However, it is theoretically possible to overdose with magnesium in people with kidney failure. I have yet to see a red cell magnesium result which is too high. The only way I can guarantee to get magnesium levels up is by using Magnesium by injection. There are lots of different ways one can do this. Therefore intracellular levels can be improved by taking magnesium supplements. Having said that, getting serum levels as high as possible will make the job of the calcium/magnesium ion pump much easier. It will drain magnesium from inside cells and indeed from bone in order to achieve this. If serum levels change this causes heart irregularities and so the body maintains serum levels at all cost. Serum levels are maintained at the expense of intracellular levels. This explains why it is a waste of time measuring serum magnesium. Doing this makes the work of the ion pumps less hard and therefore helps mitochondria to work better. So, a low red cell magnesium is an indication for giving magnesium by injection. The reason for giving magnesium by injection is in order to reduce the work of the calcium/magnesium ion pump by reducing the concentration gradient across cell membranes. This is just one of the many vicious cycles we see in patients with fatigue syndromes.
This, of course, compounds the underlying mitochondrial failure because calcium is toxic to mitochondria and magnesium necessary for normal mitochondrial function. I suspect that when mitochondria fail, these pumps malfunction and therefore calcium leaks into cells and magnesium leaks out of cells. It is the job of mitochondria to produce ATP for cell metabolism and about 40% of all mitochondrial output goes into maintaining calcium/magnesium and sodium/potassium ion pumps. I actually now believe that a low red cell magnesium is a symptom of mitochondrial failure.
Often, paradoxically, when I repeat a red cell magnesium, it is only marginally better, but nonetheless the magnesium injections often afford marked improvement clinically. You could argue that I have been a bit naughty in the past by using a low intracellular magnesium as an excuse for trying magnesium injections! This is really to encourage GPs to use the injections because clinically they are so helpful. Furthermore, so many patients with chronic fatigue syndrome do benefit from magnesium by injection. It seems that they are almost invariably low in patients with chronic fatigue syndrome. I have struggled for over twenty years to try to make sense of red cell magnesiums. 9.3 Instructions for use of magnesium sulphate crystals.7 Magnesium absorption through the skin.
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