From the Guidelines
To replace magnesium orally and improve absorption, take organic magnesium salts such as citrate or aspartate supplements at doses of 200-400mg elemental magnesium daily, divided into 2-3 doses with meals, as they have higher bioavailability than magnesium oxide or hydroxide 1. When choosing a magnesium supplement, consider the following options:
- Magnesium citrate: often well-tolerated and absorbed, but may have a mild laxative effect
- Magnesium aspartate: has higher bioavailability than magnesium oxide or hydroxide
- Avoid magnesium oxide: has poor absorption (only 4%) For optimal absorption, take supplements with food, avoid taking with high-fiber meals or calcium supplements, and ensure adequate vitamin D levels. It is also essential to stay hydrated and consider adding foods rich in magnesium like dark leafy greens, nuts, seeds, and whole grains to your diet. If you experience digestive issues like diarrhea, reduce the dose and gradually increase it. These recommendations work because certain magnesium forms create compounds that are more easily transported across intestinal cells, while food stimulates digestive enzymes that enhance absorption, as noted in the management of patients with a short bowel 1 and Bartter syndrome 1. Additionally, maintaining sodium balance is crucial, and patients with stomal losses should be cautious against consumption of plain water and instead drink oral rehydration solution (ORS) whenever they are thirsty, as recommended in the ESPEN guidelines on parenteral nutrition 1. Regular monitoring of serum magnesium levels is necessary to avoid deficiency, and intravenous supplementation may be required if oral supplementation is not successful 1.
From the FDA Drug Label
In the treatment of mild magnesium deficiency, the usual adult dose is 1 g, equivalent to 8. 12 mEq of magnesium (2 mL of the 50% solution) injected IM every six hours for four doses (equivalent to a total of 32.5 mEq of magnesium per 24 hours). For severe hypomagnesemia, as much as 250 mg (approximately 2 mEq) per kg of body weight (0. 5 mL of the 50% solution) may be given IM within a period of four hours if necessary. In the treatment of deficiency states, caution must be observed to prevent exceeding the renal excretory capacity.
To replace magnesium orally and make it absorb better, the following can be considered:
- Oral Magnesium Supplementation: The provided drug labels do not directly address oral magnesium supplementation.
- Absorption Enhancement: There is no information provided in the drug labels regarding methods to enhance magnesium absorption. 2