Man develops liver damage after overdosing on Epsom salts

A man who consumed three tablespoons of Epsom salts daily for 15 days, was diagnosed with acute liver damage, according to the journal BMJ Case Reports.

Epsom salts, otherwise known as magnesium sulphate, is often taken to relieve constipation. However, some naturopaths are known to recommend its consumption to expel or dissolve gallstones, despite their being no scientific evidence to support this claim.

The patient, who suffered from gallstones, had consumed the Epsom salts on the advice of his complementary health practitioner. He presented with jaundice and lack of appetite, but tested negative for a range of common liver diseases.

Only a subsequent biopsy revealed liver damage, reported doctors at the PVS Memorial Hospital, Cochin, Kerala, India. 

The liver injuries were described as “predominantly necrotic and dense reactive fibrotic type,” by first author of the case report Dr Cyriac Abby Philips.

 

Overdosing on magnesium

Excessive magnesium intake initially causes diarrhoea. Regular overconsumption can result in high blood levels of the mineral (hypermagnesaemia).

According to the U.S National Institutes of Health Office of Dietary Supplements (ODS), very large doses (> 5 grams/ day (g/d)) of the mineral can lead to magnesium toxicity.

“Symptoms of magnesium toxicity, which usually develop after serum concentrations exceed 1.74–2.61 millimoles/ litre (mmol/l), can include hypotension, nausea, vomiting, facial flushing, retention of urine, ileus, depression, and lethargy before progressing to muscle weakness, difficulty breathing, extreme hypotension, irregular heartbeat, and cardiac arrest. The risk of magnesium toxicity increases with impaired renal function or kidney failure because the ability to remove excess magnesium is reduced or lost,” explains ODS in their online factsheet.

In this case, the daily dose was equivalent to around 5g/d of elemental magnesium, possibly more.  The patient’s blood level of magnesium was 3.1 mmol/l – well above the range where toxicity symptoms start to occur.

After discontinuing the Epsom salts and drinking plenty of fluids, the man’s liver functions were restored to normal after 38 days.

 

A ‘cure’ for gallstones?

The consumption of Epsom salts, usually in combination with olive oil, is widely advocated on the internet, including YouTube videos, as a ‘cure’ for gallstones. Nevertheless, there is no scientific evidence supporting this. A 2014 review of these videos concluded that they were “misleading and present a risk of harmful consequences."

 

Source:   BMJ Case Reports

Published online first: 2nd October 2017.   DOI:  10.1136/bcr-2017-221718

“Severe liver injury due to Epsom salt naturopathy”

Authors:  Cyriac Abby Philips, Rajaguru Paramaguru, Pushpa Mahadevan, Philip Augustine