Staying Healthy

Is It Safe to Take Magnesium if I Have Kidney Problems? (Extended)

Whenever I do one of my Internet Radio Shows on calcification, I receive dozens of emails specifically focused on kidney disease and magnesium. Whether writers have kidney stones or decreased kidney function as a side effect from diabetes, they all ask the same question, “Is it safe for someone like me, with kidney problems, to take magnesium?” It’s a good question, because many doctors advise against supplementing with magnesium.

I’ve written and recorded on this subject many times in the past. But since this is a matter of concern for many of you, I thought I would extend the information I shared in my post, I Have Kidney Disease. Can I Use Magnesium. So, for some of you, this information will be new. For others, it will reinforce what you have already read and heard.

So, let’s answer the question, “Is it safe for someone like me, with kidney problems, to take magnesium?” I thought it might be fun and educational for you to listen to my response to this question at time stamp 10:40 of the YouTube, Clearing it up with Dr. Dean:

Since I mention my book excerpt and articles in this video, I believe it would help you decide what is best for you, if I include, in its entirety, the Kidney Disease Excerpt from The Magnesium Miracle (2017).

Kidney Disease Excerpt from The Magnesium Miracle (2017)


In the original edition of The Magnesium Miracle I did not even have a section on Kidney Disease. That was mostly because the association of magnesium with kidney disease has for many decades been to just avoid it. Over the years I’ve learned that the kidneys need magnesium just like any other organ and the attack on magnesium has no scientific merit. Magnesium is a biological necessity and the blanket avoidance of it in kidney disease has led to untold suffering.


The NIH acknowledges a “growing burden of kidney disease.” Statistics show a sharp increase with kidney disease affecting one in 10 American adults. I link those statistics with the increased use of prescription medications, but doctors do not want to admit that their treatment protocols are causing harm.

Dr. Linda Fugate PhD lists the top ten classes of drugs that cause kidney damage referencing a detailed review article published in 2009. Since that time, many other drugs have been implicated and the evidence is mounting that chronic use of medications instead of judicious short-term use is causing cumulative harm.

Top ten drugs that cause kidney damage:

  1. Antibiotics, including ciprofloxacin, methicillin, vancomycin, sulfonamides.
  2. Analgesics, including acetaminophen and non-steroidal anti-inflammatory drugs (NSAID): aspirin, ibuprofen, naproxen, and others available only by prescription.
  3. COX-2 inhibitors, including celecoxib (brand name Celebrex). Two drugs in this class have been withdrawn from the market because of cardiovascular toxicity: rofecoxib (brand name Vioxx), and valdecoxib (brand name Bextra). These drugs are a special class of NSAID that were developed to be safer for the stomach but have the same risk as other NSAIDs for kidney damage.
  4. Heartburn drugs of the proton pump inhibitor class, including omeprazole (brand name Prilosec), lansoprazole (brand name Prevacid), pantoprazole (brand name Protonix), rabeprazol (brand names Rabecid, Aciphex), esomeprazole (brand names Nexium, Esotrex).
  5. Antiviral drugs, including acyclovir (brand name Zovirax) used to treat herpes infection, and indinavir and tenofovir, both used to treat HIV.
  6. High blood pressure drugs, including captopril (brand name Capoten).
  7. Rheumatoid arthritis drugs, including infliximab (brand name Remicade); chloroquine and hydroxychloroquine, which are used to treat malaria and systemic lupus erythematosus as well as rheumatoid arthritis.
  8. Lithium, used to treat bipolar disorder.
  9. Anticonvulsants, including phenytoin (brand name Dilantin) and trimethadione (brand name Tridione), used to treat seizures and other conditions.
  10. Chemotherapy drugs, including interferons, pamidronate, cisplatin, carboplatin, cyclosporine, tacrolimus, quinine, mitomycin C, bevacizumab; and anti-thyroid drugs, including propylthiouracil, used to treat overactive thyroid.

A 2016 study gives evidence that PPI heartburn drugs cause kidney injury. (Ref: 3. Xie Y, et al. Proton Pump Inhibitors and Risk of Incident CKD and Progression to ESRD. Journal of the American Society of Nephrology. 2016 Oct; 27(10): 3153-3163) The authors echo my sentiments that any drug should only be used when necessary, not as a preventive measure. They say “The results emphasize the importance of limiting PPI use to only when it is medically necessary, and also limiting the duration of use to the shortest duration possible. A lot of patients start taking PPIs for a medical condition and they continue much longer than necessary.” Often doctors tell patients to keep taking drugs “just in case” their symptoms come back instead of instituting more natural measures to prevent recurrence of symptoms.

The number of patients enrolled in the End Stage Renal Disease (ESRD) Medicare-funded program has increased from 10,000 patients in 1973 to a frightening 615,899 as of 2012. (Ref: Thongprayoon C, et al. High Mortality Risk in Chronic Kidney Disease and End Stage Kidney Disease Patients with Clostridium Difficile Infection: A Systematic Review and Meta-analysis. Journal of Nature and Science. 2015;1(4): e85.) Medicine says they are at a loss to explain why so many people are affected. And despite the magnitude of the resources committed to the treatment of ESRD and assuming there have been improvements in the quality of dialysis therapy, these patients continue to experience significant mortality and morbidity and a reduced quality of life. If dialysis is taking over the function of the kidneys, then people should be feeling much better than they are. One reason for the escalation of symptoms could be magnesium deficiency that only gets worse with time because magnesium is avoided in dialysis patients.

Signs of kidney disease include high blood pressure, protein on urinalysis, and an elevated glomerular filtration rate. High blood pressure is a very common cause of kidney disease. But in my opinion, the most common causes of high blood pressure are magnesium deficiency and calcium excess. Why else would doctors prescribe calcium channel blockers for high blood pressure if calcium was not a problem? Kidney patients are told to keep their blood pressure under control, but how are you going to do that if you are warned to stay away from magnesium? Instead you are told to take blood pressure medications that drain more magnesium.

Protein in the urine is one of the earliest signs of kidney disease, especially if you also have diabetes. One of the known medical signs of diabetes is a low magnesium level. So, if you have kidney disease and you can’t take magnesium, your blood sugar levels are going to keep getting higher as your magnesium gets lower. And then you will be put on drugs for diabetes, which will cause more magnesium deficiency.

Doctors recommend kidney blood tests be done annually to help diagnose kidney disease early, so it can be treated. And what is the medical treatment? Using medications to prevent blood pressure and diabetes. On all the medical websites I researched, there was no mention of using magnesium to prevent and treat high blood pressure or diabetes. These sites make it clear, however, that kidney disease is usually progressive, ending in kidney failure and heart failure. All the websites warn patients to avoid magnesium.

I mentioned two kidney review papers in the introduction that are opening the dialogue about magnesium and kidney disease. The February 2012 issue of Clinical Kidney Journalincluded an extensive paper called “Magnesium in Disease.” (Ref: Geiger H, Wanner C. Magnesium in Disease. Clin Kidney J (2012) 5 (Suppl 1): i25-i38.) The authors report that low Serum Magnesium levels are associated with metabolic syndrome, type 2 diabetes and hypertension – all associated with kidney disease.

One anecdote that opened my eyes to the importance of magnesium in kidney disease was a story told me by a well-known magnesium researcher. Many years ago, he asked a colleague, a kidney disease specialist, to test his kidney patients for magnesium levels. It was agreed that both Ionized Magnesium and Serum Magnesium would be tested and compared in dialysis patients. (Ref: Markell MS, Altura BT, et al. Deficiency of Serum Ionized Magnesium in patients receiving hemodialysis or peritoneal dialysis. ASAIO J. 1993 Jul-Sep;39(3):M801-4.) The results were that people with chronic kidney disease (of all varieties) had both the highest levels of Serum Magnesium and the lowest levels of Ionized Magnesium. Their magnesium was stuck in the blood stream and not getting into their cells. It’s not reported in the study but when these patients took a liquid magnesium, their Ionized Magnesium levels improved, their Serum Magnesium levels became normal, their symptoms were alleviated, and their kidney function tests improved.

This anecdote explains for me why doctors fear magnesium. They just measure Serum Magnesium and see that the levels are elevated and assume the worst. However, they don’t test for and therefore don’t notice that Ionic Magnesium is low, showing that the cells are starved for magnesium. Unfortunately, the definitive test for magnesium – Ionized Magnesium is a research tool and not available to the public. You can read more a magnesium testing in Chapter 16.

The following is a personal story that emphasizes what end stage renal disease patients are up against. This insightful correspondence is from a PhD in Health Sciences who suffers from ESRD. She describes the magnesium deficiency caused by her dialysis and her self-treatment with magnesium.

“I am a 60-year old ESRD patient on home hemodialysis for 4 years. I am a type I diabetic as well. When I began dialysis, I gave the nurse my list of supplements, which included magnesium and I was told in no uncertain terms that dialysis patients should not and cannot take magnesium, our kidneys could be harmed by it. So, I complied with their fearful stance as I entered into the unknown realms of kidney failure care, assuming they knew what they were talking about.

Before I began Home hemodialysis I started off with Peritoneal Dialysis, since they presented it as the more ‘natural’ mode. (Fluid is introduced through a permanent tube in the abdomen and flushed out the same tube during the night.) I soon developed incredible itching all over my body that they said was from being under-dialyzed. But now I also believe that as my magnesium bottomed out, my calcium and phosphorus soared and combined to form calcium phosphate crystals, and who knows where else, which deposited in my skin? Dialysis people have lots of skin issues. Yes, they are due to toxins but perhaps more importantly to low magnesium.

I remember seeing things that looked like little white crystals in my skin which I scratched until I bled. My own dialysis doctors were not even convinced this was due to dialysis! A nephrologist at Vanderbilt gave me a second opinion and had seen it. He said they call it the ‘crazy itch’ and treat it by putting people under UV lights. Knowing what I do now, I presume the UV would be helpful by raising active vitamin D, which helps lower the calcium phosphate complex levels, by lowering both calcium and phosphate as they are sent into the bones.

I also began having horrendous nighttime calf and foot cramping on peritoneal dialysis, having to jump out of bed at night to try to soothe the unbearable pain. I was afraid to take magnesium, so I downed vitamin E, B complex, etc., whatever else I could find as suggestions online.

Then I was switched to Home Hemodialysis and there must be more magnesium in the dialysis solution they use compared to peritoneal dialysis because my skin improved. However, over a year ago I began to have heart palpitations that would at first come and go but then worsened and became more constant. After reading many recent studies online, I believe that the dialysis liquid they are putting in me is actually pulling magnesium out of my blood and depleting me. I feel my heart begin to palpitate in my chest towards the end of every treatment. Many patients have leg cramping during treatment. Many of us dialysis patients have heart issues; it’s the number 1 killer of dialysis patients, and most likely caused by magnesium deficiency.

During the 4 years since I have been on dialysis, I have broken bones in my feet 3 times; increased calcifications in my arteries (showed up on x-ray); palpitations; brain fog; changes in my teeth; and who knows what else?

Thank goodness, I have been supplementing with Dr. Dean’s ReMag, and it totally resolves my palpitations. Of course, I bump heads with the powers that be who say magnesium is dangerous for kidney patients, but my kidney specialist is finally behind my decision to use it.

Besides eliminating my palpitations, since I have been taking ReMag, my phosphorus levels have dropped to nearer normal levels, so they are reducing the phosphate binders that I take with every meal. My hope is to reach a point where I need no binders at all. I have the hope that supplementing with ReMag will reverse many of my symptoms.

Magnesium is rarely measured in the dialysis setting. I went through all kinds of red tape to get pre- and post-treatment Magnesium RBC blood testing. This should be routine! To me this is unbelievable because I’m sure most patients are having their magnesium sucked away through their dialysis treatment? And sure enough, my magnesium levels were lower after dialysis than before. So, each treatment depletes my magnesium further and further.

The more I look into magnesium deficiency, the more I attribute the majority of my health problems, since beginning dialysis, to the depletion of my magnesium levels. When I bring this up, the dialysis staff gets quite defensive. I seem to know more than they do which intimidates them, not to mention that it really is the fault of their dialysis liquid that I have suffered these symptoms. They know so little about magnesium and how it interacts with phosphorus, calcium, PTH, and vitamin D3.

I just thank God I have found the studies online saying that I really do need magnesium and then I found ReMag, which really made such a difference, almost immediately. I sometimes wake up in the middle of the night with palpitations, and no way can I sleep with my heart bouncing around in my chest, so I pour a capful of ReMag in a few swallows of water, and I swear, within minutes my heartbeat returns to normal.”

The 2015 review paper, “Magnesium and Dialysis: The Neglected Cation” explains why magnesium requirements need to be re-evaluated in the treatment of kidney disease and in dialysis patients. It should provide kidney specialists with enough updated information to accept magnesium as a necessary mineral for kidney health. At the very least, it’s an article that you can print out and give to your doctor to explain why you want to take magnesium even if you have kidney disease. (Ref: Alhosaini, Mohamad et al. Magnesium and Dialysis: The Neglected Cation. Am J Kidney Dis, Vol 66:3, 523-531.) I must say, however, that I only recommend ReMag to people with kidney disease because it’s so well absorbed into the cell that it’s not going to build up in the kidneys.


A paper by Demer and Tintut in the journal Circulation discusses what used to be a complication of chronic kidney disease called vascular calcification that is causing widespread problems. (Ref: Demer LL, Tintut Y. Vascular calcification: pathobiology of a multifaceted disease. Circulation.2008 Jun 3;117(22):2938-48.) Here is how the authors categorize this condition. “Most individuals aged over 60 years have progressively enlarging deposits of calcium mineral in their major arteries. This vascular calcification reduces aortic and arterial elastance, which impairs cardiovascular hemodynamics, resulting in substantial morbidity and mortality in the form of hypertension, aortic stenosis, cardiac hypertrophy, myocardial and lower-limb ischemia, congestive heart failure, and compromised structural integrity. The severity and extent of mineralization reflect atherosclerotic plaque burden and strongly and independently predict cardiovascular morbidity and mortality.”

I was shocked when the above paper confirmed my overwhelming concern that “Most individuals aged over 60 years have progressively enlarging deposits of calcium mineral in their major arteries.” Such a statement goes hand-in-hand with most individuals over 60 years having magnesium deficiency!

Vascular calcification is gaining more recognition, but investigators are trying to distinguish it from atherosclerosis (hardening of the arteries), which is calcified fatty plaque that clogs up arteries. Personally, I think it’s just another project that keeps researchers funded while ignoring the fact that calcium builds up in the arteries in any form is a serious health problem and magnesium is the solution.

A 2014 study did find that magnesium minimizes the buildup of vascular calcification by directly antagonizing phosphate and also by suppressing absorption of dietary phosphate. (Ref: McCarty MF, Dinicolantonio JJ, “The molecular biology and pathophysiology of vascular calcification.” Postgrad Med. 2014 Mar;126(2):54-64.) The investigators suggest this action of magnesium allows it to act as a phosphate binder, which would be very helpful in dialysis patients who suffer excess phosphate levels. They do not mention the direct effects of magnesium on calcium – to keep it dissolved in solution in the body.


* ReMag: With picometer, stabilized-ionic, non-laxative magnesium you can reach therapeutic amounts. Start with ¼ tsp (75mg) and work up to 2tsp (600mg) per day. Put in a liter of water and sip all day to achieve full absorption.

*ReMyte: Picometer, 12-Mineral Solution; ½ tsp three times a day or in a liter of water with ReMag and sipped through the day.

* B Complex: Take ReAline, 1-2 per day

Once you have watched the YouTube and had a thorough read of the Kidney Disease Section, if you would like to do more research and reading, my recommendations follow.

Here are some resources that may interest you from my archives. They certainly will help you decide that magnesium supplementation is not only safe, but could be necessary, when you have kidney challenges.

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Dr. Carolyn Dean