TL;DR
Get health and wellness essentials delivered free with Prime
- Fast, free delivery on millions of items
- Prime Video, Amazon Music and more included
- Member-only deals all year
A report from Sixty and Me highlights NIH and FDA information that long-term use of some proton pump inhibitors and diuretics can lower magnesium. The guidance supports discussing medication history and whether testing is appropriate with a health care professional; it does not mean everyone taking these medicines has a deficiency.
A Sixty and Me report is urging people who take certain heartburn medicines or diuretics over the long term to ask a clinician whether their magnesium levels should be checked. The report summarizes guidance from the National Institutes of Health and the U.S. Food and Drug Administration: some proton pump inhibitors and diuretics can affect magnesium, but the risk varies and does not establish that any individual patient has a deficiency.
Proton pump inhibitors, or PPIs, reduce stomach acid and are used for conditions including reflux and ulcers. The NIH Office of Dietary Supplements says prescription PPIs taken for a long time—typically more than a year—can cause low magnesium. Examples include omeprazole, esomeprazole, lansoprazole and pantoprazole. The report says the FDA advises clinicians to consider checking magnesium before long-term PPI treatment and periodically during treatment. People who take an over-the-counter PPI every day are advised to tell their clinician how long they have used it.
Some diuretics, often called water pills, can also increase magnesium loss in urine with long-term use. The NIH identifies loop diuretics, such as furosemide, and thiazide diuretics, such as hydrochlorothiazide. Potassium-sparing diuretics, including spironolactone, have a different effect and reduce magnesium loss, according to the source material. The medicine’s type matters; “water pill” alone is not enough to determine its effect.
The report notes that FDA-reviewed cases of PPI-associated low magnesium do not predict an individual’s likelihood of developing it. Magnesium supplements raised levels in many reported cases, but in about one-quarter of those cases they did not, and the patient had to stop the PPI. That proportion describes the cases reviewed by the FDA, not all people who take PPIs.
Medication Reviews Can Flag Magnesium Risk
The issue matters because long-term medication lists may include drugs that affect magnesium without the patient knowing, while routine blood work may not include a magnesium measurement. Older adults are among the groups the NIH identifies as being at greater risk: age-related changes in diet, absorption and kidney handling, as well as chronic conditions and medicines, can all influence magnesium levels.
Possible early signs listed by the NIH include loss of appetite, nausea, fatigue and weakness. More severe deficiency can involve numbness, tingling, muscle cramps, seizures, personality changes or an abnormal heart rhythm. Those symptoms can have many causes, however, and cannot by themselves confirm low magnesium. The report’s practical point is to review medicines and testing with a qualified health professional, not to stop a prescribed drug or start a supplement without guidance.
Magnesium is found in foods including pumpkin seeds, almonds, spinach and black beans. The report cites an NIH recommended daily amount of 320 milligrams for women over 50. Dietary information can be useful in a clinician discussion, but it does not replace individualized advice, particularly for people with kidney disease, who may have difficulty clearing extra magnesium.
Products Worth Considering
Withings BPM Vision Blood Pressure Monitor with Wi-Fi and Bluetooth
Withings BPM Connect Blood Pressure Monitor with Wi-Fi and Bluetooth
Withings BeamO Contactless Smart Thermometer, ECG Monitor, and Stethoscope
As an affiliate, we earn on qualifying purchases.
Why a Routine Blood Panel May Miss It
Less than 1% of the body’s magnesium is in the blood; most is in bones and soft tissues. The NIH says the body tightly regulates blood magnesium, so a blood level has limited correlation with total magnesium in the body. It also says magnesium is not routinely included in standard electrolyte testing in hospitals and clinics, meaning a basic chemistry panel may not measure it.
A blood test remains the most commonly used and readily available way to assess magnesium, according to the NIH, and it is the test the FDA advises clinicians to consider for people taking PPIs long term. The NIH also says no single test is considered satisfactory on its own. Clinicians may weigh a result alongside symptoms, medical history and medicines. A result within the reference range does not, by itself, establish that the body’s total magnesium stores are full.
Individual Risk Depends on the Full Picture
The source does not report new clinical research or a newly issued policy; it summarizes existing NIH and FDA information. It does not establish how often low magnesium occurs among all people taking these medicines, and the FDA case-review figure cannot be used as an individual risk estimate. The effects may also differ by specific drug, duration of use and personal health.
Symptoms such as fatigue or cramps are nonspecific, and a standard checkup may not include magnesium testing. The report does not provide a test threshold for diagnosing deficiency or a supplement dose for readers. Whether to test, change a medicine or supplement magnesium should be determined with a clinician who can consider the person’s full medical history, including kidney health.
Review Medicines With a Clinician
People taking a PPI or diuretic regularly can write down each prescription and over-the-counter medicine, including how long they have taken it, and bring the list to a doctor or pharmacist. They can ask whether any medicine may affect magnesium and whether testing is appropriate. The report advises patients to keep taking prescribed medicines until they have discussed any change with their clinician.
Patients should also ask before starting magnesium supplements, especially if they have kidney disease. A clinician can decide whether a blood test or other evaluation is warranted and interpret the result alongside symptoms and medication history. The source gives no scheduled follow-up or new policy milestone; the next step is an individual medication review. Seizures or a racing or irregular heartbeat require prompt medical care, according to the report.
Key Questions
Which heartburn medicines are linked to low magnesium?
The report identifies proton pump inhibitors, including omeprazole, esomeprazole, lansoprazole and pantoprazole. The NIH information cited concerns prescription PPIs taken long term, typically for more than a year. Tell a clinician about daily over-the-counter use as well.
Do all water pills lower magnesium?
No. The NIH identifies loop and thiazide diuretics as types that can increase magnesium loss in urine with long-term use. Potassium-sparing diuretics, such as spironolactone, reduce magnesium loss, according to the report. Ask about the specific medicine you take.
Does a normal routine blood test rule out low magnesium?
Not necessarily. A routine chemistry panel may not include magnesium, and the NIH says blood levels have limited correlation with total body magnesium. A clinician can determine whether a magnesium test is appropriate and interpret it alongside other information.
Should I stop my medicine or take a magnesium supplement?
Do not stop a prescribed medicine or begin a supplement based only on this report. Discuss the medicine and any symptoms with a qualified health professional. Extra magnesium may be a concern for people with kidney disease.
Source: sixtyandme.com
