Magnesium is the 4th most abundant mineral in our bodies. However, many of us are deficient in magnesium. About 48% of the U.S. population consumes less than required magnesium intake. Magnesium is required for over 300 biochemical reactions in our bodies. It is required for energy production, as well as bone development and DNA/RNA synthesis. It is essential for production of glutathione, an antioxidant. It assists in transporting calcium and potassium for nerve impulse conduction, heart rhythm, and muscle contraction. Also, magnesium helps to neutralize toxins, especially aluminum.
Blood levels are controlled mainly by the kidneys but only accounts for about 1% of the body’s magnesium. Most of the magnesium is stored in the cells. When our dietary intake is low, the kidneys prevent excretion of magnesium. Blood serum levels are often not reliable indicators of magnesium, as most of the magnesium in our bodies is in our bones and cells. When we have deficiency in our blood levels, magnesium can be pulled from the bone to replenish it, which makes blood levels an unreliable indicator of deficiency. There is no, one, reliable test for assessing magnesium levels, so providers often look at lab values and symptoms to determine if a magnesium issue exists.
Deficiencies that are undetected, known as sub-clinical deficiencies, are concerning, as they predispose us to chronic diseases, such as cardiovascular disease and many others. As magnesium deficiency has been described in the literature as so prevalent, it has been referred to as a public health crisis. The Standard American Diet (SAD) does not provide for adequate dietary magnesium, which means that both obese and non-obese individuals with this diet usually have sub-clinical deficiency. Both sub-clinical and clinical deficiencies are often difficult to diagnose.
Interestingly, higher serum levels of magnesium may be correlated with lower risk of heart disease, hypertension, stroke, diabetes, migraines, and osteoporosis. For people with diabetes, there is insufficient evidence that higher levels help with controlling blood sugar. A measure of inflammation, C-reactive protein is inversely related (inversely proportional) to consumption of dietary magnesium intake and serum levels. C-reactive protein is associated with heart disease, metabolic syndrome and diabetes, and other diseases. An imbalance of the ratio of calcium to magnesium, which ideally is 2:1, has increased significantly since the mid-1990s through 2008, and is related to the increasing rate of diabetes during this same period.
Low magnesium can also disrupt the gut and result in changes to the gut flora. This may result in disturbances of the gut and the gut-brain connection. Magnesium helps regulate the neurotransmitter, GABA, in the brain. When GABA is low due to a deficiency in magnesium, depression, anxiety disorder, pain, or even epilepsy can result.
Dietary requirements for Magnesium: The Estimated Average Requirement (EAR) for magnesium or the average daily amount necessary for healthy individuals, is 330 mg/day for young adult males and 255 mg/day for young adult females, increasing to 350 mg/day and 265 mg/day, respectively, for men and women over 30 years of age.
Cause of deficiency: Older adults have a greater pre-disposition due to less dietary intake, likelihood of having more chronic disease and medications. Below is a list of potential causes.
Alcoholism or alcohol dependence-Due to low dietary intake, vitamin D deficiency, increased excretion (nausea, vomiting, diarrhea, increased urination), liver disease, pancreatitis, or renal dysfunction.
Aluminum exposure-Use of aluminum cookware, and diets high in baked goods (baking powder), many medications, and many deodorants.
Bariatric surgery- Resection of the small intestine, especially the ileum-Leads to malabsorption.
Blood sugar imbalances/Diabetes-Promotes urinary excretion of magnesium with glucose being eliminated via the kidneys and additional water excretion.
Kidney Disease-Glomerulonephritis, pyelonephritis, hydronephrosis, nephrosclerosis and renal tubular acidosis.
- Acetaminophen toxicity
- Antibiotics-Gentamicin, Tobramycin
- Calcium supplements
- Chemotherapy-Cisplatinum, Tacrolimus waste magnesium via the kidneys
- Diuretics- Some can increase magnesium loss such as loop diuretics, while potassium-sparing diuretics can inhibit excretion
- Estrogen therapy
- Heart medication-Digoxin
- Proton Pump Inhibitors-If taking this long-term, your healthcare provider should monitor your magnesium status
Parathyroid disease-both hypo and hyper forms
Processed food diet-Diets mainly of processed food are deficient in magnesium.
Imbalance of dietary intake ratio of calcium to magnesium or phosphorus to magnesium-The ratio of calcium to magnesium should be 2:1. Diets proportionately high in calcium (dairy, cheese) or high in phosphorus (soft drinks and processed meats), or high vitamin D could offset magnesium balance.
Strenuous physical activity
Stress-Overexertion of the sympathetic nervous system.
Vitamin B Deficiency
Symptoms of deficiency:
Typical Symptoms of less severe deficiency:
- Appetite loss
Additional symptoms of less severe deficiency:
- Fasciculations (flickers of muscle movement below the skin)
- Tetany (muscle spasms)
Symptoms of severe deficiency:
- Abnormal heart rhythm
- Coronary spasm
- Depressed immune system
- Heart Failure
- Hearing loss
- Hypocalcemia (low calcium)
- Hypokalemia (low potassium)
- Mitral valve prolapse
- Personality changes-Aggression, anxiety, irritability, psychotic behavior
- Sudden cardiac death
- Tachycardia (above normal heart rate)
Sources: About 30-40% of magnesium is absorbed through diet.
- Bone broth
- Dark chocolate-If you crave it you may be low in Mg++
- Fortified foods
- Sprouted seeds
- Leafy, dark greens/vegetables, especially spinach
- Nuts, seeds
- Whole grains
Supplemental forms of magnesium: There are some forms of magnesium that function more like a laxative, which inhibits the absorption.
Forms that are poorly absorbed:
- Magnesium Oxide-Poorly absorbed and has a laxative effect
- Magnesium Dihydroxide (Milk of Magnesia)
- Magnesium Sulfate-Epsom Salts not recommended for consumption but can be used in baths or soaks. This absorbs through your skin.
- Magnesium Carbonate
Forms that are best absorbed:
- Magnesium Aspartate
- Magnesium Chloride-Best for baths or soaks. May cause nausea, vomiting, diarrhea which indicate that you should stop taking. Some forms are in flakes. Also, in the form of a good quality spray can be effective, but low quality could cause itching. You can make your own spray by boiling 1 cup of distilled water and adding 1 cup chloride flakes. Once dissolved, the “oil” can be put in a spray bottle. A few sprays can be applied daily, not to exceed 10-20 sprays daily.
- Magnesium Citrate-While absorption is good, if does have a laxative effect.
- Magnesium Glycinate-Does not affect the bowels.
- Magnesium Malate-This is energizing but may be too overstimulating. Good for the heart.
- Magnesium Orotate
- Magnesium Taurate
- Magnesium L-Threonate-This is the only from that crosses the blood brain barrier and is best for reducing stress, improving memory, and sleep. That said it has low bioavailability.
Dosage: How do I know what and how much to take?
- Right forms will be determined based on your tolerance, symptoms, and other medications
- Right dosage is determined by your health provider. You may possibly not be supplementing enough. Too much Magnesium is rare, but in over-supplementation, where blood levels are >2.6/dl can cause kidney failure.
- Magnesium therapy for migraine headaches should be done under the guidance of a healthcare provider, as doses exceed the recommended supplemental guidelines.
Some benefits in taking magnesium supplements:
- Decrease in muscle cramps, twitches or restless leg syndrome
- Improved cognition
- Improved mood
- Improved sleep-Magnesium supplements can help to promote a good night’s sleep
- Do not take magnesium supplements within 2 hours of other medications such:
- Antibiotics-Take supplements 2 hours before or 4-6 hours after with tetracycline or quinolone antibiotics. Ask your pharmacist.
- Bisphosphonates- Actonel, Boniva, Fosamax, Reclast, Zometa, and others.
- Heart or blood pressure medicine; – as it can cause the medications to not be absorbed.
- Zinc supplementation can interfere with magnesium absorption.
- If sensitive to sulfates, do not use Epsom salts.
Magnesium Fact Sheet for Health Professionals, National Institutes of Health, Office of dietary Supplements, https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/, September 26, 2018.
DiNicolantonio,JJ, O’Keefe,JH, and Wilson , W. Open Heart. 2018; 5(1): e000668. Subclinical magnesium deficiency: a principal driver of cardiovascular disease and a public health crisis. 2018 Jan 13. doi: 10.1136/openhrt-2017-000668,PMCID: PMC5786912, PMID: 29387426.
Rosanoﬀ, A, Weaver, CM, and Rude, RK. Suboptimal magnesium status in the United States: are the health consequences underestimated? Nutrition Reviews® Vol. 70(3):153–164 153 doi:10.1111/j.1753-4887.2011.00465.
How to Make and use homemade magnesium oil to benefit your health. Nov 29, 2018. Blog, https://theherbalacademy.com/homemade-magnesium-oil/