Magnesium Clears up Mucus and Improves Breathing in Cystic Fibrosis Patients

by | Feb 10, 2014 | 2012, Cystic Fibrosis, Lung Health, Magnesium

Written by Tatjana Djakovic, Staff Writer. Study showed 300mg of magnesium demonstrated a 5.6% improvement in the severity of cystic fibrosis.

Cystic fibrosis (CF) is caused by a genetic defect on chromosome 7 that is responsible for making cystic fibrosis transmembrane regulator protein (CFTR). The defect in this protein leads to reduced chloride secretion in the respiratory airway and enhanced absorption of sodium from the airway, resulting in a lower liquid volume, dehydrated mucus and impaired clearing of mucus (1). A promising new strategy in patients with CF could be increasing magnesium levels in the blood. This may help to break up the proteins that make up the highly viscous mucus and also provide energy for contraction of muscles needed for breathing such as the diaphragm and the abdomen (2).

In this placebo-controlled crossover study, researchers studied the effect of supplementing diet with 300 mg of magnesium per day in 44 CF patients. The patients were  in stable clinical condition, aged 7-19 years old, and were given the magnesium for 8 weeks with a 4 week washout period. The magnesium and placebo had a similar taste and appearance (3).

Researchers assessed the efficacy of magnesium using the following measurements:

  • MIP (maximal inspiratory pressure) reflects the strength of the diaphragm and other muscles used for inhalation by measuring the Forced Expiratory Volume (FEV1) which is the amount of air that can be forcefully exhaled in the first second, and indicates how well the large and medium-sized airways are functioning. FEV1 can be used as a guideline to describe the severity of lung disease
  • MEP (maximal expiratory pressure) reflects the strength of the abdominal muscles and other muscles used for exhalation
  • The Shwachman-Kulczycki (SK) score which a test used to assess the severity of cystic fibrosis.

The SK score assesses four categories: general activity, physical examination, nutrition and radiological findings. The scores of the four categories are used to obtain the final score from which the patient’s condition is assigned as excellent (86-100), good (71-85), poor (41-55) or severe (<40) (3). The SK scored improved by 5.6% (from 80.05 to 84.52 points) in the group that took magnesium while the SK score decreased in the placebo group by 1.6 % or 1.3 points (80.55 to 79.25 points) (p<0.001) (4).

Forced expiratory volume as a percentage of predicted (%FEV1) is a key outcome in cystic fibrosis (CF) and other lung diseases. The MIP was measured in FEV1% predicted, which is defined as the FEV1% of the patient divided by the average FEV1% in the population for any person of similar age, sex and body composition. After magnesium supplementation, there was an 11.8 % increase in average predicted FEV1 % (from 98.3 % to 109.3 %), compared with 0.5 %  in the placebo group (from 99.2 % to 99.7 %) (p<0.001). For MEP (maximum expiratory pressure) there was a 11.9 % increase in average predicted FEV1 % (from 97.5 % to 109.4 %) compared to 0.8 % in the placebo group (from 97.4 % to 98.2 %). (p<0.001) (4).

The study showed good to moderate benefits of magnesium supplementation in cystic fibrosis patients that were clinically stable, by improving the maximum inspiratory and expiratory pressures as well as improving the SK score. It would be interesting to repeat this study on a larger scale in patients that are not clinically stable to see if efficacy of magnesium is even greater in that population.

Source: Gontijo-Amaral, Clésio, Elizabet V. Guimarães, and Paulo Camargos. “Oral magnesium supplementation in children with cystic fibrosis improves clinical and functional variables: a double-blind, randomized, placebo-controlled crossover trial.” The American journal of clinical nutrition 96.1 (2012): 50-56.

© 2012 American Society for Nutrition

Posted February 10, 2014.

References:

  1. Riordan JR. The cystic fibrosis transmembrane conductance regulator. Annu Rev Physiol. 1993;55:609–630.
  2. Rosenecker, J., S. Naundorf, and C. Rudolph. “Airway surface liquid contains endogenous DNase activity which can be activated by exogenous magnesium.” European journal of medical research 14.7 (2009): 304.
  3. Stollar, Fabíola, et al. “Shwachman-Kulczycki score still useful to monitor cystic fibrosis severity.” Clinics 66.6 (2011): 979-83.
  4. Gontijo-Amaral, Clésio, Elizabet V. Guimarães, and Paulo Camargos. “Oral magnesium supplementation in children with cystic fibrosis improves clinical and functional variables: a double-blind, randomized, placebo-controlled crossover trial.” The American journal of clinical nutrition 96.1 (2012): 50-56.