Yes, corticosteroids (a type of steroid) can deplete magnesium by increasing its loss through urine and reducing absorption, potentially leading to muscle weakness and bone issues, so doctors often recommend magnesium, calcium, and vitamin D supplementation for long-term users.
Corticosteroids and Nutrient Depletion
To add to that side-effect, they promote nutrient depletion. According to the Natural Medicines Database, corticosteroid drugs such as prednisone deplete calcium, vitamin D, chromium, zinc, potassium and magnesium from the bodies of those who use them.
Hypomagnesemia occurs with both loop diuretics (furosemide, bumetanide, torsemide, and ethacrynic acid) and thiazide diuretics (chlorothiazide, hydrochlorothiazide, indapamide, and metolazone).
Corticosteroids may increase the body's loss of magnesium. Some doctors recommend that people taking corticosteroids for more than two weeks supplement with 300–400 mg of magnesium per day. Magnesium has also been reported to interfere with the absorption of dexamethasone.
Your body needs magnesium to function normally. Symptoms of magnesium deficiency include low appetite, nausea or vomiting, muscle spasms or tremors and abnormal heart rhythms. A blood test or urine test can be used to diagnose magnesium deficiency.
Among the known magnesium deficiency causes are prescription medications such as diuretics, antibiotics, painkillers and cortisone, which can deplete magnesium levels in the body by impairing absorption or by increasing excretion by the kidneys.
For drinks high in magnesium, opt for mineral waters, fruit juices (especially orange, cherry, watermelon), plant-based milks (soy, almond), and homemade concoctions using raw cacao, coconut milk, or magnesium powders mixed with water or smoothies, with hot chocolate (made with raw cacao) and herbal teas (like nettle) also being good choices.
Certain medications should not be taken with magnesium, including certain antibiotics, PPI drugs, diuretics, bisphosphonates, and high doses of zinc. If you take any of these medications and might need to supplement your diet with magnesium, speak to your healthcare provider.
Fluid and electrolyte imbalance: Corticosteroids may contribute to fluid retention, hypertension, and hypokalemia, all of which can complicate management of cardiovascular or renal comorbidities.
Anyone taking glucocorticoid medicine must get sufficient calcium and vitamin D. The American College of Rheumatology recommend at least 1,500 mg of calcium and 800 to 1,000 IU of vitamin D supplements each day.
Some people have a problem absorbing magnesium into their body due to an issue with their kidneys or intestines. It is also commonly found in people who are in hospital, or on long-term medication for a different illness that can cause issues with absorbing magnesium.
Chronic magnesium deficiency is often associated with normal serum magnesium despite deficiency in cells and in bone; the response to oral supplementation is slow and may take up to 40 weeks to reach a steady state.
Causes of Hypomagnesemia
Usually, the magnesium level becomes low because people consume less (most often, because of starvation) or because the intestine cannot absorb nutrients normally (called malabsorption). But sometimes hypomagnesemia develops because the kidneys or intestine excrete too much magnesium.
Steroid therapy has the potential to interfere with the normal absorption and utilization of specific nutrients, including calcium, potassium, sodium, protein, and vitamins C and D. A dramatic increase in appetite can occur.
Culprit medications linked to hypomagnesemia include antibiotics (e.g. aminoglycosides, amphotericin B), diuretics, antineoplastic drugs (cisplatin and cetuximab), calcineurin inhibitors, and proton pump inhibitors.
A decrease in bone density is extremely common when taking prednisone. Eating extra calcium and taking calcium supplements are very important for anyone taking prednisone. It is known that women and men with thin bones have a higher rate of osteoporosis.
Based on these findings we have something called as Rule of 2. If a patient consumed 20mg/day or more Cortisone or its equivalent, for a duration of 2 weeks or more, within 2 years then the dosage of the steroid medication should be doubled preoperatively.
Common side effects
Corticosteroid (CS) therapy for infectious and rheumatological diseases showed to decrease serum magnesium (Mg++) level and induce muscle atrophy in patients.
You should not mix magnesium with certain antibiotics (tetracyclines, fluoroquinolones), bisphosphonates, diuretics, proton pump inhibitors, some blood pressure drugs, and diabetes medications, as it can block absorption or alter effects, requiring spacing or avoidance. Also, separate magnesium from high doses of zinc, iron, calcium, and high-fiber/phytate/oxalate foods to prevent interference with absorption.
Foods high in magnesium are leafy greens, legumes, nuts, seeds and whole grains. A doctor can check your magnesium levels by a blood or urine (pee) test. If you have low magnesium levels, your doctor may recommend taking a supplement.
Let's dive into the top 10 foods that block magnesium absorption.
Avocados: One whole avocado = 58 mg of magnesium. Bananas: One medium banana = 32 mg of magnesium. Papaya: One small papaya = 33 mg of magnesium. Blackberries: 1 cup = 29 mg of magnesium.
Drinking enough water isn't always enough. Your body needs the right minerals to absorb and retain hydration properly. Magnesium is a key electrolyte that ensures efficient water absorption at a cellular level.
Achieving 100% of the daily recommended magnesium intake can be accomplished by eating foods rich in magnesium, such as: