Magnesium has the reputation of being a safe mineral, and for a healthy adult, this is largely true. In trials on muscle cramps, 11 to 37% of participants taking magnesium experienced adverse effects, mainly digestive, compared to 10 to 14% on placebo. Conversely, cases of hypermagnesemia, rare but sometimes fatal, have been published, almost always involving magnesium-based laxatives or antacids and poorly functioning kidneys.
This guide reviews studies identified via PubMed: diarrhea, hypermagnesemia, kidneys, interactions, special situations, taurine and vitamin B6 in Magnesium+. Each risk is classified as established, rare, theoretical, or misconception, followed by safety rules and warning signs.
What is established : the only frequent adverse effect of magnesium supplement is digestive: soft stools, diarrhea, bloating. It depends on the dose, form and timing of intake, and disappears upon discontinuation. In a 24-week trial at 450 mg of magnesium daily, no participant stopped magnesium oxide due to digestive issues, compared to 4.3% on citrate and 4.3% on sulfate; two participants on placebo also stopped due to digestive issues.
What is rare or requires monitoring : hypermagnesemia, excess magnesium in the blood, occurs mainly with fragile kidneys, advanced age and magnesium-based laxatives or antacids; in 320 hospitalized patients treated with magnesium oxide (laxative or antacid), 23% had elevated blood magnesium, most often mildly (19%). Magnesium reduces the absorption of several medications, including certain antibiotics, levothyroxine, gabapentin and dolutegravir: doses must be spaced apart. Myasthenia gravis, pregnancy and young children require medical advice.
- Established, rare, theoretical: the risk map
- Diarrhea and digestive disorders: the most frequent effect
- Oxide, citrate, chloride, bisglycinate: tolerance by form
- At what dose digestive disorders appear
- Overdose and hypermagnesemia: rare, but serious
- Magnesium and kidneys
- Interactions with medications
- Vitamin D, zinc, multivitamins: the combinations
- Taurine and vitamin B6 in Magnesium+
- Myasthenia gravis, pregnancy, children: special situations
- Common misconceptions versus the research
- Safety rules and warning signs
- Frequently asked questions
Established, rare, theoretical: the risk map
Dietary magnesium poses no known problem: when experts set a safety threshold for adults in 1997, they found no adverse effects attributable to magnesium from food, and only set a threshold for magnesium from supplements and medications, 350 mg per day, due to diarrhea. This is recalled in a 2023 review article, according to which the kidney of a healthy person eliminates magnesium well enough that excessive intake rarely raises blood magnesium.
This article comes from a research center dedicated to magnesium, which advocates for raising this threshold; one of the authors holds a patent on a magnesium cream. According to its authors, apart from osmotic diarrhea, there is no evidence of harmful effects from high supplement intakes; the cases described below show that this holds for healthy kidneys and supplement doses, not for high-dose laxatives.
Established : repeatedly observed in controlled trials or pharmacological studies. Rare : real, documented by published cases, but infrequent. Theoretical : plausible based on mechanism, without demonstration with an oral supplement. Common misconception : contradicted by evidence.
Diarrhea and digestive disorders: the most frequent effect
Magnesium that is not absorbed remains in the intestine and retains water there. One study quantified this: for each additional millimole of soluble magnesium in the stool, its weight increased by approximately 7.3 g. In 359 patients with chronic diarrhea, the authors identified 15 cases, or 4.2%, where excessive magnesium intake, from antacids or supplements, was a major cause, if not the only one, of diarrhea. This property makesmagnesium oxide a laxative: in a 28-day trial of 90 constipated individuals divided between senna, magnesium oxide, and placebo, 1.5 g of oxide per day improved symptoms in 68.3% of participants in the group, compared to 11.7% under placebo, without serious adverse effects.
Over 11 randomized trials and 735 participants treated for cramps, serious adverse effects and treatment discontinuations did not differ between magnesium and placebo (2 serious events out of 72 versus 3 out of 68). Minor effects were slightly more frequent with magnesium, relative risk of 1.51 with a confidence interval compatible with no effect, and mainly digestive: from 11% of participants (10% under placebo) to 37% (14% under placebo) depending on the trials.
Garrison SR, Korownyk CS, Kolber MR, et al. Cochrane Database Syst Rev 2020;9(9):CD009402. DOI: 10.1002/14651858.CD009402.pub3
The figures vary widely. In an older trial cited by the 2023 review article, 36% of participants, 18 out of 50, reported diarrhea with 476 mg of magnesium per day, ranging from simple stool softening to cessation in 5 people. Conversely, seven recent studies, with doses of 128 to 1,200 mg per day, found no significant difference in diarrhea between magnesium and control. One consistent finding emerges: these disorders are benign and reversible upon discontinuation or by reducing the dose.
Oxide, citrate, chloride, bisglycinate: tolerance according to form
It is often stated that citrate or bisglycinate would always be better tolerated than oxide; the only large comparative trial found does not support this. According to the 2023 review article, citrate, which is highly soluble, may affect stools more than oxide, which is poorly soluble, and gluconate and chloride would cause diarrhea less often, without supporting figures.
In 164 overweight adults with an average age of 63 years, 450 mg of magnesium per day for 24 weeks, in the form of citrate, oxide, or sulfate, were compared to placebo. No participant stopped oxide due to digestive disorders, compared to 4.3% under citrate and 4.3% under sulfate. According to the 2023 review article, two participants under placebo also stopped due to digestive disorders. The oxide group reported fewer digestive symptoms than the citrate group at 12 and 24 weeks; sulfate caused more than placebo at 24 weeks. In total, 13 mild diarrheas, 13 stomach aches, and 10 cases of bloating were reported, including placebo.
Schutten JC, Joris PJ, Groendijk I, et al. J Am Heart Assoc 2022;11(6):e021783. DOI : 10.1161/JAHA.121.021783
This trial was partly funded by a magnesium producer, with no role in its design or analysis according to the authors. A second study, co-signed by the manufacturer of the Magshape ingredient, compared in a double-blind, single-dose design among 40 healthy volunteers, four powders each providing 375 mg of magnesium: oxide, citrate, bisglycinate, and Magshape, a micronized and microencapsulated magnesium oxide. At the end of the day, volunteers reported more accelerated bowel transit with oxide and citrate than with Magshape, and more stomach heaviness with bisglycinate and oxide than with Magshape; one volunteer withdrew from the study due to adverse effects under bisglycinate. The total amounts of magnesium that passed into the bloodstream over 6 hours did not differ significantly between the four sources.
Subjective questionnaire, single dose, industrial funding: the authors themselves call for larger studies. Our Magnesium+ contains the tested ingredient, 226 mg of Magshape per capsule; the study was on the ingredient alone, in powder form, not on our capsule formula. Our bisglycinate, citrate, and marine comparison compares forms from the absorption perspective.
| Form | What studies show about tolerance | Level of evidence |
|---|---|---|
| Oxide | No discontinuation for digestive disorders at 450 mg per day; laxative at 1.5 g oxide per day | One large trial, several laxative trials |
| Citrate | 4.3% discontinuation for digestive disorders at 450 mg per day; more digestive symptoms than oxide | One large trial |
| Oral sulfate | More digestive disorders than placebo at 24 weeks; 4.3% discontinuation | One large trial |
| Bisglycinate | More stomach heaviness than with Magshape, one withdrawal, in single dose | One industrial study, single dose |
| Chloride, gluconate | Cited as causing less frequent diarrhea, without figures | Expert opinion |
| Magshape (microencapsulated oxide) | Less accelerated bowel transit than oxide and citrate, in a single dose of 375 mg magnesium | One study co-signed by the manufacturer, single dose |
From what dose do digestive disorders appear
The 350 mg per day magnesium supplementation threshold is based on a minimum dose associated with an adverse effect of 360 mg per day, drawn from four studies. The 2023 review article highlights its limitations: in one, the 2 cases of diarrhea at 360 mg concerned cardiac insufficiency patients who already had digestive disorders.
Recent data are more reassuring. In two meta-analyses on blood pressure, totaling 2,936 participants and doses often exceeding 350 mg, adverse effects were rare and mild; in one, 3 out of 13 studies mentioned discontinuations for diarrhea, at 120 to 973 mg per day, without specifying the affected group in two of them. According to the 2023 review article, Cochrane review trials on cramps used approximately 520 mg per day, with the modest digestive variations described above. Sensitivity remains highly individual.
The 2023 review article recommends taking magnesium with a meal and spreading large doses throughout the day, as the intestine absorbs only approximately 30 to 40% of magnesium with usual intakes. In the trial where 36% of participants complained of diarrhea, some saw their symptoms decrease by taking the supplement with food. See also magnesium morning or evening.
Overdose and hypermagnesemia: rare, but serious
Hypermagnesemia is an excess of magnesium in the blood. In an Italian university hospital, it affected 1.78% of the 12,696 patients whose magnesium had been measured between 2015 and 2017, compared to 8.43% for deficiency. Severe hypermagnesemia causes cardiac conduction disturbances, neuromuscular effects and muscle weakness, according to a Dutch review on kidney disease; published cases also describe drowsiness, vomiting, low blood pressure and slow pulse.
Among 320 hospitalized patients in Japan treated with magnesium oxide, used as a laxative or antacid, 23% had elevated blood magnesium, of which 4% to a marked degree. Risk factors: glomerular filtration rate of 55.4 mL/min or less, elevated blood urea, magnesium oxide dose of 1,650 mg per day or more, treatment for 36 days or more.
Wakai E, Ikemura K, Sugimoto H, et al. J Pharm Health Care Sci 2019;5:4. DOI: 10.1186/s40780-019-0133-7
Severe cases follow the same scenario. A Japanese series describes 4 patients over 65 years old, constipated, with fragile kidneys, treated with magnesium oxide laxative, one of whom died; all had difficulty expressing their symptoms following a stroke or due to dementia. In a 72-year-old constipated woman who arrived confused and severely weakened, then developed a slow pulse and low blood pressure, the CT scan showed magnesium oxide tablets retained in the colon. Another patient, with fragile kidneys and slow intestinal transit, suffered intestinal infarction after a high dose of magnesium citrate laxative.
One case shows that normal kidneys do not protect against everything: a 53-year-old woman, hospitalized for an acute exacerbation of chronic obstructive pulmonary disease and treated long-term with magnesium laxatives for chronic constipation, saw her blood magnesium rise from 2.0 to 10.8 mg/dL despite normal kidney function, and she died. The authors explain that the constipated intestine acts as a reservoir that continues to absorb magnesium. Published cases involve high-dose laxatives or antacids, not a supplement taken at the dose recommended by a healthy person: the risk is rare, but real in elderly people, those who are constipated or have fragile kidneys who combine multiple sources.
Drowsiness or confusion, muscle weakness, vomiting, low blood pressure, slow pulse, breathing difficulty, especially in an elderly person, someone who is constipated or has kidney insufficiency who is taking magnesium: seek emergency medical advice. The authors of the Japanese series recommend measuring magnesium after any prescription or dose increase in at-risk patients.
Magnesium and kidneys
According to a review on chronic kidney disease, blood magnesium most often remains normal initially, then changes when glomerular filtration rate declines; on dialysis, it depends largely on the dialysate. In case of chronic kidney disease, a supplement is therefore decided with the nephrologist, without being an absolute prohibition: in a Japanese trial conducted in 125 patients at stage 3 or 4 of the disease, magnesium oxide prescribed and monitored by physicians slowed the progression of coronary artery calcification, with progression of 11.3% versus 39.5%, but 27% of patients in the magnesium group discontinued the study, compared to 17% in the control group, mainly due to diarrhea.
In a person with healthy kidneys, nothing indicates that magnesium damages them. Data even point in the other direction for kidney stones: in a cohort of 45,619 men followed for 14 years, those whose diet was richest in magnesium had a 29% lower risk of kidney stones than those who consumed the least. This is an association, with magnesium from food: it does not prove that a supplement protects, but does not support the opposite idea.
After age 65, or in case of diabetes or hypertension, a blood test measuring creatinine and estimated glomerular filtration rate verifies, before a course of supplementation, that your kidneys eliminate magnesium normally.
Drug interactions
In the intestine, magnesium, like calcium or aluminum, forms complexes with certain molecules and reduces their absorption. Several studies used antacids combining aluminum and magnesium: their figures do not transpose directly to a magnesium supplement alone, but the mechanism is the same.
Antibiotics. In healthy men, ciprofloxacin taken 5 to 10 minutes after an aluminum and magnesium antacid retained only 15.1% of its usual bioavailability, 23.2% with a 2-hour interval and 70% with a 4-hour interval; taken 6 hours before or 2 hours after, the antacid had no effect. A pharmacology review indicates that tetracycline absorption can be reduced by more than 90% by antacids, and ciprofloxacin and ofloxacin absorption by 50 to 90%.
In 15 healthy adults, 1 mg of levothyroxine taken with 243 mg of magnesium in aspartate form gave thyroxine exposure 12% lower than that measured without magnesium; with 301 mg of magnesium in citrate form, the 7% decrease was not significant. The authors consider the effect weaker than with calcium or iron, but advise spacing levothyroxine away from magnesium, especially when TSH levels must remain within a narrow range.
Attinger MC, von Felten S, Rodrigues CL, et al. Clin Transl Sci 2025;18(11):e70409. DOI: 10.1111/cts.70409
Gabapentin. In 13 adults, 1 g of magnesium oxide taken with 200 mg of gabapentin reduced medication exposure by 43%. Dolutegravir. In a study by the manufacturer of this HIV treatment, an aluminum and magnesium antacid reduced exposure by 74% when taken simultaneously, and a multivitamin by 33%. Bisphosphonates. These osteoporosis treatments are absorbed at less than 1% orally, and a review dedicated to their absorption details the effect of meals and complex formation with calcium; we found no study specific to magnesium, but by the same mechanism, spacing is a reasonable precaution.
In the other direction. Some medications lower magnesium. A meta-analysis of 16 observational studies and 131,507 patients found hypomagnesemia in 19.4% of proton pump inhibitor users, compared to 13.5% of non-users, with higher risk at high doses; these are associations. According to a review on magnesium and medications, thiazide diuretics lower blood magnesium by 5 to 10%. A supplement may then be useful, but on medical advice.
| Medication | Measured effect | Practical advice |
|---|---|---|
| Ciprofloxacin and other quinolones | 15.1% relative bioavailability with an aluminum and magnesium antacid taken just before; no effect at 6 hours before or 2 hours after | Antibiotic at least 2 hours before or 6 hours after magnesium. Established |
| Tetracyclines | Reduced absorption by more than 90% with antacids | Space doses and ask your pharmacist for the interval. Established |
| Levothyroxine | −12% with aspartate, −7% not significant with citrate | Levothyroxine in the morning on an empty stomach, magnesium later. Established, modest effect |
| Gabapentin | −43% exposure reduction with magnesium oxide | Do not take at the same time. Established |
| Dolutegravir | −74% with simultaneous antacid, −26% with 2-hour interval | 2 hours before or 6 hours after, according to authors. Established |
| Oral bisphosphonates | Absorption less than 1%, sensitive to meals, complexes with calcium | Space doses as a precaution. Theoretical for magnesium |
| Proton pump inhibitors | Hypomagnesemia in 19.4% of users versus 13.5% | Magnesium monitoring long-term, medical advice. Established association |
| Thiazide diuretics | Blood magnesium decrease of 5 to 10% | Medical monitoring. Established |
Vitamin D, zinc, multivitamins: the combinations
Vitamin D. Magnesium plays a role in the conversion of vitamin D. In a randomized trial of 180 adults aged 40 to 85, magnesium supplementation tailored to each individual's dietary intake increased blood 25-hydroxyvitamin D3 when baseline levels were near 30 ng/mL, and conversely decreased it when levels were higher, between 30 and 50 ng/mL. The authors conclude that good magnesium status could be important for optimizing vitamin D levels. We found no toxicity data related to this combination; our article on themagnesium and vitamin D combination details the topic.
Zinc. At very high doses, zinc interferes with magnesium absorption: in a metabolic unit study, 142 mg of zinc daily in sulfate form significantly reduced magnesium absorption and balance in adult men. Our Zinc provides 14.16 mg of zinc (gluconate) per 2 capsules, approximately ten times less, a dose that the study did not test; it is not recommended during pregnancy and breastfeeding. Also see the benefits of zinc.
Multivitamins. The main risk is unknowingly combining multiple sources of magnesium: supplement, multivitamin, laxative or antacid. Our Multivitamins provide 120 mg of magnesium per 2 capsules, an amount to be added to that of any other supplement.
Taurine and vitamin B6 in Magnesium+
The Magnesium+ provides, for 4 capsules per day, 500 mg of taurine and 2 mg of vitamin B6.
Taurine. A risk assessment published in 2008 found no consistent pattern of adverse effects of taurine in humans, and established the absence of adverse effect as solidly established up to 3 g per day in healthy adults, with higher doses tested but insufficient long-term data. The authors belong to a professional association in the supplements sector. The 500 mg in Magnesium+ represent one-sixth of this level.
Vitamin B6. The risk of vitamin B6 is real, but at different doses. In 1983, seven adults developed severe damage to sensory nerves, with balance disorders, after high daily consumption of vitamin B6, and all improved upon discontinuation. In a series of 172 women with high blood B6 levels, 60% had tingling, numbness, or muscle weakness; they were taking an average of 117 mg per day, as much as women without symptoms, but for longer, 2.9 years versus 1.6, and their symptoms resolved within 6 months after stopping. The 2 mg daily dose in Magnesium+ is approximately 58 times lower than this average. However, watch out for cumulative effects: several supplements contain B6, such as our Zinc, which provides 2 mg per 2 capsules.
Myasthenia, pregnancy, children: special situations
Myasthenia. Magnesium slows the release of acetylcholine, which transmits the nerve signal to the muscle. In a 62-year-old woman with myasthenia, a standard magnesium infusion worsened weakness to the point of requiring artificial ventilation. In a patient over 90 years old, three intravenous doses triggered three respiratory distress episodes. In a woman treated with injected magnesium for preeclampsia, near-complete paralysis revealed previously unknown myasthenia, at a blood magnesium concentration usually well tolerated. All cases we found involved injected magnesium. For an oral supplement, the risk remains theoretical, but a person with myasthenia should not take it without their neurologist's approval.
Pregnancy. Magnesium sulfate administered in hospital for preeclampsia is a medication: in the Magpie trial, in 10,141 women across 33 countries, it reduced the risk of eclampsia by 58% (0.8% versus 1.9%), at the cost of adverse effects in 24% of treated women versus 5% under placebo. Oral supplements are a different matter.
In 9,090 pregnant women, oral magnesium, in the form of oxide, citrate, gluconate, aspartate, or stearate depending on the trials, did not significantly change perinatal mortality, low birth weight for gestational age, or preeclampsia. An excess of neonatal deaths observed in the analysis was mostly dependent on one trial, with severe malformations judged unlikely to be related to magnesium, and disappeared when these deaths were excluded. According to the authors, quality evidence is lacking to conclude there is a benefit.
Makrides M, Crosby DD, Bain E, et al. Cochrane Database Syst Rev 2014;2014(4):CD000937. DOI: 10.1002/14651858.CD000937.pub2
During pregnancy and breastfeeding, the decision is up to the doctor or midwife.
Children. Published pediatric cases involve laxatives. A 20-month-old girl, healthy with normal kidneys, experienced vomiting, decreased consciousness, and low muscle tone after 4 days of magnesium oxide for constipation, with blood magnesium of 11.0 mg/dL; she recovered without complications. A 14-year-old adolescent with normal kidneys arrived drowsy, blood pressure 70/40 mmHg, after 7 days of magnesium hydroxide. In children, no self-medication: Magnesium+ is not recommended before age 3, and beyond that, consulting your pediatrician remains the rule.
Common misconceptions versus the studies
| Common misconception | What studies show | Verdict |
|---|---|---|
| Magnesium damages the kidneys | Healthy kidneys eliminate excess; the risk concerns already diseased kidneys | Common misconception in healthy kidneys |
| Magnesium causes kidney stones | 29% lower risk with the highest dietary intakes, in 45,619 men | Common misconception (inverse association) |
| Overdose is impossible | Severe cases, sometimes fatal, with laxatives and antacids, even with normal kidneys | False, but rare |
| Organic forms never cause diarrhea | Citrate caused more digestive issues than oxide in the comparative trial | Common misconception |
| Magnesium lowers blood pressure | −2.00 mmHg systolic and −1.78 mmHg diastolic on average, across 34 trials | Real but modest effect |
| Magnesium prevents nighttime cramps | No clinically useful benefit in older adults (11 trials), slightly more digestive effects | Not demonstrated |
Regarding blood pressure, a meta-analysis of 34 trials and 2,028 participants, with a median dose of 368 mg per day for 3 months, measured an average drop of 2.00 mmHg in systolic pressure and 1.78 mmHg in diastolic pressure. A weak effect, which adds to that of hypertension treatment: worth mentioning to your doctor. Our article magnesium and hypertension details these trials. For cramps in older adults, our guide on nighttime calf cramps helps identify the cause. Its demonstrated benefits are gathered in our article on proven effects of magnesium.
Safety rules and warning signs
This practical advice is intended for an adult with no kidney disease or myasthenia.
Urgently : drowsiness or confusion, muscle weakness, vomiting, discomfort or low blood pressure, slow pulse, breathing difficulty, especially in an elderly person, constipated or with kidney insufficiency. Quickly : severe or persistent diarrhea, abdominal pain, worsening of myasthenia, child who has swallowed magnesium tablets.
From Magshape, a microencapsulated magnesium, combined with magnesium malate, taurine and vitamin B6, in vegetable capsules. Four capsules per day with a large glass of water, divided throughout the day if desired; one pill organizer covers one month, and a 3-month course is recommended, possible year-round.
View Magnesium+Our guide which magnesium to choose compares the forms and their uses.
Frequently asked questions
What are the side effects of magnesium?
The only frequent effect is digestive: soft stools, diarrhea, bloating or abdominal pain, which disappear upon stopping or reducing the dose. Serious effects, linked to excess magnesium in the blood, are rare.
Why does magnesium cause diarrhea?
Unabsorbed magnesium retains water in the intestine: this osmotic effect is what makes magnesium oxide a laxative. Taking the supplement during a meal and spreading doses throughout the day reduces this effect.
Which form of magnesium causes the least diarrhea?
Direct comparisons are rare. In a 24-week trial at 450 mg per day, no participant stopped magnesium oxide due to digestive disorders, compared to 4.3% with citrate and 4.3% with sulfate, with two placebo participants also stopping for this reason, and oxide caused fewer symptoms than citrate.
Can you overdose on magnesium?
Yes, but it's rare. Published cases of hypermagnesemia almost always involve magnesium laxatives or antacids taken at high doses, in elderly people, those with constipation or fragile kidneys; some have been fatal. In an adult with healthy kidneys who follows the supplement dosage, the kidneys eliminate the excess.
What are the symptoms of excess magnesium?
Drowsiness or confusion, muscle weakness, nausea and vomiting, reduced reflexes, low blood pressure, slow pulse and, in severe cases, heart rhythm disorders and breathing difficulties. These warrant urgent medical attention.
Is magnesium dangerous for the kidneys?
Not for healthy kidneys, which eliminate the excess. In case of chronic kidney disease, magnesium accumulates more easily and a supplement should be decided with the nephrologist. For kidney stones, high dietary magnesium intake is associated with a lower risk, of 29% in 45,619 men.
What are the contraindications for magnesium?
The main one is kidney insufficiency. Myasthenia requires neurologist advice, as injected magnesium has worsened it in several published cases. Pregnancy, breastfeeding and children require medical advice.
Which medications should not be taken at the same time as magnesium?
Antibiotics from the quinolone family, such as ciprofloxacin, and tetracyclines, levothyroxine, gabapentin, dolutegravir and, as a precaution, bisphosphonates. Take the medication at least 2 hours before magnesium or 6 hours after, and verify the timing with your pharmacist.
Can you take magnesium during pregnancy?
Only on the advice of a doctor or midwife. A review of 10 trials in 9,090 pregnant women did not show a significant effect of oral magnesium on perinatal mortality, low birth weight for gestational age or preeclampsia, due to lack of quality trials. Magnesium sulfate for preeclampsia is a distinct hospital medication.
Is magnesium dangerous for children?
Cases of magnesium excess have been published in children treated with magnesium laxatives, including a 20-month-old girl with normal kidneys after 4 days of magnesium oxide. In children, a supplement should be given on the advice of a pediatrician.
Can you take magnesium every day?
Yes, in a healthy adult who follows the indicated dose: trials often lasted 3 to 6 months, with effects mainly digestive and mild. You must add up all sources and have magnesium levels checked long-term in case of kidney disease, diuretic use or proton pump inhibitor use.
Can magnesium and vitamin D be taken together?
Yes, the combination is common and no toxicity data is associated with it. In a trial of 180 adults, magnesium increased blood vitamin D when the baseline level was close to 30 ng/mL and reduced it when it was higher, between 30 and 50 ng/mL.
Sources
The studies cited below were identified via PubMed.
- Garrison SR, Korownyk CS, Kolber MR, et al. Magnesium for skeletal muscle cramps. Cochrane Database of Systematic Reviews, 2020;9(9):CD009402. DOI
- Schutten JC, Joris PJ, Groendijk I, et al. Effects of magnesium citrate, oxide, and sulfate supplementation on arterial stiffness: a randomized, double-blind, placebo-controlled trial. Journal of the American Heart Association, 2022;11(6):e021783. DOI
- Wakai E, Ikemura K, Sugimoto H, et al. Risk factors for hypermagnesemia in patients treated with magnesium oxide: a retrospective cohort study. Journal of Pharmaceutical Health Care and Sciences, 2019;5:4. DOI
- Nix DE, Watson WA, Lener ME, et al. Effects of aluminum and magnesium antacids and ranitidine on ciprofloxacin absorption. Clinical Pharmacology and Therapeutics, 1989;46(6):700-705. DOI
- Taylor EN, Stampfer MJ, Curhan GC. Dietary factors and risk of kidney stones in men: new insights after 14 years of follow-up. Journal of the American Society of Nephrology, 2004;15(12):3225-3232. DOI
- Costello R, Rosanoff A, Nielsen F, West C. Perspective: call to reevaluate the upper tolerable intake level for magnesium supplementation in adults. Advances in Nutrition, 2023;14(5):973-982. DOI
- Fine KD, Santa Ana CA, Fordtran JS. Diagnosis of magnesium-induced diarrhea. The New England Journal of Medicine, 1991;324(15):1012-1017. DOI
- Morishita D, Tomita T, Mori S, et al. Senna versus magnesium oxide for chronic constipation treatment: a placebo-controlled randomized trial. The American Journal of Gastroenterology, 2021;116(1):152-161. DOI
- Pajuelo D, Meissner JM, Negra T, et al. Comparative clinical study of magnesium absorption and side effects after oral administration of microencapsulated magnesium (MAGSHAPE) and other magnesium sources. Nutrients, 2024;16(24):4367. DOI
- Catalano A, Bellone F, Chilà D, et al. Frequency of hypomagnesemia and hypermagnesemia in a hospital setting. Magnesium Research, 2021;34(1):1-8. DOI
- van de Wal-Visscher ER, Kooman JP, van der Sande FM. Magnesium in chronic kidney disease: should we be concerned? Blood Purification, 2018;45(1-3):173-178. DOI
- Yamaguchi H, Shimada H, Yoshita K, et al. Severe hypermagnesemia induced by magnesium oxide ingestion: a case series. CEN Case Reports, 2019;8(1):31-37. DOI
- Weng YM, Chen SY, Chen HC, et al. Hypermagnesemia in a constipated woman. The Journal of Emergency Medicine, 2013;44(1):e57-e60. DOI
- Hubbard G, Nerad R, Wojtasik L. Hypermagnesemia causing mesenteric ischemia and small bowel infarction. BMJ Case Reports, 2021;14(6):e241928. DOI
- Bokhari SR, Siriki R, Teran FJ, Batuman V. Fatal hypermagnesemia related to laxative use. The American Journal of the Medical Sciences, 2018;355(4):390-395. DOI
- Sakaguchi Y, Hamano T, Obi Y, et al. A randomized trial of magnesium oxide and oral carbon adsorbent on coronary artery calcification in pre-dialysis chronic kidney disease. Journal of the American Society of Nephrology, 2019;30(6):1073-1085. DOI
- Gugler R, Allgayer H. Effects of antacids on the clinical pharmacokinetics of drugs: an update. Clinical Pharmacokinetics, 1990;18(3):210-219. DOI
- Attinger MC, von Felten S, Rodrigues CL, et al. A single-center randomized crossover trial on interactions between levothyroxine and magnesium citrate or aspartate in healthy subjects: the ThyroMag trial. Clinical and Translational Science, 2025;18(11):e70409. DOI
- Yagi T, Naito T, Mino Y, et al. Impact of concurrent antacid use on plasma exposure and oral bioavailability of gabapentin in healthy adults. Drug Metabolism and Pharmacokinetics, 2012;27(2):248-254. DOI
- Patel P, Song I, Borland J, et al. Pharmacokinetics of the integrase inhibitor S/GSK1349572 (dolutegravir) combined with acid reducers and multivitamins in healthy volunteers. Journal of Antimicrobial Chemotherapy, 2011;66(7):1567-1572. DOI
- Ezra A, Golomb G. Routes of administration and delivery systems for bisphosphonates in the treatment of bone resorption. Advanced Drug Delivery Reviews, 2000;42(3):175-195. DOI
- Srinutta T, Chewcharat A, Takkavatakarn K, et al. Proton pump inhibitors and hypomagnesemia: a meta-analysis of observational studies. Medicine, 2019;98(44):e17788. DOI
- Gröber U. Magnesium and medications. International Journal of Molecular Sciences, 2019;20(9):2094. DOI
- Dai Q, Zhu X, Manson JE, et al. Magnesium status and supplementation influence vitamin D status and metabolism: results from a randomized trial. The American Journal of Clinical Nutrition, 2018;108(6):1249-1258. DOI
- Spencer H, Norris C, Williams D. Inhibitory effects of zinc on magnesium balance and absorption in humans. Journal of the American College of Nutrition, 1994;13(5):479-484. DOI
- Shao A, Hathcock JN. Risk assessment of the amino acids taurine, L-glutamine and L-arginine. Regulatory Toxicology and Pharmacology, 2008;50(3):376-399. DOI
- Schaumburg H, Kaplan J, Windebank A, et al. Sensory neuropathy from pyridoxine abuse: a new syndrome associated with megadoses of vitamins. The New England Journal of Medicine, 1983;309(8):445-448. DOI
- Dalton K, Dalton MJ. Features of the pyridoxine overdose neuropathy syndrome. Acta Neurologica Scandinavica, 1987;76(1):8-11. DOI
- Singh P, Idowu O, Malik I, Nates JL. Acute respiratory failure induced by magnesium repletion in a 62-year-old woman with myasthenia gravis. Texas Heart Institute Journal, 2015;42(5):495-497. DOI
- Jessop K. Acute respiratory failure induced by intravenous magnesium sulfate in a patient with myasthenia gravis. BMJ Case Reports, 2022;15(6):e250455. DOI
- Bashuk RG, Krendel DA. Myasthenia revealed by weakness following magnesium administration. Muscle and Nerve, 1990;13(8):708-712. DOI
- Altman D, Carroli G, Duley L, et al. Do women with preeclampsia and their babies benefit from magnesium sulfate? The Magpie trial, randomized against placebo. The Lancet, 2002;359(9321):1877-1890. DOI
- Makrides M, Crosby DD, Bain E, Crowther CA. Magnesium supplementation during pregnancy. Cochrane Database of Systematic Reviews, 2014;2014(4):CD000937. DOI
- Araki K, Kawashima Y, Magota M, Shishida N. Hypermagnesemia in a healthy 20-month-old girl due to a laxative: a clinical case. Journal of Medical Case Reports, 2021;15(1):129. DOI
- Kutsal E, Aydemir C, Eldes N, et al. Severe hypermagnesemia following excessive laxative ingestion in a child without renal insufficiency. Pediatric Emergency Care, 2007;23(8):570-572. DOI
- Zhang X, Li Y, Del Gobbo LC, et al. Effects of magnesium supplementation on blood pressure: meta-analysis of double-blind randomized controlled trials versus placebo. Hypertension, 2016;68(2):324-333. DOI
