The Importance of Magnesium for Health

Science / March 17, 2022
The Importance of Magnesium for Health

Magnesium—An Introduction

Magnesium—Atomic #12, alkaline earth metal—described and known as an element by 1775. In a sense, magnesium is a year older than the United States! Found in the 2nd column, 3rd row of the Periodic Table of Elements, it is the 8th most common element on earth. Magnesium is usually abbreviated as “Mg”.

For a chemist, that location in the Periodic Table tells a good deal of the story. The atomic number tells a chemist the number of protons, neutrons and electrons magnesium has (12 of each in the most common magnesium isotope). The location tells the chemist that magnesium will be highly reactive, giving up two electrons to achieve greater stability.

But what does this tell us about magnesium in your body? Well, a few things—it tells a biochemist that some magnesium compounds will provide more elemental magnesium than others will—because, for example, if magnesium is given as magnesium oxide or MgO, it won’t want to let the oxygen go very easily. But, if it is given as magnesium chloride or magnesium bound to an amino acid, citric acid, a sugar, or other magnesium salt—it will release the magnesium for the body’s use much more easily. And—this is important—for magnesium to benefit you, it has to be as a free cation—as Mg2+. A cation, by the way, is the general term for a positively charge ion—an anion has a negative charge. Together, these ions can function as “electrolytes” in your body.

Magnesium’s Role in Health

Magnesium’s Role in Health

Partly because of its prevalence on the planet (and because humans evolved on the planet) and partly because of its chemistry, magnesium is crucial to health. (1)

Magnesium is involved hundreds (and hundreds!!) of essential biochemical reactions that cover energy storage and production, protein synthesis, the stability of your DNA, cellular signaling systems, cellular growth and development. It is also involved in the transmission of nerve signals, muscle movement, can act as an anti-inflammatory agent and can be used to relieve muscle spasms, constipation, sleep issues, bone issues, depression, anxiety, lower blood pressure, relieve migraines, improve blood sugar levels, and relieve Premenstrual syndrome (PMS). Magnesium also functions as a co-factor in over 600 enzyme reactions and acts as an activator in over 200 more reactions! Whew—that’s a lot for one mineral to do! (2)

Magnesium deficiency has been associated with several chronic diseases including cardiovascular disease, diabetes, migraines, neuromuscular diseases, bone diseases and other mineral deficiencies. (3)  Many of these are related to long-standing magnesium deficiency—often known as “latent magnesium deficiency” or “subclinical magnesium deficiency”.(4)(5) In this context, “subclinical” indicates there are no signs or symptoms—and, by the way, magnesium blood levels are seldom tested—and don’t even always give a good indication of the actual storage levels of magnesium! The reasons for this are a bit complicated—but mainly because most magnesium is stored in bone with about 1% of total body magnesium found in the blood. (6)

How Does Subclinical Magnesium Deficiency Happen?

There are several different causes of subclinical magnesium deficiency—but probably the most significant one for most people is that our FOOD is deficient in magnesium—because the soils around the world have been, over many years, been depleted of magnesium—and the magnesium is seldom replaced and seldom at optimal levels. (7)

Other causes for subclinical magnesium deficiency include:(8)(9) 

  • Poor diet lacking in plant foods
  • Alcoholism
  • Malnutrition
  • Kidney disease
  • Diabetes
  • Poor absorption due to digestive disorders such as Crohn’s disease, ulcerative colitis, coeliac disease, short bowel syndrome, and Whipple’s disease
  • Hormonal imbalances due to thyroid, parathyroid and adrenal diseases
  • Medicationsthat cause magnesium loss (10)
    • These include various antibiotics, chemotherapeutic agents, diuretics (water pills), proton pump inhibitors (to control acid reflux), heart medications, drugs meant to treat osteoporosis, some heart medications, and medications to control diabetes.
    • Check with your own healthcare provider and pharmacist to see if any of your medication may deplete magnesium.
  • Chronic diseases with high levels of inflammation
  • Stress

Are There Signs or Symptoms of Magnesium Deficiency?

Are There Signs or Symptoms of Magnesium Deficiency?

Severe magnesium deficiency is relatively rare—but the latent or subclinical deficiencies are likely very common—but most often, never diagnosed for a few reasons.

  • Serum magnesium levels are seldom determined because it is a relatively specialized test, but more importantly, few clinicians are lookingfor or are alerted to the possibility of subclinical magnesium deficiency.
  • The symptoms of subclinical magnesium deficiency are non-specific and often vague—and they are often not severe or serious enough to gain any clinical attention.
  • Low magnesium levels are often associated with low levels of other minerals – and THESE low levels are more often the attention getters! Most doctors will be more alert to low calcium and low potassium levels than to low magnesium levels because low levels of calcium or potassium can cause obvious and serious problems.

So, what might make you suspect that your levels of magnesium are too low? What are some of the things to watch out for?

  • Muscle cramps, especially in the calf muscles and the feet. You may also notice more tics or muscular “flutters”, backaches, spasms when chewing foods or neck spasms.
  • Constipation
  • General symptoms can include lethargy, weakness, fatigue, irritability, low tolerance to stress, poor sleep
  • Migraines, headaches, tremors, seizures, poor memory, decreased cognitive abilities
  • High blood pressure
  • Complications of pregnancy—premature labor, eclampsia, miscarriage
  • Lab findings
    • An EKG may show signs of abnormal rhythms (arrhythmias, supraventricular or ventricular arrhythmias), and a finding known as Torsade de pointes where the heart ventricles beat rapidly.
    • Blood lipid (fat) levels are often high
    • Decreased glucose tolerance so blood sugar levels may be high
      • Uncontrolled diabetes
    • Low serum levels of potassium, calcium, and high serum sodium levels.

You can see from this list that many of these symptoms—with the possible exception of muscle cramps, which are quite common in subclinical magnesium deficiency—are pretty vague and to a physician’s ears, non-specific because they could be attributed to many different causes.

Another concern is that when high blood pressure, for example, is noted, the likeliest course of action for most physicians would be to put people on blood pressure lowering medication—when in fact, it is possible that the high blood pressure is due to a “simple” magnesium deficiency. The same is true for diabetes—when it appears that a case of diabetes is uncontrolled, with spiking blood sugar numbers and a high A1c, most physicians are more likely to add medications rather than check magnesium levels.

What Should You Do if You Suspect Subclinical Magnesium Deficiency?

What Should You Do if You Suspect Subclinical Magnesium Deficiency?

The very first thing you should do is consult your healthcare professional about your concerns. Self-diagnosis is very difficult for many reasons—but for one very good reason. Diagnosis requires that the diagnostician is objective—and it is nearly impossible to be objective about yourself! A running joke in medical schools is a condition called “med-student-itis”…and that is nearly all medical students (and doctors, nurses and other healthcare professionals) upon studying or reading about a particular condition are convinced that they have that!! Your mind can play tricks on you—and that is why you need an objective observer.

But—you can also safely increase foods highest in magnesium—or you can start with low amounts of magnesium supplements and slowly increase those to see if this helps your symptoms.

Foods Highest in Magnesium

For most adults, the RDA is about 300-400 mg of Mg.

Foods highest in Mg include: (11)

  • Leafy green vegetables like kale, spinach, mustard, collard greens, bok choy, Swiss chard and dandelion greens. Various lettuces are also relatively high in Mg.
  • Avocados (these also have high levels of Vitamin E, Vitamin K, B vitamins and omega-3 fatty acids)
  • Nuts and seeds (pumpkin seeds, almonds, cashews, chia seeds)
  • Legumes (lentils, chickpeas (garbanzo beans), beans (Lima, navy, kidney, black), peas, soybeans and peanuts)
  • Whole grains
  • Dark chocolate (!)

Magnesium Supplements

The most common magnesium supplement is in the form of magnesium oxide (MgO). It is usually inexpensive, but there is one major problem—the oxygen (O) in the magnesium oxide has a really good “grip” on the magnesium and doesn’t want to release it as a cation—and remember, Mg has to be released as a cation to give you a benefit. When reading the labels, you may notice that MgO products often have a higher “elemental magnesium” content—making it sound as if you would be getting more magnesium—but, because that oxygen hangs on to the magnesium and because MgO is not as well absorbed, you are not likely to get all the benefits of that higher elemental magnesium content.

So, which form of magnesium is better?  In general, amino acid chelated magnesium or magnesium bound to citrate, gluconate, lactate, glycinate, taurate, or malate are best absorbed and release the most magnesium. What do we mean when we talk about an amino acid chelate? A chelate is a form of bonding that grabs the metal ion but can release it under physiological conditions. (The word “chelate” is based on the Greek word for a crab’s claw) Amino acids—the building blocks of proteins—happen to form chelates with Mg that release the magnesium relatively easily.

How Are Magnesium Supplements Used?

Magnesium supplements are used in naturopathic medicine to relieve:

  • Muscle cramps
  • Constipation
  • Sleep issues
  • Migraines and other headaches
  • Anxiety and depression
  • Prevention of Sarcopenia—the loss of muscle mass associated with aging and osteoporosis
  • Prevention of metabolic syndrome, diabetes and high blood pressure

Always work with your healthcare professional for specific guidelines, but as a general rule of thumb, start with a lower dose and increase slowly. A low dose can be determined by checking the label for % Daily Value or %DV—a low dose should be <25% DV. Slowly increase that until you achieve your goal. Most people will start experiencing diarrhea at around 300mg Mg – but that can vary, especially if you really are magnesium deficient.

With muscle cramps, often the best approach is topical—you can apply magnesium in an oil form directly onto the muscles affected.

Medically, magnesium is used to treat eclampsia in pregnancy, heart arrhythmias, asthma, and headaches, especially migraines.

Are There Adverse Effects of Taking Magnesium Supplements?

Magnesium supplements are considered very safe—however, if you have any kidney problems, you should be extra cautious and only work with a healthcare professional. Since magnesium is excreted by the kidneys, someone with a kidney disorder may end up with too HIGH levels of magnesium and that can cause heart problems.

There have been some reports of nausea and vomiting, but diarrhea is the most common reported adverse effect. (12)  Very high doses of magnesium may lead to extreme thirst, drowsiness, serious drops in blood pressure, muscle weakness and comas.

As mentioned, many people experience diarrhea at around 300mg of magnesium—the Linus Pauling Institute lists an upper limit (UL) for magnesium at 350 mg. (13)

Takeaways

Magnesium is a critically essential mineral, involved in hundreds of important biochemical reactions. It is believed that many people may have subclinical deficiencies of magnesium. Magnesium can be obtained through the diet, but given the depletion of many soils, this may not be sufficient for some people.

Magnesium chelates (glycinates, malates, taurates, citrates, etc.) are well absorbed and well tolerated and can be used to boost the body stores of magnesium. Magnesium supplements may benefit some conditions and are used in mainstream and naturopathic medicine for a variety of conditions. People interested in magnesium supplements should always consult their healthcare professionals and use the “start low and go slow” principle.

Resources:

  1. Volpe,SL. Magnesium in Disease Prevention and Overall Health, Advances in Nutrition, Volume 4, Issue 3, May 2013, Pages 378S–383S, https://doi.org/10.3945/an.112.003483 https://academic.oup.com/advances/article/4/3/378S/4591618 
  2.  de Baaij JH, Hoenderop JG, Bindels RJ. Magnesium in man: implications for health and disease. Physiol Rev. 2015 Jan;95(1):1-46. doi: 10.1152/physrev.00012.2014. PMID: 25540137. https://pubmed.ncbi.nlm.nih.gov/25540137/ 
  3.  Ahmed F, Mohammed A. Magnesium: The forgotten electrolyte—A review on hypomagnesemia. Medical Sciences. 2019 Apr;7(4):56. https://www.mdpi.com/2076-3271/7/4/56/pdf 
  4.  DiNicolantonio JJ, O’Keefe JH, Wilson W. Subclinical magnesium deficiency: a principal driver of cardiovascular disease and a public health crisis. Open heart. 2018 Jan 1;5(1):e000668. https://openheart.bmj.com/content/5/1/e000668/
  5.  Nielsen FH. Dietary magnesium and chronic disease. Advances in chronic kidney disease. 2018 May 1;25(3):230-5. https://cpncampus.com/biblioteca/files/original/ea8b0b91c4742ef4d8812a880cd807de.pdf 
  6.  Ahmed F, Mohammed A. Magnesium: The Forgotten Electrolyte-A Review on Hypomagnesemia. Med Sci (Basel). 2019 Apr 4;7(4):56. doi: 10.3390/medsci7040056. PMID: 30987399; PMCID: PMC6524065. https://pubmed.ncbi.nlm.nih.gov/?term=Magnesium%3A+the+forgotten+electrolyte 
  7.  Guo, W, Hussain, N, Liang, Z, Yang, D. Magnesium deficiency in plants: An urgent problem, The Crop Journal, Volume 4, Issue 2, 2016, Pages 83-91, ISSN 2214-5141, https://doi.org/10.1016/j.cj.2015.11.003. https://www.sciencedirect.com/science/article/pii/S221451411500121X 
  8.  Nielsen FH. Dietary magnesium and chronic disease. Advances in chronic kidney disease. 2018 May 1;25(3):230-5.
  9.  Gröber, U.; Schmidt, J.; Kisters, K. Magnesium in Prevention and Therapy. Nutrients 2015, 7, 8199-8226. https://doi.org/10.3390/nu7095388 https://www.mdpi.com/2072-6643/7/9/5388/htm 
  10.  Gröber U. Magnesium and Drugs. Int J Mol Sci. 2019 Apr 28;20(9):2094. doi: 10.3390/ijms20092094. PMID: 31035385; PMCID: PMC6539869. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6539869/ 
  11.  https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/#h5 
  12.  Guerrera, MP, Volpe, SL, Mao, JJ, Therapeutic Uses of Magnesium. Am Fam Physician. 2009 Jul 15;80(2):157-162. https://www.aafp.org/afp/2009/0715/p157.html#afp20090715p157-b49 
  13.  https://lpi.oregonstate.edu/mic/minerals/magnesium#supplements