Mg supplements increase my BP!

Hey, all. I am finding that I only need a little of the recommended Mg supplementation (roughly 66 mg/da, or 2/3 of a tab) to keep me in sinus rhythm. It is amazing how well it works to keep away my atrial flutter.

But I have an insidious problem now. My blood pressure rises even after a little divided 33 mg Mg dose (always with food). BP goes from my normal 120/75 to 148/88 or even as high as 164/96 once yesterday during my 300mg first day dose. I can eat a banana or drink a glass of OJ for potassium and the BP drops quickly (15 min) to 133/84 or thereabouts, but a half hr later it is creeping up again to the 148/89 level.

Any thoughts on this on how to stabilize my BP through the day? I tried the recommended potassium supplement powder (1/4 tsp with food) and it worked on BP about like the banana (quick drop only to later yield to an upward BP trend after half an hr). So with this insidious increase in BP over the day, and only an ability to temporarily drop it down with potassium, I am hesitant to increase Mg - in fact I am decreasing it just to see how little I need to stay in rhythm. So far even the smallest Mg dose (33 mg) gets the BP rising.

My latest serum K level is 4.1 mEg/L – Erling said I needed that up to 4.5. Am taking a K-sparing diuretic (triamterene/hctz) as water pill to relieve Meniere’s symptoms, and the supplemental K bottle says not to take with a K-sparing diuretic.

I would love to stay on the Mg for my arrythmia, but I may have to go to a BP drug to manage BP so it is not rising/falling so much through the day. If I don’t monitor it every hr or so and do a K fix, it just creeps up and up. I have not read anything on this forum about the Mg supplement increasing BP, but that is definitely what is happening here. I wonder if my 300mg Mg blast the first day (yesterday) is responsible somehow for this pattern? I later read that a slow titration to start was preferred, so I blew that.

I took my first Taurine today, but it does not seem to be helping lower BP.

FYI, my newbie experience thus far with atrial flutter was posted here:
[www.afibbers.org]

Thanks.

Regards,
GH

GH,

You'll expect frustrations like this until your serum potassium is at least 4.5 mEq/L for awhile (up from its present abysmal 3.9). Serum K level is reflected in the intracellular K level, the most abundant intracellular cation electrolyte.

Again, having dietary K at least 4 times that of dietary Na normalizes the vast majority of high BP cases. This results from an even higher intracellular ratio needed for myriad cellular functions. Normal intracellular K : Na ratio range is 19 4 to 38.9

Biophysicist Burton Silver, PhD:

"Active transport of K and Na produces major energy processes, normal cell volume, and is vital to ion transport, as well as producing the membrane potentials for all secretory functions, neurotransmission, and neuromuscular activity. Serum potassium levels are not good indicators of tissue levels. This ratio is vital to establishment of homeostasis for normal function of intracellular biochemical events." [www.afibbers.org]

Erling



Edited 1 time(s). Last edit at 04/20/2012 02:56PM by Erling.

Erling Wrote:
-------------------------------------------------------
> GH,
>
> You'll expect frustrations like this until your
> serum potassium is at least 4.5 mEq/L for awhile
> (up from its present abysmal 3.9). Serum K level
> is reflected in the intracellular K level, the
> most abundant intracellular cation electrolyte.
>
> Again, having dietary K at least 4 times that of
> dietary Na normalizes the vast majority of high BP
> cases. This results from an even higher
> intracellular ratio needed for myriad cellular
> functions. Normal intracellular K : Na
> ratio range is 19 4 to 38.9
> [www.afibbers.org]
> 7193#msg-107193
>
> Erling

Ah, good perspective, thanks.

FYI, my last test K was 4.1 mEq/L after having been at 3.9 for 2-3 yrs before that (I recalled that incorrectly in my original post). Same conclusion though, too low.

My sodium intake is quite low (for Meniere's symptoms), so I am pretty certain my K intake exceeds it by more than 4:1. This is confirmed by the nutrition analysis in my recipe software applied to meals I eat.

Getting my serum level over the latest 4.1 mEq/L up to 4.5 mEq/L is going to take a lot of work I think. Is using the K supplement powders rigorously each day the correct way to accomplish this? How long might one expect this to take? I guess I could use a BP drug (not another diuretic though) until I can accomplish this, eh?

GH,

The way in which triamterene "spares" potassium to compensate for its loss by hctz in the renal tubules is complicated to understand, and it seems possible the compensation is only partial. You mentioned serum K having been 4.5 in the past -- is there any correlation between its drop to 3.9 and the use of triamterene hctz? In any case, it would seem a good idea to supplement with potassium gluconate powder. The U.S. Institute of Medicine set the AI (Adequate Intake) of potassium for normal healthy adults at 4,700 mg per day -- please understand "adequate" does not mean "maximum". See The Linus Pauling Institute for full details [lpi.oregonstate.edu]

An ACE or ARB would certainly be a better BP drug, but apparently you'd still need a diuretic for the Meniers. I'll not be at all surprised to see the Meniers resolved when you get all body cells' electrolytes, nutrients, and pH in order.

Erling.

Thanks Erling. Yes, both me and my neurotologist think that I still shed potassium even with the K-sparing diuretic, and I have been on that diuretic for about 9 yrs now with Meniere's. He always says "sodium oh-no" for me, but "potassium oh-yes". Perhaps it is not surprising that I am finding Mg and K deficiencies now after 9 yrs on the diuretic, but of course, it may also be due to just getting old (I am 60 now).

You asked if there is correlation between the time period where my K dropped from 4.5 to 3.9 --I checked and yes, definitely, it went from 4.5 to 4.3 the first yr on the diuretic, and to 4.0 5 yrs later, to stabilize at 3.9 after 9 yrs on the diuretic. Went up to 4.1 last yr probably because I discoverd and started using No Salt (all K no Na) more heavily on food.

I read your journey story and was intrigued by the similarities, albeit my story is very short having just started the flutters in Jan 2012.

I started the Benazepril and it seems to work great for now for BP control. I can now Mg supplement without fear of BP rise. Mg supplementation has definitley stopped my atrial flutter for now - none at all for last 2.5 days that I have been supplementing, after having flutters 3-6 hrs/day. I am still supplementing K and Taurine, among the others I was already taking. The info you offer makes me hopeful that someday when my intracellular K level improves, I might even get off the Benazepril.

Can you explain why an ACE or ARB would be a better BP drug?

Thanks much, all.

Later: Oh, I see now that you were saying ACE or ARB would be better than the diuretic (not the Benazepril).



Edited 3 time(s). Last edit at 04/21/2012 03:35PM by gehauser.

GH,

Good for you -- Benazepril is an ACE inhibitor. It will be helpful to understand the "mechanism of action" of an ACE inhibitor (angiotensin converting enzyme inhibitor) and ARBs (angiotensin receptor blockers). Their effects are much the same in that they reduce the activity of aldosterone in the renin-angiotensin-aldosterone-system (RAAS). The potential involvement of aldosterone in atrial arrhythmia is discussed in CR Session 2 [www.afibbers.org]

ACEs / ARBs are not diuretic per se but will lower blood / body fluid volume indirectly along with lowering BP by reducing aldosterone.

See ACE inhibitor [en.wikipedia.org]

under Effects:

"ACE inhibitors block the conversion of angiotensin I to angiotensin II.[3] They, therefore, lower arteriolar resistance and increase venous capacity; increase cardiac output, cardiac index, stroke work, and volume; lower renovascular resistance; and lead to increased natriuresis (excretion of sodium in the urine).

See also:
Atrial Fibrillation and ACE Inhibitors [www.afibbers.org]
Aldosterone: Villain of the Peace? [www.afibbers.org]

Erling.



Edited 4 time(s). Last edit at 04/21/2012 05:06PM by Erling.