Re: Low Magnesium Levels May Be Associated with Proton Pump Inhibitor Drugs

[Guest guest]

IN hospital setting, all pt are prescribed with PPIs. I am trying to teach my

doctor to d/c as we are LTC and the acute phase which required PPI as

prophylaxis is over... its very hard to get them to do so. NOt to mention, LTC

PPI can result in anemia due to reduces B12 absorption

Merav Levi, RD, MS, CDNA dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin " People don't forget the truth, they just

become better in lying " (Revolutionary Road)

To: rd-usa

From: nrord1@...

Date: Sun, 13 Mar 2011 08:55:32 -0400

Subject: Low Magnesium Levels May Be Associated with Proton Pump

Inhibitor Drugs

Prescription PPIs include Nexium (esomeprazole magnesium), Dexilant

(dexlansoprazole), Prilosec (omeprazole), Zegerid (omeprazole and sodium

bicarbonate), Prevacid (lansoprazole), Protonix (pantoprazole sodium),

AcipHex (rabeprazole sodium), and Vimovo (a prescription combination drug

product that contains a PPI [esomeprazole magnesium and naproxen]).

Over-the-counter (OTC) PPIs include Prilosec OTC (omeprazole), Zegerid OTC

(omeprazole and sodium bicarbonate), and Prevacid 24HR (lansoprazole).

FDA notified healthcare professionals and the public that prescription

proton pump inhibitor (PPI) drugs may cause low serum magnesium levels

(hypomagnesemia) if taken for prolonged periods of time (in most cases,

longer than one year). Low serum magnesium levels can result in serious

adverse events including muscle spasm (tetany), irregular heartbeat

(arrhythmias), and convulsions (seizures); however, patients do not always

have these symptoms. Treatment of hypomagnesemia generally requires

magnesium supplements. In approximately one-quarter of the cases reviewed,

magnesium supplementation alone did not improve low serum magnesium levels

and the PPI had to be discontinued.

PPIs work by reducing the amount of acid in the stomach and are used to

treat conditions such as gastroesophageal reflux disease (GERD), stomach and

small intestine ulcers, and inflammation of the esophagus.

Healthcare professionals should consider obtaining serum magnesium levels

prior to initiation of prescription PPI treatment in patients expected to be

on these drugs for long periods of time, as well as patients who take PPIs

with medications such as digoxin, diuretics or drugs that may cause

hypomagnesemia. For patients taking digoxin, a heart medicine, this is

especially important because low magnesium can increase the likelihood of

serious side effects. Healthcare professionals should consider obtaining

magnesium levels periodically in these patients.

*The ls of Pharmacotherapy. 2011;45(1):1-8.

*

LINK<http://www.diabetesincontrol.com/index.php?option=com_content & view=article & \

id=10607 & catid=1 & Itemid=17>

--

Ortiz, MS, RD

*The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

Check out my blog: mixture of deals and nutrition

USAIR: 2000 mile bonus for signing up for a new account exp. 3/30 = FREE

magazines <http://thefrugaldietitian.com/?p=16546>New Giveaway : Healthy

Toys from The Frugal Dietitian Ends on 3/16 8

PM<http://thefrugaldietitian.com/?p=16384> Made

my own " funny but real " movie: Me interviewing a " potential " Dietetic

student <

*Healthy Diet at any Age: We are NOT just looking

*

*at the years people have behind them but also the

*

*quality of the years ahead of them.*

[Guest guest]

and group:

Oh, great! I've been skipping over these messages for various reasons,

mostly lack of interest in some topics. After reading a few of the posts I

skipped over most of the others.

This morning I'm a bit slower and I tend to read most if not all of some

ppl's posts, being one of them. The first word I catch while scanning

is NEXIUM. Need I say more? I've been taking Nexium for GERD and extreme

upper stomach pain for abt 3 years now - usually every 2-3 days, but chronic

use nonetheless. I've printed this post below to take with me to my MD next

visit and request a magnesium level to determine if I've had this outcome.

We'll see what he says and if I have any alternatives, but in the meantime,

since I didn't pay attention during " class " , please recommend the best

supplementation for me to use.

The devil of it is that I am also taking propanonol for heartbeat

irregularities, such as ----- occasional arythmia. Never did the

prescribing MD mention the side-effects possibilities, and I'm surprised

that although I read all the literature before even purchasing the drug, I

did not read this then.

Digna

From: rd-usa [mailto:rd-usa ] On Behalf Of

Ortiz

Sent: Sunday, March 13, 2011 5:56 AM

To: RD-USA

Subject: Low Magnesium Levels May Be Associated with Proton Pump

Inhibitor Drugs

Prescription PPIs include Nexium (esomeprazole magnesium), Dexilant

(dexlansoprazole), Prilosec (omeprazole), Zegerid (omeprazole and sodium

bicarbonate), Prevacid (lansoprazole), Protonix (pantoprazole sodium),

AcipHex (rabeprazole sodium), and Vimovo (a prescription combination drug

product that contains a PPI [esomeprazole magnesium and naproxen]).

Over-the-counter (OTC) PPIs include Prilosec OTC (omeprazole), Zegerid OTC

(omeprazole and sodium bicarbonate), and Prevacid 24HR (lansoprazole).

FDA notified healthcare professionals and the public that prescription

proton pump inhibitor (PPI) drugs may cause low serum magnesium levels

(hypomagnesemia) if taken for prolonged periods of time (in most cases,

longer than one year). Low serum magnesium levels can result in serious

adverse events including muscle spasm (tetany), irregular heartbeat

(arrhythmias), and convulsions (seizures); however, patients do not always

have these symptoms. Treatment of hypomagnesemia generally requires

magnesium supplements. In approximately one-quarter of the cases reviewed,

magnesium supplementation alone did not improve low serum magnesium levels

and the PPI had to be discontinued.

PPIs work by reducing the amount of acid in the stomach and are used to

treat conditions such as gastroesophageal reflux disease (GERD), stomach and

small intestine ulcers, and inflammation of the esophagus.

Healthcare professionals should consider obtaining serum magnesium levels

prior to initiation of prescription PPI treatment in patients expected to be

on these drugs for long periods of time, as well as patients who take PPIs

with medications such as digoxin, diuretics or drugs that may cause

hypomagnesemia. For patients taking digoxin, a heart medicine, this is

especially important because low magnesium can increase the likelihood of

serious side effects. Healthcare professionals should consider obtaining

magnesium levels periodically in these patients.

*The ls of Pharmacotherapy. 2011;45(1):1-8.

*

LINK<http://www.diabetesincontrol.com/index.php?option=com_content

<http://www.diabetesincontrol.com/index.php?option=com_content & view=article &

id=10607 & catid=1 & Itemid=17> & view=article & id=10607 & catid=1 & Itemid=17>

--

Ortiz, MS, RD

*The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

Check out my blog: mixture of deals and nutrition

USAIR: 2000 mile bonus for signing up for a new account exp. 3/30 = FREE

magazines <http://thefrugaldietitian.com/?p=16546>New Giveaway : Healthy

Toys from The Frugal Dietitian Ends on 3/16 8

PM<http://thefrugaldietitian.com/?p=16384> Made

my own " funny but real " movie: Me interviewing a " potential " Dietetic

student <

*Healthy Diet at any Age: We are NOT just looking

*

*at the years people have behind them but also the

*

*quality of the years ahead of them.*

[Guest guest]

As posted before the UL is 350 mg and of course large doses can also cause

diarrhea/loose stools (which is why it is used sometimes for 'bowel

cleaning " - magnesium citrate for example - usually most potent). I think

what you would need to take would be determined by your blood levels - like

iron - UL is based on healthy normal blood level.

I checked consumerlab.com and the main concern in one was lead in it -

Gillham's Natural Vitality Natural Calm (205 mg per teaspoon, 1/2 to 3 per

day)

2005 Total Nutrition Natural Amino Acid Chelated Magnesium (100 mg per

tablet, 4 per day) - only 28% of Magnesium stated

2005 Tropical Oasis Liquid Calcium Magnesium Orange Flavor (115 mg per Tbsp,

1 Tbsp per day) - only 45% magnesium stated

Of course something like Maalox and Milk of Magnesia has magnesium in it

(thus the name) but also aluminum (a problem with renal patients). One had

200 mg magnesium hydroxide. Zegerid has magnesium hydroxide in it 700 mg.

Nexium has magnesium also. Not sure how the amounts convert to actual

magnesium content.

Of course low magnesium levels can affect insulin sensitivity in Type 2

diabetics.

On Sun, Mar 13, 2011 at 12:29 PM, Digna Cassens <dignacassens@...

> wrote:

>

>

> and group:

>

> Oh, great! I've been skipping over these messages for various reasons,

> mostly lack of interest in some topics. After reading a few of the posts I

> skipped over most of the others.

>

> This morning I'm a bit slower and I tend to read most if not all of some

> ppl's posts, being one of them. The first word I catch while scanning

> is NEXIUM. Need I say more? I've been taking Nexium for GERD and extreme

> upper stomach pain for abt 3 years now - usually every 2-3 days, but

> chronic

> use nonetheless. I've printed this post below to take with me to my MD next

> visit and request a magnesium level to determine if I've had this outcome.

> We'll see what he says and if I have any alternatives, but in the meantime,

> since I didn't pay attention during " class " , please recommend the best

> supplementation for me to use.

>

> The devil of it is that I am also taking propanonol for heartbeat

> irregularities, such as ----- occasional arythmia. Never did the

> prescribing MD mention the side-effects possibilities, and I'm surprised

> that although I read all the literature before even purchasing the drug, I

> did not read this then.

>

> Digna

>

> From: rd-usa [mailto:rd-usa ] On Behalf Of

> Ortiz

> Sent: Sunday, March 13, 2011 5:56 AM

> To: RD-USA

>

> Subject: Low Magnesium Levels May Be Associated with Proton Pump

> Inhibitor Drugs

>

> Prescription PPIs include Nexium (esomeprazole magnesium), Dexilant

> (dexlansoprazole), Prilosec (omeprazole), Zegerid (omeprazole and sodium

> bicarbonate), Prevacid (lansoprazole), Protonix (pantoprazole sodium),

> AcipHex (rabeprazole sodium), and Vimovo (a prescription combination drug

> product that contains a PPI [esomeprazole magnesium and naproxen]).

> Over-the-counter (OTC) PPIs include Prilosec OTC (omeprazole), Zegerid OTC

> (omeprazole and sodium bicarbonate), and Prevacid 24HR (lansoprazole).

>

> FDA notified healthcare professionals and the public that prescription

> proton pump inhibitor (PPI) drugs may cause low serum magnesium levels

> (hypomagnesemia) if taken for prolonged periods of time (in most cases,

> longer than one year). Low serum magnesium levels can result in serious

> adverse events including muscle spasm (tetany), irregular heartbeat

> (arrhythmias), and convulsions (seizures); however, patients do not always

> have these symptoms. Treatment of hypomagnesemia generally requires

> magnesium supplements. In approximately one-quarter of the cases reviewed,

> magnesium supplementation alone did not improve low serum magnesium levels

> and the PPI had to be discontinued.

>

> PPIs work by reducing the amount of acid in the stomach and are used to

> treat conditions such as gastroesophageal reflux disease (GERD), stomach

> and

> small intestine ulcers, and inflammation of the esophagus.

>

> Healthcare professionals should consider obtaining serum magnesium levels

> prior to initiation of prescription PPI treatment in patients expected to

> be

> on these drugs for long periods of time, as well as patients who take PPIs

> with medications such as digoxin, diuretics or drugs that may cause

> hypomagnesemia. For patients taking digoxin, a heart medicine, this is

> especially important because low magnesium can increase the likelihood of

> serious side effects. Healthcare professionals should consider obtaining

> magnesium levels periodically in these patients.

>

> *The ls of Pharmacotherapy. 2011;45(1):1-8.

> *

> LINK<http://www.diabetesincontrol.com/index.php?option=com_content

> <

> http://www.diabetesincontrol.com/index.php?option=com_content & view=article &

> id=10607 & catid=1 & Itemid=17> & view=article & id=10607 & catid=1 & Itemid=17>

> --

> Ortiz, MS, RD

> *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

>

> Check out my blog: mixture of deals and nutrition

> USAIR: 2000 mile bonus for signing up for a new account exp. 3/30 = FREE

> magazines <http://thefrugaldietitian.com/?p=16546>New Giveaway : Healthy

>

> Toys from The Frugal Dietitian Ends on 3/16 8

> PM<http://thefrugaldietitian.com/?p=16384> Made

>

> my own " funny but real " movie: Me interviewing a " potential " Dietetic

> student <

>

> *Healthy Diet at any Age: We are NOT just looking

>

> *

>

> *at the years people have behind them but also the

> *

>

> *quality of the years ahead of them.*

>

>

[Guest guest]

From Natural medicine database:

*PROTON PUMP INHIBITORS (PPIs)*: Taking a PPI long-term, especially over a

year, has been linked to an increased risk of hypomagnesemia in several

reports

(<http://naturaldatabase.therapeuticresearch.com/nd/Search.aspx?cs= & s=ND & pt=101 & \

sh=12 & id=998 & id2=17546#17546>.

PPIs are thought to inhibit active transport of magnesium in the

intestine

(<http://naturaldatabase.therapeuticresearch.com/nd/Search.aspx?cs= & s=ND & pt=101 & \

sh=12 & id=998 & id2=17549#17549>).

This appears to be a class effect. Hypomagnesemia has been reported with all

PPIs ()

Severe hypomagnesemia can cause potentially serious effects including muscle

spasm, tetany, arrhythmia, hypokalemia, hypoparathyroidism, hypocalcemia,

and seizures. Patients who are likely to take a PPI long-term should have

serum magnesium levels checked at baseline and annually thereafter. A

magnesium supplement may be necessary to treat or prevent magnesium

deficiency. In some patients, magnesium supplementation alone may not be

adequate to treat hypomagnesemia. Case reports suggest that up to 25% of

patients who developed hypomagnesemia had to discontinue the PPI in order

for magnesium levels to return to normal

(<http://naturaldatabase.therapeuticresearch.com/nd/Search.aspx?cs= & s=ND & pt=101 & \

sh=12 & id=998 & id2=17546#17546>).

In many cases, hypomagnesemia recurred when the PPI was re-initiated

In some reports, use of pantoprazole (Protonix), in combination with a

magnesium supplement, was effective for treating reflux and preventing

magnesium loss ). In another case, use of alternate day dosing of

pantoprazole (Protonix) three days per week and famotidine (Pepcid) four

days per week, in combination with a magnesium supplement, was also

effective for treating symptoms and increasing magnesium levels . Some

experts speculate that the magnesium depletion caused by PPIs could

contribute to the increased risk of fracture seen in some patients taking

PPIs long-term .

PPIs include omeprazole (Prilosec), esomeprazole (Nexium), lansoprazole,

(Prevacid), pantoprazole (Protonix), rabeprazole (AcipHex), and

dexlansoprazole (Dexilant).

Cundy T, Dissanayake A. Severe hypomagnesaemia in long-term users of

proton-pump inhibitors. Clin Endocrinol (Oxf)

2008;69:338-41<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=Pub\

Med & list_uids=18221401 & dopt=Abstract>

..

close window *17550* Doornebal J, Bijlsma R, Brouwer RM. [An unknown but

potentially serious side effect of proton pump inhibitors: hypomagnesaemia].

[Article in Dutch] Ned Tijdschr Geneeskd

2009;153:A711<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubM\

ed & list_uids=19930736 & dopt=Abstract>

.. *17551* Epstein M, McGrath S, Law F. Proton-pump inhibitors and

hypomagnesemic hypoparathyroidism. N Engl J Med

2006;355:1834-6<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=Pu\

bMed & list_uids=17065651 & dopt=Abstract>

.. *17552* François M, Lévy-Bohbot N, Caron J, Durlach V. [Chronic use of

proton-pump inhibitors associated with giardiasis: A rare cause of

hypomagnesemic hypoparathyroidism?]. [Article in French] Ann Endocrinol

2008;69:446-8<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubM\

ed & list_uids=18614153 & dopt=Abstract>

.. *17553* Broeren MA, Geerdink EA, Vader HL, van den Wall Bake AW.

Hypomagnesemia induced by several proton-pump inhibitors. Ann Intern Med

2009;151:755-6<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=Pub\

Med & list_uids=19920278 & dopt=Abstract>

.. *17554* Hoorn EJ, van der Hoek J, de Man RA, et al. A case series of

proton pump inhibitor-induced hypomagnesemia. Am J Kidney Dis

2010;56:112-6<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubM\

ed & list_uids=20189276 & dopt=Abstract>

.. *17555* Regolisti G, Cabassi A, Parenti E, et al. Severe hypomagnesemia

during long-term treatment with a proton pump inhibitor. Am J Kidney Dis

2010;56:168-74<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=Pub\

Med & list_uids=20493607 & dopt=Abstract>

..

> As posted before the UL is 350 mg and of course large doses can also cause

> diarrhea/loose stools (which is why it is used sometimes for 'bowel

> cleaning " - magnesium citrate for example - usually most potent). I think

> what you would need to take would be determined by your blood levels - like

> iron - UL is based on healthy normal blood level.

>

> I checked consumerlab.com and the main concern in one was lead in it -

> Gillham's Natural Vitality Natural Calm (205 mg per teaspoon, 1/2 to 3 per

> day)

> 2005 Total Nutrition Natural Amino Acid Chelated Magnesium (100 mg per

> tablet, 4 per day) - only 28% of Magnesium stated

> 2005 Tropical Oasis Liquid Calcium Magnesium Orange Flavor (115 mg per

> Tbsp, 1 Tbsp per day) - only 45% magnesium stated

>

> Of course something like Maalox and Milk of Magnesia has magnesium in it

> (thus the name) but also aluminum (a problem with renal patients). One had

> 200 mg magnesium hydroxide. Zegerid has magnesium hydroxide in it 700 mg.

> Nexium has magnesium also. Not sure how the amounts convert to actual

> magnesium content.

>

> Of course low magnesium levels can affect insulin sensitivity in Type 2

> diabetics.

>

>

> On Sun, Mar 13, 2011 at 12:29 PM, Digna Cassens <

> dignacassens@...> wrote:

>

>>

>>

>> and group:

>>

>> Oh, great! I've been skipping over these messages for various reasons,

>> mostly lack of interest in some topics. After reading a few of the posts I

>> skipped over most of the others.

>>

>> This morning I'm a bit slower and I tend to read most if not all of some

>> ppl's posts, being one of them. The first word I catch while

>> scanning

>> is NEXIUM. Need I say more? I've been taking Nexium for GERD and extreme

>> upper stomach pain for abt 3 years now - usually every 2-3 days, but

>> chronic

>> use nonetheless. I've printed this post below to take with me to my MD

>> next

>> visit and request a magnesium level to determine if I've had this outcome.

>> We'll see what he says and if I have any alternatives, but in the

>> meantime,

>> since I didn't pay attention during " class " , please recommend the best

>> supplementation for me to use.

>>

>> The devil of it is that I am also taking propanonol for heartbeat

>> irregularities, such as ----- occasional arythmia. Never did the

>> prescribing MD mention the side-effects possibilities, and I'm surprised

>> that although I read all the literature before even purchasing the drug, I

>> did not read this then.

>>

>> Digna

>>

>> From: rd-usa [mailto:rd-usa ] On Behalf Of

>> Ortiz

>> Sent: Sunday, March 13, 2011 5:56 AM

>> To: RD-USA

>>

>> Subject: Low Magnesium Levels May Be Associated with Proton Pump

>> Inhibitor Drugs

>>

>> Prescription PPIs include Nexium (esomeprazole magnesium), Dexilant

>> (dexlansoprazole), Prilosec (omeprazole), Zegerid (omeprazole and sodium

>> bicarbonate), Prevacid (lansoprazole), Protonix (pantoprazole sodium),

>> AcipHex (rabeprazole sodium), and Vimovo (a prescription combination drug

>> product that contains a PPI [esomeprazole magnesium and naproxen]).

>> Over-the-counter (OTC) PPIs include Prilosec OTC (omeprazole), Zegerid OTC

>> (omeprazole and sodium bicarbonate), and Prevacid 24HR (lansoprazole).

>>

>> FDA notified healthcare professionals and the public that prescription

>> proton pump inhibitor (PPI) drugs may cause low serum magnesium levels

>> (hypomagnesemia) if taken for prolonged periods of time (in most cases,

>> longer than one year). Low serum magnesium levels can result in serious

>> adverse events including muscle spasm (tetany), irregular heartbeat

>> (arrhythmias), and convulsions (seizures); however, patients do not always

>> have these symptoms. Treatment of hypomagnesemia generally requires

>> magnesium supplements. In approximately one-quarter of the cases reviewed,

>> magnesium supplementation alone did not improve low serum magnesium levels

>> and the PPI had to be discontinued.

>>

>> PPIs work by reducing the amount of acid in the stomach and are used to

>> treat conditions such as gastroesophageal reflux disease (GERD), stomach

>> and

>> small intestine ulcers, and inflammation of the esophagus.

>>

>> Healthcare professionals should consider obtaining serum magnesium levels

>> prior to initiation of prescription PPI treatment in patients expected to

>> be

>> on these drugs for long periods of time, as well as patients who take PPIs

>> with medications such as digoxin, diuretics or drugs that may cause

>> hypomagnesemia. For patients taking digoxin, a heart medicine, this is

>> especially important because low magnesium can increase the likelihood of

>> serious side effects. Healthcare professionals should consider obtaining

>> magnesium levels periodically in these patients.

>>

>> *The ls of Pharmacotherapy. 2011;45(1):1-8.

>> *

>> LINK<http://www.diabetesincontrol.com/index.php?option=com_content

>> <

>> http://www.diabetesincontrol.com/index.php?option=com_content & view=article &

>> id=10607 & catid=1 & Itemid=17> & view=article & id=10607 & catid=1 & Itemid=17>

>> --

>> Ortiz, MS, RD

>> *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

>>

>> Check out my blog: mixture of deals and nutrition

>> USAIR: 2000 mile bonus for signing up for a new account exp. 3/30 = FREE

>> magazines <http://thefrugaldietitian.com/?p=16546>New Giveaway : Healthy

>>

>> Toys from The Frugal Dietitian Ends on 3/16 8

>> PM<http://thefrugaldietitian.com/?p=16384> Made

>>

>> my own " funny but real " movie: Me interviewing a " potential " Dietetic

>> student <

>>

>> *Healthy Diet at any Age: We are NOT just looking

>>

>> *

>>

>> *at the years people have behind them but also the

>> *

>>

>> *quality of the years ahead of them.*

>>

>>

[Guest guest]

,

Thanks for the additional info. I'll consider the alternatives and try to

find the best course for me to take.

Digna

Low Magnesium Levels May Be Associated with Proton Pump

> Inhibitor Drugs

>

> Prescription PPIs include Nexium (esomeprazole magnesium), Dexilant

> (dexlansoprazole), Prilosec (omeprazole), Zegerid (omeprazole and sodium

> bicarbonate), Prevacid (lansoprazole), Protonix (pantoprazole sodium),

> AcipHex (rabeprazole sodium), and Vimovo (a prescription combination drug

> product that contains a PPI [esomeprazole magnesium and naproxen]).

> Over-the-counter (OTC) PPIs include Prilosec OTC (omeprazole), Zegerid OTC

> (omeprazole and sodium bicarbonate), and Prevacid 24HR (lansoprazole).

>

> FDA notified healthcare professionals and the public that prescription

> proton pump inhibitor (PPI) drugs may cause low serum magnesium levels

> (hypomagnesemia) if taken for prolonged periods of time (in most cases,

> longer than one year). Low serum magnesium levels can result in serious

> adverse events including muscle spasm (tetany), irregular heartbeat

> (arrhythmias), and convulsions (seizures); however, patients do not always

> have these symptoms. Treatment of hypomagnesemia generally requires

> magnesium supplements. In approximately one-quarter of the cases reviewed,

> magnesium supplementation alone did not improve low serum magnesium levels

> and the PPI had to be discontinued.

>

> PPIs work by reducing the amount of acid in the stomach and are used to

> treat conditions such as gastroesophageal reflux disease (GERD), stomach

> and

> small intestine ulcers, and inflammation of the esophagus.

>

> Healthcare professionals should consider obtaining serum magnesium levels

> prior to initiation of prescription PPI treatment in patients expected to

> be

> on these drugs for long periods of time, as well as patients who take PPIs

> with medications such as digoxin, diuretics or drugs that may cause

> hypomagnesemia. For patients taking digoxin, a heart medicine, this is

> especially important because low magnesium can increase the likelihood of

> serious side effects. Healthcare professionals should consider obtaining

> magnesium levels periodically in these patients.

>

> *The ls of Pharmacotherapy. 2011;45(1):1-8.

> *

> LINK<http://www.diabetesincontrol.com/index.php?option=com_content

> <

>

http://www.diabetesincontrol.com/index.php?option=com_content & view=article &

> id=10607 & catid=1 & Itemid=17> & view=article & id=10607 & catid=1 & Itemid=17>

> --

> Ortiz, MS, RD

> *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

>

> Check out my blog: mixture of deals and nutrition

> USAIR: 2000 mile bonus for signing up for a new account exp. 3/30 = FREE

> magazines <http://thefrugaldietitian.com/?p=16546>New Giveaway : Healthy

>

> Toys from The Frugal Dietitian Ends on 3/16 8

> PM<http://thefrugaldietitian.com/?p=16384> Made

>

> my own " funny but real " movie: Me interviewing a " potential " Dietetic

> student <

>

> *Healthy Diet at any Age: We are NOT just looking

>

> *

>

> *at the years people have behind them but also the

> *

>

> *quality of the years ahead of them.*

>

>

[Guest guest]

There is a company called Cardiovascular Research that sells magnesium

taurate.... so far so good with my patients with that one...........(can find

online). 

 

>

>

> and group:

>

> Oh, great! I've been skipping over these messages for various reasons,

> mostly lack of interest in some topics. After reading a few of the posts I

> skipped over most of the others.

>

> This morning I'm a bit slower and I tend to read most if not all of some

> ppl's posts, being one of them. The first word I catch while

scanning

> is NEXIUM. Need I say more? I've been taking Nexium for GERD and extreme

> upper stomach pain for abt 3 years now - usually every 2-3 days, but

> chronic

> use nonetheless. I've printed this post below to take with me to my MD

next

> visit and request a magnesium level to determine if I've had this outcome.

> We'll see what he says and if I have any alternatives, but in the

meantime,

> since I didn't pay attention during " class " , please recommend the best

> supplementation for me to use.

>

> The devil of it is that I am also taking propanonol for heartbeat

> irregularities, such as ----- occasional arythmia. Never did the

> prescribing MD mention the side-effects possibilities, and I'm surprised

> that although I read all the literature before even purchasing the drug, I

> did not read this then.

>

> Digna

>

> From: rd-usa [mailto:rd-usa ] On Behalf Of

> Ortiz

> Sent: Sunday, March 13, 2011 5:56 AM

> To: RD-USA

>

> Subject: Low Magnesium Levels May Be Associated with Proton Pump

> Inhibitor Drugs

>

> Prescription PPIs include Nexium (esomeprazole magnesium), Dexilant

> (dexlansoprazole), Prilosec (omeprazole), Zegerid (omeprazole and sodium

> bicarbonate), Prevacid (lansoprazole), Protonix (pantoprazole sodium),

> AcipHex (rabeprazole sodium), and Vimovo (a prescription combination drug

> product that contains a PPI [esomeprazole magnesium and naproxen]).

> Over-the-counter (OTC) PPIs include Prilosec OTC (omeprazole), Zegerid OTC

> (omeprazole and sodium bicarbonate), and Prevacid 24HR (lansoprazole).

>

> FDA notified healthcare professionals and the public that prescription

> proton pump inhibitor (PPI) drugs may cause low serum magnesium levels

> (hypomagnesemia) if taken for prolonged periods of time (in most cases,

> longer than one year). Low serum magnesium levels can result in serious

> adverse events including muscle spasm (tetany), irregular heartbeat

> (arrhythmias), and convulsions (seizures); however, patients do not always

> have these symptoms. Treatment of hypomagnesemia generally requires

> magnesium supplements. In approximately one-quarter of the cases reviewed,

> magnesium supplementation alone did not improve low serum magnesium levels

> and the PPI had to be discontinued.

>

> PPIs work by reducing the amount of acid in the stomach and are used to

> treat conditions such as gastroesophageal reflux disease (GERD), stomach

> and

> small intestine ulcers, and inflammation of the esophagus.

>

> Healthcare professionals should consider obtaining serum magnesium levels

> prior to initiation of prescription PPI treatment in patients expected to

> be

> on these drugs for long periods of time, as well as patients who take PPIs

> with medications such as digoxin, diuretics or drugs that may cause

> hypomagnesemia. For patients taking digoxin, a heart medicine, this is

> especially important because low magnesium can increase the likelihood of

> serious side effects. Healthcare professionals should consider obtaining

> magnesium levels periodically in these patients.

>

> *The ls of Pharmacotherapy. 2011;45(1):1-8.

> *

> LINK<http://www.diabetesincontrol.com/index.php?option=com_content

> <

>

http://www.diabetesincontrol.com/index.php?option=com_content & view=article &

> id=10607 & catid=1 & Itemid=17> & view=article & id=10607 & catid=1 & Itemid=17>

> --

> Ortiz, MS, RD

> *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

>

> Check out my blog: mixture of deals and nutrition

> USAIR: 2000 mile bonus for signing up for a new account exp. 3/30 = FREE

> magazines <http://thefrugaldietitian.com/?p=16546>New Giveaway : Healthy

>

> Toys from The Frugal Dietitian Ends on 3/16 8

> PM<http://thefrugaldietitian.com/?p=16384> Made

>

> my own " funny but real " movie: Me interviewing a " potential " Dietetic

> student <

>

> *Healthy Diet at any Age: We are NOT just looking

>

> *

>

> *at the years people have behind them but also the

> *

>

> *quality of the years ahead of them.*

>

>

[Guest guest]

Btw, I have never seen a patient on this Rx that did better and have

only seen their health gradually decline!

Sent from my iPhone

On Mar 14, 2011, at 11:36 AM, Linke

wrote:

>

> There is a company called Cardiovascular Research that sells

> magnesium taurate.... so far so good with my patients with that

> one...........(can find online).

>

>

>

>

>

> >

> >

> > and group:

> >

> > Oh, great! I've been skipping over these messages for various

> reasons,

> > mostly lack of interest in some topics. After reading a few of the

> posts I

> > skipped over most of the others.

> >

> > This morning I'm a bit slower and I tend to read most if not all

> of some

> > ppl's posts, being one of them. The first word I catch while

> scanning

> > is NEXIUM. Need I say more? I've been taking Nexium for GERD and

> extreme

> > upper stomach pain for abt 3 years now - usually every 2-3 days, but

> > chronic

> > use nonetheless. I've printed this post below to take with me to

> my MD

> next

> > visit and request a magnesium level to determine if I've had this

> outcome.

> > We'll see what he says and if I have any alternatives, but in the

> meantime,

> > since I didn't pay attention during " class " , please recommend the

> best

> > supplementation for me to use.

> >

> > The devil of it is that I am also taking propanonol for heartbeat

> > irregularities, such as ----- occasional arythmia. Never did the

> > prescribing MD mention the side-effects possibilities, and I'm

> surprised

> > that although I read all the literature before even purchasing the

> drug, I

> > did not read this then.

> >

> > Digna

> >

> > From: rd-usa [mailto:rd-usa ] On

> Behalf Of

> > Ortiz

> > Sent: Sunday, March 13, 2011 5:56 AM

> > To: RD-USA

> >

> > Subject: Low Magnesium Levels May Be Associated with

> Proton Pump

> > Inhibitor Drugs

> >

> > Prescription PPIs include Nexium (esomeprazole magnesium), Dexilant

> > (dexlansoprazole), Prilosec (omeprazole), Zegerid (omeprazole and

> sodium

> > bicarbonate), Prevacid (lansoprazole), Protonix (pantoprazole

> sodium),

> > AcipHex (rabeprazole sodium), and Vimovo (a prescription

> combination drug

> > product that contains a PPI [esomeprazole magnesium and naproxen]).

> > Over-the-counter (OTC) PPIs include Prilosec OTC (omeprazole),

> Zegerid OTC

> > (omeprazole and sodium bicarbonate), and Prevacid 24HR

> (lansoprazole).

> >

> > FDA notified healthcare professionals and the public that

> prescription

> > proton pump inhibitor (PPI) drugs may cause low serum magnesium

> levels

> > (hypomagnesemia) if taken for prolonged periods of time (in most

> cases,

> > longer than one year). Low serum magnesium levels can result in

> serious

> > adverse events including muscle spasm (tetany), irregular heartbeat

> > (arrhythmias), and convulsions (seizures); however, patients do

> not always

> > have these symptoms. Treatment of hypomagnesemia generally requires

> > magnesium supplements. In approximately one-quarter of the cases

> reviewed,

> > magnesium supplementation alone did not improve low serum

> magnesium levels

> > and the PPI had to be discontinued.

> >

> > PPIs work by reducing the amount of acid in the stomach and are

> used to

> > treat conditions such as gastroesophageal reflux disease (GERD),

> stomach

> > and

> > small intestine ulcers, and inflammation of the esophagus.

> >

> > Healthcare professionals should consider obtaining serum magnesium

> levels

> > prior to initiation of prescription PPI treatment in patients

> expected to

> > be

> > on these drugs for long periods of time, as well as patients who

> take PPIs

> > with medications such as digoxin, diuretics or drugs that may cause

> > hypomagnesemia. For patients taking digoxin, a heart medicine,

> this is

> > especially important because low magnesium can increase the

> likelihood of

> > serious side effects. Healthcare professionals should consider

> obtaining

> > magnesium levels periodically in these patients.

> >

> > *The ls of Pharmacotherapy. 2011;45(1):1-8.

> > *

> > LINK<http://www.diabetesincontrol.com/index.php?option=com_content

> > <

> >

> http://www.diabetesincontrol.com/index.php?option=com_content & view=article &

> > id=10607 & catid=1 & Itemid=17>

> & view=article & id=10607 & catid=1 & Itemid=17>

> > --

> > Ortiz, MS, RD

> > *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

> >

> > Check out my blog: mixture of deals and nutrition

> > USAIR: 2000 mile bonus for signing up for a new account exp. 3/30

> = FREE

> > magazines <http://thefrugaldietitian.com/?p=16546>New Giveaway :

> Healthy

> >

> > Toys from The Frugal Dietitian Ends on 3/16 8

> > PM<http://thefrugaldietitian.com/?p=16384> Made

> >

> > my own " funny but real " movie: Me interviewing a " potential "

> Dietetic

> > student <

> >

> > *Healthy Diet at any Age: We are NOT just looking

> >

> > *

> >

> > *at the years people have behind them but also the

> > *

> >

> > *quality of the years ahead of them.*

> >

> >

[Guest guest]

My husband couldn't survive without his Prilosec (omprezalone) with his

hiatal hernia. But many start it for a temporary problem and don't

discontinue. Many can then have a rebound effect and/or aggravate a

potential Vit B12 deficiency especially in the elderly.

On Mon, Mar 14, 2011 at 1:05 PM, Weaver wrote:

>

>

>

> Btw, I have never seen a patient on this Rx that did better and have

> only seen their health gradually decline!

> Sent from my iPhone

>

> On Mar 14, 2011, at 11:36 AM, Linke

> wrote:

>

>

> >

> > There is a company called Cardiovascular Research that sells

> > magnesium taurate.... so far so good with my patients with that

> > one...........(can find online).

> >

> >

> >

> >

> >

> > >

> > >

> > > and group:

> > >

> > > Oh, great! I've been skipping over these messages for various

> > reasons,

> > > mostly lack of interest in some topics. After reading a few of the

> > posts I

> > > skipped over most of the others.

> > >

> > > This morning I'm a bit slower and I tend to read most if not all

> > of some

> > > ppl's posts, being one of them. The first word I catch while

> > scanning

> > > is NEXIUM. Need I say more? I've been taking Nexium for GERD and

> > extreme

> > > upper stomach pain for abt 3 years now - usually every 2-3 days, but

> > > chronic

> > > use nonetheless. I've printed this post below to take with me to

> > my MD

> > next

> > > visit and request a magnesium level to determine if I've had this

> > outcome.

> > > We'll see what he says and if I have any alternatives, but in the

> > meantime,

> > > since I didn't pay attention during " class " , please recommend the

> > best

> > > supplementation for me to use.

> > >

> > > The devil of it is that I am also taking propanonol for heartbeat

> > > irregularities, such as ----- occasional arythmia. Never did the

> > > prescribing MD mention the side-effects possibilities, and I'm

> > surprised

> > > that although I read all the literature before even purchasing the

> > drug, I

> > > did not read this then.

> > >

> > > Digna

> > >

> > > From: rd-usa [mailto:rd-usa ] On

> > Behalf Of

> > > Ortiz

> > > Sent: Sunday, March 13, 2011 5:56 AM

> > > To: RD-USA

> > >

> > > Subject: Low Magnesium Levels May Be Associated with

> > Proton Pump

> > > Inhibitor Drugs

> > >

> > > Prescription PPIs include Nexium (esomeprazole magnesium), Dexilant

> > > (dexlansoprazole), Prilosec (omeprazole), Zegerid (omeprazole and

> > sodium

> > > bicarbonate), Prevacid (lansoprazole), Protonix (pantoprazole

> > sodium),

> > > AcipHex (rabeprazole sodium), and Vimovo (a prescription

> > combination drug

> > > product that contains a PPI [esomeprazole magnesium and naproxen]).

> > > Over-the-counter (OTC) PPIs include Prilosec OTC (omeprazole),

> > Zegerid OTC

> > > (omeprazole and sodium bicarbonate), and Prevacid 24HR

> > (lansoprazole).

> > >

> > > FDA notified healthcare professionals and the public that

> > prescription

> > > proton pump inhibitor (PPI) drugs may cause low serum magnesium

> > levels

> > > (hypomagnesemia) if taken for prolonged periods of time (in most

> > cases,

> > > longer than one year). Low serum magnesium levels can result in

> > serious

> > > adverse events including muscle spasm (tetany), irregular heartbeat

> > > (arrhythmias), and convulsions (seizures); however, patients do

> > not always

> > > have these symptoms. Treatment of hypomagnesemia generally requires

> > > magnesium supplements. In approximately one-quarter of the cases

> > reviewed,

> > > magnesium supplementation alone did not improve low serum

> > magnesium levels

> > > and the PPI had to be discontinued.

> > >

> > > PPIs work by reducing the amount of acid in the stomach and are

> > used to

> > > treat conditions such as gastroesophageal reflux disease (GERD),

> > stomach

> > > and

> > > small intestine ulcers, and inflammation of the esophagus.

> > >

> > > Healthcare professionals should consider obtaining serum magnesium

> > levels

> > > prior to initiation of prescription PPI treatment in patients

> > expected to

> > > be

> > > on these drugs for long periods of time, as well as patients who

> > take PPIs

> > > with medications such as digoxin, diuretics or drugs that may cause

> > > hypomagnesemia. For patients taking digoxin, a heart medicine,

> > this is

> > > especially important because low magnesium can increase the

> > likelihood of

> > > serious side effects. Healthcare professionals should consider

> > obtaining

> > > magnesium levels periodically in these patients.

> > >

> > > *The ls of Pharmacotherapy. 2011;45(1):1-8.

> > > *

> > > LINK<http://www.diabetesincontrol.com/index.php?option=com_content

> > > <

> > >

> >

> http://www.diabetesincontrol.com/index.php?option=com_content & view=article &

> > > id=10607 & catid=1 & Itemid=17>

> > & view=article & id=10607 & catid=1 & Itemid=17>

> > > --

> > > Ortiz, MS, RD

> > > *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

> > >

> > > Check out my blog: mixture of deals and nutrition

> > > USAIR: 2000 mile bonus for signing up for a new account exp. 3/30

> > = FREE

> > > magazines <http://thefrugaldietitian.com/?p=16546>New Giveaway :

> > Healthy

> > >

> > > Toys from The Frugal Dietitian Ends on 3/16 8

> > > PM<http://thefrugaldietitian.com/?p=16384> Made

> > >

> > > my own " funny but real " movie: Me interviewing a " potential "

> > Dietetic

> > > student <

> > >

> > > *Healthy Diet at any Age: We are NOT just looking

> > >

> > > *

> > >

> > > *at the years people have behind them but also the

> > > *

> > >

> > > *quality of the years ahead of them.*

> > >

> > >

[Guest guest]

My husband couldn't survive without his Prilosec (omprezalone) with his

hiatal hernia. But many start it for a temporary problem and don't

discontinue. Many can then have a rebound effect and/or aggravate a

potential Vit B12 deficiency especially in the elderly.

On Mon, Mar 14, 2011 at 1:05 PM, Weaver wrote:

>

>

>

> Btw, I have never seen a patient on this Rx that did better and have

> only seen their health gradually decline!

> Sent from my iPhone

>

> On Mar 14, 2011, at 11:36 AM, Linke

> wrote:

>

>

> >

> > There is a company called Cardiovascular Research that sells

> > magnesium taurate.... so far so good with my patients with that

> > one...........(can find online).

> >

> >

> >

> >

> >

> > >

> > >

> > > and group:

> > >

> > > Oh, great! I've been skipping over these messages for various

> > reasons,

> > > mostly lack of interest in some topics. After reading a few of the

> > posts I

> > > skipped over most of the others.

> > >

> > > This morning I'm a bit slower and I tend to read most if not all

> > of some

> > > ppl's posts, being one of them. The first word I catch while

> > scanning

> > > is NEXIUM. Need I say more? I've been taking Nexium for GERD and

> > extreme

> > > upper stomach pain for abt 3 years now - usually every 2-3 days, but

> > > chronic

> > > use nonetheless. I've printed this post below to take with me to

> > my MD

> > next

> > > visit and request a magnesium level to determine if I've had this

> > outcome.

> > > We'll see what he says and if I have any alternatives, but in the

> > meantime,

> > > since I didn't pay attention during " class " , please recommend the

> > best

> > > supplementation for me to use.

> > >

> > > The devil of it is that I am also taking propanonol for heartbeat

> > > irregularities, such as ----- occasional arythmia. Never did the

> > > prescribing MD mention the side-effects possibilities, and I'm

> > surprised

> > > that although I read all the literature before even purchasing the

> > drug, I

> > > did not read this then.

> > >

> > > Digna

> > >

> > > From: rd-usa [mailto:rd-usa ] On

> > Behalf Of

> > > Ortiz

> > > Sent: Sunday, March 13, 2011 5:56 AM

> > > To: RD-USA

> > >

> > > Subject: Low Magnesium Levels May Be Associated with

> > Proton Pump

> > > Inhibitor Drugs

> > >

> > > Prescription PPIs include Nexium (esomeprazole magnesium), Dexilant

> > > (dexlansoprazole), Prilosec (omeprazole), Zegerid (omeprazole and

> > sodium

> > > bicarbonate), Prevacid (lansoprazole), Protonix (pantoprazole

> > sodium),

> > > AcipHex (rabeprazole sodium), and Vimovo (a prescription

> > combination drug

> > > product that contains a PPI [esomeprazole magnesium and naproxen]).

> > > Over-the-counter (OTC) PPIs include Prilosec OTC (omeprazole),

> > Zegerid OTC

> > > (omeprazole and sodium bicarbonate), and Prevacid 24HR

> > (lansoprazole).

> > >

> > > FDA notified healthcare professionals and the public that

> > prescription

> > > proton pump inhibitor (PPI) drugs may cause low serum magnesium

> > levels

> > > (hypomagnesemia) if taken for prolonged periods of time (in most

> > cases,

> > > longer than one year). Low serum magnesium levels can result in

> > serious

> > > adverse events including muscle spasm (tetany), irregular heartbeat

> > > (arrhythmias), and convulsions (seizures); however, patients do

> > not always

> > > have these symptoms. Treatment of hypomagnesemia generally requires

> > > magnesium supplements. In approximately one-quarter of the cases

> > reviewed,

> > > magnesium supplementation alone did not improve low serum

> > magnesium levels

> > > and the PPI had to be discontinued.

> > >

> > > PPIs work by reducing the amount of acid in the stomach and are

> > used to

> > > treat conditions such as gastroesophageal reflux disease (GERD),

> > stomach

> > > and

> > > small intestine ulcers, and inflammation of the esophagus.

> > >

> > > Healthcare professionals should consider obtaining serum magnesium

> > levels

> > > prior to initiation of prescription PPI treatment in patients

> > expected to

> > > be

> > > on these drugs for long periods of time, as well as patients who

> > take PPIs

> > > with medications such as digoxin, diuretics or drugs that may cause

> > > hypomagnesemia. For patients taking digoxin, a heart medicine,

> > this is

> > > especially important because low magnesium can increase the

> > likelihood of

> > > serious side effects. Healthcare professionals should consider

> > obtaining

> > > magnesium levels periodically in these patients.

> > >

> > > *The ls of Pharmacotherapy. 2011;45(1):1-8.

> > > *

> > > LINK<http://www.diabetesincontrol.com/index.php?option=com_content

> > > <

> > >

> >

> http://www.diabetesincontrol.com/index.php?option=com_content & view=article &

> > > id=10607 & catid=1 & Itemid=17>

> > & view=article & id=10607 & catid=1 & Itemid=17>

> > > --

> > > Ortiz, MS, RD

> > > *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

> > >

> > > Check out my blog: mixture of deals and nutrition

> > > USAIR: 2000 mile bonus for signing up for a new account exp. 3/30

> > = FREE

> > > magazines <http://thefrugaldietitian.com/?p=16546>New Giveaway :

> > Healthy

> > >

> > > Toys from The Frugal Dietitian Ends on 3/16 8

> > > PM<http://thefrugaldietitian.com/?p=16384> Made

> > >

> > > my own " funny but real " movie: Me interviewing a " potential "

> > Dietetic

> > > student <

> > >

> > > *Healthy Diet at any Age: We are NOT just looking

> > >

> > > *

> > >

> > > *at the years people have behind them but also the

> > > *

> > >

> > > *quality of the years ahead of them.*

> > >

> > >

[Guest guest]

My husband couldn't survive without his Prilosec (omprezalone) with his

hiatal hernia. But many start it for a temporary problem and don't

discontinue. Many can then have a rebound effect and/or aggravate a

potential Vit B12 deficiency especially in the elderly.

On Mon, Mar 14, 2011 at 1:05 PM, Weaver wrote:

>

>

>

> Btw, I have never seen a patient on this Rx that did better and have

> only seen their health gradually decline!

> Sent from my iPhone

>

> On Mar 14, 2011, at 11:36 AM, Linke

> wrote:

>

>

> >

> > There is a company called Cardiovascular Research that sells

> > magnesium taurate.... so far so good with my patients with that

> > one...........(can find online).

> >

> >

> >

> >

> >

> > >

> > >

> > > and group:

> > >

> > > Oh, great! I've been skipping over these messages for various

> > reasons,

> > > mostly lack of interest in some topics. After reading a few of the

> > posts I

> > > skipped over most of the others.

> > >

> > > This morning I'm a bit slower and I tend to read most if not all

> > of some

> > > ppl's posts, being one of them. The first word I catch while

> > scanning

> > > is NEXIUM. Need I say more? I've been taking Nexium for GERD and

> > extreme

> > > upper stomach pain for abt 3 years now - usually every 2-3 days, but

> > > chronic

> > > use nonetheless. I've printed this post below to take with me to

> > my MD

> > next

> > > visit and request a magnesium level to determine if I've had this

> > outcome.

> > > We'll see what he says and if I have any alternatives, but in the

> > meantime,

> > > since I didn't pay attention during " class " , please recommend the

> > best

> > > supplementation for me to use.

> > >

> > > The devil of it is that I am also taking propanonol for heartbeat

> > > irregularities, such as ----- occasional arythmia. Never did the

> > > prescribing MD mention the side-effects possibilities, and I'm

> > surprised

> > > that although I read all the literature before even purchasing the

> > drug, I

> > > did not read this then.

> > >

> > > Digna

> > >

> > > From: rd-usa [mailto:rd-usa ] On

> > Behalf Of

> > > Ortiz

> > > Sent: Sunday, March 13, 2011 5:56 AM

> > > To: RD-USA

> > >

> > > Subject: Low Magnesium Levels May Be Associated with

> > Proton Pump

> > > Inhibitor Drugs

> > >

> > > Prescription PPIs include Nexium (esomeprazole magnesium), Dexilant

> > > (dexlansoprazole), Prilosec (omeprazole), Zegerid (omeprazole and

> > sodium

> > > bicarbonate), Prevacid (lansoprazole), Protonix (pantoprazole

> > sodium),

> > > AcipHex (rabeprazole sodium), and Vimovo (a prescription

> > combination drug

> > > product that contains a PPI [esomeprazole magnesium and naproxen]).

> > > Over-the-counter (OTC) PPIs include Prilosec OTC (omeprazole),

> > Zegerid OTC

> > > (omeprazole and sodium bicarbonate), and Prevacid 24HR

> > (lansoprazole).

> > >

> > > FDA notified healthcare professionals and the public that

> > prescription

> > > proton pump inhibitor (PPI) drugs may cause low serum magnesium

> > levels

> > > (hypomagnesemia) if taken for prolonged periods of time (in most

> > cases,

> > > longer than one year). Low serum magnesium levels can result in

> > serious

> > > adverse events including muscle spasm (tetany), irregular heartbeat

> > > (arrhythmias), and convulsions (seizures); however, patients do

> > not always

> > > have these symptoms. Treatment of hypomagnesemia generally requires

> > > magnesium supplements. In approximately one-quarter of the cases

> > reviewed,

> > > magnesium supplementation alone did not improve low serum

> > magnesium levels

> > > and the PPI had to be discontinued.

> > >

> > > PPIs work by reducing the amount of acid in the stomach and are

> > used to

> > > treat conditions such as gastroesophageal reflux disease (GERD),

> > stomach

> > > and

> > > small intestine ulcers, and inflammation of the esophagus.

> > >

> > > Healthcare professionals should consider obtaining serum magnesium

> > levels

> > > prior to initiation of prescription PPI treatment in patients

> > expected to

> > > be

> > > on these drugs for long periods of time, as well as patients who

> > take PPIs

> > > with medications such as digoxin, diuretics or drugs that may cause

> > > hypomagnesemia. For patients taking digoxin, a heart medicine,

> > this is

> > > especially important because low magnesium can increase the

> > likelihood of

> > > serious side effects. Healthcare professionals should consider

> > obtaining

> > > magnesium levels periodically in these patients.

> > >

> > > *The ls of Pharmacotherapy. 2011;45(1):1-8.

> > > *

> > > LINK<http://www.diabetesincontrol.com/index.php?option=com_content

> > > <

> > >

> >

> http://www.diabetesincontrol.com/index.php?option=com_content & view=article &

> > > id=10607 & catid=1 & Itemid=17>

> > & view=article & id=10607 & catid=1 & Itemid=17>

> > > --

> > > Ortiz, MS, RD

> > > *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

> > >

> > > Check out my blog: mixture of deals and nutrition

> > > USAIR: 2000 mile bonus for signing up for a new account exp. 3/30

> > = FREE

> > > magazines <http://thefrugaldietitian.com/?p=16546>New Giveaway :

> > Healthy

> > >

> > > Toys from The Frugal Dietitian Ends on 3/16 8

> > > PM<http://thefrugaldietitian.com/?p=16384> Made

> > >

> > > my own " funny but real " movie: Me interviewing a " potential "

> > Dietetic

> > > student <

> > >

> > > *Healthy Diet at any Age: We are NOT just looking

> > >

> > > *

> > >

> > > *at the years people have behind them but also the

> > > *

> > >

> > > *quality of the years ahead of them.*

> > >

> > >

[Guest guest]

Hi ,

Great article. The numbers are adding up in favor of laying off pharmaceuticals

instead of teachers! i wish the state governers around here would get on board

with that budget plan. (I bet the Medicaid and Medicare costs would save a lot)

My blog this morning hit a nerve; 91 people have read it already - my vitamin D

article (next highest) is just approaching 60 views, added up gradually.

I would appreciate feed back if you had time. It was initially just geared

towards safe use of seaweed supplements vs iodoral or potassium iodide -

controlled dose w no goiterogens. My thesis statement tends to get lost in

trivia too often. but in doing the fact check/bib building I realized that fear

is high about fallout - taking iodine is safe and does reduce long term cancer

risk. but I don't want to add to fear and I think I may have lost the forest for

the trees. Questions/prods about gaps/leaps would be helpful. Actually it is

mostly in the bibliography that the story gets into nuclear fallout

recommendations and hx.

So my real question, I think - does the opening - Seaweed supplement story tell

enough to the lay person without fear-building and the bibliography add detail

for the more curious without creating too much fear?

R Vajda, R.D.

www.GingerJens.com

________________________________

To: rd-usa

Sent: Sun, March 13, 2011 1:13:17 PM

Subject: Re: Low Magnesium Levels May Be Associated with Proton Pump

Inhibitor Drugs

From Natural medicine database:

*PROTON PUMP INHIBITORS (PPIs)*: Taking a PPI long-term, especially over a

year, has been linked to an increased risk of hypomagnesemia in several

reports

(<http://naturaldatabase.therapeuticresearch.com/nd/Search.aspx?cs= & s=ND & pt=101 & \

sh=12 & id=998 & id2=17546#17546>.

PPIs are thought to inhibit active transport of magnesium in the

intestine

(<http://naturaldatabase.therapeuticresearch.com/nd/Search.aspx?cs= & s=ND & pt=101 & \

sh=12 & id=998 & id2=17549#17549>).

This appears to be a class effect. Hypomagnesemia has been reported with all

PPIs ()

Severe hypomagnesemia can cause potentially serious effects including muscle

spasm, tetany, arrhythmia, hypokalemia, hypoparathyroidism, hypocalcemia,

and seizures. Patients who are likely to take a PPI long-term should have

serum magnesium levels checked at baseline and annually thereafter. A

magnesium supplement may be necessary to treat or prevent magnesium

deficiency. In some patients, magnesium supplementation alone may not be

adequate to treat hypomagnesemia. Case reports suggest that up to 25% of

patients who developed hypomagnesemia had to discontinue the PPI in order

for magnesium levels to return to normal

(<http://naturaldatabase.therapeuticresearch.com/nd/Search.aspx?cs= & s=ND & pt=101 & \

sh=12 & id=998 & id2=17546#17546>).

In many cases, hypomagnesemia recurred when the PPI was re-initiated

In some reports, use of pantoprazole (Protonix), in combination with a

magnesium supplement, was effective for treating reflux and preventing

magnesium loss ). In another case, use of alternate day dosing of

pantoprazole (Protonix) three days per week and famotidine (Pepcid) four

days per week, in combination with a magnesium supplement, was also

effective for treating symptoms and increasing magnesium levels . Some

experts speculate that the magnesium depletion caused by PPIs could

contribute to the increased risk of fracture seen in some patients taking

PPIs long-term .

PPIs include omeprazole (Prilosec), esomeprazole (Nexium), lansoprazole,

(Prevacid), pantoprazole (Protonix), rabeprazole (AcipHex), and

dexlansoprazole (Dexilant).

Cundy T, Dissanayake A. Severe hypomagnesaemia in long-term users of

proton-pump inhibitors. Clin Endocrinol (Oxf)

2008;69:338-41<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=Pub\

Med & list_uids=18221401 & dopt=Abstract>

..

close window *17550* Doornebal J, Bijlsma R, Brouwer RM. [An unknown but

potentially serious side effect of proton pump inhibitors: hypomagnesaemia].

[Article in Dutch] Ned Tijdschr Geneeskd

2009;153:A711<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubM\

ed & list_uids=19930736 & dopt=Abstract>

.. *17551* Epstein M, McGrath S, Law F. Proton-pump inhibitors and

hypomagnesemic hypoparathyroidism. N Engl J Med

2006;355:1834-6<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=Pu\

bMed & list_uids=17065651 & dopt=Abstract>

.. *17552* François M, Lévy-Bohbot N, Caron J, Durlach V. [Chronic use of

proton-pump inhibitors associated with giardiasis: A rare cause of

hypomagnesemic hypoparathyroidism?]. [Article in French] Ann Endocrinol

2008;69:446-8<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubM\

ed & list_uids=18614153 & dopt=Abstract>

.. *17553* Broeren MA, Geerdink EA, Vader HL, van den Wall Bake AW.

Hypomagnesemia induced by several proton-pump inhibitors. Ann Intern Med

2009;151:755-6<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=Pub\

Med & list_uids=19920278 & dopt=Abstract>

.. *17554* Hoorn EJ, van der Hoek J, de Man RA, et al. A case series of

proton pump inhibitor-induced hypomagnesemia. Am J Kidney Dis

2010;56:112-6<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubM\

ed & list_uids=20189276 & dopt=Abstract>

.. *17555* Regolisti G, Cabassi A, Parenti E, et al. Severe hypomagnesemia

during long-term treatment with a proton pump inhibitor. Am J Kidney Dis

2010;56:168-74<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=Pub\

Med & list_uids=20493607 & dopt=Abstract>

..

> As posted before the UL is 350 mg and of course large doses can also cause

> diarrhea/loose stools (which is why it is used sometimes for 'bowel

> cleaning " - magnesium citrate for example - usually most potent). I think

> what you would need to take would be determined by your blood levels - like

> iron - UL is based on healthy normal blood level.

>

> I checked consumerlab.com and the main concern in one was lead in it -

> Gillham's Natural Vitality Natural Calm (205 mg per teaspoon, 1/2 to 3 per

> day)

> 2005 Total Nutrition Natural Amino Acid Chelated Magnesium (100 mg per

> tablet, 4 per day) - only 28% of Magnesium stated

> 2005 Tropical Oasis Liquid Calcium Magnesium Orange Flavor (115 mg per

> Tbsp, 1 Tbsp per day) - only 45% magnesium stated

>

> Of course something like Maalox and Milk of Magnesia has magnesium in it

> (thus the name) but also aluminum (a problem with renal patients). One had

> 200 mg magnesium hydroxide. Zegerid has magnesium hydroxide in it 700 mg.

> Nexium has magnesium also. Not sure how the amounts convert to actual

> magnesium content.

>

> Of course low magnesium levels can affect insulin sensitivity in Type 2

> diabetics.

>

>

> On Sun, Mar 13, 2011 at 12:29 PM, Digna Cassens <

> dignacassens@...> wrote:

>

>>

>>

>> and group:

>>

>> Oh, great! I've been skipping over these messages for various reasons,

>> mostly lack of interest in some topics. After reading a few of the posts I

>> skipped over most of the others.

>>

>> This morning I'm a bit slower and I tend to read most if not all of some

>> ppl's posts, being one of them. The first word I catch while

>> scanning

>> is NEXIUM. Need I say more? I've been taking Nexium for GERD and extreme

>> upper stomach pain for abt 3 years now - usually every 2-3 days, but

>> chronic

>> use nonetheless. I've printed this post below to take with me to my MD

>> next

>> visit and request a magnesium level to determine if I've had this outcome.

>> We'll see what he says and if I have any alternatives, but in the

>> meantime,

>> since I didn't pay attention during " class " , please recommend the best

>> supplementation for me to use.

>>

>> The devil of it is that I am also taking propanonol for heartbeat

>> irregularities, such as ----- occasional arythmia. Never did the

>> prescribing MD mention the side-effects possibilities, and I'm surprised

>> that although I read all the literature before even purchasing the drug, I

>> did not read this then.

>>

>> Digna

>>

>> From: rd-usa [mailto:rd-usa ] On Behalf Of

>> Ortiz

>> Sent: Sunday, March 13, 2011 5:56 AM

>> To: RD-USA

>>

>> Subject: Low Magnesium Levels May Be Associated with Proton Pump

>> Inhibitor Drugs

>>

>> Prescription PPIs include Nexium (esomeprazole magnesium), Dexilant

>> (dexlansoprazole), Prilosec (omeprazole), Zegerid (omeprazole and sodium

>> bicarbonate), Prevacid (lansoprazole), Protonix (pantoprazole sodium),

>> AcipHex (rabeprazole sodium), and Vimovo (a prescription combination drug

>> product that contains a PPI [esomeprazole magnesium and naproxen]).

>> Over-the-counter (OTC) PPIs include Prilosec OTC (omeprazole), Zegerid OTC

>> (omeprazole and sodium bicarbonate), and Prevacid 24HR (lansoprazole).

>>

>> FDA notified healthcare professionals and the public that prescription

>> proton pump inhibitor (PPI) drugs may cause low serum magnesium levels

>> (hypomagnesemia) if taken for prolonged periods of time (in most cases,

>> longer than one year). Low serum magnesium levels can result in serious

>> adverse events including muscle spasm (tetany), irregular heartbeat

>> (arrhythmias), and convulsions (seizures); however, patients do not always

>> have these symptoms. Treatment of hypomagnesemia generally requires

>> magnesium supplements. In approximately one-quarter of the cases reviewed,

>> magnesium supplementation alone did not improve low serum magnesium levels

>> and the PPI had to be discontinued.

>>

>> PPIs work by reducing the amount of acid in the stomach and are used to

>> treat conditions such as gastroesophageal reflux disease (GERD), stomach

>> and

>> small intestine ulcers, and inflammation of the esophagus.

>>

>> Healthcare professionals should consider obtaining serum magnesium levels

>> prior to initiation of prescription PPI treatment in patients expected to

>> be

>> on these drugs for long periods of time, as well as patients who take PPIs

>> with medications such as digoxin, diuretics or drugs that may cause

>> hypomagnesemia. For patients taking digoxin, a heart medicine, this is

>> especially important because low magnesium can increase the likelihood of

>> serious side effects. Healthcare professionals should consider obtaining

>> magnesium levels periodically in these patients.

>>

>> *The ls of Pharmacotherapy. 2011;45(1):1-8.

>> *

>> LINK<http://www.diabetesincontrol.com/index.php?option=com_content

>> <

>> http://www.diabetesincontrol.com/index.php?option=com_content & view=article &

>> id=10607 & catid=1 & Itemid=17> & view=article & id=10607 & catid=1 & Itemid=17>

>> --

>> Ortiz, MS, RD

>> *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

>>

>> Check out my blog: mixture of deals and nutrition

>> USAIR: 2000 mile bonus for signing up for a new account exp. 3/30 = FREE

>> magazines <http://thefrugaldietitian.com/?p=16546>New Giveaway : Healthy

>>

>> Toys from The Frugal Dietitian Ends on 3/16 8

>> PM<http://thefrugaldietitian.com/?p=16384> Made

>>

>> my own " funny but real " movie: Me interviewing a " potential " Dietetic

>> student <

>>

>> *Healthy Diet at any Age: We are NOT just looking

>>

>> *

>>

>> *at the years people have behind them but also the

>> *

>>

>> *quality of the years ahead of them.*

>>

>>

[Guest guest]

Hi ,

Great article. The numbers are adding up in favor of laying off pharmaceuticals

instead of teachers! i wish the state governers around here would get on board

with that budget plan. (I bet the Medicaid and Medicare costs would save a lot)

My blog this morning hit a nerve; 91 people have read it already - my vitamin D

article (next highest) is just approaching 60 views, added up gradually.

I would appreciate feed back if you had time. It was initially just geared

towards safe use of seaweed supplements vs iodoral or potassium iodide -

controlled dose w no goiterogens. My thesis statement tends to get lost in

trivia too often. but in doing the fact check/bib building I realized that fear

is high about fallout - taking iodine is safe and does reduce long term cancer

risk. but I don't want to add to fear and I think I may have lost the forest for

the trees. Questions/prods about gaps/leaps would be helpful. Actually it is

mostly in the bibliography that the story gets into nuclear fallout

recommendations and hx.

So my real question, I think - does the opening - Seaweed supplement story tell

enough to the lay person without fear-building and the bibliography add detail

for the more curious without creating too much fear?

R Vajda, R.D.

www.GingerJens.com

________________________________

To: rd-usa

Sent: Sun, March 13, 2011 1:13:17 PM

Subject: Re: Low Magnesium Levels May Be Associated with Proton Pump

Inhibitor Drugs

From Natural medicine database:

*PROTON PUMP INHIBITORS (PPIs)*: Taking a PPI long-term, especially over a

year, has been linked to an increased risk of hypomagnesemia in several

reports

(<http://naturaldatabase.therapeuticresearch.com/nd/Search.aspx?cs= & s=ND & pt=101 & \

sh=12 & id=998 & id2=17546#17546>.

PPIs are thought to inhibit active transport of magnesium in the

intestine

(<http://naturaldatabase.therapeuticresearch.com/nd/Search.aspx?cs= & s=ND & pt=101 & \

sh=12 & id=998 & id2=17549#17549>).

This appears to be a class effect. Hypomagnesemia has been reported with all

PPIs ()

Severe hypomagnesemia can cause potentially serious effects including muscle

spasm, tetany, arrhythmia, hypokalemia, hypoparathyroidism, hypocalcemia,

and seizures. Patients who are likely to take a PPI long-term should have

serum magnesium levels checked at baseline and annually thereafter. A

magnesium supplement may be necessary to treat or prevent magnesium

deficiency. In some patients, magnesium supplementation alone may not be

adequate to treat hypomagnesemia. Case reports suggest that up to 25% of

patients who developed hypomagnesemia had to discontinue the PPI in order

for magnesium levels to return to normal

(<http://naturaldatabase.therapeuticresearch.com/nd/Search.aspx?cs= & s=ND & pt=101 & \

sh=12 & id=998 & id2=17546#17546>).

In many cases, hypomagnesemia recurred when the PPI was re-initiated

In some reports, use of pantoprazole (Protonix), in combination with a

magnesium supplement, was effective for treating reflux and preventing

magnesium loss ). In another case, use of alternate day dosing of

pantoprazole (Protonix) three days per week and famotidine (Pepcid) four

days per week, in combination with a magnesium supplement, was also

effective for treating symptoms and increasing magnesium levels . Some

experts speculate that the magnesium depletion caused by PPIs could

contribute to the increased risk of fracture seen in some patients taking

PPIs long-term .

PPIs include omeprazole (Prilosec), esomeprazole (Nexium), lansoprazole,

(Prevacid), pantoprazole (Protonix), rabeprazole (AcipHex), and

dexlansoprazole (Dexilant).

Cundy T, Dissanayake A. Severe hypomagnesaemia in long-term users of

proton-pump inhibitors. Clin Endocrinol (Oxf)

2008;69:338-41<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=Pub\

Med & list_uids=18221401 & dopt=Abstract>

..

close window *17550* Doornebal J, Bijlsma R, Brouwer RM. [An unknown but

potentially serious side effect of proton pump inhibitors: hypomagnesaemia].

[Article in Dutch] Ned Tijdschr Geneeskd

2009;153:A711<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubM\

ed & list_uids=19930736 & dopt=Abstract>

.. *17551* Epstein M, McGrath S, Law F. Proton-pump inhibitors and

hypomagnesemic hypoparathyroidism. N Engl J Med

2006;355:1834-6<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=Pu\

bMed & list_uids=17065651 & dopt=Abstract>

.. *17552* François M, Lévy-Bohbot N, Caron J, Durlach V. [Chronic use of

proton-pump inhibitors associated with giardiasis: A rare cause of

hypomagnesemic hypoparathyroidism?]. [Article in French] Ann Endocrinol

2008;69:446-8<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubM\

ed & list_uids=18614153 & dopt=Abstract>

.. *17553* Broeren MA, Geerdink EA, Vader HL, van den Wall Bake AW.

Hypomagnesemia induced by several proton-pump inhibitors. Ann Intern Med

2009;151:755-6<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=Pub\

Med & list_uids=19920278 & dopt=Abstract>

.. *17554* Hoorn EJ, van der Hoek J, de Man RA, et al. A case series of

proton pump inhibitor-induced hypomagnesemia. Am J Kidney Dis

2010;56:112-6<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubM\

ed & list_uids=20189276 & dopt=Abstract>

.. *17555* Regolisti G, Cabassi A, Parenti E, et al. Severe hypomagnesemia

during long-term treatment with a proton pump inhibitor. Am J Kidney Dis

2010;56:168-74<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=Pub\

Med & list_uids=20493607 & dopt=Abstract>

..

> As posted before the UL is 350 mg and of course large doses can also cause

> diarrhea/loose stools (which is why it is used sometimes for 'bowel

> cleaning " - magnesium citrate for example - usually most potent). I think

> what you would need to take would be determined by your blood levels - like

> iron - UL is based on healthy normal blood level.

>

> I checked consumerlab.com and the main concern in one was lead in it -

> Gillham's Natural Vitality Natural Calm (205 mg per teaspoon, 1/2 to 3 per

> day)

> 2005 Total Nutrition Natural Amino Acid Chelated Magnesium (100 mg per

> tablet, 4 per day) - only 28% of Magnesium stated

> 2005 Tropical Oasis Liquid Calcium Magnesium Orange Flavor (115 mg per

> Tbsp, 1 Tbsp per day) - only 45% magnesium stated

>

> Of course something like Maalox and Milk of Magnesia has magnesium in it

> (thus the name) but also aluminum (a problem with renal patients). One had

> 200 mg magnesium hydroxide. Zegerid has magnesium hydroxide in it 700 mg.

> Nexium has magnesium also. Not sure how the amounts convert to actual

> magnesium content.

>

> Of course low magnesium levels can affect insulin sensitivity in Type 2

> diabetics.

>

>

> On Sun, Mar 13, 2011 at 12:29 PM, Digna Cassens <

> dignacassens@...> wrote:

>

>>

>>

>> and group:

>>

>> Oh, great! I've been skipping over these messages for various reasons,

>> mostly lack of interest in some topics. After reading a few of the posts I

>> skipped over most of the others.

>>

>> This morning I'm a bit slower and I tend to read most if not all of some

>> ppl's posts, being one of them. The first word I catch while

>> scanning

>> is NEXIUM. Need I say more? I've been taking Nexium for GERD and extreme

>> upper stomach pain for abt 3 years now - usually every 2-3 days, but

>> chronic

>> use nonetheless. I've printed this post below to take with me to my MD

>> next

>> visit and request a magnesium level to determine if I've had this outcome.

>> We'll see what he says and if I have any alternatives, but in the

>> meantime,

>> since I didn't pay attention during " class " , please recommend the best

>> supplementation for me to use.

>>

>> The devil of it is that I am also taking propanonol for heartbeat

>> irregularities, such as ----- occasional arythmia. Never did the

>> prescribing MD mention the side-effects possibilities, and I'm surprised

>> that although I read all the literature before even purchasing the drug, I

>> did not read this then.

>>

>> Digna

>>

>> From: rd-usa [mailto:rd-usa ] On Behalf Of

>> Ortiz

>> Sent: Sunday, March 13, 2011 5:56 AM

>> To: RD-USA

>>

>> Subject: Low Magnesium Levels May Be Associated with Proton Pump

>> Inhibitor Drugs

>>

>> Prescription PPIs include Nexium (esomeprazole magnesium), Dexilant

>> (dexlansoprazole), Prilosec (omeprazole), Zegerid (omeprazole and sodium

>> bicarbonate), Prevacid (lansoprazole), Protonix (pantoprazole sodium),

>> AcipHex (rabeprazole sodium), and Vimovo (a prescription combination drug

>> product that contains a PPI [esomeprazole magnesium and naproxen]).

>> Over-the-counter (OTC) PPIs include Prilosec OTC (omeprazole), Zegerid OTC

>> (omeprazole and sodium bicarbonate), and Prevacid 24HR (lansoprazole).

>>

>> FDA notified healthcare professionals and the public that prescription

>> proton pump inhibitor (PPI) drugs may cause low serum magnesium levels

>> (hypomagnesemia) if taken for prolonged periods of time (in most cases,

>> longer than one year). Low serum magnesium levels can result in serious

>> adverse events including muscle spasm (tetany), irregular heartbeat

>> (arrhythmias), and convulsions (seizures); however, patients do not always

>> have these symptoms. Treatment of hypomagnesemia generally requires

>> magnesium supplements. In approximately one-quarter of the cases reviewed,

>> magnesium supplementation alone did not improve low serum magnesium levels

>> and the PPI had to be discontinued.

>>

>> PPIs work by reducing the amount of acid in the stomach and are used to

>> treat conditions such as gastroesophageal reflux disease (GERD), stomach

>> and

>> small intestine ulcers, and inflammation of the esophagus.

>>

>> Healthcare professionals should consider obtaining serum magnesium levels

>> prior to initiation of prescription PPI treatment in patients expected to

>> be

>> on these drugs for long periods of time, as well as patients who take PPIs

>> with medications such as digoxin, diuretics or drugs that may cause

>> hypomagnesemia. For patients taking digoxin, a heart medicine, this is

>> especially important because low magnesium can increase the likelihood of

>> serious side effects. Healthcare professionals should consider obtaining

>> magnesium levels periodically in these patients.

>>

>> *The ls of Pharmacotherapy. 2011;45(1):1-8.

>> *

>> LINK<http://www.diabetesincontrol.com/index.php?option=com_content

>> <

>> http://www.diabetesincontrol.com/index.php?option=com_content & view=article &

>> id=10607 & catid=1 & Itemid=17> & view=article & id=10607 & catid=1 & Itemid=17>

>> --

>> Ortiz, MS, RD

>> *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

>>

>> Check out my blog: mixture of deals and nutrition

>> USAIR: 2000 mile bonus for signing up for a new account exp. 3/30 = FREE

>> magazines <http://thefrugaldietitian.com/?p=16546>New Giveaway : Healthy

>>

>> Toys from The Frugal Dietitian Ends on 3/16 8

>> PM<http://thefrugaldietitian.com/?p=16384> Made

>>

>> my own " funny but real " movie: Me interviewing a " potential " Dietetic

>> student <

>>

>> *Healthy Diet at any Age: We are NOT just looking

>>

>> *

>>

>> *at the years people have behind them but also the

>> *

>>

>> *quality of the years ahead of them.*

>>

>>

[Guest guest]

Just something else to think about. . . my pets are also on these

medications - in approporiate doses. If we are taking humans off them, it

may be worth considering taking our pets off of them as well.

Penny L. , PhD, RD, LD

Dietitian, Memorial Hermann Sports Medicine Institute

Owner, Eating for Performance

www.eatingforperformance.com

>

>

> Prescription PPIs include Nexium (esomeprazole magnesium), Dexilant

> (dexlansoprazole), Prilosec (omeprazole), Zegerid (omeprazole and sodium

> bicarbonate), Prevacid (lansoprazole), Protonix (pantoprazole sodium),

> AcipHex (rabeprazole sodium), and Vimovo (a prescription combination drug

> product that contains a PPI [esomeprazole magnesium and naproxen]).

> Over-the-counter (OTC) PPIs include Prilosec OTC (omeprazole), Zegerid OTC

> (omeprazole and sodium bicarbonate), and Prevacid 24HR (lansoprazole).

>

> FDA notified healthcare professionals and the public that prescription

> proton pump inhibitor (PPI) drugs may cause low serum magnesium levels

> (hypomagnesemia) if taken for prolonged periods of time (in most cases,

> longer than one year). Low serum magnesium levels can result in serious

> adverse events including muscle spasm (tetany), irregular heartbeat

> (arrhythmias), and convulsions (seizures); however, patients do not always

> have these symptoms. Treatment of hypomagnesemia generally requires

> magnesium supplements. In approximately one-quarter of the cases reviewed,

> magnesium supplementation alone did not improve low serum magnesium levels

> and the PPI had to be discontinued.

>

> PPIs work by reducing the amount of acid in the stomach and are used to

> treat conditions such as gastroesophageal reflux disease (GERD), stomach

> and

> small intestine ulcers, and inflammation of the esophagus.

>

> Healthcare professionals should consider obtaining serum magnesium levels

> prior to initiation of prescription PPI treatment in patients expected to

> be

> on these drugs for long periods of time, as well as patients who take PPIs

> with medications such as digoxin, diuretics or drugs that may cause

> hypomagnesemia. For patients taking digoxin, a heart medicine, this is

> especially important because low magnesium can increase the likelihood of

> serious side effects. Healthcare professionals should consider obtaining

> magnesium levels periodically in these patients.

>

> *The ls of Pharmacotherapy. 2011;45(1):1-8.

> *

> LINK<

>

http://www.diabetesincontrol.com/index.php?option=com_content & view=article & id=10\

607 & catid=1 & Itemid=17

> >

> --

> Ortiz, MS, RD

> *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

> Check out my blog: mixture of deals and nutrition

> USAIR: 2000 mile bonus for signing up for a new account exp. 3/30 = FREE

> magazines <http://thefrugaldietitian.com/?p=16546>New Giveaway : Healthy

> Toys from The Frugal Dietitian Ends on 3/16 8

> PM<http://thefrugaldietitian.com/?p=16384> Made

> my own " funny but real " movie: Me interviewing a " potential " Dietetic

> student <

>

> *Healthy Diet at any Age: We are NOT just looking

> *

>

> *at the years people have behind them but also the

> *

>

> *quality of the years ahead of them.*

>

>

[Guest guest]

My warning is to be careful immediately taking them off (pets or humans)

because of the rebound effect...long term use said a year or more but I

thought the rebound effect was shorter duration. Not sure....

On Tue, Mar 15, 2011 at 2:58 PM, Penny wrote:

> Just something else to think about. . . my pets are also on these

> medications - in approporiate doses. If we are taking humans off them, it

> may be worth considering taking our pets off of them as well.

>

> Penny L. , PhD, RD, LD

> Dietitian, Memorial Hermann Sports Medicine Institute

> Owner, Eating for Performance

> www.eatingforperformance.com

>

>

>

>

>

> >

> >

> > Prescription PPIs include Nexium (esomeprazole magnesium), Dexilant

> > (dexlansoprazole), Prilosec (omeprazole), Zegerid (omeprazole and sodium

> > bicarbonate), Prevacid (lansoprazole), Protonix (pantoprazole sodium),

> > AcipHex (rabeprazole sodium), and Vimovo (a prescription combination drug

> > product that contains a PPI [esomeprazole magnesium and naproxen]).

> > Over-the-counter (OTC) PPIs include Prilosec OTC (omeprazole), Zegerid

> OTC

> > (omeprazole and sodium bicarbonate), and Prevacid 24HR (lansoprazole).

> >

> > FDA notified healthcare professionals and the public that prescription

> > proton pump inhibitor (PPI) drugs may cause low serum magnesium levels

> > (hypomagnesemia) if taken for prolonged periods of time (in most cases,

> > longer than one year). Low serum magnesium levels can result in serious

> > adverse events including muscle spasm (tetany), irregular heartbeat

> > (arrhythmias), and convulsions (seizures); however, patients do not

> always

> > have these symptoms. Treatment of hypomagnesemia generally requires

> > magnesium supplements. In approximately one-quarter of the cases

> reviewed,

> > magnesium supplementation alone did not improve low serum magnesium

> levels

> > and the PPI had to be discontinued.

> >

> > PPIs work by reducing the amount of acid in the stomach and are used to

> > treat conditions such as gastroesophageal reflux disease (GERD), stomach

> > and

> > small intestine ulcers, and inflammation of the esophagus.

> >

> > Healthcare professionals should consider obtaining serum magnesium levels

> > prior to initiation of prescription PPI treatment in patients expected to

> > be

> > on these drugs for long periods of time, as well as patients who take

> PPIs

> > with medications such as digoxin, diuretics or drugs that may cause

> > hypomagnesemia. For patients taking digoxin, a heart medicine, this is

> > especially important because low magnesium can increase the likelihood of

> > serious side effects. Healthcare professionals should consider obtaining

> > magnesium levels periodically in these patients.

> >

> > *The ls of Pharmacotherapy. 2011;45(1):1-8.

> > *

> > LINK<

> >

>

http://www.diabetesincontrol.com/index.php?option=com_content & view=article & id=10\

607 & catid=1 & Itemid=17

> > >

> > --

> > Ortiz, MS, RD

> > *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

> > Check out my blog: mixture of deals and nutrition

> > USAIR: 2000 mile bonus for signing up for a new account exp. 3/30 = FREE

> > magazines <http://thefrugaldietitian.com/?p=16546>New Giveaway : Healthy

> > Toys from The Frugal Dietitian Ends on 3/16 8

> > PM<http://thefrugaldietitian.com/?p=16384> Made

> > my own " funny but real " movie: Me interviewing a " potential " Dietetic

> > student <

> >

> > *Healthy Diet at any Age: We are NOT just looking

> > *

> >

> > *at the years people have behind them but also the

> > *

> >

> > *quality of the years ahead of them.*

> >

> >

[Guest guest]

I must admit I have not thought much about iodine except concerns regarding

cutting out salt and thus a source of iodine. Will take a look...If you are

writing to the consumer - I always say keep it simple!! To the professional

don't dumb it down BUT remember even some of the basics, if one is not up to

date, may need some simple explaining too!! (can we say me)

On Tue, Mar 15, 2011 at 2:53 PM, Vajda wrote:

>

>

> Hi ,

>

> Great article. The numbers are adding up in favor of laying off

> pharmaceuticals

> instead of teachers! i wish the state governers around here would get on

> board

> with that budget plan. (I bet the Medicaid and Medicare costs would save a

> lot)

>

> My blog this morning hit a nerve; 91 people have read it already - my

> vitamin D

> article (next highest) is just approaching 60 views, added up gradually.

>

> I would appreciate feed back if you had time. It was initially just geared

> towards safe use of seaweed supplements vs iodoral or potassium iodide -

> controlled dose w no goiterogens. My thesis statement tends to get lost in

> trivia too often. but in doing the fact check/bib building I realized that

> fear

> is high about fallout - taking iodine is safe and does reduce long term

> cancer

> risk. but I don't want to add to fear and I think I may have lost the

> forest for

> the trees. Questions/prods about gaps/leaps would be helpful. Actually it

> is

> mostly in the bibliography that the story gets into nuclear fallout

> recommendations and hx.

>

> So my real question, I think - does the opening - Seaweed supplement story

> tell

> enough to the lay person without fear-building and the bibliography add

> detail

> for the more curious without creating too much fear?

>

> R Vajda, R.D.

> www.GingerJens.com

>

> ________________________________

>

>

> To: rd-usa

> Sent: Sun, March 13, 2011 1:13:17 PM

> Subject: Re: Low Magnesium Levels May Be Associated with Proton

> Pump

> Inhibitor Drugs

>

> From Natural medicine database:

> *PROTON PUMP INHIBITORS (PPIs)*: Taking a PPI long-term, especially over a

> year, has been linked to an increased risk of hypomagnesemia in several

> reports

> (<

>

http://naturaldatabase.therapeuticresearch.com/nd/Search.aspx?cs= & s=ND & pt=101 & sh\

=12 & id=998 & id2=17546#17546

> >.

>

>

> PPIs are thought to inhibit active transport of magnesium in the

> intestine

> (<

>

http://naturaldatabase.therapeuticresearch.com/nd/Search.aspx?cs= & s=ND & pt=101 & sh\

=12 & id=998 & id2=17549#17549

> >).

>

>

> This appears to be a class effect. Hypomagnesemia has been reported with

> all

> PPIs ()

> Severe hypomagnesemia can cause potentially serious effects including

> muscle

> spasm, tetany, arrhythmia, hypokalemia, hypoparathyroidism, hypocalcemia,

> and seizures. Patients who are likely to take a PPI long-term should have

> serum magnesium levels checked at baseline and annually thereafter. A

> magnesium supplement may be necessary to treat or prevent magnesium

> deficiency. In some patients, magnesium supplementation alone may not be

> adequate to treat hypomagnesemia. Case reports suggest that up to 25% of

> patients who developed hypomagnesemia had to discontinue the PPI in order

> for magnesium levels to return to normal

> (<

>

http://naturaldatabase.therapeuticresearch.com/nd/Search.aspx?cs= & s=ND & pt=101 & sh\

=12 & id=998 & id2=17546#17546

> >).

>

>

> In many cases, hypomagnesemia recurred when the PPI was re-initiated

> In some reports, use of pantoprazole (Protonix), in combination with a

> magnesium supplement, was effective for treating reflux and preventing

> magnesium loss ). In another case, use of alternate day dosing of

> pantoprazole (Protonix) three days per week and famotidine (Pepcid) four

> days per week, in combination with a magnesium supplement, was also

> effective for treating symptoms and increasing magnesium levels . Some

> experts speculate that the magnesium depletion caused by PPIs could

> contribute to the increased risk of fracture seen in some patients taking

> PPIs long-term .

> PPIs include omeprazole (Prilosec), esomeprazole (Nexium), lansoprazole,

> (Prevacid), pantoprazole (Protonix), rabeprazole (AcipHex), and

> dexlansoprazole (Dexilant).

>

> Cundy T, Dissanayake A. Severe hypomagnesaemia in long-term users of

> proton-pump inhibitors. Clin Endocrinol (Oxf)

> 2008;69:338-41<

>

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

8221401 & dopt=Abstract

> >

>

>

> .

> close window *17550* Doornebal J, Bijlsma R, Brouwer RM. [An unknown but

> potentially serious side effect of proton pump inhibitors:

> hypomagnesaemia].

> [Article in Dutch] Ned Tijdschr Geneeskd

> 2009;153:A711<

>

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

9930736 & dopt=Abstract

> >

>

> . *17551* Epstein M, McGrath S, Law F. Proton-pump inhibitors and

>

> hypomagnesemic hypoparathyroidism. N Engl J Med

> 2006;355:1834-6<

>

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

7065651 & dopt=Abstract

> >

>

> . *17552* François M, Lévy-Bohbot N, Caron J, Durlach V. [Chronic use of

>

> proton-pump inhibitors associated with giardiasis: A rare cause of

> hypomagnesemic hypoparathyroidism?]. [Article in French] Ann Endocrinol

> 2008;69:446-8<

>

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

8614153 & dopt=Abstract

> >

>

> . *17553* Broeren MA, Geerdink EA, Vader HL, van den Wall Bake AW.

>

> Hypomagnesemia induced by several proton-pump inhibitors. Ann Intern Med

> 2009;151:755-6<

>

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

9920278 & dopt=Abstract

> >

>

> . *17554* Hoorn EJ, van der Hoek J, de Man RA, et al. A case series of

>

> proton pump inhibitor-induced hypomagnesemia. Am J Kidney Dis

> 2010;56:112-6<

>

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=2\

0189276 & dopt=Abstract

> >

>

> . *17555* Regolisti G, Cabassi A, Parenti E, et al. Severe hypomagnesemia

>

> during long-term treatment with a proton pump inhibitor. Am J Kidney Dis

> 2010;56:168-74<

>

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=2\

0493607 & dopt=Abstract

> >

>

>

> .

>

>

>

> > As posted before the UL is 350 mg and of course large doses can also

> cause

> > diarrhea/loose stools (which is why it is used sometimes for 'bowel

> > cleaning " - magnesium citrate for example - usually most potent). I think

> > what you would need to take would be determined by your blood levels -

> like

> > iron - UL is based on healthy normal blood level.

> >

> > I checked consumerlab.com and the main concern in one was lead in it -

>

> > Gillham's Natural Vitality Natural Calm (205 mg per teaspoon, 1/2 to 3

> per

> > day)

> > 2005 Total Nutrition Natural Amino Acid Chelated Magnesium (100 mg per

> > tablet, 4 per day) - only 28% of Magnesium stated

> > 2005 Tropical Oasis Liquid Calcium Magnesium Orange Flavor (115 mg per

> > Tbsp, 1 Tbsp per day) - only 45% magnesium stated

> >

> > Of course something like Maalox and Milk of Magnesia has magnesium in it

> > (thus the name) but also aluminum (a problem with renal patients). One

> had

> > 200 mg magnesium hydroxide. Zegerid has magnesium hydroxide in it 700 mg.

> > Nexium has magnesium also. Not sure how the amounts convert to actual

> > magnesium content.

> >

> > Of course low magnesium levels can affect insulin sensitivity in Type 2

> > diabetics.

> >

> >

> > On Sun, Mar 13, 2011 at 12:29 PM, Digna Cassens <

> > dignacassens@...> wrote:

> >

> >>

> >>

> >> and group:

> >>

> >> Oh, great! I've been skipping over these messages for various reasons,

> >> mostly lack of interest in some topics. After reading a few of the posts

> I

> >> skipped over most of the others.

> >>

> >> This morning I'm a bit slower and I tend to read most if not all of some

> >> ppl's posts, being one of them. The first word I catch while

> >> scanning

> >> is NEXIUM. Need I say more? I've been taking Nexium for GERD and extreme

> >> upper stomach pain for abt 3 years now - usually every 2-3 days, but

> >> chronic

> >> use nonetheless. I've printed this post below to take with me to my MD

> >> next

> >> visit and request a magnesium level to determine if I've had this

> outcome.

> >> We'll see what he says and if I have any alternatives, but in the

> >> meantime,

> >> since I didn't pay attention during " class " , please recommend the best

> >> supplementation for me to use.

> >>

> >> The devil of it is that I am also taking propanonol for heartbeat

> >> irregularities, such as ----- occasional arythmia. Never did the

> >> prescribing MD mention the side-effects possibilities, and I'm surprised

> >> that although I read all the literature before even purchasing the drug,

> I

> >> did not read this then.

> >>

> >> Digna

> >>

> >> From: rd-usa [mailto:rd-usa ] On Behalf

> Of

> >> Ortiz

> >> Sent: Sunday, March 13, 2011 5:56 AM

> >> To: RD-USA

> >>

> >> Subject: Low Magnesium Levels May Be Associated with Proton

> Pump

> >> Inhibitor Drugs

> >>

> >> Prescription PPIs include Nexium (esomeprazole magnesium), Dexilant

> >> (dexlansoprazole), Prilosec (omeprazole), Zegerid (omeprazole and sodium

> >> bicarbonate), Prevacid (lansoprazole), Protonix (pantoprazole sodium),

> >> AcipHex (rabeprazole sodium), and Vimovo (a prescription combination

> drug

> >> product that contains a PPI [esomeprazole magnesium and naproxen]).

> >> Over-the-counter (OTC) PPIs include Prilosec OTC (omeprazole), Zegerid

> OTC

> >> (omeprazole and sodium bicarbonate), and Prevacid 24HR (lansoprazole).

> >>

> >> FDA notified healthcare professionals and the public that prescription

> >> proton pump inhibitor (PPI) drugs may cause low serum magnesium levels

> >> (hypomagnesemia) if taken for prolonged periods of time (in most cases,

> >> longer than one year). Low serum magnesium levels can result in serious

> >> adverse events including muscle spasm (tetany), irregular heartbeat

> >> (arrhythmias), and convulsions (seizures); however, patients do not

> always

> >> have these symptoms. Treatment of hypomagnesemia generally requires

> >> magnesium supplements. In approximately one-quarter of the cases

> reviewed,

> >> magnesium supplementation alone did not improve low serum magnesium

> levels

> >> and the PPI had to be discontinued.

> >>

> >> PPIs work by reducing the amount of acid in the stomach and are used to

> >> treat conditions such as gastroesophageal reflux disease (GERD), stomach

> >> and

> >> small intestine ulcers, and inflammation of the esophagus.

> >>

> >> Healthcare professionals should consider obtaining serum magnesium

> levels

> >> prior to initiation of prescription PPI treatment in patients expected

> to

> >> be

> >> on these drugs for long periods of time, as well as patients who take

> PPIs

> >> with medications such as digoxin, diuretics or drugs that may cause

> >> hypomagnesemia. For patients taking digoxin, a heart medicine, this is

> >> especially important because low magnesium can increase the likelihood

> of

> >> serious side effects. Healthcare professionals should consider obtaining

> >> magnesium levels periodically in these patients.

> >>

> >> *The ls of Pharmacotherapy. 2011;45(1):1-8.

> >> *

> >> LINK<http://www.diabetesincontrol.com/index.php?option=com_content

> >> <

> >>

> http://www.diabetesincontrol.com/index.php?option=com_content & view=article &

> >> id=10607 & catid=1 & Itemid=17> & view=article & id=10607 & catid=1 & Itemid=17>

> >> --

> >> Ortiz, MS, RD

> >> *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

> >>

> >> Check out my blog: mixture of deals and nutrition

> >> USAIR: 2000 mile bonus for signing up for a new account exp. 3/30 = FREE

> >> magazines <http://thefrugaldietitian.com/?p=16546>New Giveaway :

> Healthy

> >>

> >> Toys from The Frugal Dietitian Ends on 3/16 8

> >> PM<http://thefrugaldietitian.com/?p=16384> Made

> >>

> >> my own " funny but real " movie: Me interviewing a " potential " Dietetic

> >> student <

> >>

> >> *Healthy Diet at any Age: We are NOT just looking

> >>

> >> *

> >>

> >> *at the years people have behind them but also the

> >> *

> >>

> >> *quality of the years ahead of them.*

> >>

> >>

[Guest guest]

Excellent reminder ! I meant to say " many " but yes, one of my dogs is

on a PPI.

Penny L. , PhD, RD, LD

Dietitian, Memorial Hermann Sports Medicine Institute

Owner, Eating for Performance

www.eatingforperformance.com

>

>

> My warning is to be careful immediately taking them off (pets or humans)

> because of the rebound effect...long term use said a year or more but I

> thought the rebound effect was shorter duration. Not sure....

>

> On Tue, Mar 15, 2011 at 2:58 PM, Penny wrote:

>

>

>

> > Just something else to think about. . . my pets are also on these

> > medications - in approporiate doses. If we are taking humans off them, it

> > may be worth considering taking our pets off of them as well.

> >

> > Penny L. , PhD, RD, LD

> > Dietitian, Memorial Hermann Sports Medicine Institute

> > Owner, Eating for Performance

> > www.eatingforperformance.com

> >

> >

> >

> >

> >

> > >

> > >

> > > Prescription PPIs include Nexium (esomeprazole magnesium), Dexilant

> > > (dexlansoprazole), Prilosec (omeprazole), Zegerid (omeprazole and

> sodium

> > > bicarbonate), Prevacid (lansoprazole), Protonix (pantoprazole sodium),

> > > AcipHex (rabeprazole sodium), and Vimovo (a prescription combination

> drug

> > > product that contains a PPI [esomeprazole magnesium and naproxen]).

> > > Over-the-counter (OTC) PPIs include Prilosec OTC (omeprazole), Zegerid

> > OTC

> > > (omeprazole and sodium bicarbonate), and Prevacid 24HR (lansoprazole).

> > >

> > > FDA notified healthcare professionals and the public that prescription

> > > proton pump inhibitor (PPI) drugs may cause low serum magnesium levels

> > > (hypomagnesemia) if taken for prolonged periods of time (in most cases,

> > > longer than one year). Low serum magnesium levels can result in serious

> > > adverse events including muscle spasm (tetany), irregular heartbeat

> > > (arrhythmias), and convulsions (seizures); however, patients do not

> > always

> > > have these symptoms. Treatment of hypomagnesemia generally requires

> > > magnesium supplements. In approximately one-quarter of the cases

> > reviewed,

> > > magnesium supplementation alone did not improve low serum magnesium

> > levels

> > > and the PPI had to be discontinued.

> > >

> > > PPIs work by reducing the amount of acid in the stomach and are used to

> > > treat conditions such as gastroesophageal reflux disease (GERD),

> stomach

> > > and

> > > small intestine ulcers, and inflammation of the esophagus.

> > >

> > > Healthcare professionals should consider obtaining serum magnesium

> levels

> > > prior to initiation of prescription PPI treatment in patients expected

> to

> > > be

> > > on these drugs for long periods of time, as well as patients who take

> > PPIs

> > > with medications such as digoxin, diuretics or drugs that may cause

> > > hypomagnesemia. For patients taking digoxin, a heart medicine, this is

> > > especially important because low magnesium can increase the likelihood

> of

> > > serious side effects. Healthcare professionals should consider

> obtaining

> > > magnesium levels periodically in these patients.

> > >

> > > *The ls of Pharmacotherapy. 2011;45(1):1-8.

> > > *

> > > LINK<

> > >

> >

>

http://www.diabetesincontrol.com/index.php?option=com_content & view=article & id=10\

607 & catid=1 & Itemid=17

> > > >

> > > --

> > > Ortiz, MS, RD

> > > *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

> > > Check out my blog: mixture of deals and nutrition

> > > USAIR: 2000 mile bonus for signing up for a new account exp. 3/30 =

> FREE

> > > magazines <http://thefrugaldietitian.com/?p=16546>New Giveaway :

> Healthy

> > > Toys from The Frugal Dietitian Ends on 3/16 8

> > > PM<http://thefrugaldietitian.com/?p=16384> Made

> > > my own " funny but real " movie: Me interviewing a " potential " Dietetic

> > > student <

> > >

> > > *Healthy Diet at any Age: We are NOT just looking

> > > *

> > >

> > > *at the years people have behind them but also the

> > > *

> > >

> > > *quality of the years ahead of them.*

> > >

> > >

[Guest guest]

Friend sent me the Mg hydroxide equivalents: The molecular weight of

magnesium hydroxide is 58.3 g/mol. So, 200 mg equals 0.0034 mol. Multiply

that by the atomic weight of magnesium (24.3 g/mol), and we get 83.36 mg.

For 700 mg, it would be 291.77 mg. You could also do it with percentages.

24.3/58.3 = 41.6%. Multiply that by 200mg or 700mg and you'll get the same

results.

*So 200 mg magnesium hydroxide= 83 mg of Mg

700 = 292 mg of Mg*

Thanks Josh!!

On Tue, Mar 15, 2011 at 3:22 PM, Penny wrote:

> Excellent reminder ! I meant to say " many " but yes, one of my dogs is

> on a PPI.

>

> Penny L. , PhD, RD, LD

> Dietitian, Memorial Hermann Sports Medicine Institute

> Owner, Eating for Performance

> www.eatingforperformance.com

>

>

>

>

>

> >

> >

> > My warning is to be careful immediately taking them off (pets or humans)

> > because of the rebound effect...long term use said a year or more but I

> > thought the rebound effect was shorter duration. Not sure....

> >

> > On Tue, Mar 15, 2011 at 2:58 PM, Penny <plwlistservs@...

> >wrote:

> >

> >

> >

> > > Just something else to think about. . . my pets are also on these

> > > medications - in approporiate doses. If we are taking humans off them,

> it

> > > may be worth considering taking our pets off of them as well.

> > >

> > > Penny L. , PhD, RD, LD

> > > Dietitian, Memorial Hermann Sports Medicine Institute

> > > Owner, Eating for Performance

> > > www.eatingforperformance.com

> > >

> > >

> > >

> > >

> > >

> > > >

> > > >

> > > > Prescription PPIs include Nexium (esomeprazole magnesium), Dexilant

> > > > (dexlansoprazole), Prilosec (omeprazole), Zegerid (omeprazole and

> > sodium

> > > > bicarbonate), Prevacid (lansoprazole), Protonix (pantoprazole

> sodium),

> > > > AcipHex (rabeprazole sodium), and Vimovo (a prescription combination

> > drug

> > > > product that contains a PPI [esomeprazole magnesium and naproxen]).

> > > > Over-the-counter (OTC) PPIs include Prilosec OTC (omeprazole),

> Zegerid

> > > OTC

> > > > (omeprazole and sodium bicarbonate), and Prevacid 24HR

> (lansoprazole).

> > > >

> > > > FDA notified healthcare professionals and the public that

> prescription

> > > > proton pump inhibitor (PPI) drugs may cause low serum magnesium

> levels

> > > > (hypomagnesemia) if taken for prolonged periods of time (in most

> cases,

> > > > longer than one year). Low serum magnesium levels can result in

> serious

> > > > adverse events including muscle spasm (tetany), irregular heartbeat

> > > > (arrhythmias), and convulsions (seizures); however, patients do not

> > > always

> > > > have these symptoms. Treatment of hypomagnesemia generally requires

> > > > magnesium supplements. In approximately one-quarter of the cases

> > > reviewed,

> > > > magnesium supplementation alone did not improve low serum magnesium

> > > levels

> > > > and the PPI had to be discontinued.

> > > >

> > > > PPIs work by reducing the amount of acid in the stomach and are used

> to

> > > > treat conditions such as gastroesophageal reflux disease (GERD),

> > stomach

> > > > and

> > > > small intestine ulcers, and inflammation of the esophagus.

> > > >

> > > > Healthcare professionals should consider obtaining serum magnesium

> > levels

> > > > prior to initiation of prescription PPI treatment in patients

> expected

> > to

> > > > be

> > > > on these drugs for long periods of time, as well as patients who take

> > > PPIs

> > > > with medications such as digoxin, diuretics or drugs that may cause

> > > > hypomagnesemia. For patients taking digoxin, a heart medicine, this

> is

> > > > especially important because low magnesium can increase the

> likelihood

> > of

> > > > serious side effects. Healthcare professionals should consider

> > obtaining

> > > > magnesium levels periodically in these patients.

> > > >

> > > > *The ls of Pharmacotherapy. 2011;45(1):1-8.

> > > > *

> > > > LINK<

> > > >

> > >

> >

>

http://www.diabetesincontrol.com/index.php?option=com_content & view=article & id=10\

607 & catid=1 & Itemid=17

> > > > >

> > > > --

> > > > Ortiz, MS, RD

> > > > *The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

> > > > Check out my blog: mixture of deals and nutrition

> > > > USAIR: 2000 mile bonus for signing up for a new account exp. 3/30 =

> > FREE

> > > > magazines <http://thefrugaldietitian.com/?p=16546>New Giveaway :

> > Healthy

> > > > Toys from The Frugal Dietitian Ends on 3/16 8

> > > > PM<http://thefrugaldietitian.com/?p=16384> Made

> > > > my own " funny but real " movie: Me interviewing a " potential " Dietetic

> > > > student <

> > > >

> > > > *Healthy Diet at any Age: We are NOT just looking

> > > > *

> > > >

> > > > *at the years people have behind them but also the

> > > > *

> > > >

> > > > *quality of the years ahead of them.*

> > > >

> > > >