Low serum Magnesium associated with increased occurance of AFIB

Here is a new study showing what will not be surprising to most of us ... significant correlation with low serum Magnesium and AFIB.

Shannon

Low Serum Magnesium and increased likelihood of AFIB

The wheels of medical progress sure grinds slowly. The connection between magnesium deficiency and atrial fibrillation was well known and briefly discussed in the very first issue of The AFIB Report published in January 2001.

A study done in 2008 found that lone afibbers tended to be deficient in intracellular magnesium, but found no correlation between intracellular magnesium and serum magnesium levels [www.afibbers.com].

Hans



Edited 1 time(s). Last edit at 11/24/2012 12:19AM by Hans Larsen.

I recently engaged a concierge cardiologist to support me in playing with propantheline bromide as a vagolytic med. I gave him my supplement protocol (heavy on the mag) and he commented that when he was a fellow, they did a study with injected mag. and afib. The results were promising, but because the sample size wasn't large enough, there wasn't enough statistical power.

George

HI Hans and George .. yes indeed Hans, these studies are almost quaint at this point :-) ... and think of all the Docs and EPs who have been convinced there is little to nothing to Magnesium and AFIB simply because that is what they were told in residency!?

And George, my Hawaii EP, who is quite good, also was involved while an EP resident in a magnesium infusion study ..who knows, maybe the same one with your EP cardio?? And they too found it was promising but he said they were side tracked because it was so hard to get sustained serum Mag improvements even with IV mag and so they felt it would be up to Big Pharma to make a more sustained release and more consistently assimilable magnesium form available before they could really get anywhere with such studies. Alas, he also recognized the catch-22 sicne there is so littel monetary incentive for Big Pharma to invest in none patentable molecule like Magnesium .. even if they could patent the sustained release delivery method.. it would still be nothing like the return on a fully patentable drug. As such, its littler surprise nothing really has been done on that front by Big Pharma. That was back in the late 1980s.

Shannon

Shannon,

When I was in the hospital at Ohio State, following my five box procedure, my magnesium and potassium levels were checked twice daily. I was given IV Mag Sulfate at least twice (may have been more than that, due to general anesthesia my memory is foggy for the first couple of days.) One of the nurses commented that Mag IVs were SOP and very common post op.

So some members of the medical community do get the message.

EB

Shannon,

He also commented that mag was the only way they found to reduce potassium wasting. Jackie has made that point, too.

George

Here's more on magnesium infusions to stop afib:

The researchers conclude that magnesium infusions are safe and effective in achieving both rate and rhythm control in patients presenting with rapid atrial fibrillation.
Onalan, O, et al. Meta-analysis of magnesium therapy for the acute management of rapid atrial fibrillation. American Journal of Cardiology, Vol. 99, June 15, 2007, pp. 1726-32

[www.afibbers.org]

Hans

On my initial ER visit for AF: they took me right in after telling them my symptoms. They hooked me up and confirmed AF, took vitals, put an IV line in, and took blood. It came back that my serum magnesium was low. They gave me an infusion of magnesium, and it converted me within a short time.

The good news is that not all doctors (and by extension, ERs) are unaware of this.

I guess the next step is convincing the docs to give us magnesium injections or infusions on demand!

lisa
__________________________

So much of medicine is looking solely down the wrong end of the gun barrel, and that is really a pity for all of us---Shannon

Actually, the association goes back much farther than that.

Erling always reminds us that all this info is in Mildred Seelig's book, Magnesium Deficiency in the Pathogenesis of Disease, published in 1980 where she documents much earlier studies making this association. Through his discovery of this book long ago, he was able to cure his afib. Fortunately and thanks to Paul Mason's website www.mgwater.com, Dr. Seelig's entire book is available online. So unfortunate that the medical community has been so slow in recognizing the basic, fundamentals.

Here's a clip... every afibber should be reading this.

Jackie


Part II, Chapter 10
Therapeutic Use of Magnesium in Cardiovascular Disease

With such strong evidence that magnesium deficiency-or other factors that cause subnormal magnesium levels-can lead to functional and morphologic cardiovascular abnormalities, it is surprising that there has been so little clinical application of these findings. It is to be hoped that the detailed case reports published by Chadda et al. (1973b) and Iseri et al. (1975), in which they described rapid correction by magnesium of arrhythmias that had been refractory to the widely accepted therapeutic modalities, will stimulate others to consider magnesium treatment and evaluation of the magnesium status of patients with cardiac, and especially life- threatening arrhythmias. It must be cautioned that severe hypomagnesemia is not a necessary finding. For example, Chadda et al. (1973b, 1976/1980) found only slightly subnormal serum magnesium levels, but histories of diuretic intake and myocardial infarctions (which cause magnesium loss) in patients with a high incidence of ventricular ectopia. Iseri et al. (1975) reviewed the clinical states and drugs associated with magnesium deficiency and loss, and pointed out that magnesium deficiency can clearly exist without hypomagnesemia. They cited a reference (Loeb et al., 1968) that demonstrated that hypomagnesemia can predispose to arrhythmia (which eventually responded to standard therapy without magnesium repletion). Noting the rapid response to magnesium of hypomagnesemic arrhythmias reported by others (Scheinman et al., 1969; Rosefsky, 1972; Chadda et al., 1973a) they instituted magnesium therapy in refractory arrhythmic patients after taking a blood specimen for pretreatment magnesium values, and affirmed the rapidity with which the arrhythmias were corrected.
Unfortunately, magnesium determinations are rarely part of the routine electrolyte evaluation of patients with arrhythmia. Even when detected, its correction may be delayed until failure of classic approaches; addition of magnesium results in rapid amelioration of rhythmic disturbances (R. Singh et al., 1975). Among those who have diagnosed hypomagnesemia, electrocardiographic evaluation is reported only occasionally. Thus, there are no firm data at present as to the frequency with which both abnormalities coexist. In a pilot study, Chadda et al. (1977) found that 10 among 12 patients with hypomagnesemia (7 secondary to alcoholism, 2 secondary to malabsorption and intestinal fistulae, 2 as a result of postsurgery hyperalimentation, and 1 in chronic renal failure), 10 had cardiac arrhythmias. Seven had ventricular tachycardia, fibrillation or more than 6 premature beats (VPBs) per minute, or atrial arrhythmia with hypotension. All of the patients with VPBs had a prolonged QT interval. Two patients had electrical alternans. The serious arrhythmias of 4 of the patients had been unresponsive to any treatment other than magnesium. All of the arrhythmic patients improved when magnesium was given.

When one considers the unreliability of serum magnesium as an index of the cellular magnesium status, the difficulty of correlating (occult) magnesium deficiency with ECG abnormalities or predisposing cardiomyopathies can be readily appreciated.

In this section, attention is given to the dramatic responses of arrhythmias to magnesium therapy and to the conditions in which such responses have been described. Consideration is also given to the nature of the magnesium therapy, and to the differences in results obtained when it is used simply as a pharmacologic agent, and when it is given as sustained therapy (in which event one may presume that an underlying deficit may be repaired). It is possible that prophylactic long-term use of magnesium supplements, possibly from the beginning of life, might be preventative of the cardiomyopathies and arterial lesions that predispose to arrhythmias (supra vide), as well as of some skeletal and renal disorders (infra vide).

10.1. Magnesium in the Treatment of Arrhythmias
Continue
[www.mgwater.com]

Yes EB,
Some docs do get it and I've noticed that a lot of the younger ER docs are quick to add a bag of IV mag sulfate when I went in for all those cardioversions. In fact I never had an ER doc deny it when I requested it so they clearly understand now that it may well help the situation and certainly wont hurt.

I think the big problem with wider exploration as a more consistent treatment tool in their AFIB tool box is two fold.

1. Firstly their dependence on serum mag testing to determine whether or not it is working is so often misleading. It is very common for people to be well within the 'normal' serum magnesium range and still have significant heart destabilizing Intracellular deficiency of magnesium. AS such, when researchers and docs restore someone to what they deem sufficient 'normal' serum mag repletion .. say around 2.2 to 2.4 for example and the person still of pounding away in fast AFIB, they conclude it doesn't work reliably at all.

Its not surprising then that this study found magnesium's most consistent benefit with frankly low serum mag levels in which everyone who is that low would be seriously IC mag deficient. But the apparent mixed message they get from higher normal ranges of magnesium belie how much more magnesium is often required .. particularly in magnesium wasters which my guess is endemic in Afibbers in general ... and thus hanging a couple backs of 1 to 2grams of IV magnesium is not going to do the trick even though the persons serum mag may look fine to these docs.. Its a lack of deeper understanding of the biochemistry and physiology of magnesium that has led a lot of docs astray.

2. Secondly, and no doubt more fundamentally, there is very little incentive to study magnesium in this light with the kind of rigor and thoroughness it deserves. As a non-patentable natural chemical, magnesium research is not going to bring in copious amounts of money for Big Pharma and, as such, there will be at least disinterested neglect, if not downright active avoidance, in really trying to show the potential of these vital ions in cardiac health when doing so could well undermine to one degree or another some of their favorite cash cow drugs.

Magnesium is not a panacea, but its the first place to start in helping to manage this beast.

Shannon



Edited 2 time(s). Last edit at 11/30/2012 05:50AM by Shannon.

Shannon,

I agree that it is not a panacea- I don't know what my serum levels were post-op at Ohio State; just as side info, I was not in afib when I was receiving my post-op Mag Sulfate IVs. This may be a standard protocol following the Five Box.

But the problem is this- here is a quote from a post by Namor on November 3, 2012:

"It seems that many people on this forum are under an impression that electrolyte and amino-acid deficiencies are the primary causes behind lone AF. I do not agree with this hypothesis. While magnesium and potassium deficiencies are common in North American population, effecting close to 50% of the population by some estimates, they can not explain why only 0.1% under the age of 55 have AF. Even if that 0.1% are highly deficient in electrolytes, what about the other 49.9% of people with deficiencies that do not have AF?"

So there are plenty of Mag deficient people walking around afib free- how come we weren't so lucky?

EB

Yep, I think afib is a symptom of at least several disorders, whether they be alone or in concert. My afib progressed rapidly toward persistent while my intake of potassium and magnesium were optimized.

Tom

Hi EB,
I think its closer to the mark to view magnesium and potassium deficiency as a significant contributing factor toward the likelihood and ability of already predisposed cardiac myocytes to trigger into AFIB when they are fundamentally predisposed to doing so t through some individually variable combination of potential sources either genetic, acquired biochemical in nature, through tissue damage and/or some other possible scenarios that are more primary than electrolyte deficiency itself.

The tendency toward magnesium deficiency and possible magnesium and/or potassium wasting as a precipating cause in many, but certainly not for all afibbers, is I feel, further up the chain from what I would label the ultimate metabolic cause. This is a complex condition and nothing so simple as a one size fits all prescription and answer is likely to work for everyone ... at least not at the level of our understanding as it is now.

However, I do feel that anyone with a diagnosed or even likely magnesium deficiency based on the constellation of symptoms commonly associated with too low IC mag, should make every effort to insure they try to replete and keep at a decent level their own IC magnesium in whatever ways that may work for them and verified by competent testing as well as symptom relief. But I don't think it is true, nor do I demand, that taking magnesium will cure everyone's AFIB. It is just smart physiology to replace such a vital mineral which is known to be too low is so many Americans and indeed most every culture in the world.

And I do understand the inspiration felt by those that have had what seems to be very complete success and perhaps causing them to get a little carried away in proclaiming it a universal 'cure' for AFIB .. those that may do so ... however much I disagree with such a sweeping all-inclusive proclamation. And I'm happy as a clam for those that have found it to work so well and that is why I wholeheartedly support and recommend nearly everyone to first give it the good 'ole college effort to confirm or not if it will help significantly in each person's case.

I also caution that no one should get too disappointed if it is only partially, or even less, successful than you had hoped or imagined. Nothing was wasted and it is highly likely that a number other benefits will accrue, even if killing off this pesky AFIB isn't one of those benefits in every person's case.

A more balanced approach that life experience teaches us is, in my view, the most useful and accurate accessment rahter than grand claims of a sure fired 'cure'.

Shannon



Edited 1 time(s). Last edit at 11/25/2012 01:47AM by Shannon.

Shannon,

Totally agree- for any afibber it is worth a shot and if you are one of the lucky few, "good on ya" as they say down under.

EB

That;s my approach EB,

To encourage everyone before deciding on ablation to pay very close and dedicated attention to applying 'The Strategy' for a minimum of 6 months to a year religiously. That is, if their episodes are not too frequent and too disrupting and they don't have such a many years long history of severe AFIB that delaying too long might be counter productive.

But if it isn't working well enough after giving it a genuinely 'heroic' effort and too frequent and disrupting AFIB still occurs, then by all means get thee to the best ablationist possible, whether catheter or surgical.

On the other hand, if the person just takes some oral magnesium for some months and decides without much deeper investigation that it just isn't working, they may well be short-changing themselves as well.

I should add a third variable to the two I listed above for why Magnesium/potassium repletion has not gottent the attention it deserves in the medical community at large .. though as EB and others here including myself have noted that the situation is improving especially with younger EPs, Cardios and ER docs. That third variable that too often gives people an incomplete impression of magnesiums possible utility in thier case is that they do not thoroughly investigate if they are properly digesting and assimilation their oral magnesium intake.

Oral magnesium is notoriously difficult to absorb as it is, and if there are any disgestive issues at all which also increase exponetially in people over 50 to 55 years old, then it is highly likely simply taking your 600mg to 900mg a day of magnesium is not going to come close to cutting it and it will be all too easy to dismiss it as a failure when it still might be a big success for you if you take the time and patience to really confirm how much intracellular magnesium you really are getting from your oral supplementation routine plus diet.

Since so many Afibbers are likely magnesium wasters as well in which whatever magnesium you take .. even by IV as I discovered ... just fly's right out of the system it is all the more reason to work hard at this to not leave any stone un-turned in your investigation and trial and adjustment process before coming to the conclusion that this approach is simply not going to cut it for you .. as it didn't for me even though it has helped, and in other ways beyond AFIB as well.

I realize too there are those whose disposition or temperament with regard to supplements makes them not such a good candidate for following through with such a disciplined protocol and for them its no doubt better to go ahead sooner rather than later as well to get into NSR as soon as possible.

That being said, however, for everyone there should also be a realistic time limit placed on going the mineral repletion investigation route alone. Sticking with an inadequate strategy that is not working as well as it should while you are still experiencing enough episodes to continue, through on-going remodeling, to slowly accelerate this progressive condition is penny wise but pound foolish in my view.

Shannon



Edited 1 time(s). Last edit at 11/30/2012 05:51AM by Shannon.

Shannon,
In my case, magnesium supplements actually would trigger afib...many trials to establish that fact. I went the dietary route and ate foods rich in both magnesium and potassium (a 4:1 + K to na ratio as a matter-of-fact) which I still follow religiously - even after my recent ablation if I don't take in enough potassium my heart becomes less stable and my BP becomes too high-.

My journey to persistent afib was in spite of my very disciplined 2 year effort of magnesium and potassium intake - the latter supported by cardymeter readings.

You should see an EKG of my heart when I take magnesium supplements - very very disruptive to normal rhythm - so I can only wonder if I am unique or some of those taking such supplements may be doing as much harm as good with regard to afib onsets. When I was in persistent afib the mag supplements (an experiment) would accentuate the errant P waves and flatten the QRS and T waves...very scary. I sent a copy to my cardiologist for her info - I have no problem with dietary magnesium - likely due to a more even distribution into bloodstream over time.

BTW the above mag supplements were varied as to molecular makeup and brand...it didn't make any difference.

There is no argument that having sufficient magnesium and potassium is key to a healthy heart, but I doubt that is the over-riding issue with regard the initial onset of afib for many, perhaps most of us.

Tom

Hi TomB

Your experience highlights a good solid effort to find out, and yours apparently is an unusual case where magnesium, at least in the forms you have been taking is excititory rather than calming. In my case, magnesium and potassium alone were not enough without isolating my LAA. Everyone needs to give it a consistent effort and in the process will learn a lot about their own needs and nutrient assimilation.

Shannon

Good discussion on the magnesium/potassium influence, but of course, those are just a couple elements in the ultimate shortfall that causes the electrical conduction disruption and that has to do with the heart energy/voltage requirement that keeps hearts in NSR. A major finding is the link between Mg deficiency and formation of cardiac fibrosis which then disrupts the normal electrical pathway.

As previously discussed prolifically with references to the science which is the basis for The Body Electric and Healing is Voltage, ultimately, optimal voltage determines whether we can achieve and maintain NSR or not. It would be difficult to target which specifically since so many influences cause an acidic body which = low pH = low voltage = inability to make new cells, but fundamentally, we know that some of the core heart support nutrients have enabled many people to reverse their Afib. As author of Healing is Voltage (Jerry Tennant, MD) observes:

When your voltage is low and you can’t get up to -50 mV, then you are stuck in chronic disease… because the only way you can get well is to make the cells to replace those that are destroyed by various forms of injury. If you can’t make new cells (which you can’t if you can’t get to -50 mV), then whatever part or organ that is damaged will never work right.

Of course, then, let’s not forget about the influence of gene expression. A deficiency in Mg or K or many other key nutrients allows the gene flaw to express negatively in those with a broken gene whereas, in another individual, the epigenetic influence does not cause arrhythmia but may cause another ailment that may or may not have immediate, noticeable symptoms. With Afib, we are ‘lucky’ in a sense to be alerted early on since often while we work to stabilize heart rhythm, we correct other defects along the way and we become more healthy overall as a result of our heroics.

When individuals have adverse reactions to supplements, often they have the complication of impaired detoxification pathways (liver) which need to be addressed whether or not they intend to use nutritional supplements or for what purpose. Additionally, it's often found they are sensitive to the materials used for the capsules, themselves and sometimes, the fillers and additives used in supplements not produced specifically for those with detoxing impairment.

Jackie

Jackie you raise an interesting question in regards to the capsules, fillers and additives in the supplements. I went down the path of trying to ensure nothing in these supplements is affecting me, and it was difficult to ascertain.

I took my supplement list to the local health food store and cornered a knowledgable person to help out. I also had my doctor review the contents of the supplements.

In my case, the foods I am sensitive to seem to be increasing. The offending foods I have eliminated seem to be doing push ups while I am away from them, and when they creep, or sneak back into my diet the reaction is strong.

I fear my gut has not healed like it should be, and I have to admit that I continued to drink red wine and coffee through the past year of supplements and changing diet.

I've made a decision to take my health back, and eliminate the red wine for at least 6 months. Maybe, just maybe if I strictly clear up my intake of offending items my gut will heal.

I am getting very weary of the beast.

Yes, you can blame this food, that food, capsules and fillers (was ruled out in my case) and it all adds up to the same...the afib is progressing. For most of us it progresses to a point that, as I told my EP, "drinking purified water will surely someday set it off...ablate me".

Tom

Hans Larsen Wrote:
-------------------------------------------------------
> Here's more on magnesium infusions to stop afib:
>
> The researchers conclude that magnesium
> infusions are safe and effective in achieving both
> rate and rhythm control in patients presenting
> with rapid atrial fibrillation.
> Onalan, O, et al. Meta-analysis of magnesium
> therapy for the acute management of rapid atrial
> fibrillation. American Journal of Cardiology, Vol.
> 99, June 15, 2007, pp. 1726-32
>
> [www.afibbers.org]
>
> Hans

There is no doubt in my mind from hearsay and from observation that Magnesium AND Potassium are critical to the effective prevention and treatment of aFib. While being started on TIKOSYN, guy in next bed was given IV Magnesium, took his FIRST Tikosyn pill and converted to NSR. The finished the induction of TIKOSYN but to this day I believe it was the Magnesium and not the TIKOSYN that converted him to NSR.

There is also a fellow in here who's mom went in for TIKOSYN uptake and was given magnesium IV... and converted before they gave her the first TIKOSYN capsule.

Magnesium is indeed a critical part of the formula but so is Potassium/Sodium. Take in too much salt or allow your Potassium to drop and you are going to have electrical problems for sure. I take two beer cups of Low Sodium V8 or the equivilant in Potassium Gluconate powder in Seltzer water (no salt) daily. Works like a charm. Gives me about 3g of Potassium intake. I also take in 400-500 mg. of Magnesium Glycinate daily and should probably be taking in more but that's my bowel tolerance.

Murray L

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Tikosyn uptake Dec 2011 500ug b.i.d. NSR since!
Herein lies opinion, not professional advice, which all are well advised to seek.