Thank you for visiting this video segment of Dr. AFib, I'm Dr. Morales, Dr. AFib
Is your online expert source to all your questions about living with atrial fibrillation. In today's video segment
we're going to discuss the role of magnesium in the treatment of atrial fibrillation.
I'll discuss the data behind using it for afib management and when it may be helpful.
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So what is the role of
magnesium in
managing a patient's atrial fibrillation?
When a patient goes online and searches about magnesium and afib
they'll find a lot of information out there about its use there are several web pages promoting magnesium use as a
natural treatment for atrial fibrillation and promoting several different types of over-the-counter supplements for magnesium.
But what does the data show? Is there any medical literature out there that says magnesium is beneficial for atrial fibrillation?
Magnesium deficiency is common as most people in the United States do not eat enough magnesium in their daily diet
Magnesium is a very important mineral that's involved in the coordination of a natural heartbeat and it is a key component of the energy
molecules needed to help keep your heart beating strong.
About 99 percent of total body magnesium was located in the bone,
muscles, a soft tissue, and non-muscular soft tissue.
Whereas only a small percentage of about 1 percent is located in the bloodstream at any time. However,
when being tested for magnesium deficiency it is that blood concentration that is normally tested in a blood test.
There are a few studies out there testing out whether magnesium deficiency actually affects AFib.
For example in the 2013 study as part of the Framingham Heart Study over
3,500 pages were studied over 20 years in this study individuals in the lowest quartile of serum magnesium were
more likely to develop AFib compared to those in the upper quartiles of magnesium concentrations. In another study from
2016, an HMO database show that an increased a-fib risk associated with mild and moderate decreased serum magnesium levels.
So there's certainly data showing a link between low magnesium levels and the risk of afib
But is there actually data showing that supplementing magnesium will decrease improve or even reverse a patient's atrial fibrillation?
At this point there has been no long term clinical trials to date that demonstrate replacing magnesium either
reduces or reverses atrial fibrillation.
Meaning that there are no clinical studies at this time that have shown for people who take magnesium supplements
For years have a decrease in their afib or reversal in their AFib.
To date the research and data is shown associated mostly in the short term management afib,
Usually in the setting of a hospital or an emergency room or in the setting of someone having heart surgery.
Actually, the majority of studies involving magnesium and atrial fibrillation are in the situation of patients who are undergoing heart surgery.
Episodes of atrial fibrillation are significant concern for patients who are undergoing open heart surgery such as a bypass surgery,
because it can significantly prolong the hospitalization and recovery after surgery.
There have been over 10 studies published over the years about giving magnesium supplementation
prior to heart surgery and
there's still no clear consensus, some studies say it helps others say it does not help. In
addition there are several studies that looked at into the use of magnesium infusion in
the setting in the emergency room or in the hospital and it has been found that intravenous magnesium can slow the heart rate down
when it's going too fast during an afib episode
also giving magnesium can also help with the conversion of afib back to normal rhythm and it can also improve the success rate of a
cardioversion especially when given in combination with anti arrhythmic type heart
medications.
As I recently mentioned the majority of a person's magnesium is in the inside of your cells. It was only a very small portion
is found inside in your bloodstream, whereas most typical blood tests only test for magnesium levels inside the serum,
which only comes from very small percentage of the total body magnesium.
There are several tests available that can test for deficiency in total body magnesium
Which in theory would be more accurate way to test for magnesium deficiency.
However, these types of tests are not typically covered by insurance and which may end up costing a patient several hundreds of dollars out of
pocket.
In addition,
there's no clear clinical trial data that says that using these more expensive tests to determine if testing for magnesium deficiency
in a more total body deficiency versus just a simple blood test has any benefit to the patient?
For those who have found to be magnesium deficient, how do you supplement magnesium?
There have been
over 10 types of magnesium supplements available and many are advertised directly to heart patients to help them manage their afib and
other heart arrhythmias.
There does appear to be a lot of variability between the different types of supplements and how much of the magnesium is actually absorbed.
But do they actually help with a patient's atrial fibrillation?
Like any over-the-counter
supplement they are not as strictly monitored by the FDA and there's no clear clinical trial data that shows that any particular supplement or
brand or
particular supplement reduces the amount of afib a patient has.
So what do I recommend to my patients?
First for any patient with atrial fibrillation. It's important to routinely check a patient's magnesium level. I
routinely check a serum blood test
for the magnesium level because it's readily available and covered by most insurances. In addition,
the clinical studies that have been looked at magnesium deficiency in atrial fibrillation have looked at your typical serum blood test magnesium.
Despite theoretical advantages. I
don't routinely test for those intracellular magnesium to the higher out-of-pocket
cost to patients and the fact that there has been no clear clinical trial data looking at intracellular magnesium and the risk of atrial fibrillation.
If you're found to be deficient consider supplementing with foods that are high in magnesium
such as dark green vegetables, avocados, bananas,
Legumes, nuts ,or fatty fish just to name a few.
Another option is to increase your magnesium level is with over-the-counter supplements. I
I typically start with magnesium oxide due the fact that it's widely available in most drug stores and is typically well tolerated.
However, there's a wide range of supplements available
and I've seen several patients benefit from other types of supplements such as magnesium glycinate and magnesium taurate.
But please always discuss with your doctor which supplement may be
right for you, and I always routinely check your magnesium level if you have atrial fibrillation to see if you have a deficiency.
Thank you for reading this video segment for Dr. AFib. I'll see you next time.