Magnesium (Mg) deficiency is a common nutrient deficiency even in a generally healthy cohort of individuals. Cancer patients then have an increased risk of this nutrient deficiency as they are subject to possible gastrointestinal losses and drug-induced depletion. Hypomagnesemia has been shown to occur in at least 29% and anywhere up to 100% of patients on platinum-based chemotherapy (PBC). Although serum levels can be tested they don’t appear to be the most reliable resource when it comes to determining deficiency, and clinical symptoms are what ultimately should be looked at. Loss of appetite, nausea, vomiting, headache, weakness, numbness, tingling, muscle cramps, constipation, fatigue, anxiety, restless legs, insomnia, depression, irritability, asthma, refractory hypocalcemia and hypokalemia, hypertension, tremors, tetany, prolonged QT intervals, cardiac arrhythmias, ataxia, seizures, metabolic alkalosis, psychiatric disturbances and cortical blindness are the symptoms that are reported.

This deficiency can last up to 4-5-month post chemotherapy in adults and in children can last years post treatment. This deficiency also appears to follow a dose-dependent relationship as it worsens with cumulative doses of treatment.

Why does this matter? Mg deficiency is thought to contribute to the oncogenic milieu by various mechanisms. This deficiency induces inflammation, oxidative stress and can inhibit DNA repair enzymes whereas adequate levels help to stabilize DNA structure and repair mechanisms and act as a co-factor in DNA metabolism. Furthermore, the supplementation of Mg with PBC appears to be safe and does not negatively affect the progression-free survival, overall survival or blood concentrations of the chemotherapy, which are always important considerations when supplementing along with treatment. It appears then that IV administration of Mg of about 3-5g in conjunction with PBC should be considered an important part of this protocol and treatment.

Identifying and Treating Magnesium Deficiency in Cancer Patients Receiving Platinum-based Chemotherapy A review of the literature on hypomagnesemia in cancer patients By Jen Green, ND, FABNO, Meighan Valero, ND, and Laura Perkowski, ND