Table of Contents

1 * Introduction: Consideration of Epidemiologic Factors.- 1.1. Ischemic Heart Disease.- 1.2. Concomitant Cardiovascular, Skeletal, and Renal Diseases.- 1.3. Changing Magnesium, Vitamin D, and Phosphate Intakes.- 1.4. Sex Difference in Magnesium Retention.- 1.5. Hard/Soft Water and Cardiovascular Disease.- 1.6. Epidemiologic Factors in Calcific Urinary Calculi.- 1.7. Genetic Factors in Cardiovascular, Skeletal, and Renal Diseases.- I Magnesium Deficiency during Gestation, Infancy, and Early Childhood.- 2 * The Role of Magnesium in Normal and Abnormal Pregnancy.- 2.1. Magnesium Balance in Pregnancy.- 2.2. Fetal Magnesium Requirements.- 2.3. Magnesium Serum Levels in Normal and Abnormal Pregnancy.- 2.3.1. Normal Pregnancy: Magnesium Levels.- 2.3.2. Preeclampsia and Eclampsia: Magnesium Levels and Treatment.- 2.3.2.1. Possible Contribution of Magnesium Deficiency to Eclamptic Pregnancy.- 2.3.2.2. Possible Contribution of Magnesium Deficiency to Placental and Coagulation Abnormalities.- 2.4. Magnesium Levels in Women with Recurrent or Imminent Abortion.- 3 * Consideration of Magnesium Deficiency in Perinatal Hormonal and Mineral Imbalances.- 3.1. Magnesium Deficiency during Gestation.- 3.1.1. Effects of Experimental Maternal Magnesium Deficiency on the Fetus.- 3.2. Perinatal Parathyroid Secretion: Interrelations with Magnesium and Calcium.- 3.2.1. Hyperparathyroidism of Pregnancy.- 3.2.2. Fetal Parathyroid Activity, and Phosphate, Calcium, and Magnesium Homeostasis.- 3.2.3. Hypoparathyroidism of Infancy.- 3.2.3.1. Hypocalcemia of Infancy.- 3.2.3.2. Magnesium Deficiency and Infantile Hypoparathyroidism.- 3.3. Calcitonin during Gestation; Interrelations with Magnesium and Calcium.- 3.3.1. Calcitonin during Pregnancy.- 3.3.2. Fetal Secretion of Calcitonin.- 3.3.3. Neonatal Calcitonin.- 3.4. Perinatal Hypervitaminosis D.- 3.4.1. Toxicity of Excess Vitamin D during Pregnancy.- 3.5. Summary of Maternal Factors That Might Contribute to Infantile Magnesium Abnormalities: Morbidity and Mortality.- 3.5.1. Genetic Hypoparathyroidism.- 3.5.2. Genetic Hyperparathyroidism.- 3.5.3. Reciprocal Maternal and Fetal Mineral Status.- 3.5.4. Maternal Age and Parity: Diabetes Mellitus.- 3.5.5. Eclampsia.- 4 * Magnesium Status in Infancy.- 4.1. Infantile Magnesium Deficiency: A Factor in Hypocalcemic Tetany, Seizures, and Respiratory Distress.- 4.1.1. Magnesium Deficiency in Metabolic Convulsions of Otherwise Normal Newborn Infants.- 4.1.2. Low-Birth-Weight Infants.- 4.1.3. Neonatal Hypoxia.- 4.1.4. Neonatal Infants of Diabetic Mothers.- 4.1.5. Neonatal Hypermagnesemia.- 4.1.6. Magnesium Depletion by Exchange Transfusions with Citrated Blood.- 4.1.7. Low Ionized Calcium and Hypomagnesemia.- 4.2. Treatment of Infantile Conditions Associated with Abnormalities of Magnesium.- 4.2.1. Correction of Neonatal Acidosis.- 4.2.2. Intensification of Magnesium Deficiency by Treatment of Hypocalcemia with Calcemic Agents.- 4.3. Influence of Infant Feeding on Magnesium Status: Interrelations with Calcium, Phosphorus, and Vitamin D.- 4.3.1. Human versus Cows' Milk.- 4.3.1.1. Metabolic Balances of Infants Fed Human or Cows' Milk.- 4.3.1.2. Serum Magnesium, Calcium and Phosphorous Levels in Infants Fed Cows' and Human Milk.- 4.3.2. Risks of Excessive Vitamin D in Infancy.- 4.4. Primary Malabsorption of Magnesium.- 4.5. Acute and Protracted Gastroenteritis in Infancy and Childhood.- 4.6. Protein Calorie Malnutrition (PCM).- 4.7. Sudden Death in Infancy: Possible Role of Magnesium Deficiency1.- 4.7.1. Sudden Infant Death Syndrome (SIDS).- 4.7.1.1. Acute Magnesium Deficiency, Histamine Release, and Hypoxia in SIDS.- 4.7.1.2. Subacute Magnesium Deficiency and Cardiac Lesions in SIDS.- 4.7.1.3. SIDS and Hypoparathyroidism.- 4.7.1.4. Epidemiologic Factors in SIDS.- II Magnesium Deficiency in the Pathogenesis of Cardiovascular Diseases.- 5 * Failure to Reduce Incidence of Ischemic Heart Disease by Lowering Blood Lipids.- 5.1. Magnesium and Lipid Interrelationships.- 5.1.1. Influence of Fat on Magnesium Retention (Man).- 5.1.1.1. Dietary Fat and Magnesium Balance.- 5.1.1.2. Steatorrhea and Magnesium Loss.- 5.1.1.3. Dietary Fat and Blood Lipids (Man).- 5.1.1.4. Serum Magnesium and Cholesterol Levels in Cardiovascular Patients and High-Risk Populations..- 5.1.1.5. Clinical Use of Magnesium in Cardiovascular Disease with Hyperlipidemia.- 5.1.2. Blood and Cardiovascular Magnesium and Cholesterol in Experimental Dietary Atherogenesis and Cardiopathies.- 5.1.3. Magnesium/Lipid/Catecholamine Interrelationships.- 5.1.4. Estrogen, Lipids, and Magnesium; Interrelationships with Arteriosclerosis and Thrombosis.- 5.1.4.1. Estrogen Therapy of Ischemic Heart Disease.- 5.1.4.2. Estrogen, Cardiovascular Effects, and Magnesium..- 5.1.4.3. Magnesium, Estrogen, and Thrombotic Events.- 6 * Is Clinical Arteriosclerosis a Manifestation of Absolute or Conditioned Magnesium Deficiency?.- 6.1. The Arterial Wall and Arteriosclerosis.- 6.1.1. Mucopolysaccharides and Elastica in Arteriosclerotic Arteries.- 6.1.2. Pathology of Infantile Arteriosclerosis.- 6.1.3. Incidence of Infantile Coronary Arteriosclerosis.- 6.2. Factors Suggesting Magnesium Deficiency in Infantile Cardiovascular Disease.- 6.2.1. Experimental Arteriosclerosis of Magnesium Deficiency.- 6.2.1.1. Arterial Damage Caused by "Pure" Magnesium Deficiency.- 6.2.1.2. Arterial Damage of Magnesium Deficiency Intensified by High Calcium and Vitamin D Intakes.- 6.2.1.3. Arterial Damage of Magnesium Deficiency Intensified by High Fat Intakes.- 6.2.1.4. The Cardiovasopathic (CVP) Diet.- 6.2.1.5. Other Cardiovasopathic Models That Might Entail Relative Magnesium Deficiency.- 6.3. Catecholamine-Induced Arterial Damage; Magnesium Interrelationships.- 6.4. Magnesium Deficiency, Mast Cells, and Arteriosclerosis.- 6.5. Arterial Resistance, Blood Pressure, and Magnesium.- 6.5.1. Increased Arterial Resistance: Low Mg + K; High Ca + Na.- 6.5.2. Magnesium Deficiency and Decreased Blood Pressure; Refractoriness to Vasoactive Hormones.- 6.5.3. Clinical Magnesium Deficiency and Blood Pressure.- 7 * Magnesium Deficiency/Loss from Myocardium.- 7.1. Cardiac Magnesium Lability.- 7.7. The Magnesium Status of the Myocardium.- 7.3. Myocardial Changes with Magnesium Deficiency or Loss (Animal).- 7.3.1. Experimental Magnesium Deficiency.- 7.3.2. Magnesium Loss from the Hypoxic Heart.- 7.3.3. Magnesium Loss from the Stressed Heart or in Association with Catecholamine Administration.- 7.3.4. Corticosteroid + Phosphate-Induced Myocardial Necrosis.- 7.3.5. Hereditary Cardiomyopathy of Hamsters.- 7.3.6. Stress and Free Fatty Acids/Myocardial Necrosis and Magnesium.- 7.3.7. Myocardial Loss of Magnesium after Parathyroidectomy and Sodium Phosphate Load.- 7.4. Cardiac Magnesium Loss: Central to Cardiac Dysionism, Disease, and Dysfunction.- 8 * Clinical Cardiac Abnormalities and Magnesium.- 8.1. Cardiomyopathies Not Secondary to Disease of the Major Coronary Arteries or to Infection.- 8.1.1. Peripartum Cardiomyopathy.- 8.1.2. Infantile Cardiomyopathy.- 8.1.3. Alcoholic Cardiomyopathy and Magnesium Deficiency.- 8.1.4. Diabetic Cardiomyopathy.- 9 * Magnesium Deficiency and Cardiac Dysrhythmia.- 9.1. Electrocardiographic Changes of Experimental Magnesium Deficiency.- 9.2. Magnesium Interrelationships with Other Factors in Cardiac Rhythmicity.- 9.2.1. Magnesium/Potassium in Cardiac Rhythmicity.- 9.2.2. Catecholamine/Magnesium/Potassium Interrelationships.- 9.2.3. Postinfarction/Catecholamine/Free Fatty Acid/Magnesium Interrelationships with Arrhythmia.- 9.2.4. Blood Primes for Extracorporeal Circulation.- 9.3. Magnesium Deficiency in Clinical Arrhythmia.- 9.3.1. Experimental Magnesium Deficiency (Man).- 9.3.2. Electrocardiographic Changes with Use of ACD Blood.- 9.3.2.1. Exchange Transfusion.- 9.3.2.2. Open-Heart Surgery.- 9.3.2.3. Surgery, Drainage, and Magnesium-Free Intravenous Infusions.- 9.3.3. Malabsorption and Magnesium-Deficient Arrhythmias.- 9.3.4. Arrhythmias of Starvation.- 9.3.5. Arrhythmias of Alcoholism.- 9.3.6. Dysrhythmia in Diabetes Mellitus.- 9.3.7. Arrhythmias and Abnormal ECGs in Toxemias of Pregnancy and Peripartal Cardiomyopathy.- 9.3.8. Infantile Arrhythmias and Cardiomyopathies.- 9.3.9. "Idiopathic" and Postinfarct ECG Abnormalities That May Be Related to Magnesium Deficiency or Loss.- 9.3.9.1. "Benign" Arrhythmias.- 9.3.9.2. Similarity to ECGs of Magnesium Deficiency.- 9.3.10. Heart Block of Dialyzed Uremic Patients.- 10 * Therapeutic Use of Magnesium in Cardiovascular Disease.- 10.1. Magnesium in the Treatment of Arrhythmias.- 10.1.1. Magnesium and Digitalis Arrhythmias.- 10.1.2. Magnesium Treatment of Ischemic Arrhythmia.- 10.1.2.1. Magnesium in Experimental Hypoxic Arrhythmia.- 10.1.2.2. Magnesium in Clinical Arrhythmias of Ischemic and Unknown Origin.- 10.1.2.3. Glucose Solutions and Insulin to Increase Myocardial Magnesium and Potassium Uptake.- 10.1.2.4. The Role of the Anion.- 10.2. Formulation of a Metabolic Therapeutic Program for Treating Cardiomyopathies and Arrhythmias.- III Skeletal and Renal Effects of Magnesium Deficiency.- 11 * Magnesium, Bone Wasting, and Mineralization.- 11.1. Mobilization of Bone Magnesium.- 11.2. Influence of High Vitamin D and High or Low Calcium Intakes.- 11.2.1. High Calcium: Decreased Mobilization.- 11.2.2. Low Calcium: Increased Mobilization.- 11.3. High Phosphate Intakes: Effects on Bones.- 11.3.1. Effects on Bone Magnesium.- 11.3.2. High P/Ca; P/Mg and Bone Wasting; Mineralization.- 11.3.2.1. Bone Wasting.- 11.3.2.2. Bone Mineralization.- 11.4. Influence of Metabolic Activity of Bone on Availability of Bone Magnesium.- 11.5. Influence of Age on Mobilization of Bone Magnesium.- 11.6. Physicochemical Exchange of Bone Magnesium and Calcium.- 11.7. Alkaline and Pyrophosphatases, Magnesium, and Mineralization of Bone.- 11.7.1. Magnesium Requirement for Phosphatase Activation and Synthesis.- 11.7.2. Alkaline Phosphatase and Skeletal Mineralization.- 12 * Abnormal Bone in Magnesium Deficiency.- 12.1. Osteopenia of Magnesium Deficiency (Animals).- 12.2. Abnormal Bone: Hypermineralization and Hyperplasia of Magnesium Deficiency.- 12.3. Bone Diseases Possibly Related to Magnesium Deficiency.- 12.3.1. Fetal Magnesium Deficiency and Bone Damage.- 12.3.1.1. Interrelationships with Parathyroid Hormone and Calcitonin.- 12.3.1.2. Interrelationships with Gestational Hypervitaminosis D.- 12.3.2. Magnesium Deficiency and Bone Disease in Low-Birth-Weight Infants.- 12.4. Magnesium Status and Vitamin D Requirements and Responses.- 12.4.1. Increased Vitamin D Requirements of Magnesium Deficiency.- 12.4.2. Vitamin-D-Refractory Rickets and Osteomalacia.- 12.4.2.1. Hypophosphatemic Hyperparathyroid Rickets.- 12.4.2.2. Hyperphosphatemic Hypoparathyroid Osteopenia.- 12.4.3. Other Abnormal Function of, or Response to, Parathyroids.- 12.4.4. Osteopetrosis or Osteosclerosis and Hyperreactivity to Vitamin D.- 12.4.4.1. High Vitamin D and Calcium/Low Magnesium.- 12.4.4.2. Magnesium/Calcitonin Interrelationships in Osteoporosis.- 12.5. Other Genetic Bone Diseases and Possible Role of Magnesium.- 12.5.1. Osteogenesis Imperfecta.- 12.5.2. Hypophosphatasia.- 12.6. Other Osteopenias Possibly Mediated by Magnesium Deficiency.- 12.6.1. Osteoporosis.- 12.6.2 Renal Osteodystrophy.- 12.7. Joint Diseases Possibly Mediated by Magnesium Deficiency.- 12.7.1. Osteochondrosis.- 12.7.2. Chondrocalcinosis and Osteoarthritis.- 12.8. Magnesium Deficiency and Dental Disorders.- 13 * Renal Damage Caused by Magnesium Deficiency.- 13.1. Experimental Magnesium Deficiency.- 13.2. Intensification of Magnesium Deficiency Renal Damage by Excess Vitamin D (Animal).- 13.3. Intensification of Magnesium Deficiency Renal Damage by Excess Phosphates (Animal).- 13.4. Mediation by Secondary Hyperparathyroidism; Protection by Parathyroidectomy.- 13.5. Tissue Magnesium Loss and Damage: Not Parathyroid-Mediated.- 13.6. Phosphatases and Extraskeletal Mineralization.- 13.7. Magnesium Effect on Precipitation of Calcium Crystals in Urine.- 13.8. Clinical Renal Diseases Possibly Related to Magnesium Deficiency.- 13.8.1. Renal Tubular Defects in Magnesium Reabsorption.- 13.8.1.1. Contributions to Clinical Renal Magnesium Wastage by Calcemic Factors and Phosphate Therapy.- 13.8.1.2. Contribution to Clinical Renal Magnesium Wastage by Malabsorption.- 13.8.1.3. Miscellaneous Factors in Renal Magnesium Wastage.- 13.8.2. Renal Damage during Pregnancy: Related to Magnesium Deficiency?.- 13.8.3. Diabetic Renal Disease: Contributed to by Magnesium Deficiency?.- 14 * Intensification of Magnesium Deficiency by Calcemic and Phosphate Therapy.- 14.1. Calcemic Therapy during Pregnancy.- 14.2. Calcemic Therapy during Infancy.- 14.3. Calcemic Therapy for Osteopenias.- 14.4. Treatment for Hypercalcemia.- 14.4.1. Risks of Phosphate Therapy.- 14.5. Complex of Diseases to Which Magnesium Deficiency Contributes Especially When Complicated by Calcemic and Phosphate Therapy.- Appendix * Tests for Magnesium Deficiency Cases of Infantile Ischemic Heart Disease.- A. 1. Limitations of Serum or Plasma Magnesium Levels.- A.1.1. What is the Normal Range?.- A. 1.2. Bound and Free Magnesium in Plasma.- A.2. The Importance of Cellular Magnesium Determinations.- A.2.1. Erythrocyte Magnesium.- A.2.2. Skeletal Muscle Magnesium.- A.2.3. White Blood Cell Magnesium Determinations.- A.3. Percentage Retention of Parenteral Magnesium Loads.- A. 3.1. Recommended Procedures for Determining Percentage Retention of Parenteral Magnesium Load.- A.3.1.1. Adults: Intramuscular Load.- A.3.1.2. Adults: Intravenous Load.- A.3.1.3. Infants: Intravenous Load.- A.3.1.4. Infants: Intramuscular Load.- A.3.2. Evaluation of Renal Handling of Magnesium.