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Inulin improves magnesium levels in patients with PPI-induced hypomagnesemia
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Inulin supplementation increased serum magnesium levels in patients with proton pump inhibitor-induced hypomagnesemia, according to the results of a recent study.
“[PPI]-induced hypomagnesemia is a severe side effect of PPI use that is present in approximately 10% of chronic PPI users,” Jeroen de Baaij, PhD, from the department of physiology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, the Netherlands, told Healio Gastroenterology. “The effect of PPI use on serum magnesium levels is hypothesized to be caused by intestinal malabsorption of magnesium in the colon.”
Mark W. Hess
Baaij and colleagues, including Mark W. Hess, MSc, performed a series of n-of-1 crossover trials involving 11 patients with PPI-induced hypomagnesemia and 10 healthy controls who did not use PPIs. Participants received 20 g orally administered fructooligosaccharide inulin fibers per day for two 14-day treatment cycles each followed by a 14-day washout period. All patients continued to use PPIs during the study. Serum magnesium levels in the treatment population vs. controls served as the primary endpoint.
They found that inulin significantly increased serum magnesium levels in patients with PPI-induced hypomagnesemia, from 0.6 to 0.68 mmol/L during the first treatment cycle and from 0.61 to 0.69 mmol/L in the second (both P < .01). Magnesium levels increased significantly from 0.84 to 0.93 mmol/L in controls during the second treatment cycle.
As a result, 24-hour urinary magnesium excretion significantly increased in patients with PPI-induced hypomagnesemia, from 0.3 to 2.2 mmol per day (P < .01). Moreover, hypomagnesemia-related symptoms, including muscle cramps and paraesthesia, improved during treatment.
The researchers acknowledged that lack of blinding is a limitation of their study design.
“Inulin significantly increased serum magnesium concentrations under PPI maintenance in patients with PPI-induced hypomagnesemia,” Baaij said. “Therefore, inulin provides a promising new treatment option for PPI-induced hypomagnesemia.” – by Adam Leitenberger
Disclosure: The researchers report no relevant financial disclosures.
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