Magnesium by injection - the only way to guarantee getting magnesium levels up in the body
[UPDATED JULY 2022]
I used to be able to prescribe magnesium to my patients but since deregistering from the GMC, this is no longer possible. So, now please see Magnesium and B12 Injections - what to do if your GP refuses to give for how you can do it by yourself. On that page I reference various German suppliers of magnesium suplhate for injection [see section below] - the concentration of these German ampoules of magnesium sulphate is different from the magnesium sulphate I used to supply. Please note that -
- I used to supply 500mg/ml Magnesium Sulphate
- So, if you were doing a 0.5ml injection, this supplied 250mg Magnesium Sulphate.
- By weight Magnesium Sulphate contains about 10% elemental Magnesium.
- So, each 0.5ml injection delivers about 250mg x 10% = 25mg elemental Magnesium.
- The German 4mmol product states that it contains 97.22mgs elemental Magnesium per ampoule as below.
- So, to get around the same [25mgs], you should inject a quarter of an ampoule, and keep the other 3/4's [maybe in a syringe] for the next 3 injections.
What to do
The only way that I can guarantee to raise serum magnesium to a therapeutic level is to give it by injection. I prefer people to use the small volume daily injections. Because magnesium sulphate is a hypertonic solution, it can sting, and so adding a little lignocaine, which is a common local anaesthetic, helps, but this is, of course, optional.
You can find lignocaine [Lidocaine] here:
Giving yourself a magnesium injection - smaller volume
[These notes are based on the old Magnesium Sulphate I used to supply, but the ideas are the same for the German ampoules]
Use a 0.5 ml disposable insulin syringe. The needle is very fine and this makes for a virtually painless insertion. Take off the protective white cap over the plunger and the orange cap over the needle. The plunger is set at 0.05ml, so push this down so there is no air in the barrel of the syringe. Firstly draw up about 0.05 ml of lignocaine (whilst you are trying it to see if you need it and if it suits you), then fill up the rest of the syringe with magnesium sulphate. This gives you about 0.55 ml of clear liquid.
You can inject in several different sites. Start with the roll of fat round the tummy button that everyone has when they sit down. This is where most diabetics inject. You can also use the front or outside muscle of the leg between the knee and the hip, or the upper outer quadrant of the buttock. Hold the syringe like a dart, rest the needle against the skin at 90° (right angles) to the skin, push gently, bit harder, until suddenly the needle slides through. You just have to go through the skin. Inject slowly over say 30 seconds, then withdraw the syringe when empty. Hold a wad of cotton wool firmly against the site for one minute.
Then massage the area of injection gently for TWO MINUTES to disperse the magnesium. Everyone is a risk of getting injection lumps but I hope this gentle massage will make this less likely! DISPOSE OF THE SYRINGE AND NEEDLE SAFELY IN THE ENCLOSED SHARPS BIN OR BY USING A SAFE CLIP. DO NOT RE-USE NEEDLES! Take full sharps bins or safe clips to your chemist, your GP surgery or your local hospital for safe disposal.
I prefer these subcutaneous injections because they cause less tissue damage and bruising compared to the intramuscular injection.
You will also find excellent instructions in the guide on giving subcutaneous injections published by the National Institutes of Health, Clinical Center: Giving a subcutaneous injection
Larger volume injections
If you can't face injecting yourself several times a week, then larger volume injections can be given weekly. A suggested regime is 1 gm/2 mls given intra-muscularly weekly for 10 weeks.
The injection is painful because one is injecting a hypertonic solution. It is best given at room temperature or blood heat, i.m., either into triceps (back upper arm), deltoid (rounded contour of the shoulder), or glutens maximus slowly over 1-2 minutes. For a 2ml injection I usually use an orange needle. Magnesium is a powerful vasodilater. Even if one takes care to check the tip of the needle is not in a vein, sometimes there is such a powerful local vasodilatation that the vessels open up and an i.v. injection is inadvertently given. This does not matter much, except that the patient develops a generalised vasodilatation, feels hot and alarmed, goes red and may faint (if upright).
In fact it is partly this effect which is taken advantage of in the treatment of acute myocardial infarction (MI) or acute stroke - see reference below. In both these conditions there is a local obstruction of blood supply. I use i.v. magnesium (2-5mls of 50%) as a bolus to treat both these conditions - often with dramatic effects. With acute MIs there is often immediate pain relief as either the obstruction is relieved or good collateral circulation restored. Furthermore, magnesium is antiarrhytmic. Trials with magnesium have clearly demonstrated benefit and magnesium is used as a front line medication in many hospitals. See Reference (2) below.
How long should injections continue for?
At least 8 weeks at the above rates of dosing. If the injection sites get sore, you can try moving to other methods, eg, oral, transdermal skin, bath, per rectum or nebuliser. Please refer to Magnesium Magnesium by nebuliser and Magnesium Per Rectum.
(1). Lancet 337: 757-60 (1991) "Red blood cell magnesium and chronic fatigue syndrome." Cox IM, Campbell MJ, Dowson D. -- Paper Abstract
(2). Lancet 339, 1553-1558 (1992) "Intravenous magnesium sulphate is a simple, safe and widely applicable treatment. Its efficacy in reducing early mortality of myocardial infarction is comparable to, but independent of, that of thrombolytic or antiplatelet therapy". Woods KL, Fletcher S, Roffe C, et al. -- Paper Abstract
- Magnesium by nebuliser
- Magnesium Per Rectum
- What Happens If Your GP Refuses To Give The Magnesium And B12 Injections
- Magnesium and B12 injections - what to do if you get better with them?
German suppliers of magnesium sulphate
These German websites can supply magnesium for injection -
- VersandApo Magnesium for injection
- Shop Opotal Magnesium for injection
- Homoempatia Magnesium for injection
- Giving a subcutaneous injection - a clear and helpful guide on giving a subcutaneous injection from the National Institutes of Health Clinical Center.
- Versandaop lidocaine for injection
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