Magnesium by nebuliser
[UPDATED NOVEMBER 2021]
See Magnesium - treating a deficiency for other ways of delivering magnesium and a fuller discussion of these issues.
A nebuliser bubbles air through a solution and turns it into a vapour or mist which can be inhaled. The lungs have a large absorptive surface (about the size of a tennis court) and so magnesium can easily be absorbed in this way. I now have patients whose levels I have checked before and after nebulisation and so far results consistently show increased magnesium levels in red cells.
The solution that is used in the nebuliser may be slightly irritant to some people because it may make them sneeze or cough but after a few breaths this settles down (I found it best just to inhale through the mouth and not the nose). There are no theoretical or practical reasons why anyone should get problems, such as wheezing, while nebulising - indeed, magnesium works well for asthma. Some patients respond clinically as well as if they'd had an injection. In fact, a study in New Zealand of magnesium by nebuliser for the treatment of acute asthma showed this to be a very effective treatment, over and above the effect of standard bronchodilators. If you feel you are getting short of breath during the nebulisation, stop the treatment.
How to use the nebuliser
The idea is to convert the liquid magnesium sulphate into a vapour which can be inhaled and absorbed by the lungs. This is achieved by bubbling air through a solution of magnesium. Most of the nebuliser is a simple pump which pumps air. Plug it in and start. You can feel the air coming out of the nozzle. There is a length of plastic tubing - push one end over this nozzle, the other end goes into the base of the nebulisation chamber. From the top of the nebulisation chamber the mask fits on via a connecting piece. The nebulisation chamber divides in two when the top half is unscrewed from the bottom. Magnesium needs to go into the bottom half of the chamber - you can see there is a little plastic float which directs the air from the pump down through the liquid magnesium. This float needs to be positioned squarely over the air flow; otherwise the nebulisation chamber won't screw back together snugly again. You can see when the nebuliser is working because air bubbles through the magnesium and a white mist comes up out of the mask. Nebulisation is complete when the pool of magnesium is almost gone and no more white mist comes out of the mask - it should take 10-15 minutes.
How to obtain a nebuliser
EverGreen Nebulisers Ltd supply a range of nebulisers at affordable prices. There is no additional carrigage cost and no VAT when the machine is delivered direct to the patient. You simply ring them and discuss the best machine for you.
Lloyds Pharmacy also supply good nebulisers - see Lloyds Pharmacy nebulisers
Instructions for nebulising with magnesium sulphate
Magnesium sulphate is hygroscopic – this means that it will absorb water from the atmosphere if exposed to air. It does not matter much if it does - the powder simply goes a bit hard! Therefore, keep the pot sealed and only open it very briefly when you are measuring your dose of magnesium sulphate.
Initially I suggest using 1gm daily of magnesium sulphate – this delivers approximately 100mgs of elemental magnesium. Epsom salts are magnesium sulphate and can be bought over the counter from a chemist. Because magnesium sulphate is a salty solution, you may see white crystals appearing in the nebuliser and the tubing but these can be easily washed away. They may block the small hole through which the solution bubbles in the nebuliser, in which case rinse it out.
One gram of magnesium sulphate is contained in approximately a third of a teaspoon. The actual dose is not critical at all – it will be obvious within a week or two if you are using a little bit too much or a bit too little as, of course, you can expect the whole pot to last two months. 1gm of magnesium dissolves easily in a small teaspoon of water. I recommend you use spring water, put the powder of magnesium sulphate and water straight into the nebulisation chamber and the air bubbling through will quickly mix and dissolve the powder. After a while it may go a bit foggy, but this does not matter – it will still work just as well.
I am very happy for people to experiment with stronger or weaker solutions. Sometimes the stronger solutions give a metallic taste in the mouth and throat – but on the other hand the weaker solutions take longer to nebulise. It is up to everybody to find the right balance for themselves.
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