Bronchial asthma affects approximately 334 million people worldwide. It's an inflammatory condition characterized by recurrent bronchospasm which results from a hyper-responsiveness. The things which trigger asthmatics and cause their inflammation do not really impact most individuals. There is some evidence that suggests asthmas is linked to magnesium deficiency and insufficiency.
Overall, magnesium deficiency has been shown to contribute to increased inflammation within the body, and for those interested, this is due to activation of the phagocytic cells, as well as the opening of calcium channels, activation of the N-methyl-D-aspartate (NMDA) receptor, and activation of nuclear factor (NF)-KB. The resulting increased inflammation leads to an increased risk for a variety of inflammatory conditions, including #asthma.
Several studies have demonstrated how low serum magnesium levels in children and adults are correlated with asthma, including one study finding 58.8 percent of asthmatics had hypomagnesemia. Asians were found to have the greatest disparity. Studies suggested that values within a lower normal range may be insufficient or suboptimal for asthmatics, and that serum magnesium levels may be an important biomarker in the assessment of control of asthma severity.
Not only is there relation, but there seems also to be a sort of dose-dependence, in that the mean serum magnesium level is related to the severity of the individual's asthma, their attack frequency, and their exacerbations of asthma. Individuals with chronic, stable asthma were negatively correlated with asthma severity and were found to be lower in those with severe persistent asthma than in those with moderate persistent and mild persistent asthma.
The literature has further demonstrated that pulmonary function tests are positively correlated with magnesium levels in individuals with chronic stable asthma. Specifically, FEV1, FEV1%, PEF, and PEF% were significantly lower in asthmatics with hypomagnesemia compared to asthmatics with normal magnesium levels, suggesting that asthma is less likely to cause hypomagnesemia and more likely that hypomagnesemia increases the risk of asthma and of symptom severity. This answers the chicken and egg question - its the magnesium that drives the asthma and its severity, rather than the asthma.
Treatment of Asthma with Magnesium
There are a variety of results regarding the efficacy of magnesium in the prevention and treatment of asthma attacks. A systematic review and meta-analysis examined the efficacy of oral magnesium in the management of stable bronchial asthma and found that lung performance (FEV1) improved after 8 weeks of oral magnesium therapy, but at other follow-up sessions, there wasn't a lot of additional improvement. Other lung function tests (FVC, bronchodilator use, or symptoms score) weren't necessarily improved.
When magnesium sulfate is nebulized, researchers in a few studies have found minimal bronchodilatory effects and they felt this related more to the cause of the bronchospasm. However, one study found that adding nebulized magnesium to standard therapy in individuals with moderate to severe asthma led to favorable reports, including greater and faster improvement in peak expiratory flow rate, oxygen saturation, and respiratory rate, as well as reduced hospitalization rate (Hossein, Pegah, Davood, Said, Babak, Mani, Mahdi, & Peyman, 2016). Overall, the literature suggests that while nebulized magnesium may result in improvements in pulmonary function, this is not an overwhelming outcome.
Intravenous magnesium though does seem to be beneficial as an adjunctive therapy in the treatment of acute asthma in a multitude of studies. Hospital admission for those with severe acute asthma is reduced by as much as 68 percent. Bronchial hyper-reactivity is reduced with intravenous magnesium, and respiratory function is improved. Researchers seem to agree that the efficacy and favorable side-effect profile of intravenous magnesium sulfate justifies its use in those presenting to the emergency department with acute severe asthma. One study found that weekly or biweekly maintenance therapy consisting of magnesium and other nutrients resulted in enhanced asthma control.
Side effects are nil, with exception of one report of hypotension. Cost is reasonable. Oral route seems to offer little benefit, and intravenous clearly offered the greatest benefit making strong argument for intravenous magnesium as an adjunct therapy for acute asthma. The research regarding intravenous magnesium for prophylaxis treatment is minimal, but certainly, this seems an appropriate investment as we await further research development.
Eden Family Practice is now offering IV Nutritional Therapy for active wellness clients. If this is something you are interested in exploring further, contact our office or visit one of our Meet the Doc discussions to better understand our services.
Adding Myer's Cocktail
The #MyersCocktail can be added to magnesium therapy for superior asthma treatment. This includes a host of vitamins and minerals, including magnesium chloride, calcium gluconate, thiamine, pyridoxine, vitamin B12, calcium, vitamin B-complex and vitamin C. We are able to offer this for adults in our IV Nutrition Lounge.