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#1
Mon Apr 28, 2014, 12:12 PM
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Magnesium
Hey everyone, I was diagnosed with AA in December and did the ATG/cyclo route. Numbers are just above the need for transfusions, but I have to have magnesium transfused 3 times a week for 4 hours each time. I am wondering if anyone has had similar problems?
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#2
Mon Apr 28, 2014, 03:40 PM
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Marc,
Between the chemo and the disease, your body may eat up more magnesium than you are used to. I take 4 grams of magnesium every day through my triple lumen catheter for 3 hours. I have been on it for about 5 weeks, and will probably be on for another 3-5 at this point in time.
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MDS RCMD w/grade 2-3 fibrosis. Allo-MUD Feb 26, 2014. Relapsed August 2014. Free and clear of MDS since November 2014 after treatment with Vidaza and Rituxan. Experiencing autoimmune attack on CNS thought to be GVHD, some gut, skin and ocular cGVHD. Neuropathy over 80% of body.
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#3
Mon Apr 28, 2014, 10:08 PM
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Hi Marc,
Unfortunately, there is a known link between Cyclosporine and low magnesium levels. My magnesium level wasn't tested until 2 years post-ATG when I was having unexplained muscle cramping. I have been taking Magnesium Oxide ever since. When I was off cyclosporine for 6+ months, my magnesium levels remained low- possibly suggesting structural kidney changes due to my long term cyclosporine use. Attached is an interesting paper on this topic. The article does mention that IV magnesium replacement typically only lasts 3-4 days. How low are your magnesium levels? Are you on a high dose of cyclosporine? Unfortunately, this article mentions that Tacrolimus can also lead to hypomagnesemia.
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58 yo female, dx 9/08, AA/hypo-MDS, subclinical PNH, ATG/CsA 12/08, partial response. small trisomy 6 clone, low-dose cyclosporine dependent
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#4
Mon Apr 28, 2014, 10:13 PM
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I am on tacrolimus stand alone so far. Tac does have a very deleterious effect on magnesium levels, but they do expect this to normalize after tac is decreased.
I am at 1.8 most days, but that is after 4mg of IV mag every day.....so i will probably be on some supplementation for a while.
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MDS RCMD w/grade 2-3 fibrosis. Allo-MUD Feb 26, 2014. Relapsed August 2014. Free and clear of MDS since November 2014 after treatment with Vidaza and Rituxan. Experiencing autoimmune attack on CNS thought to be GVHD, some gut, skin and ocular cGVHD. Neuropathy over 80% of body.
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#6
Tue Apr 29, 2014, 07:25 PM
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Marc,
I know that you could use oral magnesium to try and boost your levels, but it can be hard on the digestive tract among other things, but it might be worth exploring in between your infusion days.
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MDS RCMD w/grade 2-3 fibrosis. Allo-MUD Feb 26, 2014. Relapsed August 2014. Free and clear of MDS since November 2014 after treatment with Vidaza and Rituxan. Experiencing autoimmune attack on CNS thought to be GVHD, some gut, skin and ocular cGVHD. Neuropathy over 80% of body.
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#7
Tue Apr 29, 2014, 08:14 PM
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Cyclosporine at 200mg 2x a day really effected my sons Magnesium level. He was having horrible headaches and neuropathy symptoms (tremors of the hands and burning of the feet and lower legs). When we went for a second opinion, the new doc immediately recognized the problem. My son is now taking Mag Tab SR. This is a stronger slow release form of oral magnesium. This has returned my son's Mag level to normal. Caution: Magnesium causes diarrhea. We had to decrease the dose from 2x/day to daily.
On the positive note: Be thankful your AA team recognized the problem. I will never forget the day we asked our previous nurse practitioner about starting Mag supplement because of the symptoms. Her reply was there is "No Correlation between Cyclosporine and Magnesium levels"! Well, I knew different because of info from my friends on Marrow Forums. That is the day we decided to look for a different AA team. May God Bless You. May the Lord Bless All with Bone Marrow Failure.
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#8
Sat May 3, 2014, 01:45 AM
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My son takes (2) Mag-Ox 400 by Blain daily w/meals and this has worked very well for him. He takes 300mg CsA (Gengraf) 2X daily. His Magnesium is usually at around 1.8 also
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06/2004 my son was dx with SAA at the age of 10. No sibling BM match. He underwent ATG (H)/CsA. Relapsed 05/12 & dx'ed w/PNH. Currently in wait/see mode for Solaris as he is asymptomatic... 
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