blood circulation clot

Blood Clot (Thrombosis) Risk Increases With Inflammation

Inflammation and viral infections like influenza, hepatitis C, HIV, Sepsis, Aplastic anemia and Severe Acute Respiratory Stress Coronavirus 1 & 2, can cause blood clotting disorders – either excessive clots and vascular blockages, or low platelet count causing excessive bleeds.

If you’ve never heard of thrombosis before, then take note, because it is a sign that the blood is in a state of ‘dis-ease’. Our blood forms rivers of life in our body that need to keep flowing properly to maintain health and wellbeing.  The blood’s red blood cells, via their haemoglobin, deliver vital oxygen and nutrients all around the body to the furthest extremities and back again.

Maintaining a healthy blood pH is extremely important so that blood can flow smoothly and fluidly around the body through the arteries, veins and all the tiniest capillaries to the extremities of the body. If the blood is not fluid enough the blood circulation is restricted and the micro capillaries get starved of blood and oxygen. Some capillaries are so small they can only pass through the tube one blood cell at a time (single file), so you can imagine how a slightly thicker blood can retract the reach of circulation to the extremities. Oxygen deprivation in cells via restricted blood circulation is called hypoxia, which results in damage and cell death.

We need some blood clotting ability so that our blood doesn’t all spill out of our vessels in the case of punctures. If you accidentally cut yourself blood will escape, you put some pressure on the gash and shortly afterwards, if your clotting system is working normally, the blood thickens in that location to form a plug (a clot), which stops you losing too much blood. The body gets to work to repair tissue cells and remove debris, after which your skin has repaired itself and returned to normal.

Clotting disorders can either be because platelets keep aggragating and clumping, which endangers blood flow, or it can go the other way, whereby not enough platelets are available for plugging breaches and bleeds occur too easily. Those on blood-thinner medications will know all too well the feeling of panic when that blood just keeps coming out of the cut because the platelets are slow to form a plug.

Thrombosis, Blood Clotting and Platelets

Platelets, along with red blood cells, and the white blood cells of the immune system, are all made in the bone marrow. The platelets help the blood to coagulate (get thicker like a gel). According to an 2018 study, “Blood and bone marrow are not fundamentally different solutions, but rather a continuation of the same biological system. All blood cells have a similar life history: they are generated from a common stem cell in the bone marrow.” 

“Inflammation is part of the wound healing process. In the first step of tissue repair, platelets arrive at a wound site, degranulate, and release their diverse contents, inclusive of growth factors. Platelets provide proteins for primary and secondary hemostasis including fibrinogen and von Willebrand factor. Once bound to extracellular matrix at a wound site, activated platelets secrete a wide variety of chemokines which attract white blood cells.”

Platelets move into the blood in response to an injury on the vessel wall. They are part of the immune system and stimulate the attraction of white blood cells, interacting with endothelial cells to quickly stem any internal bleeding from an injured blood vessel. 

Platelets release proteins that cause a stickiness in the clot due to positive surface charges that are attracted to the negative surface charge of the red blood cells. Fibrin is a protein which increases and further binds the mass. Other red blood cells moving past can also get caught up in the melee and become part of the growing clot.

In the clean-up process the macrophages get activated to swallow up and remove damaged cells or platelets, debris, or any associated pathogens. As the inflammation itself produces more acids, the body also needs to send alkalising antioxidant enzymes to bring pH back to normal. New tissue cells are made to repair the breach, after which the healing process is complete.  At a small scale with no significant breaches, you may not even notice symptoms. The body just deals with it.

Blood Clot (Thrombosis) Risk Increases With Inflammation thrombus diagram

In thrombosis however, the clots are not dissolved fast enough by enzymes, leading to the formation and growth of a larger clumpy mass, known as a thrombus (blood clot), which forms on the endothelial lining. This is more likely to happen in an acidic environment which means more attractive positive charges pull cells together, as opposed to an alkaline environment which has more negative charges repelling cells so they bounce off one another in a more fluid environment.

If the clot breaks off from the site where it was formed, it can travel through the bloodstream and get stuck in a smaller vessel. This is known as an embolism and can cut off blood supply to the area.

You may have heard of some people sitting for very long periods of time, such as on an international flight or long road trip, developing Deep Vein Thrombosis (DVT), which is a clot in the leg or pelvic veins. The lack of oxygen, water, antioxidants and electrolytes promote an acidic environment, which is more conducive to clotting.

A clot that gets stuck in the lung arteries is called a pulmonary embolism, and a clot that lodges in the brain is known as a stroke. All these clots have in common inflammation, oxygen deprivation and acidity.

An aneurysm is when a blood vessel wall balloons outward like a blood blister because the wall has become too thin and lost its structural resilience.  It can sometimes be associated with a clot or stroke due to the pressure build up caused by the obstruction. The thinning of the vessel walls can also be caused by acidosis, which damages the proteins making up the collagen matrix of the endothelial linings.

Genetic factors increasing risk of thrombosis

Factor V Leiden is the most frequent genetic risk for thrombosis, with an occurrence of about five per cent in the population. With this gene mutation coagulation responses occur naturally, but normal inactivation of coagulation is impaired. It means that coagulation can keep building up beyond what is necessary, and be slow to break up and dissipate, which causes thrombosis.

“The relative risk of thrombosis increases by five to ten-fold in heterozygote individuals (where the gene mutation is inherited from one parent), however the relative risk of thrombosis is increased by 50 to 100 fold in homozygous individuals (mutation inherited from both parents).”1

You can get genetic testing to see if you have Factor V Leiden, and if so, then you must be extra cautious to avoid circumstances that can induce inflammatory responses and clots – such as long distance flights or sitting for long periods of time without movement.  Also, nutritional needs will be more significant in the control of pH balance to avoid acidosis.

Hypertension and cardiovascular disease increase clot risk

Clotting disorders are more prevalent in those with cardiovascular disease, metabolic syndrome and diabetic acidosis.  These metabolic issues are also strongly associated with chronic magnesium deficiency.  Research shows consistently that low magnesium status in platelets of “those with excess adiposity, insulin resistance, diabetes mellitus type I and II, and hypertension, accounts for hypercoagulability in these patients.” 2  These conditions are also associated with acidic pH, starving the cells of enough oxygen for proper respiration and metabolism.

When viral infections get loaded on top of their already low magnesium and acidic cell environments, they are more prone to hyper-inflammatory responses, increasing acidosis and consequent severity of symptoms.  Low magnesium itself is known to prime inflammatory responses to make us more sensitive and reactive to provocations.

According to a new study in the Open Heart Journal 2020, “Hyperinsulinaemia decreases cholesterol sulfurylation to cholesterol sulfate, as low vitamin D regulation due to magnesium depletion and/or vitamin D sequestration and/or diminished activation capacity decreases sulfotransferase enzyme SULT2B1b activity, consequently decreasing plasma membrane negative charge between red blood cells, platelets and endothelial cells, thus increasing agglutination and thrombosis.”3

In most cases hypertension is caused by a combination of stiffening arterial walls and a thickening of the blood itself. This means that the heart has to do a lot more work to pump the blood around the body to deliver oxygen and nutrients to cells, as well as to remove waste products. 

It’s like trying to push water through an old dry hose:  It takes a lot more energy to push that water through so that you get the right amount of water coming out the other end.  Not only do you have to pump harder, but the more the hose resists because of stiffness, the more likely it is to develop splits and break. 

Your blood vessels work like the water hose.  When they are young they are flexible, hydrated and juicy, allowing the flow of blood to be adjusted more easily to maintain a normal pressure range. The vessel walls have plenty of collagen and elastin to allow for expansion and contraction without shearing. Nitric oxide (NO) is also used to help the vessels expand as needed. 

Magnesium is a very important player in this system.  Not only is it used to make NO, but magnesium can even help the smooth muscle wall of the endothelium relax and expand independently of NO, due to its control of the calcium channels. When you have plenty of magnesium available it helps move the calcium into the bone matrix for strengthening, but if you don’t have enough magnesium, the calcium leaches out of the bones and can cause osteoporosis.

heart blood clot

Calcium, like magnesium, can be used as an alkaliser to neutralise the effect of acids. In the case of magnesium deficiency, calcium moves into the blood as ‘free calcium’ and can bring the pH back to normal range. However, there is a thickening effect in the blood (as in dehydration). This short-term fix can lead to precipitation of calcium onto the endothelial walls of vessels, which causes stiffening. 

As more calcium deposits over time, the smooth muscle wall becomes more rigid, increasing the risk of splitting as the blood is pumped through. The micro splits at the calcium deposit sites are called calcium lesions. To fix the emergency, the body creates micro clots at the breaches.

It also sends extra cholesterol to try to mop up acidic wastes and toxins.  This mixture forms fatty plugs (ie. plaque) that can grow and reduce the opening space of the vessel, which further increases blood pressure, heart strain and angina pain. If the plugs (plaque) increase too much, they can block the vessel completely and cause a heart attack (ie. cardiac arrest).

Magnesium helps our vessels, ligaments, muscles etc., maintain flexibility and resilience to accommodate movement.  It brings water into cells for better hydration due to its large hydration shell. It also helps the body make the proteins collagen and elastin, which are necessary for the matrix structure and flexibility of the vessel wall. Magnesium in this way acts as a blood pressure normaliser and even outperforms statin drugs. 1

Studies have also shown that, “Magnesium deficiency promotes atherosclerosis, thrombosis and hypertension.” 4

Metabolism, oxygen and pH balance

Magnesium is used by the body to do more jobs than any other mineral.  One of its most important functions is to recharge the mitochondria so they can make adenosine triphosphate (ATP), the body’s electrical energy currency. Magnesium is also used to store ATP in the cell membrane for later use as backup battery power. Without enough magnesium you can too quickly run into fatigue.

The mitochondria use oxygen and magnesium to produce ATP, which is called oxidative phosphorylation, or aerobic glycolysis. It is a very efficient form of energy production because you get 38 ATP molecules per molecule of glucose used up, but it is a slower process.

Cells can also use anaerobic metabolism (anaerobic glycolysis) without the mitochondria if a fast energy hit is required and if not enough stored ATP is available. However the downside of anaerobic metabolism is that you only get 2 ATP molecules per glucose molecule used up. This means a lot more glucose molecules are required to produce energy when oxygen is in short supply.  It leads to sugar cravings and more insulin and blood sugar release into the blood. This leads to an acidic cascade because more sugar metabolism produces more waste acids from the excess use of glucose. On top of it all you are also short-changed on energy supply.  You could be caught in a revolving door made out of sugar; that is, feeling more fatigued despite the increase in glucose.

Therefore, either path of metabolism (with or without oxygen) produces acid wastes, but anaerobic metabolism has been shown to produce the most acid wastes. If you don’t have enough buffers to neutralise the free radicals and detox, acidosis will suffocate cells.

“The acid produced by glycolysis lowers the pH both inside cells where lactate is produced, as well as outside where protons can diffuse. Since the pH range in which cells can function is quite narrow (pH 7.0–7.6), uncontrolled glycolysis can lead to cell death… In the final analysis it is overproduction of acid and lowering of the pH by glycolysis that kills most organisms, including humans.” 5(p32)

“Conditions in humans that greatly increase anaerobic glycolysis because of a shortage of oxygen, for example, failure of the respiratory system or the blood circulatory system, often cause the production of more acid than can be handled by the buffering systems of the body. The consequence is lactic acidosis, a life-threatening condition. Lactic acidosis can be dealt with most effectively by re-establishing the supply of oxygen.” 5(p32)

It’s a revolving door because in order to absorb more oxygen into the plasma to supply mitochondria, you need to lift pH. To do this you need more antioxidants, which are electron donors and acid buffers. And you need to stop feeding your body with so many processed carbohydrates, which encourage anaerobic glycolysis and excessive acid production. Once the pH balance is restored, more oxygen can get access to cells. Together with magnesium, the mitochondria can then do their more efficient aerobic phosphorylation to supply the energy you need, without as many acid waste byproducts.

The body’s pH war

Magnesium is also used to make detoxification enzymes like Superoxide Dismutase (SOD), which has an important role to neutralise the acidic ‘oxidised’ waste products of metabolism. The production of ATP itself results in oxidised waste products which are free radicals.  When magnesium is low, and therefore SOD is low, the mitochondria slow down metabolism. They slow production of ATP in line with magnesium levels because ATP without magnesium becomes toxic to mitochondria and can kill them. 6

blood platelet clot

Our cells can only perform and do their job well if the environmental conditions of the cell are optimal, and the pH is right. The ideal pH for blood plasma is 7.35, which is slightly alkaline. If nutrients are missing that are essential, if cell pH is driven downward and free radicals are not neutralised, then cells perform sub-optimally… a bit like the ‘safe mode’ on the computer, basically working, but high-level functions are not available, so that fatigue becomes pervasive.

The plasma, a clear watery substance inside cells and blood, is made up mainly of water and electrolytes, magnesium being the master mineral component to maintain electrical charge integrity.  This charge creates a slightly alkaline fluid matrix that pulls the water molecules closer together like train tracks. Scientist Gerald Pollack explained it well in his book Cells, Gels and the Engines of Life.  

This slippery hexagonal water structure enables better transport of nutrients and organelles. In blood plasma, as the alkaline environment helps maintain a negative charge on the surface of the organelles, whatever components are carried in the vascular system can bounce off one another, maintaining distance and optimal surface area.  Everything glides, flows and slips to where it needs to go.

There is an association between low magnesium and a low plasma pH (acidity). This happens when the body has too many free radicals (ie. acid wastes) roaming around looking to steal electrons from other cellular tissue. In an acidic environment, blood components don’t slip like they should, but instead get sticky and disordered. If they degrade further, they get wobbly and bumpy looking, with spiky protrusions that tend to attract more clumping of cells.

Blood Clot (Thrombosis) Risk Increases With Inflammation Microscope blood cells
LEFT: Healthy cells: negative charge RIGHT: Acidic degenerated cells

Fungi and bacteria use acids to break down carbon-based materials like plants and meat, leaves and timber, sewage etc., so they can be turned back into soil to grow more plants in nature’s recycling factory.  Your compost heap is a great example of how this degradation system works.  However, in the well-ordered balanced pH environment of a living organism, cells look plump and round because of a negative charge from an alkaline environment, and energy is produced efficiently.

There are circumstances where we need a temporary high level of acidity, such as with stomach digestion. When the stomach produces hydrochloric acid to break down the food we eat, we need a strong acid – as much as 2-3pH. However, once the food is mulched enough, some sodium bicarbonate from the pancreas is pumped into the mix via the stomach glands to neutralise the acid, allowing it to pass to the next level in the digestive system, the small intestine, for absorption of the nutrients. 

For the rest of the journey through the bowel, the food materials need to be neutral or alkaline.  If they get acidic, it is associated with constipation and drying up of faecal matter.  Also, our beneficial bacteria which are necessary for good digestion, the making of neurotransmitters and immune cells, don’t like acidic conditions and start to die off.  This leaves the way open for more pathogenic bacteria and fungi (like candida) to flourish, which love the acidic conditions. They also produce too much acid which then starts to eat into the endothelial lining, loosening the tight junctions and degrading the protective mucin layer, which causes ‘leaky gut syndrome’. This triggers an immune response, that is, inflammation.

Think of free radicals like robbers stealing bricks that hold up a house.  Magnesium acts like an antioxidant because it has two spare electrons (extra bricks) in its outer shell to donate to the free radicals, which have missing electrons (empty spaces). This joining of yin and yang helps to keep our cellular house in tact. The compound then becomes stable, that is, neutral. 

Keeping pH and inflammation under control

To increase pH add more antioxidant foods to your diet, like vegetables and fruits (low sugar) with high vitamin C, flavanoids and flavanols. These foods help to cleanse, detox and support your garbage-disposal system.

It’s always a see-saw balancing act in the body: We use nutrients to create and spend energy, which makes acidic wastes, and those wastes need to be neutralised and removed by antioxidant enzymes. Some of the enzymes are supplied by plant foods, and some are made by our body if it has the right minerals available, like magnesium and zinc.  Extra enzyme support is also available via supplements.

If your digestive system isn’t working well, it may be hard to digest and absorb supplements, and more attention needs to be given first to cleansing, restoration of balanced gut microbiome, and functional stomach digestion. If digestion is poor you can rely more on transdermal magnesium.

Magnesium is also used by the body to make another powerful detoxing enzyme (like SOD) called glutathione, which helps neutralise, chelate and remove toxins – and especially toxins like heavy metals. The body also uses magnesium to make melatonin during deep sleep, which is a powerful detoxification hormone for the brain and cerebrospinal fluid.

Pregnant woman soaking

The food supply has become very deficient in modern times due to industrial farming, use of pesticides and genetic modification. This makes it hard to fortify and replenish ourselves unless we grow our own foods naturally or buy organic.  Even then, you have no assurance that the soils have enough magnesium, or if your digestive system is working well enough to extract magnesium.  In this case you can get more magnesium faster via skin using magnesium chloride, which, once dissolved in water, is already in the right form for cellular uptake without further digestion.

Sodium bicarbonate, alkalising vegetables, foods high in vitamin C and magnesium can all help to neutralise the acids so they don’t take over the system and destroy healthy cells.  Sunshine exposure also helps produce vitamin D in the skin – which can be enhanced if you put magnesium cream on before sun exposure. Vitamin D is an important hormone that supports mental health, bone health and the immune system.  Moderate exercise in the fresh air and deep breathing exercises can help to re-oxygenate the system.  We need to be working at this pH rebalancing system from all sides.

Stresses that cause increase in acidity include sleep deprivation, excessive exercise and work load, emotional stress, anxiety, exposure to chemicals and drugs, refined sugars and flours, as well as radiation or EMF over-exposure.  Even just a bit of each of these kinds of influences can add up to high impact stress and free radical damage. High or chronic stress causes excessive magnesium loss. If we don’t get enough antioxidant nutrients and magnesium, the whole system can get overloaded and spiral out of control.

Interestingly, the more magnesium deficiency, the less we can cope with stress and the more it produces acid wastes, which pollute our rivers of life – the cardiovascular system.

Stress and acidosis increase the risk of inflammation

Inflammation increases the risk of diabetes and heart disease

“Inflammation, and perhaps chronic infection, may play important roles in the initiation and progression of atherosclerosis. Atherosclerotic lesions are heavily infiltrated by cellular components associated with inflammation (macrophages and T lymphocytes), and acute plaque rupture is also associated with inflammatory components.” 7

Diabetes and heart disease increases the risk of thrombosis and serious complications from viral infections due to acid load

Magnesium is anti-thrombotic and anti-inflammatory

Magnesium has the best reputation as a natural anti-thrombotic. Even in critical situations in hospital, magnesium has come to the rescue as an intravenous treatment. “High dose of IV magnesium can inhibit thrombus formation and is associated with suppression of platelet aggregation.  Magnesium treatment can dose-dependently inhibit a wide variety of agonists of platelet aggregation, such as thromboxane A2 and stimulate prostacyclin synthesis.”  8

What about thrombocytopenia – low platelet count?

Thrombocytopenia is a low platelet count usually below 150 x 109/L. It can impair normal clotting processes, leading to vascular bleeds. This can occur when insufficient numbers of platelets are made in the bone marrow, or the platelets that are made are being destroyed during the inflammatory response.

Blood platelets are produced in the bone marrow and remain in the blood for roughly 10 days until they are naturally destroyed. In healthy people, they are always being produced, so you will almost never have a shortfall. However, certain cancers that affect the bone marrow can limit platelet production, including bone marrow cancer, leukemia, and other varieties of the marrow. Problems with the spleen, as well as heart conditions like atrial fibrillation and other heart rhythm dysfunctions can be associated with low platelet count.

Drugs that can cause low platelet count range from prescribed anti-clotting drugs to over-the-counter pain pills. Prescription antibiotics can also lead to thrombocytopenia. Certain ingredients like quinine, found in tonic water and sports drinks, can reduce platelet counts, as can deficiencies in nutrients like iron, vitamin B12, and folate (B9). Alcohol has been found to temporarily slow the production of platelets, as it works like a blood thinner.  This effect is intensified in heavy drinkers due to low vitamin B12, iron, or folate.

Low platelet count signs and symptoms include:

Viral infections commonly cause low platelet count

If your immune system is battling a virus or disease, thrombocytopenia symptoms may be more pronounced. Recent research is revealing the role of platelets in the (antiviral) immune response, showing that platelets interact with cells of the innate and adaptive immune system, as well as directly with viruses. Despite not having a nucleus, platelets do contain some RNA to make proteins, but it appears also potentially supporting replication of some RNA viruses. 9   This may make them a target for the immune system’s white blood cells.

Some common viral infections associated with low platelet count include:

  • Severe Acute Respiratory Stress (Coronavirus) SARS-CoV1 & SARS-CoV2
  • Aplastic anemia
  • Hepatitis C
  • HIV
  • Sepsis

Nutritional supports include:

Blood Clot (Thrombosis) Risk Increases With Inflammation Couple beach
  • Antioxidant supplements like vitamin C and plant flavanols
  • Vitamin D from sunshine (or cod liver oil or similar D source)
  • Eating a variety of fruits and vegetables, especially leafy greens
  • Including fatty fish like salmon in your diet a couple of times per week
  • Buying organic to avoid possible threats of pesticides and herbicides
  • Lowering your intake of sugar, refined carbohydrates, and processed food
  • Include healthy fats from sources like olive oil, almonds, avocado
  • Support better detoxification with minerals like selenium, magnesium and zinc, and alkaline clays and charcoal for intestinal cleansing.
  • Drink more mineral water for better hydration, flushing of toxins and blood fluidity.

SUMMARY: Magnesium plays a regulatory role in the immune system to avoid clotting disorders

As stress depletes magnesium, thereby suppressing metabolism and depressing the immune system, the restoration of adequate magnesium can help to calm the nervous system, improve metabolism and strengthen the immune system and detoxification responses.

Magnesium has both anti-thrombotic effects, and it also lowers the risk of thrombocytopenia.  Magnesium works as an adaptogenic nutrient and regulator of the immune system via its control of calcium channels, role in metabolism and in enzyme co-factoring support. In this way it helps the body regulate pH balance, detoxification and tissue repairs, which then calms down the inflammatory response and moves the nervous system back to a parasympathetic mode.

“Magnesium plays a key role in the immune response, that is, as a co-factor for immunoglobulin synthesis, C’3 convertase, immune cell adherence, antibody-dependent cytolysis, IgM lymphocyte binding, macrophage response to lymphokines and T-helper B cell adherence (Galland 1988).”  10  In this way it makes the virulence of the immune system more potent.

In the case of low platelet activity and immune depression, studies in acute care conditions have shown; “When serum magnesium was treated as a continuous variable, each one standard deviation increase of magnesium was associated with 12 and 8% lower risk of thrombocytopenia in men and women respectively. Serum magnesium was inversely associated with thrombocytopenia.” 11

Please consult your doctor if you have any health issues, as this article was intended only for educational purposes. I hope it helped to raise awareness about potential issues with blood and inflammation, and to better understand how to preserve good health and avoid disease.

By Sandy Sanderson © 2021 www.elektramagnesium.com.au

REFERENCES

1.         Thrombosis & Genetic Disorders. Accessed September 16, 2021. https://www.anticoagulationeurope.org/conditions/thrombisis-genetic-disorders

2.         Belin RJ, He K. Magnesium physiology and pathogenic mechanisms that contribute to the development of the metabolic syndrome. Magnes Res. 2007;20(2):107-129.

3.         Cooper ID, Crofts CAP, DiNicolantonio JJ, et al. Relationships between hyperinsulinaemia, magnesium, vitamin D, thrombosis and COVID-19: rationale for clinical management. Open Heart. 2020;7(2):e001356. doi:10.1136/openhrt-2020-001356

4.         Maier JAM, Malpuech-Brugère C, Zimowska W, Rayssiguier Y, Mazur A. Low magnesium promotes endothelial cell dysfunction: implications for atherosclerosis, inflammation and thrombosis. Biochimica et Biophysica Acta (BBA) – Molecular Basis of Disease. 2004;1689(1):13-21. doi:http://dx.doi.org/10.1016/j.bbadis.2004.01.002

5.         KANTOR PF, LOPASCHUK GD, OPIE LH. CHAPTER 32 – Myocardial Energy Metabolism. In: SPERELAKIS N, KURACHI Y, TERZIC A, COHEN MV, eds. Heart Physiology and Pathophysiology (Fourth Edition). Academic Press; 2001:543-569. doi:10.1016/B978-012656975-9/50034-1

6.         Pontes MH, Sevostyanova A, Groisman EA. When too much ATP is bad for protein synthesis. Journal of molecular biology. 2015;427(16):2586-2594. doi:10.1016/j.jmb.2015.06.021

7.         Tousoulis D, Davies G, Stefanadis C, Toutouzas P, Ambrose JA. Inflammatory and thrombotic mechanisms in coronary atherosclerosis. Heart. 2003;89(9):993. doi:10.1136/heart.89.9.993

8.         Shechter M, Merz CN, Rude RK, et al. Low intracellular magnesium levels promote platelet-dependent thrombosis in patients with coronary artery disease. Am Heart J. 2000;140(2):212-218. doi:10.1067/mhj.2000.107553

9.         Raadsen M, Du Toit J, Langerak T, van Bussel B, van Gorp E, Goeijenbier M. Thrombocytopenia in Virus Infections. Journal of Clinical Medicine. 2021;10(4). doi:10.3390/jcm10040877

10.      Tam M, Gómez S, González-Gross M, Marcos A. Possible roles of magnesium on the immune system. European Journal Of Clinical Nutrition. 2003;57:1193. doi:10.1038/sj.ejcn.1601689

11.       Lu L, Zhan Y, Yu J, Sui L. Prevalence of Thrombocytopenia and Its Association with Serum Magnesium. Biological Trace Element Research. 2016;169(1):46-51. doi:10.1007/s12011-015-0406-4

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