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M.G. Lyrics

Victor B

My attending pimped me on this subject a couple of days ago and I couldn't find much information on the it at all. I did see your video on YouTube's education channel and decided to venture a view. I'm glad I did! Thanks for an easy understanding of Magnesium's role in the body!

Strong Medicine

Victor, you're most welcome!  I'm glad it helped!

Nate Nute

I know this has been done long time ago but I wonder if you wanted to put hypocalcaemia in 3:54 - as Mg helps to produce PTH so low Mg generally leads to low Ca (it's possible to have low Mg secondary to high Ca but not the other way around). Then it would make sense, as the examples of symptoms you described are due to low calcium and not high (calcium is Na channel stabilizer so low levels cause increase na influx into cell hence easier depolarisation hence tetatni etc).

Raymond Keller

In my opinion, you should explore the role that magnesium has in birth. This situation provides a very clear physiological response pattern to magnesium.

Pkcheyanne

Culotta Spider

@Merline Spoon

Merline Spoon

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Maria Inez Machado

Excellent explanation and video! Thanks.

Fay Louise

ah, i think it would be great if you would address the role magnesium plays in enzymatic reactions, ie pth, calcidiol, calcitriol .... (of course every enzymatic rx needs a vit and a mineral,.. so it is a very large topic) in addition dr osborne has a good short magnesium overview: Signs and Symptoms of Magnesium Deficiency

Fay Louise

@Eric's Medical Lectures hi eric! first thank you for your efforts and videos. 
i kept my comment a bit open, so narrowing it down, if you could i would like if you went over the role magnesium plays in the enzymatic conversions in numerous activation in the body, just for example because of this video pth, calcidiol, calcitriol, and any other you would like to add, (there are a few hundred), the purpose of that being to put emphasis on a not very well emphasized role, basically at which steps is magnesium needed and which anatomical structure....

Strong Medicine

Thanks for the suggestions.  This video was originally created primarily with medical students in mind, who have limited attention spans when it comes to electrolytes, so I wanted to keep it relatively concise.  Unfortunately, some important details may have been left out.  I am familiar with Dr. Osborne's video that you've linked to.  The only thing I'd say about it is that some of the consequences of mag deficiency that he mentions are speculative and/or don't (yet) have a huge amount of solid data behind them.  Hopefully with time, larger and better studies will be conducted and published so that unresolved questions can be answered.

Wanda Mendes

Magnesium made my calf cramps go away!! Havent had a single one since starting daily magnesium supplement at the suggestion of my OB when I was pregnant with my first kid 6 years ago. Also I have less foggy brain :).

Dan

Thank you for this interesting and informative video. i have two suggestions and one question,

- you didn;t cover transdermal Mg absorbtion (Mg chloride also known as Mg Oil)

= Mg serum levels are a very poor indicator of overall Mg levels

- source on the Mg and loop of Henle please?

Strong Medicine

I appreciate that transdermal application of magnesium is used in complementary/alternative medicine, but the peer-reviewed scientific literature has just 1 study on it, published in 2015, which was a non-randomized, non-controlled study of 24 patients with fibromyalgia in whom magnesium levels (serum or intracellular) weren't even measured (http://www.ncbi.nlm.nih.gov/pubmed/26343101) - it's the kind of paper that is meant to generate hypotheses leading to more research; it is not enough to actually recommend a change in practice. This isn't to say that transdermal magnesium isn't effective, but rather, there is no significant evidence of its effectiveness. Since there is no specific reason to think it's superior to oral magnesium, with which we have greater experience, I personally advise patients to stick with oral mag supplements.

I totally agree that the correlation between serum magnesium levels and total body magnesium levels is not great. (Same holds true for potassium, calcium, and phosphate) If I didn't explicitly state that in the video, I meant to - thanks for pointing it out. Unfortunately, we don't have a good alternative to serum magnesium levels. Although there are websites that promote measurement of intracellular magnesium, this test is not currently accepted by the medical community as an appropriate alternative. There is more research being done though, and hopefully someday there will be a way to more accurately assess total body magnesium stores.

Regarding the reference for magnesium and loop of Henle, was there a specific fact that you were interested in? (i.e. effect of pH on reasborption, rapid administration of IV mag leads to increase renal tubular mag wasting, etc...)

plateofeggs1

Very useful thank you very much for your time and effort

Silvio Fontana

My Gi tract does not take kindly to Mag of any type, so, I use spray on mag oil from mag chloride and mag sulfate from ES.
Is there any likelihood of hyper mag from this method of application on a daily basis.
sleep patterns are greatly improved with my application of mag to date.
cheers and thanks, great learning with your style and presentation.

riadh jalel

Great presentation , thank you

Wittawat Kasayapanand

Thank you Dr Strong I picked up more from listening second time. Thanks

Mandilyn Cartwright

I've had dangerously low levels of potassium and magnesium most of my life, I've also had UC since I was 6. I started having chronic kidney stones at 19. Although many of my friends who have UC also have had chronic Calcium kidney stones the Doc's say it's not related. Perhaps the low absorption of magnesium and potassium from UC is also causing an access of calcium?

Ashok Charan

@Mandilyn Cartwright

Mandilyn Cartwright

Very interesting.

Strong Medicine

Mandilyn, while I can't give you any specific advice regarding your own medical situation, I can tell you that IBD (both UC and Crohn's) is associated with higher risk of kidney stones.  It's not a widely discussed problem, so it's not surprising that most doctors don't know about it.  The reasons for the association between IBD and stones are complicated and not completely understood, though the risk appears highest in patients with the worst disease (worst in terms of both anatomic extent of intestinal inflammation, and disease activity).  Related to this is that low serum potassium is also a risk factor for the development of calcium stones, though the mechanism of this is unknown.  I honestly don't know of any association between magnesium and calcium stones, but since balance of each electrolyte is intertwined with the others, it's not hard to believe there is one waiting to be discovered.  Finally, another consideration for stones in a patient with IBD is whether the stones are actually not primarily composed of calcium but rather uric acid, since uric acid stones can be caused by the systemic acidemia (i.e. acid in the blood) and mild volume depletion that can be seen in IBD characterized by severe, chronic diarrhea. 

Eric Smith

Anyone having passed a high school biology class should be able to follow most of this lecture.  What's so difficult about this?  If there are terms you don't understand, google them!  Educational videos are for learning, not for pure entertainment.

Sovereign SOULutions

Hi, can you please talk about why magnesium supplements (no matter what form) causes me to have anxiety, restlessness, sleep disturbances, and sweaty hands and feet? It makes me paranoid if I take it for a while...its so bad...but magnesium RBC is only 4.6 (range is 4.2-6.8) and I get PVCs...so I think I need more magnesium. So frustrating.

Strong Medicine

I'm sorry, but I can't give specific, individualized medical advice here and I recommend speaking with your own physician about your concerns. Having said that, the symptoms you've described are not common side effects of oral magnesium supplements - although taking magnesium at the same time as some other medications can affect their absorption, so one might experience effects related to that kind of interaction. Depending on where you live, there may be more than one form of oral magnesium available; one could try a different formulation. I also always make sure other electrolytes (e.g. potassium, calcium) are checked at the same time as magnesium. Last, despite direct-to-consumer labs loving RBC magnesium testing, it hasn't been sufficiently validated as an accurate enough method of diagnosing magnesium depletion to recommend as a screening test. As I said - not medical advice, and you should speak to your own doctors about this. Hope you get it figured out!

Rasha Tariq

thank you for your amazing effort. God bless you.

Natasha Wilson

Your video is educational and reminds me of biology class I have the urge to take notes and make diagrams. I really enjoyed your lecture.

YapLapWombat

Thank you for this excellent summary. What is the music at the start?

YapLapWombat

Should have waited for the end. BWV 862.

uofagrad2009

can you provide your references for the guidelines you mentioned in this video regarding the repletion of Mg etc

Strong Medicine

@uofagrad2009 That's a great question. First, what I've discussed regarding mg repletion is more my opinion, and not official guidelines - since there aren't any official guidelines on the general management of hypomagnesemia. Most importantly, no one knows to what level magnesium should be repleted in either acute medical illness, chronic medical illness, or in an asymptomatic presumably healthy person. Thus, we have the common practice by which medical/surgical residents and hospitalists insist on repleting magnesium to 2.0 mEq/L in hospitalized patients, despite the normal range frequently being something like 1.8-2.2 mEq/L (i.e. they are unsatisfied with low normal levels, and insist on repleting to high normal levels). This is probably not necessary in asymptomatic patients who are without active cardiovascular/arrhythmogenic disease or prolonged QT syndrome. Related to that is the practice of almost always repleting magnesium via IV route in the hospital, when this may not always be necessary, and may be counterproductive (significant spikes in serum magnesium leads to renal magnesium wasting before cellular uptake can occur - thus patients may immediately lose in the urine a significant portion of the infused magnesium).


For a review of magnesium repletion in patients who are hypomagnesemic, I'd recommend starting with UpToDate's article "Evaluation and Treatment of Hypomagnesemia" by Alan Yu - but given limited literature, much of the treatment section is presumably his opinion (albeit, a relatively well-informed opinion). Also, although it's more recent than my video (i.e. it wasn't a source I used), another relevant paper is: Ayuk J, Gittoes N. "Treatment of Hypomagnesemia" Am J Kidney Diseases. 2014: 63;691-695. PMID: 24100128.

ruqaya suadad

I understand well from your videos your explanation is good Go on ♥

Sol luna

Great lecturer thanks 

lorna jimenez

ang komentonato imakikita ng pampuliko

Strong Medicine

@Ines Cruz (sorry YouTube is not letting me directly link to your comments): While I can't offer you specific, individualized medical advice on here, I will say that it is not standard of care in the US for a physician to prescribe an electrolyte supplement without first checking the serum chemistries.  While serum magnesium does not correlate well with total body magnesium stores, supplemental magnesium should be used very cautiously if significant renal dysfunction were also present.  Also, palpitations related to electrolyte deficiencies could easily be from potassium depletion - though both low magnesium and low potassium only cause palpitations via their possible contribution to abnormal heart rhythms - specifically atrial fibrillation, ventricular tachycardia, and multifocal atrial tachycardia (the last of which is very uncommon).  

Clarise Viljoen

Thank you for the great video !

Rimsha Siddique

Which test is best to diagnose MG deficiency?

Fay Louise

hi eric, please dont remove this video, i see there are no like/dislike numbers...
im hoping you can clear up the serum mag test, rbc mag test, mag loading test, and any other lab tests to evaluate magnesium, there is a lot on the web about having the active/rcbmag test done,..there is a great deal of information by carolyne dean i was wondering if you are familiar with her work, also i appreciate being clear in the clarification of the limits of clinical use of magnesium in standard care and evaluation, it is important to make the distinction between what is known and what is used in regular medical care, as usual there is a great discrepancy gap....

Strong Medicine

@Dogmaof Oodles The RBC Magnesium test is best described as investigational.  In 10 years of practice, I've literally never seen anyone order it or attempt to order it, and Stanford on-site labs doesn't offer the test at all.

The bottom line is that there is no established, reliable test for assessing total body magnesium stores.  Unfortunately, there is no formula for magnesium as there is for calcium.

Fay Louise

@Eric's Medical Lectures i wasnt aware that the rbc mag test, was alternative, i thought it was a test to measure with more accuracy the active level of magnesium similar to intracellular b12 vs serum... im one of those you can freely bore away with detail  : ) what is the best assays for assessing magnesium? serum is fairly useless, ( but i find it interesting that serum calcium is fairly good, as well if known albumin can estimate ionized,.. is there some formula comparable for assessing magnesium?

 

Strong Medicine

Don't worry, I'm not planning on removing the video.  I just blocked the like/dislike buttons ever since YouTube placed this as a featured video on their general education channel.  Because it's relatively technical, and because there are many people now clicking on it without necessarily having a strong desire to learn the technical details of magnesium balance, it was getting many dislikes that was hurting my ego...

I'm not remotely an expert on alternative ways to diagnose magnesium deficiency (i.e. tests other than the unreliable standard serum magnesium test).  All I can say is that none of the alternatives have entered into routine clinical practice in conventional medical settings.  In the scientific literature, the magnesium loading test appears to be the most studied, but as I said, using it hasn't become standard practice.  It's interesting that something like the mag loading test, which has a small and limited amount of data suggesting it's useful doesn't have widespread acceptance, whereas the typical serum magnesium level, for which there is a strong consensus that it is a flawed measure of total body mag stores, is used all the time without second thought.  

I suspect the apparent discrepancy is because routine serum mag tests probably correlate relatively well with the risk of complications from acute hypomagnesemia in critically ill patients (i.e. risk of arrhythmias from magnesium depletion during active diuresis of a patient in severe heart failure).  Doctors then make the leap that the conventional serum mag test is also appropriate for assessment of chronic mag deficiency, which, as implied above, is probably largely false.

Medical science is incomplete, and unfortunately, an accurate, reproducible, practical, and clinically useful means of assessing chronic magnesium deficiency has so far eluded us.

thọ võ

Thank you for great video!

Floridaball123

Eric don't remove your videos. They are helpful.

Lisa Le

Love your videos. Pharmd student from Canada. Binge watching all your videos over Netflix.

Strong Medicine

Wait, my videos are on Netflix? I feel like someone should be sending me a check! lol

Climate Change

Is magnesium also good for people with kidney failure?

Wittawat Kasayapanand

Thank you Doctor Strong. It is good, I don’t know why anyone would tumb down

Strong Medicine

Thanks for all of your positive comments over the last few days! Sorry I haven't been able to reply to them individually! A funny story about the down votes on this video... about a year after it was posted, some automatic YouTube algorithm selected it to be featured for 2-3 months on YouTube's Featured Education Channel (I don't think the channel even exists any more). So a huge volume of non-medical people clicked on it expecting a video made for laypersons, and seeing it was clearly not what they expected, down voted it and quit watching after 30 seconds. It has the most extreme analytics, by far, of any video I've made. It was kind of ironic to have been selected like that since it was one of the least layperson-friendly videos I had made up until that point.

Velicia Hiley

Helped me to understand why most of the people I know who take high blood pressure meds are ending up on dialysis. Physicians are not checking their patients who are on meds for years at a time.

jo beth. rico

@Peter Johnson : U r a Bully w/the name calling. like u don’t know these guys in the white lab 🥼 kick back from these drug companies. Honey I have family and friends that work in these doctors office ,spare me!

Peter Johnson

@jo beth. rico So how would doct
ors benefit from that? Why don't you think it through before you parrot airhead myths?

jo beth. rico

Why would they do that , That would interfere with big Pharma’s bottom line$ $!

Łukasz Paschała

Great upload :)

Hornoiu Angela Doina

Thank you one of the best on you tube..

Irish dudz

I'm amazed at your finding of magnesium I have a ruptured discs L4 and L5 and magnesium and B12 have been my best pain Killers if this information helps you please use it and pass it on I've manged without surgery but plenty of therapy thank you for your findings I was worried of any future side effects of magnesium, but with this information I can see I can over due it I'll value now more my yearly (Medical) physical

nichellehowell

When I take magnesium, I feel terrible! I feel it tanks my sodium levels. No Dr listens or understands. I have no known kidney issues.

Kathy Vaught

subscribed! Thank you, thank you

jheckmann

Why not topical magnesium oil, especially for those taking PPIs who might have poor absorption?

jheckmann

Oh, nevermind, I found your answer buried deep in the comments. Thank you.

Jen Gulas

thanks doc!

Rachel Ahearn

If I feel terrible every time I take magnesium what could be the issue? What route would be good to take? Have told a few doctors and there’s always a blank stare. Have tested this out many times past three years. Every time I take magnesium glycinate I feel awful; neck becomes extra stiff and headache comes on.

Spiritual Outlaw

@Strong Medicine Every doc you talk too have no clue on this stuff so that's why most are here to get advise I hate when people say talk to your doc when then don't have a clue lol

Strong Medicine

I'm sorry but I can't give specific, individualized medical advice on here, and you should always discuss any concerns about your medications with your own physicians and other healthcare providers. However, there are more than one type of magnesium supplementation (e.g. magnesium oxide, magnesium chloride, etc...).

Sandra Cuthbertson

Thank you soooooo much....

Josip Vrdoljak

Hypocalcemia* not hyper leads to tetany, neuromuscular irritability etc.. (at 3:57)

sederquest

Between google and YouTube who needs doctors 😆

Dominique Pordeus Araújo

THAAAAANK YOOOOOU! Hahah :) great video!

m.shamaileh

I have mg deficiency since 4 years i took supplements through 4 years and none of them helped to raise the amount of mg in my body please tell me what is the problem with my body
Ps my potassium and calcium are normal in my body
I really dont know what to do ?

Peter Johnson

@m.shamaileh It's probably a renal issue. Suggest this to a doctor who has an interest in this area.

m.shamaileh

@Peter Johnson you won’t believe it if i told u that i visited a lot of doctors for this issue and none of them knew what is the problem, and the PPI’S medications i stopped all of them a year ago and still have the same issue

Peter Johnson

Consult a doctor (especially one with an interest in this topic). In the meantime, consider any medications you are taking - especially proton pump inhibitors (PPIs).

Lester E

👏🏽👏🏽👏🏽

cordis9999

Excellent

Steve Moir

m

Carding Pula

Good Video Thanks

kaka maka

at around 3,58 you said hipercalcemia is associated with tetany, but isnt that found in hypocalcemia?

TheMitchwich

Because the thyroid plays a large part in calcium regulation, and because hypermagnesemia presents similarly to hypercalcemia, wouldn't one look to the thyroid/parathyroid as a player in Mg regulation?

Strong Medicine

mitch0310, you make a great point, one which I should have made clearer in the video.  Calcitonin (produced by the thyroid) and PTH (produced by the parathyroids) have both been shown to affect renal handling of magnesium (among other hormone).  And derangements of magnesium have been shown to impact PTH secretion.  What hasn't been shown yet, is whether primary derangements of any hormone (including calcitonin and PTH) can lead to a clinically relevant (i.e. significant enough to cause symptoms) alteration in the body's magnesium balance.  My guess it that we simply still have much to learn about human physiology. I've embedded an annotation into the video mentioning the above.  Thanks!

Maryjuana Rasta

Can someone with later stages of CKD supplement Mg?

WingYi

Thank you

Ceiling Fan

Good video

Alberto HERNANDEZ MARTINEZ

Hypomagnesemia cause Hypocalcemia not Hypercalcemia!

Alberto HERNANDEZ MARTINEZ

@Eric's Medical Lectures No worries, I love your videos anyway!!!
Kind regards

Strong Medicine

@Alberto HERNANDEZ MARTINEZ Ahh!!! How embarrassing!  Thanks you, you are correct:  Hypomagnesemia causes HYPOcalcemia.  I added an annotation into the video pointing out the mistake.  I wish I knew someone willing to "proofwatch" these before I posted them!

tzekos tzekoos

10000000 thanks

LUISARTIS

I want to the traduction for the spanish people

Hoshang Haris

For 2 years now I am very weak in the body every muscle is weak i can't even barely walk down the street ring in ears nervousness before . Never got this in my whole life 40 years old please i need so much health the doctors think i'm depressed and psychic that i am not even weak but i am. l magnesium deficiency?? What magnesium to take their so many out there??

Strong Medicine

I'm very sorry, but I can't give specific, individualized medical advice on here. But I will say that generalized weakness and ringing in the ears are not common manifestations of magnesium deficiency. I would seek a second opinion from another physician, if you haven't already.

Waseem Kabir

As good as Harrison

Hien Hoang Thi

the video image is too poor, you need to fix it more

Strong Medicine

You mean the video thumbnail? It's just a random frame taken from the video.

Kristy Heltne

Too bad no subtitles - hard of hearing.

Strong Medicine

Kristy, closed captioning is now available for this video (not sure why it wasn't before), and I just proofread the subtitles for accuracy.  (YouTube really needs to add more medical terms to their voice recognition software!)

Ali Abdulzahra

goood

M O