Is 120mg of magnesium glycinate (Mg) excessive for an adult with a pre-existing heart condition and potential interactions with medications such as blood thinners or heart rhythm medications?

Is 120mg of Magnesium Glycinate Excessive?

No, 120mg of elemental magnesium glycinate is not excessive for an adult with a pre-existing heart condition and represents a conservative supplementation dose well below established safety thresholds, even when considering potential medication interactions.

Dosing Context and Safety Thresholds

The 120mg dose you're asking about falls well within safe supplementation ranges:

• Normal serum magnesium range is 1.3-2.2 mEq/L, and therapeutic supplementation aims to maintain levels above 1.3 mEq/L 1
• Oral magnesium oxide (a common supplement form) is typically dosed at 12-24 mmol daily (approximately 290-580mg of elemental magnesium) for treating documented hypomagnesemia 2
• For chronic constipation, magnesium oxide is commonly used at 400-500mg daily, with some studies using 1,000-1,500mg daily without establishing a clear maximum dose 2
• Your 120mg dose represents roughly 20-40% of typical therapeutic supplementation doses, making it a modest amount 2

Cardiac Considerations

For patients with heart conditions, magnesium has specific cardiovascular benefits and risks:

Benefits in cardiac patients:

• Magnesium improves myocardial metabolism, inhibits calcium accumulation and myocardial cell death, improves vascular tone, reduces cardiac arrhythmias, and improves lipid metabolism 3
• Hypomagnesemia is associated with increased mortality from coronary artery disease and increased incidence of arrhythmias 3
• Magnesium increases ventricular threshold for fibrillation and prolongs AV node conduction 4

Safety concerns specific to cardiac patients:

• The American Heart Association warns that magnesium overload can cause bradycardia, cardiac arrhythmias, respiratory depression, and cardiorespiratory arrest, but these occur at much higher doses than 120mg 1
• Life-threatening toxicity develops at serum levels of 6-10 mmol/L, which typically requires substantially decreased kidney function (GFR <30 mL/min) combined with magnesium-containing medications 5

Medication Interactions

Blood Thinners

• Calcium and iron supplements should be separated from magnesium by at least 2 hours as they inhibit each other's absorption 5
• There is no specific contraindication for magnesium with blood thinners in the provided guidelines 6

Heart Rhythm Medications

• Magnesium is actually therapeutic for certain arrhythmias, including torsades de pointes and digitalis toxicity 6, 1
• For patients on digoxin, magnesium supplementation may be beneficial as hypomagnesemia increases digitalis toxicity risk 7
• Drugs with SA and/or AV nodal-blocking properties (beta-blockers, calcium channel blockers, digoxin) require monitoring when combined with magnesium, but 120mg is unlikely to cause clinically significant interactions 6

Critical Caveats

When to avoid or use extreme caution:

• Severe renal insufficiency (GFR <30 mL/min): Maximum dose should be limited and serum magnesium monitored frequently 2, 5
• AV block greater than first degree or SA node dysfunction without a pacemaker requires caution with any magnesium supplementation 6
• Hypotension or decompensated heart failure: Monitor closely as magnesium acts as a vasodilator 6, 8

Monitoring recommendations:

• Obtain baseline serum magnesium level and ECG if you have cardiac symptoms, arrhythmias, or use diuretics or digoxin 5
• Check for QTc prolongation on ECG, as hypomagnesemia increases ventricular arrhythmias, particularly with diuretic use 5
• Monitor for concurrent electrolyte abnormalities, particularly potassium and calcium, which often accompany magnesium disorders 5

Practical Guidance

For your specific situation (120mg magnesium glycinate with heart condition):

• This dose is safe for most adults with heart conditions and may actually be beneficial 8, 3
• Ensure adequate kidney function before starting supplementation 2
• Take at night when intestinal transit is slower to optimize absorption 2
• Do not exceed recommended doses as stated on the FDA label 9
• Consult your physician if undergoing treatment for specific cardiac conditions 9

The evidence strongly suggests that 120mg of magnesium glycinate is not excessive and may provide cardiovascular benefits, particularly if you have any degree of magnesium deficiency, which is common in patients with heart disease taking diuretics 7, 3.