Wednesday, September 29, 2010

Cystic Fibrosis and Magnesium

Hypomagnesaemia in patients with cystic fibrosis (CF) is underrecognized. Many patients are asymptomatic, although severe deficiency may be associated with muscle weakness, cramps and tetany.
Hypomagnesaemia may be a risk factor for post-transplant complications including convulsions, which may be exacerbated by the use of calcineurin inhibitors.
Hypomagnesaemia is a common finding in patients with CF referred for lung transplant assessment. Serum magnesium levels should be monitored in all CF patients being referred for lung transplant irrespective of the results of other renal function tests.

(Magnesium) deficiency probably occurs with significant frequency in cystic fibrosis and should be considered in such patients so that important morbidity can be prevented.
PMID: 6648626 [PubMed - indexed for MEDLINE]

The removal of highly viscous mucus from the airways is an important task in the treatment of chronic lung disease like in cystic fibrosis.
Increasing the magnesium concentration in the airway surface liquid by aerosolisation of magnesium solutions or oral magnesium supplements could improve the removal of highly viscous mucus in chronic lung disease by activating endogenous DNase activity.
PMID: 19661013 [PubMed - indexed for MEDLINE].

Median salivary magnesium concentration and lactate dehydrogenase activity were significantly lower in CF patients than in the healthy controls.
Salivary profile and oxidative stress in children and adolescents with cystic fibrosis.
Livnat G, Bentur L, Kuzmisnsky E, Nagler RM.
Pediatric Pulmonary Unit, Meyer Children's Hospital, Rambam Medical Center, Haifa, Israel.

Scalp hair of neonates with cystic fibrosis contains significantly elevated concentrations of sodium and potassium. Nearly all of the calcium and 80% of the magnesium in the hair of these patients may be extracted by washing or boiling the hair in water, whereas only a small fraction of the calcium and magnesium of the hair of healthy infants is water soluble.

The increased or decreased solubilities of calcium complexes have been previously observed in various tissues of patients with CF. The inability of hair from patients with CF to bind calcium and magnesium may be related to the basic defect in this disease.

Cystic fibrosis is disease that significantly impacts the lungs and the digestive tract. Because of genetic mutations, secretions become very thick leading to damage of the lungs, along with chronic inflammation and chronic infections.

The gastrointestinal tract is also affected because the digestive enzymes of the pancreas are not effectively released in to the intestines. Lack of digestive enzymes means that food is not properly broken down and digested. This leads to MANY nutritional deficiencies.

The problems for the CF patient include:

Lack of digestive power leading to many nutritional deficiencies including magnesium.
Low Concentrations of Sodium and Magnesium in Erythrocytes From Cystic Fibrosis Heterozygotes. Foucard, T., et al, ACTA Pediatrica Scand., 1991;80:57-61.
As lung capacity decreases, more vitamins will be used at an even faster rate.

The lungs are more prone to inflammation and thus more infections [Source: Keitcher].

Infections are often harder to clear.

Bowel issues: poorly digested food, constipation, diarrhoea, odorous stools.

Colonization of bad bacteria such as pseudomonas, a bug that is often very hard to treat and very hard to rid the body of.

Supplementation should focus on a program that includes vitamins E, A, K, zinc and magnesium.

Magnesium is needed for all muscles, including the chest wall and also to utilize essential fatty acids [Source: Tirouvanziam].

By controlling inflammation in the lungs, the body is much less prone to infection. (See: Inflammation and Magnesium)

The lungs are the organs that stand to get hit the hardest with more and more infections. These infections must be prevented so that antibiotic resistance does not develop and lung function can be maintained.

Glutathione provides significant benefit to the lungs.  The body actually makes glutathione as one of its major treatments critical for repair and detoxification. Glutathione requires magnesium for synthesis.

CF patients have been shown to be low in glutathione, particularly in the lining of the lungs.

In CF, lower levels of glutathione have correlated with poorer lung function [Source: Mangione].

Fatty stools cause malabsorption of calcium and magnesium. Many of the other problems of CF patients such as poor immunity, bronchospasm (asthma), heart problems, diabetes, poor growth, delayed puberty and abnormal genital development are due to these micronutrient deficiencies.

Magnesium deficiency is extremely common and should be treated as deficiency results in heart disease, bronchospasm and immune incompetence.


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