Saturday, August 9, 2014

Topical Magnesium Sulfate: its effectiveness in question

Topical Magnesium Sulfate (Epsom Salts baths): its effectiveness in question.
Jose Mahfoud, ND, MSc

MgSO4 is used in medicine both orally and intravenously, and it certainly has concrete effects through these routes.  Intravenously it is used in the treatment of preeclampsia and as a tocolytic; orally it acts as an osmotic laxative. It is also very popular as a folk remedy for treating musculoskeletal pain, and for removing “toxins” from the body. When challenging the validity of traditional remedies one often encounters resistance from some members of the Alternative Medicine community (both professionals and patients), who sometimes feel very strongly about certain topics, being one of them the topical use of MgSO4 (Epsom Salts baths) for the relief of musculoskeletal pain and the popular concept of “detox”.

 No adequate studies have been published regarding MgSO4 and its transdermal delivery.  Most sources that claim Magnesium is systemically absorbed through the skin lack scientific basis and their statements are anecdotal.  One small study is found to be repeatedly referenced by supporters of Magnesium transdermal delivery, some of which also claim that it is best achieved by applying “Magnesium Oil”, which is not truly an oil but a saturated aqueous solution of Magnesium Chloride (MgCl2), which behaves in a similar manner as Magnesium Sulfate in terms of dissociation.

MgSO4 is a white crystalline substance, highly soluble in water and alcohol but insoluble in oil, with a molecular mass of 120.366 g/mol (1 g/mol is equivalent to 1 Da).  Like other salts, when dissolved in water it dissociates in Mg+2 and SO4-2.  Similarly, Magnesium Chloride dissociates into Mg+2 and 2Cl.  Dissociation in an aqueous solution occurs when water molecules bind to each of the ions that form the original substance, therefore breaking apart the crystalline form.  If we were to dehydrate this solution, the ions once again form bonds between each other, reconstituting the salt crystal.

Therefore, an aqueous solution of Epsom Salts makes it nearly impossible for Mg-2 to cross the epidermal layer, due to its necessary bond with water molecules and, as we know, the stratum corneum is largely impervious to water, but highly permeable to oils.  Magnesium sulfate is not liposoluble, hence no transdermal absorption of the compound (nor its ions) occurs.  It lacks two of the three conditions necessary for a drug to be absorbed through the skin.  If any magnesium were in fact absorbed through the skin the amounts would be negligible, with no perceivable effect.
For a drug to have good transdermal delivery, it must be:

  1.   of low molecular mass (<500 Da)
  2.   highly liposoluble
  3.   potent enough [low required daily dose (<2 mg)] [1]



The analgesic (and often spasmolytic) effect attributed to topical MgSO4 is most likely due to the vasodilating and relaxing effects of heat (warm water)or, even perhaps, the placebo effect.  If it were that easy for magnesium to be absorbed transdermally, one can infer that sodium (as NaCl) in sea water would be similarly absorbed (if not more, due to sodium’s smaller mass compared to magnesium) every time we go for a swim.  Such instance would be highly detrimental to one’s health, especially due to sodium’s well known effects on blood pressure.

Magnesium is best obtained orally, mainly from foods like almonds, spinach, cashews, beans, etc., which provide a good (bioavailable) source of the mineral. Nutritional supplements may also be used should they be indicated to treat deficiency, or if dietary intake is deemed insufficient.






[1] Transdermal drug delivery: principles and opioid therapy.  Lyn Margetts, FRCA and Richard Sawyer, FRCA FIPP.  http://ceaccp.oxfordjournals.org/content/7/5/171.full Accessed 8-7-2014

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