Magnesium and Alcoholism
Chronic alcohol consumption is strongly associated with magnesium deficiency due to a combination of poor dietary intake, gastrointestinal losses, renal wasting, and intracellular shifts. Ethanol acts as a diuretic, increasing urinary magnesium excretion even in the absence of overt kidney dysfunction. Additionally, individuals with alcohol use disorder (AUD) often consume diets low in magnesium-rich foods, and alcohol-induced gastrointestinal damage can impair absorption. During alcohol withdrawal, shifts in magnesium from extracellular to intracellular compartments may further reduce serum magnesium levels, compounding the clinical picture.
Magnesium deficiency in individuals with AUD has been linked to a range of complications, including neuromuscular irritability, cardiac arrhythmias, seizures, and increased risk of Wernicke’s encephalopathy, particularly when thiamine is also deficient. Hypomagnesemia can also contribute to disturbances in calcium and potassium homeostasis, exacerbating metabolic instability during withdrawal and detoxification. Clinical guidelines often recommend magnesium repletion during alcohol detoxification, particularly in the presence of symptoms or other electrolyte imbalances. Emerging evidence suggests that correcting magnesium deficiency may improve withdrawal outcomes and support neurocognitive recovery, highlighting the importance of routine magnesium assessment and management in comprehensive care for individuals with AUD.
The following is a selective bibliography of magnesium and alcoholism-focused articles, in reverse chronological order:
Airagnes G, Valter R, Ducoutumany G, Vansteene C, Trabut JB, Gorwood P, Dubertret C, Matta J, Charles-Nelson A, Limosin F. Magnesium in the treatment of alcohol withdrawal syndrome: a multicenter randomized controlled trial. Alcohol Alcohol. 2023 May 9;58(3):329-335. https://pubmed.ncbi.nlm.nih.gov/37012631/
Nicoll R, Gerasimidis K, Forrest E. The Role of micronutrients in the pathogenesis of alcohol-related liver disease. Alcohol Alcohol. 2022 May 10;57(3):275-282. https://pubmed.ncbi.nlm.nih.gov/34491307/
Vanoni FO, Milani GP, Agostoni C, Treglia G, Faré PB, Camozzi P, Lava SAG, Bianchetti MG, Janett S. Magnesium metabolism in chronic alcohol-use disorder: meta-Analysis and systematic review. Nutrients. 2021 Jun 7;13(6):1959. https://pubmed.ncbi.nlm.nih.gov/34200366/
Grochowski C, Blicharska E, Baj J, Mierzwińska A, Brzozowska K, Forma A, Maciejewski R. Serum iron, Magnesium, Copper, and Manganese Levels in Alcoholism: A Systematic Review. Molecules. 2019 Apr 7;24(7):1361. https://pubmed.ncbi.nlm.nih.gov/30959950/
Sarai M, Tejani AM, Chan AH, Kuo IF, Li J. Magnesium for alcohol withdrawal. Cochrane Database Syst Rev. 2013 Jun 5;2013(6):CD008358. https://pubmed.ncbi.nlm.nih.gov/23740536/
Poikolainen K, Alho H. Magnesium treatment in alcoholics: a randomized clinical trial. Subst Abuse Treat Prev Policy. 2008 Jan 25;3:1. https://pubmed.ncbi.nlm.nih.gov/18218147/
Gullestad L, Dolva LO, Søyland E, Manger AT, Falch D, Kjekshus J. Oral magnesium supplementation improves metabolic variables and muscle strength in alcoholics. Alcohol Clin Exp Res. 1992 Oct;16(5):986-90. https://pubmed.ncbi.nlm.nih.gov/1443440/
Stasiukyniene V. Blood plasma potassium, sodium and magnesium levels in chronic alcoholism during alcohol withdrawal. Medicina (Kaunas). 2002;38(9):892-5. https://pubmed.ncbi.nlm.nih.gov/12474772/
Hristova EN, Rehak NN, Cecco S, Ruddel M, Herion D, Eckardt M, Linnoila M, Elin RJ. Serum ionized magnesium in chronic alcoholism: is it really decreased? Clin Chem. 1997 Feb;43(2):394-9. https://pubmed.ncbi.nlm.nih.gov/9023146/
Abbott L, Nadler J, Rude RK. Magnesium deficiency in alcoholism: possible contribution to osteoporosis and cardiovascular disease in alcoholics. Alcohol Clin Exp Res. 1994 Oct;18(5):1076-82. https://pubmed.ncbi.nlm.nih.gov/7847587/
Skal’nyi AV, Dadashev RS, Slavin FI, Semenov AS. [The content of calcium, magnesium, sodium, potassium and phosphorus of the hair in patients with alcoholism]. Lab Delo. 1989;(1):42-4. https://pubmed.ncbi.nlm.nih.gov/2467059/
Torizumi K, Yasui M, Ueyoshi A, Shimizu E, Okamoto Y, Tuda T, Ota K. [Magnesium, parathyroid hormone and osteocalcin in the sera of hospitalized patients with chronic alcoholism]. Radioisotopes. 1988 Jul;37(7):406-9. https://pubmed.ncbi.nlm.nih.gov/3262889/
Yoshimoto Y. [Calcium, phosphate and magnesium metabolism disorders associated with alcoholism]. Nippon Rinsho. 1988 Sep;46(9):1755-8. https://pubmed.ncbi.nlm.nih.gov/3236441/
Flink EB. Magnesium deficiency in alcoholism. Alcohol Clin Exp Res. 1986 Dec;10(6):590-4. https://pubmed.ncbi.nlm.nih.gov/3544909/
Ferguson ER, Blachley JD, Knochel JP. Experimental alcoholism induces phosphorus and magnesium deficiency in skeletal muscle. Adv Exp Med Biol. 1982;151:291-302. https://pubmed.ncbi.nlm.nih.gov/6295091/
Hoes MJ. Plasma concentrations of magnesium and vitamin B-1 in alcoholism and delirium tremens. Pathogenic and prognostic implications. Acta Psychiatr Belg. 1981 Jan-Feb;81(1):72-84. https://pubmed.ncbi.nlm.nih.gov/7304218/
Geurts J, Berkenboom G. [Alcoholism and magnesium deficiency (author’s transl)]. Rev Med Brux. 1980 Apr;1(4):169-74. https://pubmed.ncbi.nlm.nih.gov/7466017/
Hoes MJ. The significance of the serum levels of vitamin B-1 and magnesium in delirium tremens and alcoholism. J Clin Psychiatry. 1979 Nov;40(11):476-9. https://pubmed.ncbi.nlm.nih.gov/489530/
Ikonomoff SI.[Therapy of alcoholism. The use of thiamine, ATP and magnesium and the control of clomethiazole sympathetic blockade (author’s transl)]. MMW Munch Med Wochenschr. 1978 Jun 23;120(25):905-8. https://pubmed.ncbi.nlm.nih.gov/307166/
Jones JE, Shane SR, Jacobs WH, Flink EB. Magnesium balance studies in chronic alcoholism. Ann N Y Acad Sci. 1969 Aug 15;162(2):934-46. https://pubmed.ncbi.nlm.nih.gov/5259582/
Sullivan JF, Wolpert PW, Williams R, Egan JD. Serum magnesium in chronic alcoholism. Ann N Y Acad Sci. 1969 Aug 15;162(2):947-62. https://pubmed.ncbi.nlm.nih.gov/5259583/
Durlach J, Cachin M. [Magnesium deficiency in chronic alcoholism]. Munch Med Wochenschr. 1968 Sep 20;110(38):1776-82. https://pubmed.ncbi.nlm.nih.gov/5755402/
Sullivan JF, Lankford HG, Robertson P. Renal excretion of lactate and magnesium in alcoholism. Am J Clin Nutr. 1966 Apr;18(4):231-6. https://pubmed.ncbi.nlm.nih.gov/4951504/
Sullivan JF, Lankford HG, Swartz MJ, Farrell C. Magnesium metabolism in alcoholism. Am J Clin Nutr. 1963 Nov;13(5):297-303. https://pubmed.ncbi.nlm.nih.gov/14080503/
McCollister RJ, Flink EB, Doe RP. Magnesium balance studies in chronic alcoholism. J Lab Clin Med. 1960 Jan;55:98-104. https://pubmed.ncbi.nlm.nih.gov/13470719/
Jankelson OM, Vitale JJ, Hegsted DM. Serum magnesium, cholesterol, and lipoproteins in patients with atherosclerosis and alcoholism; some preliminary observations. Am J Clin Nutr. 1959 Jan-Feb;7(1):23-9. https://pubmed.ncbi.nlm.nih.gov/13626882/
Martin HE, McCuskey C Jr, Tupikova N. Electrolyte disturbance in acute alcoholism: with particular reference to magnesium. Am J Clin Nutr. 1959 Mar-Apr;7(2):191-6. PMID: 13637021. 1955;(80th Meeting):162-5. https://pubmed.ncbi.nlm.nih.gov/13312029/
Flink EB, Stutzman FL, Anderson AR, Konig T, Fraser R. Magnesium deficiency after prolonged parenteral fluid administration and after chronic alcoholism complicated by delirium tremens. J Lab Clin Med. 1954 Feb;43(2):169-83. https://pubmed.ncbi.nlm.nih.gov/13130933/