Pilot study of a topical magnesium preparation to treat hypomagnesaemia in patients with an ileostomy

TL;DR

This pilot study tested a magnesium spray to treat low magnesium levels in ileostomy patients and found it helped maintain or increase magnesium and reduce muscle cramps.

Contribution

The study introduces a topical magnesium chloride spray as a potential treatment for hypomagnesaemia in ileostomy patients.

Findings

Three out of six patients showed improved serum magnesium levels after using the spray.

Five patients reported reduced muscle cramping within three weeks of treatment.

Serum and whole cell magnesium levels showed a strong linear correlation.

Abstract

Patients with a high output ileostomy often have hypomagnesaemia. This study aimed to determine if a magnesium chloride hexahydrate spray would maintain or increase serum magnesium in ileostomy patients with hypomagnesaemia.

Outpatients with an ileostomy and having chronic hypomagnesaemia (serum magnesium <0.66 mmol/L) applied 10 sprays of magnesium chloride hexahydrate spray twice daily for 6 weeks (150 mg/day, 6.2 mmol magnesium). Serum and whole cell Mg+2 levels were measured at weeks 0, 1, 3 and 6. A treatment response was a rise in serum Mg+2 > 0.10 mmol/L at week 6, or the avoidance of a planned magnesium infusion. Serum vitamin D and aldosterone levels, and a 24-hour urinary magnesium concentration were measured.

6 patients completed the study, all had normal vitamin D levels (>45 nmol/L), and 5 of 6 had urinary magnesium concentrations below 0.28 mmol/L. 2 patients had a rise in serum Mg+2 of 0.27 and 0.13 mmol/l respectively and one avoided their planned six-weekly magnesium infusion, No patient had a fall in serum Mg+2 of more than 0.07 mmol/L. Serum and whole cell Mg+2 correlation was linear (r = 0.9181, p < 0.0001). All 6 patients complained of muscle cramping at enrolment; 5 reported an improvement or complete resolution by week 3. Serum aldosterone levels were high at the start in 4 and reduced in 3. Urine magnesium concentration increased in 2.

A topical magnesium chloride hexahydrate spray maintains or improves serum magnesium levels in patients with an ileostomy and hypomagnesaemia and prevents muscle cramps.

RD13–045

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