This technical paper [www.mgwater.com] was fairly heavy going for this layman, but certainly covers a subject of great importance to us afibbers.

Josiah

Josiah - so glad you are visiting Paul Mason's website. That is a place you can lose many many weeks with study. Awesome. I shall be re-reading it again soon. Jackie

In this very excellent and relevant article, I was glad to be reminded of this section:

Refractory potassium deficiency
For a long time it was not clear that with magnesium deficiency potassium will also be affected, because this combination must seem very paradoxical. Previously when those connections were not recognized, surprise was expressed, that an existing potassium deficiency could not be equalized by potassium substitution. This situation then was called 'a refractory potassium dose with refractory hypokalemia refractory potassium deficiency,' but it was dismissed as a curious event. Later on it was shown that increasing potassium supply aggravated the hypokalemic situation more and more. Today fortunately it is known, that increasing potassium supply will stimulate aldosterone secretion, so that renal excretion will increase too.

Thanks Josiah, this is excellent! And thanks once more to Paul Mason for his incomparable website [www.mgwater.com]

This is exactly what Jackie's 'The Strategy' is all about, which properly focuses more specifically on the need for a high intracellular potassium-to-sodium ratio (K:Na), hence dietary intake. For maintenance of electrolyte homeostasis, magnesium is the first key; endemic dietary Mg deficiency is reflected in the high prevalence of dysrhythmia.

This seems a good time to re-post comments by two noted magnesium experts. Intracellular magnesium deficiency - IC MgD - is often extremely difficult to overcome (refractory MgD):

1) In his booklet MAGNESIUM Alan R. Gaby, MD, MS biochemistry, writes:

"As disease progresses, cells lose their ability to function properly. Most of the cells of the body maintain a very high magnesium concentration relative to that in the blood serum. For example, there is about ten times as much magnesium inside the cells of a healthy heart as there is in the serum. This high concentration of magnesium is necessary for cells to perform their various biochemical tasks. However, maintaining this steep concentration gradient between cells and blood requires a great deal of energy. The laws of random motion cause magnesium ions to leak continually out of the cells and into the bloodstream. Each time a magnesium ion leaks out, another one must be pulled back in by special pumps that reside on the cell membrane.

Pulling against a concentration gradient is analogous to swimming upstream or to carrying bowling balls up a hill, only to see them roll right back down. As inefficient as that sounds, that is how the body works. Indeed, a substantial proportion of the calories you burn each day are used to maintain higher concentrations of some nutrients inside cells than in the bloodstream. When you become ill, some of the cells in your body may become less efficient in holding on to magnesium. The cell membranes may break down, allowing more magnesium to leak out. In addition, the cell membrane pumps that pull magnesium back in may also be weakened by disease. The end result is that disease itself can be a cause of magnesium deficiency.

Since magnesium deficiency may have been one of the original causes of the disease, a vicious cycle of greater deficiency and increasingly severe disease may result .... a substantial minority of patients ... fail to improve after taking oral magnesium for months or even years. In these cases, administering magnesium by injection is necessary to overcome their medical problems."

2) From the magnesium Forum and Bulletin Board by Walt Stoll, M.D. [askwaltstollmd.com]:

"Magnesium metabolism has one quirk in that, if the level is low enough (in that person) to cause symptoms, it is low enough that the body loses its ability to absorb it efficiently orally.

Since it is almost impossible to hurt someone by giving them too much magnesium, doing a therapeutic trial of an easily absorbed (orally) form of chelated magnesium (orotate, aspartate or glycinate) might be tried by anyone.

This paragraph is just to warn those who try it that way--and get no results--not to throw out the baby with the bath water. They may just be not absorbing it orally. For those, they will need intravenous infusions of at least 2 grams of elemental magnesium/IV about 3 times a week for 2 weeks. This can be injected over a period of about 5 minutes with no risk or negative side effects. By then, they should be able to absorb it orally for maintenance. By then, they will also know if their body-mind laboratory says they needed it (did they get better?)"

I recently came across this post by a UK doctor recommending a nebuliser as a magnesium delivery system.

[drmyhill.co.uk]

In some posts I've read, nebuliers are compared to direct injection. I'm wondering if this might be tried in lieu of injection?

I checked my local Craigslist & found a never used nebuliser for $30 US.

Just a thought.

If you Google magneisum nebuliser, there are a lot of hits.

George

George - I know of a couple people using magnesium in nebulizers for asthma treatment and it seems to be effective... too bad they won't buy into upping their IC level to help avoid the asthma attack in the first place.

The link you provided was useful...as I'm looking for a refillable nebulizer type apparatus for another purpose. Thanks.

I'll check Craig's list.

Jackie

More from Dr. Myhill on mag:

[www.drmyhill.co.uk]

[www.drmyhill.co.uk]

A very important "take-away" from the paper Josiah posted:

"If the maintenance of the electrolyte gradients under electrolyte homeostasis is disturbed - for whatever reasons - then it has serious consequences for the cell:
• their activity and vitality is impaired,
• their action- and resting membrane potential is decreased
• electric instability develops and
• the cellular membrane becomes permeable for ions.
Only within a certain limit and time will this be tolerable for the cell. Whenever the limits of injury are exceeded and the injury is irreversible, cellular death will be imminent. Then necrosis will develop, which later will be repaired by scarred tissue."

MgD => necrosis (heart muscle cell death) => scar tissue (fibrosis) => Afib.

The time worn cliche: 'Afib begets Afib' is incomplete and unfortunately misleading.
It should be: 'Magnesium deficiency begets fibrosis, which begets Afib, which begets further fibrosis and Afib'

See: CR session 24, 'Cardiac Fibrotic Remodeling' [www.afibbers.org]

See also 6 year old forum posts: 'Fibrosis, a-fib, magnesium' [www.afibbers.org]

Hi, Josiah and all -

I wonder if anyone here was ever told by their cardio or EP that a magnesium deficiency had likely caused cardiac fibrosis, consequently a likely cause of their Afib? Certainly I never was in my 10 year struggle, and that's exactly what it was. But Dr. Seelig said so in 1980, and she relied on research by others many years earlier. Josiah's posted article by Armin Schroll is dated 1997. Jackie's summary CR Session 24 on cardiac fibrosis, MgD, and Afib was 2004. Still waiting to be told?- and treated? Good luck...

On Paul Mason's website is Dr. Mildred Seelig's complete 1980 book Magnesium Deficiency in The Pathogenesis of Disease [mgwater.com]. Here is a brief excerpt from Chapter 7, Magnesium Deficiency in The Pathogenesis of Cardiovascular Disease (I capitalized a few relevant words):

7.4. Cardiac Magnesium Loss: Central to Cardiac Dysionism, Disease, and Dysfunction (Fig. 7-7)

As indicated in the sections on the effects of magnesium deficiency on the arteries, early damage to the small coronaries with narrowing of their lumina is characteristic of magnesium deficiency. Such myocardial arterial disease is not what is referred to by "coronary disease," but it certainly contributes to microfocal areas of hypoxia, which can give rise to the MICROFOCAL NECROSES, infiltration, and FIBROSIS that have been described in MAGNESIUM-DEFICIENT animals (Review: Seelig and Haddy, 1976/1980). It is provocative that Lehr (1965b, 1969, 1972) and his co workers (Lehr et al., 1966, 1970/1972, 1976/1980), who proposed that the loss of myocardial magnesium might contribute to the disseminated MYOCARDIAL NECROSIS caused by dissimilar agents (including catecholamines and sodium phosphate loading of corticosteroid-treated or parathyroidectomized rats), had also implicated damage to the microcirculation (Lehr, 1965a, 1966, 1969). If magnesium nutritional deficiency or drug-induced myocardial loss is a basic contributory factor [and it has been shown to predispose also to the dysionism (decreased potassium and increased sodium), as well as to increased accretions of mitochondrial calcium (Lehr, 1969, 1972; Review: Seelig, 1972)], then Lehr was correct in both postulates.

Erling - great contribution and reminder about the importance of magnesium.... too bad this critical information remains neglected in the standard-of-care treatment protocols offered today for all types of heart conditions and for heart health. So inexpensive; so highly effective.

I was never told about the fibrosis connection/ magnesium deficiency from any of the physicians I saw during my AF journey.

This is excellent:
MgD => necrosis (heart muscle cell death) => scar tissue (fibrosis) => Afib

Thank you for keeping this going.

Jackie

First of all, thank you all for distilling the information/translating into English.

Most of those studies are way way over my head. It is extremely helpful that there are people whose emphasis (heart-health and specifically AF) is the same as mine who can understand and glean the necessary info. More importantly, the fact that you are willing to help others understand it is greatly appreciated.

I am wondering, though, if a person was to consider a more aggressive (and probably expensive) approach of magnesium supplementation of either IV or intramuscular injections, what are the pros and cons of each? How often? How long? Will that help bowel tolerance once the IC mag. is increased?

Thanks,
Lisa

George,

Many thanks for the links to Dr. Sarah Myhill! She seems a truly excellent, caring physician with great sense. The articles are nicely written, very informative and instructive. The idea of 'Magnesium by nebuliser' is fascinating, lungs having a surface area about equal to a tennis court?!

She suggests using daily 1 gm magnesium sulphate (~1/3 tsp) dissolved in 1 tsp water, yielding about 100 mg elemental magnesium, inhaled via a nebulizer.

I'm wondering what you might think of this portable nebulizer: [www.medicalproductsdirect.com]. It's single-unit, only 7 oz, battery or AC. The medication cup holds only 5 ml max (1 tsp - too small, perhaps). A bit pricey at $75? Optional rechargeable battery and car adapter for additional cost.

Erling

I'm an old visitor that jumps in just once in a while. It's good to still see Jackie and Erling as active contributors; they've added a lot of info over the years, as have so many others.

But my question on magnesium: Is anyone using magnesium oil in their quest to absorb more? I know an afibber who wants to try that along with Epsom salts (MgS04-7H2O) baths.

I told him I'd try it but no longer have afib after 2004 ablation.

Thanks,
Anton

My Gosh! Hello Anton - Nice to know you are still reading the BB. I've sent you an email regarding your questions. Jackie