Showing posts with label supplements. Show all posts
Showing posts with label supplements. Show all posts

Magnesium supplement side effects

   ›      ›      ›   Magnesium supplement side effects
Magnesium (Mg) supplements rarely cause side effects in healthy individuals as excess Mg is removed and excreted by the kidneys.
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Magnesium is available in multivitamin-mineral supplements. Magnesium is also available in dietary supplements and magnesium fortified foods. Compounds of magnesium as aspartate, citrate, lactate, and chloride are readily absorbed. Mg is also present in certain laxatives and antacids, which may cause mild side effects.

Magnesium is naturally available in plant food such as leafy green vegetables, seeds, nuts, and whole cereal products. Eating balanced diet rich with fruits and vegetables can contribute much to the daily requirement of the mineral. However, dietary surveys in the United States consistently show that a majority of Americans of all ages ingest less magnesium than their daily demand. The situation is due excessive emphasis on calcium supplementation as well as erratic eating habits, nutrient-depleted diet and skewed nutrient ratios.

Considering the possible harmful outcome of megadose of magnesium, the Food and Nutrition Board (FNB) at the Institute of Medicine of the National Academies (USA) has established the upper limit for magnesium in dietary supplements. Please note that this daily upper limit pertains only to supplements. There is no limitation for magnesium sourced from natural foods. The upper limits are: children 1–3 years - 65 mg; children 4–8 years - 110 mg; children 9–18 years - 350 mg; and adults - 350 mg.

Side effects of magnesium supplements

  • The common supplements of Mg are compounds containing aspartate, taurate, carbonate, oxide, hydroxide, citrate, lactate, glycinate and chloride of Mg, which are generally well tolerated.
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  • In very rare cases Mg tablets and liquids can cause severe allergic reactions. Persons developing symptoms like angioedema, itching, difficulty in breathing, swelling of the mouth and throat or tightness in the chest must seek medical aid immediately.
  • In some people these supplements may cause abdominal pain, upset stomach, bloating, nausea, vomiting, cramps, loose stools and diarrhea.
  • In a patient suffering from diarrhea, taking Mg pills can worsen or prolong diarrhea.
  • Patients with bleeding disorders should consult their health provider, as magnesium supplements may slow down blood clotting and increase the risk of side effects like bleeding and hemorrhage.
  • Healthy functioning of kidney is essential for removing metabolic wastes as well as removing excess minerals and salts from the body. In persons with impaired renal function, Magnesium tablets can cause several side effects.
  • Mg tablets, liquids and intravenous injection have been found to have side effects and interactions and are contraindicated in patients taking certain medications.
  • Seek medical advice when you are taking calcium supplements. The calcium to magnesium ratio is very important for proper absorption and utilization of the minerals. The side effects of excess magnesium is calcium depletion.
  • Mg pills can increase, decrease or block the efficacy of certain medications such as diuretics, heart medicines, diabetic medicines and antibiotics.
  • Mg pills can interact With certain medications and create harmful health conditions.
  • Weng YM et al reported a case of prolonged hypotension and hypoxic encephalopathy caused by rebound hypermagnesemia. The magnesium oxide tablets taken by the patient for constipation were retained in the gastrointestinal tract without evacuation leading side effects like continued absorption and hypermagnesemia.
  • Patients with gastrointestinal diseases, hypothyroidism, hyperparathyroidism, heart diseases, diabetes, pregnant women under preeclampsia treatment or renal diseases should take medical opinion before taking magnesium supplements, as in some cases the diseases may worsen with several side effects.
Some of the severe side effects when megadoses of magnesium supplements, antacids or laxatives are taken, especially when there is renal impairment or severe bowel impaction are given below:
  • Lethargy,
  • nausea,
  • hypotension,
  • hyporeflexia,
  • hypoventilation,
  • vasodilatation,
  • arrhythmia,
  • hypoxic encephalopathy,
  • bradycardia,
  • asystole and
  • cardiac arrest.
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References:
1.http://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional
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Current topic in nutritional deficiency diseases: Magnesium supplements side effects.
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Calcium and magnesium - Relationship - Supplements - Benefits

Mar 2014   › › › Calcium magnesium relationship, supplements and benefits
Calcium (Ca) and magnesium (Mg) have a complex relationship, being antagonistic as well as complementing each other.
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Magnesium and calcium are two sides of the physiological processes, required at appropriate ratios for getting optimal benefits from diet and supplements. Above 90% of the body's calcium is present in bones and teeth whereas 60% of Magnesium is present in bones.

is the root cause of most of the ailments and diseases. The health of the bones and kidneys as well as the functions of neuromusculoskeletal and cardiovascular systems depend on the Ca and Mg status of an individual. Many biochemical reactions in the body as well as enzymes are magnesium-dependent or calcium-dependent.

Relationship between calcium and magnesium

The relationship between Ca and Mg is not yet fully understood. Bones function as reservoirs of Ca and Mg. Severe Mg deficiency has been found to induce low calcium levels in the blood. Severe is also found to cause hypoparathyroidism, which in turn induces hypocalcemia. The decrease in blood levels of either Mg or Ca increases the parathyroid hormone (PTH) secretion.

Both the minerals have active role in the regulation of muscle contraction and relaxation including cardiac muscle.
    • Ca helps in the contraction of muscles, while Mg relaxes them. Deficiency of either Ca or Mg is found to cause insomnia and interrupted sleep. The normal ratio of Ca to Mg in the blood is approximately 2:1. The suggested proportion for calcium magnesium supplement for optimal benefits is 2 parts Ca with 1 part Mg. A higher Ca to Mg ratio can cause Mg inefficiency or deficiency.

    Being divalent cations, calcium and compete for the same active transport system for absorption into the body. Mg deficiency can lead to increase in intracellular Ca concentrations and calcification of otherwise normal soft tissues. It is also observed that phosphate depletion in the body increases the excretion of Ca and Mg in the urine.

    Calcium and magnesium absorption

    The in the gastrointestinal system is by two mechanisms.
    • Active transcellular process occurs in the duodenum and upper jejunum. As the chyme passage through the duodenum is only for a minute or so, active transport contributes only for a fraction of the absorbed mineral. However when the intestinal Calcium concentration is low, the active transport becomes the predominant process.

    The transcellular process is mediated by cytosolic calcium-binding protein (Calbindin-D9k) which in turn is mediated by caATPase.
    • The functioning of caATPase and the synthesis of Calbindin-D9k is vitamin D-dependent. The second process is a passive paracellular process. It takes place throughout the intestine, driven by chemical, osmotic and electrical gradients and solvent drag. When the intestinal Ca concentration is high, greater proportions of calcium in diet and supplement are absorbed by the passive process.

    Magnesium in diet or supplement is mostly absorbed by the small intestine. Most of the Mg is absorbed by a passive paracellular process, driven by chemical, osmotic and electrical gradients and solvent drag. There is also a active transcellular transport mechanism taking place in the distal end of intestine and colon. When intestinal Mg concentration is low, active transport is dominant. Mg supplement absorption is dependent mainly on Mg status and not on the amount of the mineral intake.

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    Reference:
    Dietary Supplement Fact Sheet. National Institutes of Health.
    http://ods.od.nih.gov/factsheets/Magnecium-HealthProfessional/

    Current topic on nutrition, deficiency diseases:
    Calcium magnesium relationship - Calcium magnesium supplements and benefits.
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    Calcium supplement side effects

    Mar 2014   › › › Calcium supplement side effects
    Calcium supplements, when taken within the tolerable upper intake levels (UL), are well tolerated and have almost no side effects.
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    In rare cases, taking calcium supplements may cause some minor side effects such as stomach and intestinal irritation, belching, bloating, flatulence and constipation. These minor side effects may be nullified by taking the calcium supplements with food. The absorption of the supplement is directly related to the vitamin D status of an individual. However doses over and above the UL can increase the risk of renal calculus (kidney stone), prostate cancer and cardiovascular disease.

    Dietary calcium supplements

    Calcium supplements are prescribed and used to prevent and treat deficiency. Recommended dietary allowance (RDA) by the Office of Dietary Supplements, National Institutes of Health, United States, for adults ranges from 1000 mg to 1300 mg. It is recommended to spread the doses over the day, ideally every 6 to 8 hours. It is also advised not to take more than 600 mg at a time as with the increase in the intake, the absorption of the mineral decreases.

  • Calcium carbonate side effects
  • Calcium citrate side effects
    • These supplements are marketed in various forms of carbonate, citrate, phosphate, lactate, gluconate, aspartate, malate and fumarate salts of calcium. An important fact to be noted is that the mineral requirements are always expressed in terms of the amount of required elemental form. For example, 1000 mg of carbonate supplement tablet will contain only 40% or 400 mg of the elemental calcium.

    Calcium carbonate
    It is the most common and the least expensive supplement. It better absorbed when taken along with the food. Acidic conditions in the intestine help in better absorption. Some individuals may develop mild side effects like stomach and intestinal discomfort and flatulence when the carbonate form is consumed. Carbonate form contains 40% of the element. Coral calcium is predominantly a carbonate salt and has traces of other minerals. Several brands of antacids also contain the carbonate salt.

    Calcium citrate
    • Citrate supplements are easily absorbed by the intestines and are devoid of side effects. The bioavailability of the citrate is comparable to carbonate supplements. Citrate salt has no effect over the stomach acid. In persons with impaired gastric acid production the citrate compound is the supplement of choice. Citrate form is prefered over carbonate form in patients who have undergone gastric bypass surgery. These citrate salts contribute about 21.1% of the element. However citrate supplements are costlier when compared to carbonates and more of it has to be taken to get same amount of the element.

    Calcium phosphate
    Calcium phosphate supplement is available in the form of dicalcium phosphate and Microcrystalline Hydroxyapatite (MH). Hydroxyapatite is about 40% of the element. It is expensive when compared to carbonate supplements. In some persons mild side effects have been noted.

    Calcium lactate
    Unlike carbonate salt, lactate compound can be absorbed at various PHs and can be taken separately with no side effects. It is used as a supplement as well as an antacid. The available element in the compound is less and it is expensive.

    Calcium gluconate
    This compound is used intravenously to treat hypocalcemia. Side effects include nausea, constipation, upset stomach.

    The tolerable upper intake levels (ULs)

    In order not to have side effects ULS for calcium should never be exceeded. The Tolerable Upper Intake Levels (ULs) established by the Food and Nutrition Board to avoid side effects are:
    ULs for infants
    0-6 months of age is 1,000 mg/day
    6-12 months of age is 1,500 mg/day
    ULs for children
    1-8 years of age is 2,500 mg/day
    9-13 years of age is 3,000 mg/day
    ULs for adolescents
    14-18 years of age is 3,000 mg/day
    ULs for adults
    19-50 years of age is 2,500 mg/day
    above 51 years of age is 2,000 mg/day
    ULs for pregnant or lactating women
    14-18 years of age is 3,000 mg/day
    19-50 years of age is 2,500 mg/day

    Calcium side effects

    The major side effect of excessively high intake of calcium is hypercalcemia. Hypercalcemia, high levels of calcium in the blood, is primarily associated with primary hyperparathyroidism and cancers. Some of the side effects of excessive intake of calcium supplements are:
    Hypercalcemia
    Some of the symptoms and side effects of severe hypercalcemia include, loss of appetite, nausea, vomiting, abdominal pain, indigestion, constipation, excessive thirst, frequent urination, muscle pain, joint pain, weakness, lethargy, formation of kidney stones, high levels of calcium in the urine, prostate cancer, calcification of soft tissues, heart arrhythmia and confusion.
    Hypercalciuria
    Hypercalciuria is a side effect of high intake of supplements. Hypercalciuria is considered to be present when urinary excretion of calcium exceeds 250 mg/day in women or 275-300 mg/day in men. It is the outcome of kidney's inability to reabsorb calcium. The presence of hypercalcemia and the related renal insufficiency leads to hypercalciuria. Hypercalciuria may also occur due to hyperabsorption of calcium in the intestines or enhanced excretion of the mineral.
    Decreased renal efficiency
    Decreased renal efficiency can either be the cause of hypercalcemia or arise as the side effect of hypercalcemia. Excessive blood levels of calcium damages kidney function affecting the renal efficiency. In persons with compromised renal health slightly higher levels of the mineral in the diet can bring about many of the side effects. In aged people there is decrease in renal efficiency and slightly higher levels of calcium may become problematic.
    Metastatic calcification (soft tissue calcification)
    Metastatic calcification is deposition of calcium salts in the normal tissues. The cause is high blood levels of the mineral. Interstitial tissues of the blood vessels, kidneys, lungs, and gastric mucosa may get affected. Nephrocalcinosis, deposition of calcium salts in the renal parenchyma, may occur as a side effect of excess consumption of the supplements. Hypercalciuria and hypercalciuria are the basic causes for nephrocalcinosis.
    Calcification of vascular tissues and cardiovascular risks
    Decrease in the renal function increases the risks of cardiovascular disease. Deposition of the mineral inside the blood vessels leads to side effects like their calcinosis.
    Nephrolithiasis (formation of kidney stones)
    Hypercalciuria is the primary contributing factor for the formation of kidney stones. Various dietary and non-dietary factors are involved in the formation of kidney stones. About 80% of the kidney stones involve calcium.
    Burnett's syndrome (milk-alkali syndrome)
    is characterized by hypercalcemia. Milk-alkali syndrome is caused in persons taking excessive amounts of milk and antacids in order to control dyspepsia (indigestion). High alkaline condition along with the side effects of excessive calcium inhibits parathyroid hormone secretion by the parathyroid gland leading to high blood levels. Milk-alkali syndrome when not properly treated can lead to deposition of the mineral salts in otherwise normal tissue and renal failure.

    Calcium and nutrient interactions

    Absorption of iron in the intestines is affected in the presence of calcium. The interaction can be minimized by taking the supplement a few hours after the food. When anemia is being treated, milk, yogurt and antacids should not be taken at the same time as iron as they will interfere with iron absorption.

    Calcium and zinc compete in their absorption by the body. Calcium at higher doses affects the absorption zinc whereas zinc at high doses affects absorption of the other mineral. It is advisable to take these supplements at different times to avoid the side effects.

    Calcium supplements interactions with medications

    Dietary supplements are known to interact with several types of medications. Individuals under any type of medication may take the advice of their health provider before starting on any supplement, as there is always a possibility of interaction or side effect.
    • Calcium supplements can give side effects and decrease the absorption of antibiotics like fluoroquinolone, ciprofloxacin, norfloxacin and tetracyclines. At least one hour gap may be given between the antibiotic and the supplement.
    • The absorption of bisphosphonates given for the treatment of osteoporosis is decreased. The absorption of phenytoin (antiepileptic drug) and levothyroxine (hormone) is affected.
    • Thiazide-type diuretics can increase the risk of side effects when taken along with the supplements.
    • Antacids containing aluminum or magnesium increase the urinary excretion of the element.
    • Laxatives decrease the absorption of the mineral.
    • Prolonged use of glucocorticoids has serious side effects and can deplete the mineral in the body.
    • Estrogen pills apart from their side effects can increase the blood levels of the mineral in the body.
    • Intravenous ceftriaxone and calcium can give rise life-threatening side effects and there should be at least 48 hours gap in administration.
    Pyruvic acid helps in the conversion of sugar and starches into energy. Pyruvic acid is a naturally occurring chemical in the body. Pyruvic acid is found to increase the fat metabolism. To increase metabolic rates and burn more fat, calcium pyruvate supplement is taken, which is a combination of pyruvic acid and with the element. Up to one gram of pyruvic acid per meal per day is recommended for a week. During the treatment, if is consumed or supplements are also taken, there is a likelihood of exceeding the safe upper limits causing several side effects.
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    Reference:
    Dietary Supplement Fact Sheet. National Institutes of Health.
    http://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/

    Current topic on nutrition, deficiency diseases:
    calcium supplements and side effects.
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    Fatty acid - DHA supplements

    Mar 2014   › › DHA supplements
    Docosahexaenoic acid (DHA) is vital for overall health and recent research studies have indicated an array of health benefits in taking DHA supplements.
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    Many chronic disease conditions in the human body are brought about by the excessive immune responses and inflammatory processes. DHA supplements have been found to reduce these inflammatory processes. Considering these benefits, it is being recommended to include fatty fish at least twice a week in the diet.

    Though DHA can be synthesized from alpha-linolenic acid (ALA) by the body, the capacity for conversion has been found to be very low.
    Hence it becomes necessary for us to consume DHA food sources like fatty fish or take DHA supplements to protect ourselves from
    fatty acid deficiency diseases.

    Graham C. Burdge et all in their study on ALA metabolism have concluded that the capacity of adult males to convert ALA to DHA was either very low or absent. Hence the uptake of pre-formed DHA in diet as fatty fish or as supplements is critical for maintaining adequate membrane DHA concentrations.

    Pregnant women, nursing women, infants and children are the highly vulnerable group for developing DHA deficiency as their DHA requirements are high. People taking vegetarian food and vegans also are vulnerable group for developing the deficiency. Some of the supplements are discussed here.

    Fish oil fatty acid supplements

    Fish lipids include up to 40 percent of polyunsaturated long-chain fatty acids. Fish oil from cold water oceanic fatty fish is rich in omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Fatty fish from cold waters have more omega-3 fatty acids in their body.

    Bigger fish higher on the food chain accumulate toxins and heavy metals. The smaller plankton feeding fish are less contaminated. The FDA released an advisory about eating fish. Woman planning a pregnancy, Pregnant women and breastfeeding women are advised against eating shark, swordfish, king mackerel, or tilefish as they contain high levels of mercury. The FDA recommended eating two meals, or up to 12 ounces a week, canned light tuna, catfish, pollock, salmon and shrimp.

    The amount of DHA fatty acids vary among the brands of fish oil supplements (10% - 20%). The amount of EPA is greater than DHA in many of the brands. The main disadvantages of fish oil supplements is the level of purity. The fatty acids in the supplements tend to become rancid and the quality of the fish oil degrades fast.

    Krill oil supplements

    Krill are small crustaceans found in the oceans. Krill oil is extracted from the krill species (Euphausia superba). Krill are plankton feeders and are lower on the food chain. Usually krill oil does not contain any toxic contaminant.

    Moreover, 50% the DHA in krill oil is attached to phospholipids. In phospholipid form the bioavailability of supplements is greatly increased. The astaxanthin present in krill oil is a potent antioxidant and it also protects the fatty acid supplement from turning rancid.

    Krill is the largest biomass in the world. Most of the marine animals are dependent directly or indirectly on krill for their survival. Hence overexploitation of krill will be disastrous. Commission for the Conservation of Antarctic Marine Living Resources (CCAMLR) is seized of this issue.

    Algal supplements

    Production of DHA from algae is a spin off from NASA research. Algal DHA is produced from microalgae grown in ponds. As such in this culture method there is no depletion of natural resources. Food contaminants can be totally avoided in the farm culture.

    As algal DHA is plant based it is preferred by vegetarians and vegans. The fatty algal extract is rich in DHA and very little EPA is present. As the product is plant based it can be an ideal source of omega-3 fatty acids for vegetarians and vegans.

    Green-lipped mussel oil and powder

    Dietary shellfish supplements have been the traditional remedy for inflammatory diseases like arthritis in humans. Green-lipped mussel (Perna canaliculus) is cultured in coastal farms located in sheltered or semi-sheltered areas of New Zealand. Natural  mussel spat (seed mussels) encrusted on drift kelp is collected and introduced into the modified Japanese longline system. The sufficient availability of natural seed will reflect on the production trends.

    Apart from DHA and EPA, green-lipped mussel oil or powder supplement contains a unique omega-3 fatty acid, eicosatetraenoic acid (ETA). It is well known that arachidonic acid oxygenation related metabolites play a major role in the inflammatory processes. ETA is found to selectively block cyclooxygenase (COX) and lipoxygenase pathways of inflammatory processes. Fatty acids DHA and ETA enhance the anti-inflammatory function of the fatty mussel extract.

    Being a filter feeding animal, green-lipped mussel passes large amounts of seawater through its filters to collect its food. Filter feeding can accumulate toxins and mercury in its fatty flesh.

    Concerns

    All these supplements have excellent health benefits. The issues concerned with the selection of the most beneficial supplement are:
    • the toxins and heavy metal presence,
    • the action taken to remove contaminants, 
    • the concentration of DHA,
    • the display or non-display of content in the labels, 
    • the use of additives and preservatives,
    • the oxidative process in the product,
    • the environment from where they are caught and
    • the process involved in the production of the DHA supplement.

    Related topics in nutritional deficiency diseases:
    Deficiency diseases of proteins.
    Krill oil omega-3.
    Protein energy malnutrition in children.
    Definition of trans fatty acids.
    Deficiency diseases of minerals.
    DHA and health.
    Deficiency diseases of vitamins.
    DHA from algae.
    Deficiency diseases of carbohydrates.
    Fish oil DHA and EPA. Current topic in nutritional deficiency diseases:
    Supplements of DHA (docosahexaenoic acid)
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    Selenium dietary supplements - Dosage of selenium supplements

    Home > Selenium dietary supplements - Dosage

    Selenium has to be taken in dietary supplements in proper dosage in cases of nutritional deficiency.

    Selenium is an essential trace mineral required in small quantities for the normal and healthy functioning of human body.
    In a typical diet in United States on an average 70 - 140 micrograms of this essential trace mineral is present.
    Though this dosage is more than the Recommended Dietary Allowances (RDA), which is 55-60 mcg, its use in protection/treatment from conditions like cancers and heart diseases require higher concentrations.
    People living in selenium deficient soils and sourcing locally grown food become chronically deficient and develop the deficiency diseases (see topic on selenium deficiency).
    In such specific conditions (found in China and Russia) they require to take the essential trace mineral in sufficient level to remain healthy.

    Forms of selenium dietary supplements

    Most of the present day multivitamin pills contain this essential trace mineral ranging in dosage between 30 - 200 mcg of of this mineral.
    Apart from the dietary sources its dosage in multivitamin is more than sufficient.
    This essential trace mineral in its elemental form it is not bio-available and it can become toxic on ingestion.
    Selenium is available both in organic, chelated and inorganic forms.
    Its inorganic forms like selenate and selenite have poor absorption rate and poor bioavailability.
    selenium chelates and aspartates also have poor bioavailability.
    Its organic form is selenomethionine which has greater absorption rate and bioavailability.
    Selenomethionine exists in D- and L- isomer forms and the it naturally occurs as L-selenomethionine in foods.
    'High selenium yeasts' contain a high dosage of 1000 -2000 mcg of this trace mineral per gram in the form of selenomethionine.
    Synthetic selenomethionine was made in 1984 and is also available in dietary supplements.
    Intravenous selenium forms are also available for treatment of patients in critical stage and on TPN (total parenteral nutrition) and the dosage has to be monitored by qualified health care professional.
    In its sulphide form it is being successfully used in the treatment of fungal infections like dandruff and tinea versicolor.

    Selenium dietary supplements: quantity and quality concerns

    Many products are marketed with miraculous treatments for a number of ailments.
    They usually contain high amounts of its inorganic salts and the quantity is not properly disclosed.
    Some supplements are marketed as selenium yeast, but are made with yeast containing inferior inorganic selenate and selenite salts instead of selenomethionine.
    Many of its chealate forms do not disclose the exact form of this trace mineral used in formulation.
    Many infant formulations, protein foods and health products contain inorganic salts of this mineral whereas selenomethionine is the efficacious and preferred one over other forms.
    Excess of its salts in some formulations had caused selenosis (overdose of this essential trace mineral).

    Safety factors in use of selenium supplements

    When products of 200 mcg are taken, considering the food inputs, the total input increases in an adult to 250 to 400 mcg of selenium which is under safe levels.
    The upper tolerance level is 400mcg for adults including sensitive groups.
    In healthy individuals prolonged use of these products with dosage up to 800 mcg do not produce adverse effects.
    Overt toxicity symptoms appear when the lowest adverse effect level of 1500+mcg/day is exceeded.

    Selenium dietary supplements: risk factors

    Though the formulations of this essential trace mineral are safer in present days, decades ago accidental very high dosage had caused death of ponies and also selenosis in humans.
    Related topics on selenium nutrition:
    What is selenium.
    Role in human nutrition.
    Health benefits.
    Vanadium in diabetes.
    Essential trace minerals.
    Chromium in diabetes.
    Good natural food sources.
    Deficiency and symptoms.
    Overdose and side effects.
    Selenium dietary supplements and dosage (current topic).
    Considering the possibility of higher selenium dosage and resultant selenosis, it is advisable to take dietary supplements under the supervision of qualified medical professional.
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