Alternate Dosing Protocol for Magnesium Sulfate in Obese Women With Preeclampsia: A Randomized Controlled Trial
Clinical Trial Obstet Gynecol. 2020 Dec;136(6):1190-1194. doi: 10.1097/AOG.0000000000004137.
Kathleen F Brookfield 1, Kierstyn Tuel, Monica Rincon, Abbie Vinson, Aaron B Caughey, Brendan Carvalho
Magnesium and Vitamin D contains the following highlights
- Overview Magnesium and vitamin D
- Magnesium deficiency – causes and symptoms – May 2016
- Vitamins and Metals needed by the Immune System – Jan 2020
- Magnesium deficiency estimated by just 6 Yes No questions - Dec 2019
- Magnesium etc. reduced in crops (must supplement) – 2009
- Magnesium in Healthcare (Rickets, Stones, Pregnancy, Depression, etc.) with level of evidence – Sept 2017
- Magnesium is great for health, topical much faster than oral, MgCl2 is the best – 2019
- Magnesium is important for health but levels are low – July 2018
- Dr. Coimbra interview covering Vitamin D, Magnesium, Folate, Vaccines - Oct 2018
- How to get lots of Magnesium – especially needed for Coimbra MS and Autoimmune Protocol
Mg and Vitamin D
- Vitamin D and Magnesium need each other - many studies
- Why Vitamin D is Useless without This Critical Nutrient (Magnesium) - Jan 2019
- 500 mg of Magnesium for 8 weeks increased Vitamin D by 4 ng – July 2020
- Magnesium supplementation raises Vitamin D if initially less than 30 ng – RCT Dec 2018
- Magnesium is vital to Vitamin D in 4 places (maybe 8) – March 2018
- Magnesium and Vitamin D – recent deficiencies, needed, synergistic - good overview 2017
- Vitamin D Cofactors in a nutshell
- Magnesium and Vitamin D - similar, different and synergistic
Dr. Dean
- Some Podcasts by Dr. C Dean – Magnesium, Vitamin D, Iodine, etc.
- Magnesium and the body - depletion and reduced intake - Dean Oct 2019
- Magnesium, Vitamin D, Omega-3, TSH - importance and testing - Dean and Baggerly - Oct 2019
Number of studies in both of the categories of Magnesium and:
Bone
Overview Magnesium and vitamin D Has a venn diagram of relationship of Mg and Vit D
| Magnesium | not Magnesium | |
| Vitamin D | Magnesium or Vitamin D Aging, Amytrophic Lateral Sclerosis, Alzheimer's Disease; Asthma, Attention Deficit Disorder; Autism, Cancer, Cerebrovascular, Chronic Fatigue, Diabetes, Hearing Loss, Heart Disease, Heart Attack, Atherosclerosis, Cardiovascular Disease, HIV, AIDS; Hypertension; Kidney Stones, Migraine Headache, Multiple Sclerosis, Obesity, Osteoporosis; Peripheral vascular disease; Pregnancy-related problems, Rheumatoid Arthritis; Sports-related problems, | Vitamin D only Acne, Allergy, Autoimmune, Bone, Breathing, Celiac, Cognition, Colds and Flu, Cystic Fibrosis, Dental, Fertility, Hyperparathyroid, Immunity, Kidney, Liver, Lupus, Osteoarthritis, Pain - chronic, Parkinson, Psoriasis, Rickets, Strokes, Sarcoidosis, Thyroid, Parathyroid, Tuberculosis, Vision, Hair, Skin, Sports |
| Not Vitamin D | Magnesium only Aggressive Behavior, Alcoholism, Arrhythmia, Cerebral Palsy, Chemical Sensitivity, Cluster Headaches; Cocaine-related Stroke; Constipation, Cramps, Fluoride Toxicity; Head Injuries, Central Nervous System Injuries, Magnesium Deficiency; Menopause, Mitral Valve Prolapse, Nystagmus, Psychiatric Disorders; Repetitive Strain Injury, Sickle Cell Disease, SIDS, Stress, Stuttering, Tetanus; Tinnitus, Sound Sensitivity; TMJ; Toxic Shock; Violence | Neither ALL OTHER DISEASES |
Magnesium Miracle, 2nd edition - Aug 2017
Objective: To evaluate whether obese women need greater doses of magnesium sulfate to obtain therapeutic serum concentrations for eclamptic seizure prevention.
Methods: Women with preeclampsia and a body mass index (BMI) of 35 or higher were randomly allocated to either the Zuspan regimen of magnesium sulfate (4-g intravenous IV loading dose, then a 1-g/h infusion) or to alternate dosing (6-g IV loading dose, then a 2-g/h infusion). Women had serum magnesium concentrations obtained at baseline, as well as after administration of magnesium sulfate at 1 hour, 4 hours, and delivery. The primary outcome was the proportion of women who had subtherapeutic serum magnesium concentrations (less than 4.8 mg/dL) 4 hours after administration. A sample size of 18 women per group was planned to compare the proportion of women with subtherapeutic serum magnesium concentrations in each group.
Results: From July 12, 2016, to March 14, 2019, 89 women with preeclampsia were screened and 37 were enrolled: 18 to the Zuspan regimen and 19 to the alternate regimen. A significantly greater proportion of women administered the Zuspan regimen had subtherapeutic serum magnesium concentrations at 4 hours (100% [95% CI 59-100] vs 63% [95% CI 41-81]; P=.01) compared with women administered the alternate higher dose regimen. At 4 hours, mean concentrations were significantly higher in the alternate regimen group (3.53 mg/dL±0.3 [Zuspan regimen] vs 4.41±0.5 [alternate regimen]; P<.01).
Conclusion: The alternate dosing regimen of a 6-g IV loading dose followed by a 2-g/h IV maintenance dose more reliably achieves therapeutic serum magnesium concentrations (as defined by a concentration of at least 4.8 mg/dL) in obese women with preeclampsia.
Clinical trial registration: ClinicalTrials.gov, NCT02835339.
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