Magnesium and Magnesium Depleting Drugs
Posted to one of my previous health sites years ago with permission from the original author, Kim Payne. Originally written in 2007. Edited slightly to remove personal info and editorializing.
Here's the real deal on magnesium and azithromycin:
1) Macrolide antibiotics (i.e., azithromycin, clarithromycin, and erythromycin) deplete magnesium (Mg).
Nearly every med prescribed for CF depletes Mg, which further lowers body pH, including lowering pH of the lungs making them more acidic. Many bacteria, fungus and cancer thrive in an acidic environment.
2) Mg inhibits antibiotic efficacy. You can't take Mg and certain antibiotics together because they compete for the same receptor site on the cell membrane, and magnesium will win, cutting antibiotic efficacy. So you must follow a rule of thumb:
Take antibiotic, wait 2 hours.
Take Mg, wait at least 4 hours before next antibiotic dose.
The exception is Cipro; you must wait 6-7 hours after taking Mg before you can take another dose of Cipro.
3) Mucoid pseudomonas is more likely to grow in a Mg-deficient host. Additionally, the mucoid PA will likely be resistant to aminoglycoside antibiotics (i.e., gentamycin, tobramycin, amikacin). Studies suggest this is reversible when Mg-deficiency is reversed (and it did prove reversible in my son, eventually even eliminating mucoid PA).
4) If you take aminoglycoside antibiotics during Mg-deficiency, you run a greater risk of ototoxicity and vestibular damage. There is some evidence that supplementing Mg at the first sign of ototoxicity may slightly attenuate the damage, but not completely reverse it.
5) During Mg-deficiency, taking macrolide antibiotics alone (and taking macrolides along with antifungals) increases risk of developing prolonged QT waves and Torsade de points, which can result in cardiac death.
Therefore, some authors have stated in cardiac journals that they feel it's crucial to have your Mg levels in the high-normal range before taking macrolide antibiotics.
But how many CF doctors know or even check Mg status?
Perhaps the reason that Pulmozyme (rhDNA) works better in a Mg-sufficient host is that Mg helps regulate opening-closing of the CFTR. With better channel gating, mucus is less likely to be as thick... Maybe. I don't know. But that's my guess anyway.
Kim Payne recommended magnesium glycinate and the dosing formula found here:
http://www.krispin.com./magnes.html
Here's the real deal on magnesium and azithromycin:
1) Macrolide antibiotics (i.e., azithromycin, clarithromycin, and erythromycin) deplete magnesium (Mg).
Nearly every med prescribed for CF depletes Mg, which further lowers body pH, including lowering pH of the lungs making them more acidic. Many bacteria, fungus and cancer thrive in an acidic environment.
2) Mg inhibits antibiotic efficacy. You can't take Mg and certain antibiotics together because they compete for the same receptor site on the cell membrane, and magnesium will win, cutting antibiotic efficacy. So you must follow a rule of thumb:
Take antibiotic, wait 2 hours.
Take Mg, wait at least 4 hours before next antibiotic dose.
The exception is Cipro; you must wait 6-7 hours after taking Mg before you can take another dose of Cipro.
3) Mucoid pseudomonas is more likely to grow in a Mg-deficient host. Additionally, the mucoid PA will likely be resistant to aminoglycoside antibiotics (i.e., gentamycin, tobramycin, amikacin). Studies suggest this is reversible when Mg-deficiency is reversed (and it did prove reversible in my son, eventually even eliminating mucoid PA).
4) If you take aminoglycoside antibiotics during Mg-deficiency, you run a greater risk of ototoxicity and vestibular damage. There is some evidence that supplementing Mg at the first sign of ototoxicity may slightly attenuate the damage, but not completely reverse it.
5) During Mg-deficiency, taking macrolide antibiotics alone (and taking macrolides along with antifungals) increases risk of developing prolonged QT waves and Torsade de points, which can result in cardiac death.
Therefore, some authors have stated in cardiac journals that they feel it's crucial to have your Mg levels in the high-normal range before taking macrolide antibiotics.
But how many CF doctors know or even check Mg status?
Perhaps the reason that Pulmozyme (rhDNA) works better in a Mg-sufficient host is that Mg helps regulate opening-closing of the CFTR. With better channel gating, mucus is less likely to be as thick... Maybe. I don't know. But that's my guess anyway.
Footnote
Kim Payne recommended magnesium glycinate and the dosing formula found here:
http://www.krispin.com./magnes.html
