Common Reflux Drug Linked to Low Magnesium Levels

Jane Hart, MD notes how magnesium is an important mineral that contributes to bone health, heart health, and hundreds of other functions.

While often a useful treatment for health conditions, certain medications may lead to a variety of unwanted side effects, including depleting nutrients. In a study published in Pharmacoepidemiology and Drug Safety, researchers found that people who took proton pump inhibitors (PPIs)—a common class of drugs used for peptic ulcers and gastroesophageal reflux—were at risk for magnesium deficiency.

PPIs may lower magnesium

In this study, researchers reviewed the hospital records of 487 hospitalised adults and explored the link between PPI use and magnesium levels in the blood. They found that people who took a proton pump inhibitor before being admitted to the hospital had a 2.5-fold increased risk of low magnesium, compared with people who did not take one of these drugs. This was true for people taking the standard or higher PPI dose.

In 2011, the US Food and Drug Administration (FDA) first warned consumers and healthcare professionals of the possible link between long-term proton pump inhibitor use and low magnesium. According to the study authors, “Our study results support the general notion that proton pump inhibitor therapy may lead to sub-clinical degrees of low magnesium levels or deplete magnesium stores as suggested by the Food and Drug Administration and others.”

The authors state that while their findings show an association between proton pump inhibitor use and low magnesium levels, their study does not prove cause and effect, and other factors such as illness or a poor diet may have also led to a lack of the mineral. They recommend further research to confirm these findings.

What you should know about magnesium

Why is magnesium important? Magnesium is a mineral that contributes to bone health, heart health, and hundreds of other functions in the body. Symptoms of low magnesium include nausea, muscle cramps, feeling tired, and irregular heartbeat. As these symptoms are common to many other medical conditions, it is important to see a doctor if you experience any. Severe magnesium deficiency can lead to heart attack and death.

What foods contain magnesium? Many foods contain magnesium, but foods that are particularly rich in the mineral include whole grains, Swiss chard, spinach, almonds and other nuts, and seeds such as sunflower seeds. Tap water also contains varying levels of magnesium.

Should a doctor check my magnesium level? There are a number of potential causes of low magnesium. Medications such as diuretics (typically taken for heart disease or high blood pressure) and some anticancer drugs can lead to low magnesium, as can medical conditions such as diabetes or alcoholism. Talk with your doctor about whether or not your magnesium level should be checked regularly. The Food and Drug Administration recommends that healthcare professionals consider checking magnesium levels before writing a prescription for long-term proton pump inhibitor use and then monitor a person’s levels during use.

(Pharmacoepidemiol Drug Saf 2012;21:553–9)

Jane Hart, MD, board-certified in internal medicine, serves in a variety of professional roles including consultant, journalist, and educator. Dr. Hart, a Clinical Instructor at Case Medical School in Cleveland, Ohio, writes extensively about health and wellness and a variety of other topics for nationally recognised organizations, websites, and print publications. Sought out for her expertise in the areas of integrative and preventive medicine, she is frequently quoted by national and local media. Dr. Hart is a professional lecturer for healthcare professionals, consumers, and youth and is a regular corporate speaker.

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