Inulin significantly improves serum magnesium levels in proton pump inhibitor‐induced hypomagnesaemia

Summary Background Proton pump inhibitors (PPI) are among the most widely prescribed drugs to treat gastric acid‐related disorders. PPI‐induced hypomagnesaemia, a defect in intestinal absorption of Mg2+, can be a severe side effect of chronic PPI use. Aim To restore serum Mg2+ concentrations in PPI‐induced hypomagnesaemia patients by dietary supplementation with inulin fibres. Methods Eleven patients with PPI‐induced hypomagnesaemia and 10 controls were treated with inulin (20 g/day). Each trial consisted of two cycles of 14‐day inulin treatment followed by a washout period of 14 days. Patients continued to use their PPI. Serum Mg2+ levels served as the primary endpoint. Results Inulin significantly enhanced serum Mg2+ levels from 0.60 to 0.68 mmol/L in PPI‐induced hypomagnesaemia patients, and from 0.84 to 0.93 mmol/L in controls. As a consequence 24 h urinary Mg2+ excretion was significantly increased in patients with PPI‐induced hypomagnesaemia (0.3–2.2 mmol/day). Symptoms related to hypomagnesaemia, including muscle cramps and paraesthesia, were reduced during intervention with inulin. Conclusion Inulin increases serum Mg2+ concentrations under PPI maintenance in patients with PPI‐induced hypomagnesaemia.