about pill taking and supplements and she asked me what else she should take. I showed her TWO DECADES of research in medical journals about supplements that are extremely safe and effective for her heart problems. Based on the medical literature, in addition to her prescription drugs, she began taking Coenzyme Q10, Carnitine, Taurine, etc. (I will discuss these supplements in a separate post.) Before this she was in the emergency room several times a year. Since the addition of the supplements more than FIVE YEARS AGO, she has never had to go to the emergency room.

The Turf War

Despite this irrational reluctance to tell people to take supplements, the medical industry routinely prescribes drugs that increase magnesium and potassium levels. For example, AFTER you develop deficiency-related heart problems, they are likely to prescribe drugs like Captopril, which increases intracellular magnesium and potassium (29). It is well known that ACE inhibitors “have an important magnesium conserving action” (31). In fact, the improvement in insulin sensitivity caused by ACE inhibitor drugs is related to their ability to increase magnesium levels and improve the calcium/magnesium ratio (32). Magnesium supplements have been recommended as an adjunct to prescription calcium channel blockers in treating hypertensive patients (30).

However, from what I have seen with my mother, all this research doesn”t seem to have much effect on what doctors tell their patients. This is ridiculous! My mother has congestive heart failure and NOT ONE DOCTOR HAS TOLD HER TO TAKE MAGNESIUM SUPPLEMENTS despite the fact that research shows that “patients with a low serum magnesium concentration had a significantly worse prognosis during long-term follow-up (45% versus 71% 1 year survival, p less than 0.05)” (33). This sort of insanity is the reason why I study medicine. There really seems to be no alternative. It”s funny, musicians are generally not very reliable, but it”s not all that difficult to find a musician that can play ALL styles of music. Why are doctors not equally versatile?

This reluctance to use (or ignorance of) alternative medicine is most baffling. I keep hearing people say that the situation is improving, but I don”t see it. My mother has seen quite a few doctors, but they routinely neglect to tell her that she should take magnesium, coenzyme Q10, carnitine, taurine, etc. Since I simply cannot understand this situation, the best that I can do is post referenced information and make it easy for people to get copies of the medical studies. Hopefully, if enough people go to their doctors waving a bunch of medical studies, things will HAVE to change.

Why didn”t you tell me about magnesium, coenzyme Q10, carnitine, and taurine?

There is a ton of research showing that these nutrients are safe and that they can improve the QUALITY and the LENGTH of life of people with heart failure. There is no rational medical reason why so many doctors do not tell their patients about them. I would really like to hear from medical students and doctors who think they have some insight into this. Send me an e-mail.

There seems to be an irrational opposition to acknowledging the fact that the scientific data shows that — no matter how good your diet is — you cannot achieve optimum nutrition (i.e., optimum disease prevention/treatment) without taking supplements. One of the most knowledgeable people in alternative medicine, Brian Leibovitz, has written about this situation:

“I have observed an incredible resistance to the “Journal of Optimal Nutrition” (JON) at the very top of the academic community. Both the “American Journal of Clinical Nutrition” and the “Journal of Nutrition” refused to run my “calls for papers” notice . . . several members of JON”s Editorial Board have related instances where they have been warned NOT to publish positive results on supplemental nutrients, for by doing so their careers would suffer. The fear of having ones career ruined is, in my estimation, one of the methods whereby the system has survived for so many years . . . I believe that as nutritionists we can no longer hide behind the veil of academia; we must stand up for what we know to be the truth.” (24-BK).

Safety & Bioavailability

Although the focus of this post has been on magnesium, I want to take a moment to discuss potassium. I often read posts on the newsgroups from people who are worried about getting too much potassium — probably because the FDA restricts the amount of potassium in supplements. The fact of the matter is that most people do not get enough potassium — in fact, one study showed that “A 10-mmol increase in daily potassium intake (approximately one serving of fresh fruit or vegetables) was associated with a 40 percent reduction in risk [of stroke]” (23). Lets put this in perspective: one medium sized banana contains 451 mg of potassium, yet the FDA limits potassium supplements to 99 mg. How many strokes could be prevented if multivitamins contained 500 mg of potassium?

Interestingly, anyone can go to a grocery store and buy salt substitutes and “low salt” foods that can easily add several GRAMS of potassium to ones daily intake. People who take certain medications, or have kidney problems or other conditions, should not use these products without consulting their doctors. However, for most people, this is a good way to consume adequate potassium.

Serum magnesium balance is controlled by urinary magnesium excretion. In the case of deficiency, the body tries to retain magnesium; if you consume too much magnesium, the excess is excreted in the urine. If your kidneys are functioning properly, there is little danger in any rational supplementation program. Personally, I think the research strongly suggests that supplements should contain approximately a 1:1 ratio (equal amounts) of calcium and magnesium, instead of the common 2:1 ratio. A reasonable dose for most people is 500-1,000 mg of magnesium a day. People with heart conditions or hypertension (who are working with a doctor) might take up to 2,000 mg a day.

Most multivitamins contain magnesium oxide, which is not well absorbed. The supplement manufacturers use magnesium oxide because they can list big numbers (see the green box) without telling people to take a lot of pills.

People want big numbers and very few pills to take. Well . . . they get it, but they aren”t told that they will absorb VERY little of the elemental magnesium in magnesium oxide. If you really want to improve your magnesium status, you need a  form of magnesium that is highly bioavailable (e.g., aspartate, malate, citrate) For example, magnesium oxide is only one-tenth as bioavailable as magnesium aspartate (9-BK).

Magnesium oxide contains 60.3 % elemental magnesium. Thus, if a supplement maker puts 500 mg of magnesium oxide in a product, the labels will read:

* Magnesium . . . 301 mg  (from magnesium oxide).

Magnesium citrate contains 16.2% elemental magnesium. Thus, if a supplement maker puts 500 mg of magnesium citrate in a product, the labels will read:

* Magnesium . . . 81 mg  (from magnesium citrate).

Many people think that a good diet and one multivitamin pill a day is all they need. However, when you look at what is actually assimilated, you can see that it is not even possible to fit sufficient magnesium in a single pill. That should tell you something about the quality of most multivitamins. However, we cannot lay all the blame on the supplement companies: how many people would buy a multivitamin that said “take ten capsules with each meal” on the label?

Unfortunately,  no matter how good ones diet is, optimum nutrition involves taking a LOT of pills. There”s just no way around it. Durk Pearson and Sandy Shaw were candid about this reality:

“Get your vitamins and minerals from a bottle, rather than relying on diet. It is difficult to get large amounts of vitamins in even the best of unsupplemented diets. For example, you are unlikely to be getting as much as 25 I.U. of vitamin E from your diet, even if you are devoted to unprocessed whole-grain foods” (34-BK).

It is comforting to think that mother nature wants to provide us with everything we need to live long and healthy lives. However, a huge amount of scientific evidence documents the fact that optimum disease prevention requires MANY TIMES the level of nutrients found in food — even if it were grown under ideal conditions. The Darwinian view is probably closer to reality: we are designed to reproduce and die. Modern man lives longer because of improved sanitation and medicine, but our health gives out because the nutrient content of food is not designed for much more than the fulfillment of our purpose — to reproduce and die. Personally, I have other plans. Taking a lot of pills costs money, but it”s cheaper than a heart attack or a stroke. Taking a lot of pills is a hassle, but it”s one hell of a lot safer than playing the magnesium lottery.

References

1.) Durlach J, Bara M, Guiet-Bara A “Magnesium level in drinking water and cardiovascular risk factor: a hypothesis” Magnesium 1985, Vol 4 (1), Pg 5-15. PMID: 0004033205.

2.) Marier JR and Neri LC “Quantifying the role of magnesium in the interrelationship between human mortality/morbidity and water hardness” Magnesium 1985, Vol 4 (2-3), Pg 53-9. PMID: 0004046646.

3.) Marx A and Neutra RR “Magnesium in drinking water and ischemic heart disease” Epidemiol Rev 1997, Vol 19 (2), Pg 258-72. PMID: 0009494787.

4.) Rubenowitz E, Axelsson G, Rylander R “Magnesium in drinking water and death from acute myocardial infarction” Am J Epidemiol 1996, Vol 143 (5), Pg 456-62. PMID: 0008610660.

5.) Yang CY “Calcium and magnesium in drinking water and risk of death from cerebrovascular disease” Stroke 1998, Vol 29 (2), Pg 411-4. PMID: 0009472882.

6.) Yang CY and Chiu HF “Calcium and magnesium in drinking water and the risk of death from hypertension” Am J Hypertens 1999, Vol 12 (9 Pt 1), Pg 894-9. PMID: 0010509547.

7.) Yang CY, Chiu HF, Cheng MF, Tsai SS, Hung CF, Lin MC “Esophageal cancer mortality and total hardness levels in Taiwan”s drinking water” Environ Res 1999, Vol 81 (4), Pg 302-8. PMID: 0010581108.

8.) Yang CY, Chiu HF, Cheng MF, Tsai SS, Hung CF, Tseng YT “Magnesium in drinking water and the risk of death from diabetes mellitus” Magnes Res 1999, Vol 12 (2), Pg 131-7. PMID: 0010423708.

9-BK.) Dr. Michael Colgan “Optimum Sports Nutrition: Your Competitive Edge” New York: Advanced Research Press 1993, ISBN: 0962484059.

10.) Joborn H, Akerstrom G, Ljunghall S “Effects of exogenous catecholamines and exercise on plasma magnesium concentrations” Clin Endocrinol (Oxf) 1985, Vol 23 (3), Pg 219-26. PMID: 0004075536.

11.) Kynast-Gales SA and Massey LK “Effect of caffeine on circadian excretion of urinary calcium and magnesium” J Am Coll Nutr 1994, Vol 13 (5), Pg 467-72. PMID: 0007836625.

12.) Altura BM and Altura BT “New perspectives on the role of magnesium in the pathophysiology of the cardiovascular system. I. Clinical aspects” Magnesium 1985, Vol 4 (5-6), Pg 226-44. PMID: 0003914580.

13.) Ma J, Folsom AR, Melnick SL, Eckfeldt JH, Sharrett AR, Nabulsi AA, Hutchinson RG, Metcalf PA “Associations of serum and dietary magnesium with cardiovascular disease, hypertension, diabetes, insulin, and carotid arterial wall thickness: the ARIC study. Atherosclerosis Risk in Communities Study” J Clin Epidemiol 1995, Vol 48 (7), Pg 927-40. PMID: 0007782801.

14.) Paolisso G and Barbagallo M “Hypertension, diabetes mellitus, and insulin resistance: the role of intracellular magnesium” Am J Hypertens 1997, Vol 10 (3), Pg 346-55. PMID: 0009056694.

15.) Altura BM and Altura BT “Cardiovascular risk factors and magnesium: relationships to atherosclerosis, ischemic heart disease and hypertension” Magnes Trace Elem 1991-1992, Vol 10 (2-4), Pg 182-92. PMID: 0001844551.

16.) Abraham AS “Potassium and magnesium status in ischaemic heart disease” Magnes Res 1988, Vol 1 (1-2), Pg 53-7. PMID: 0003079203.17.) Gettes LS “Electrolyte abnormalities underlying lethal and ventricular arrhythmias” Circulation 1992, Vol 85 (1 Suppl), Pg I70-6. PMID: 0001728508.18-NA.) Dawson R Jr, Tang E, Shih D, Hern H, Hu M, Baker D, Eppler B “Taurine inhibition of iron-stimulated catecholamine oxidation” Adv Exp Med Biol 1998, Vol 442 Pg 155-62. PMID: 0009635027.

19.) Whang R, Whang DD, Ryan MP “Refractory potassium repletion. A consequence of magnesium deficiency” Arch Intern Med 1992, Vol 152 (1), Pg 40-5. PMID: 0001728927.

20.) Whyte KF, Addis GJ, Whitesmith R, Reid JL “Adrenergic control of plasma magnesium in man” Clin Sci 1987, Vol 72 (1), Pg 135-8. PMID: 0003542342.

21.) Dyckner T and Wester PO “Potassium/magnesium depletion in patients with cardiovascular disease” Am J Med 1987, Vol 82 (3A), Pg 11-7. PMID: 0003565422.

22-NA.) Lauler DP “Magnesium–coming of age” Am J Cardiol 1989, Vol 63 (14), Pg 1g-3g. PMID: 0002705371.

23.) Khaw KT and Barrett-Connor E “Dietary potassium and stroke-associated mortality. A 12-year prospective population study” N Engl J Med 1987, Vol 316 (5), Pg 235-40. PMID: 0003796701.

24-BK.) Leibovitz, B “Nutrition: At the Crossroads” in Morgenthaler, J and Fowkes, S “Stop the FDA: Save Your Health Freedom” Health Freedom Publications 1992, ISBN 0-9627418-8-4.

25.) Deuster PA, Dolev E, Kyle SB, Anderson RA, Schoomaker EB “Magnesium homeostasis during high-intensity anaerobic exercise in men” J Appl Physiol 1987, Vol 62 (2), Pg 545-50. PMID: 0003558215.

26.) Keen CL, Lowney P, Gershwin ME, Hurley LS, Stern JS “Dietary magnesium intake influences exercise capacity and hematologic parameters in rats” Metabolism 1987, Vol 36 (8), Pg 788-93. PMID: 0003600291.

27.) Stendig-Lindberg G, Shapiro Y, Epstein Y, Galun E, Schonberger E, Graff E, Wacker WE “Changes in serum magnesium concentration after strenuous exercise” J Am Coll Nutr 1987, Vol 6 (1), Pg 35-40. PMID: 0003453693.

28.) Geiss KR, Stergiou N, Jester, Neuenfeld HU, Jester HG “Effects of magnesium orotate on exercise tolerance in patients with coronary heart disease” Cardiovasc Drugs Ther 1998, Vol 12 Suppl 2 Pg 153-6. PMID: 0009794089.

29.) O”Keeffe S, Grimes H, Finn J, McMurrough P, Daly K “Effect of captopril therapy on lymphocyte potassium and magnesium concentrations in patients with congestive heart failure” Cardiology 1992, Vol 80 (2), Pg 100-5. PMID: 0001611628.

30.) Touyz RM “Magnesium supplementation as an adjuvant to synthetic calcium channel antagonists in the treatment of hypertension” Med Hypotheses 1991, Vol 36 (2), Pg 140-1. PMID: 0001664038.

31.) Stevenson RN, Keywood C, Amadi AA, Davies JR, Patterson DL “Angiotensin converting enzyme inhibitors and magnesium conservation in patients with congestive cardiac failure” Br Heart J 1991, Vol 66 (1), Pg 19-21. PMID: 0001854570.

32.) Haenni A, Berglund L, Reneland R, Anderssson PE, Lind L, Lithell H “The alterations in insulin sensitivity during angiotensin converting enzyme inhibitor treatment are related to changes in the calcium/magnesium balance” Am J Hypertens 1997, Vol 10 (2), Pg 145-51. PMID: 0009037321.

33.) Gottlieb SS, Baruch L, Kukin ML, Bernstein JL, Fisher ML, Packer M “Prognostic importance of the serum magnesium concentration in patients with congestive heart failure” J Am Coll Cardiol 1990, Vol 16 (4), Pg 827-31. PMID: 0002212365.

34-BK.) Pearson, D and Shaw, S “Life Extension : A Practical Scientific Approach” Warner Books 1987, ISBN 0446387355.

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