When it comes to magnesium and its role in around six hundred different biochemical reactions in the body, essential is an understatement.
In this article, we’re going to break down some of the key reasons this vital mineral is one of the first interventions for me when patients initially visit me. We’ll look at some of the different forms, which one is best to take if you’re just getting started, and some of the primary functions for sleep, stress, anxiety, depression and vitamin D!
When it comes to currency, magnesium is one of the most widely used in the body.
Have you read my article about the role vitamins and minerals play as a source of currency for your body to pay its bills?
If you are new to the concept, one of the easy ways to understand it is via thinking of the vitamins and minerals (and macronutrients in some ways) as denominations of currency that pay transactions in your body.
These transactions can be as basic as helping a molecule change from one form to another to turn glucose into energy or as complex as the multiple stages it takes to get the protein you eat to turn into serotonin for your mood.
Issues with not getting enough magnesium in the diet seem to be ubiquitous across different regions.
For example, in Hong Kong, more than seventy per cent of the male population were found to consume below the WHO recommended nutrient intake (RNI) for magnesium. More than sixty per cent of the female population ate below the RNI in the same study.[1]
In the US, estimates have fifty per cent of the population as magnesium deficient. This deficiency is mainly down to the structure of the western and standard American diets.[2]
One study in Australia demonstrated a clear relationship between magnesium deficiency, amongst other micronutrients, and obesity levels. As people’s BMI increased, so did their magnesium deficiency.[3]
Factor this into recent statistics showing that up to one-third of the Australian population is obese; we can draw inferences around the rate of magnesium deficiency based on this alone.[4]
But it’s not just diet that can reduce magnesium in the body. There are several other common factors too.
For instance, diets high in sodium, calcium and protein, caffeine and alcohol consumption, and certain medications such as antibiotics, diuretics and proton-pump inhibitors reduce the amount of magnesium retained in the body.[5]
If so many people are deficient worldwide, why don’t they see more pronounced symptoms?
What a great question!
Bone, muscles, and other soft tissue house about ninety-nine per cent of the total magnesium in the body[6] making measuring magnesium in the blood misleading.
This challenging level of assessment introduces the concept of subclinical deficiency. A subclinical deficiency occurs when the deficit in the micronutrient, in this case, magnesium, is enough to affect the body on a transactional level but not enough for signs and symptoms to present.
This concept is the foundation of what I believe to be modern nutrition. An idea named micronutrient triage. I’ve explained it more deeply in this article or Free and Inspired Radio episode. For the context of this article, let’s explain again briefly.
Let’s say you have six hundred transactions worth one milligram of magnesium. These each need to be paid daily, requiring six hundred milligrams daily to cover costs. If you get that much from your diet or supplementation daily, money in, money out, this isn’t a problem.
But what if you don’t get enough magnesium from the diet daily?
For our example, let’s say that you only get four hundred and fifty milligrams in your diet, which equates to a one hundred and fifty-milligram deficit. Due to this deficit, the body must choose which one hundred and fifty transactions not to pay.
The body generally chooses transactions based on short-term survival nearly every time.[7] You might not immediately feel any different over days or weeks because of this. What if the one hundred and fifty transactions are left unpaid, and the magnesium deficit continues for months or even years?
And it’s right here we see the problems that subclinical deficiencies can cause. For example, evidence already states that a subclinical magnesium deficiency can induce a long-term form of low-grade inflammation or make existing inflammation worse.[8] Furthermore, magnesium supplementation can reduce inflammatory markers in your blood tests, such as C-reactive protein.[9]
These subclinical deficiencies often go undetected, leading to the point of no return after decades of the body choosing which bills it can pay and which it can’t. As you’ll see now, this critical mineral covers a lot of transactions!
Magnesium can improve the quality of your sleep.
It’s fair to say that clinically, improving sleep is the benefit I see patients experience the most from supplemental magnesium. No more so than in our elderly populations.
Would you believe that fifty per cent of the elderly population suffer from some form of insomnia?
In a placebo-controlled, double-blind trial (one of the gold standards in research), forty-six elderly participants took five hundred milligrams of magnesium over eight weeks.
Once the trial ended, the magnesium group saw improvements in getting to sleep, sleep time and staying asleep. The researchers also saw the serum levels of melatonin increased and serum cortisol levels decreased—both critical markers in insomnia.[10]
Before you rush out to buy parents or grandparents a supplement, this study was small and used a form of magnesium, magnesium oxide, that’s classically not very well absorbed.
These aspects mean that we need some studies with more significant amounts of people to confirm these results are valid. We also need to use a better form of magnesium to see if five hundred milligrams are necessary as other forms are more effectively absorbed, as we’ll see later in this article.
To completely contradict myself, if you were to buy a supplement for your parents and grandparents, even a small dose compared to the study above could be valuable.
Why?
Magnesium absorption decreases as we age by up to thirty per cent![11] Even a good quality supplement can fill a significant deficit, as we’ll discuss later. For now, though, let’s continue with magnesium’s role in the brain and look at how it can help your mental health, specifically anxiety and depression.
Magnesium can unlock your brain, especially in stress and depression.
Magnesium’s role in anxiety and depression seems connected to correcting a dietary deficiency. An interesting review from 2020 revived a concept known as the vicious circle concept linking low magnesium status and stress. One of the first notes in this review is the similarity of symptoms between deficiency and stress. For example, both states see fatigue, irritability and mild anxiety.
Galland and Seelig proposed that the relationship between magnesium and stress was bidirectional in the early nineties. Hence, the vicious circle reference. This vicious circle infers that stress can increase magnesium turnover, causing a deficiency. In turn, this deficiency amplifies the body’s susceptibility to stress.[12]
Therefore, supplementation should help balance this relationship if this connection is proven true. I would say from clinical experience, over time, the evidence becomes clear after four to eight weeks.
One of the world leaders in nutritional psychiatry, Professor Felice Jacka, director of the Food and Mood Centre at Deakin University in Australia and her research group have investigated low magnesium status and depression. The results of the study confirmed a link between dietary consumption and depression.[13]
Building on this, a small randomised controlled trial looked into the use of magnesium for mild to moderate depression for eleven months. Subjects improved their symptoms after just six weeks, with some experiencing benefits after just two weeks.[14]
Magnesium’s other role in depression comes as a form of currency to pay for creating serotonin via its transformation from the protein you eat. This role is, of course, a prime example of the problems that can appear when the body may not have enough magnesium to spend daily.
There is another essential vitamin that relies heavily on magnesium, vitamin D.
Yep, magnesium is essential for the activation and function of vitamin D.[15] Interestingly, deficiencies in both nutrients can play a role in depression, cardiovascular disease and metabolic syndrome (the condition that combines high cholesterol, triglycerides, fasting glucose, BMI and blood pressure).[16]
Most importantly, magnesium’s role in correcting a vitamin D deficiency is often left unattended. Not only is this case, but large doses of vitamin D given by both modern medical and natural medicine practitioners can deplete magnesium. This connection makes supplementation critical for all people to correct a vitamin D deficiency. Something that can be especially significant in treating osteoporosis.[17]
Magnesium can therefore be a vital element for the correction of osteoporosis.
Building on this relationship between vitamin D and magnesium is how corrected vitamin D status then, in turn, increases and stabilises calcium absorption—a critical factor in the maintenance of bone health. One particular study has shown that sufficient vitamin D levels can increase the absorption of calcium and magnesium through the small intestine by up to three hundred per cent![18]
This link with vitamin D shows the potential timeline for treating osteoporosis or osteopenia (the condition preceding osteoporosis). Making vitamin D the priority if the blood tests confirm a deficiency can open the door for magnesium and calcium to follow and complete the job.
Ok, so I think I’d like to make sure I’m getting enough magnesium in my diet.
And food is always the best place to start. Some good sources of magnesium in the diet are whole and unrefined grains, seeds, cocoa, nuts, almonds and green leafy vegetables.[19] All foods come with a list of other vital micronutrients alongside their magnesium content. Bonus!
Another easy way to think about increasing your intake is that foods that contain dietary fibre have high magnesium levels, but remember that the more grain, for example, is processed, the less magnesium it may offer.[20]
What if you want to make sure and take a supplement too? Are they all the same?
Unfortunately, they’re not. Often cheaper supplements use magnesium oxide, which isn’t all bad. It’s an effective smooth muscle relaxant which can significantly relieve constipation. An estimated ten million patients have their constipation treated using magnesium oxide annually.[21]
Of course, this action on the bowel is excellent if you would like some assistance with challenging bowel motions. But not so much if you are looking to unlock some of the functions we’ve mentioned in this article.
Small studies comparing absorption demonstrate that the citrate, aspartate, lactate and chloride forms, in contrast to the oxide and sulphate forms, had more effective absorption levels.[22]
I would also look towards magnesium malate and glycinate forms as preferential forms over the oxide version.
Magnesium: deficient for some, essential for all?
What do you think? I feel that I say this at the end of many articles I write, but there is a part two coming for our rundown on how magnesium can help. We haven’t touched on its role in metabolism or looked deeper into exercise performance and energy. So stay tuned for that one.
For now, though, if you feel that your diet might not be enough, then magnesium is a great place to start. Especially if you are evaluating nutritional gaps you can fill with more nutritious food. Don’t be afraid to try a supplement if the diet is out of reach at this point.
Hope this helps.
References
[1]https://www.cfs.gov.hk/english/programme/programme_firm/files/Report_on_the_1st_HK_Total_Diet_Study_Minerals_e.pdf, viewed 12th May 2022.
[2] DiNicolantonio JJ, O’Keefe JH, Wilson W. Subclinical magnesium deficiency: a principal driver of cardiovascular disease and a public health crisis [published correction appears in Open Heart. 2018 Apr 5;5(1):e000668corr1]. Open Heart. 2018;5(1):e000668. Published 2018 Jan 13. doi:10.1136/openhrt-2017-000668
[3] McKay J, Ho S, Jane M, Pal S. Overweight & obese Australian adults and micronutrient deficiency. BMC Nutr. 2020;6:12. Published 2020 May 1. doi:10.1186/s40795-020-00336-9
[4] https://www.aihw.gov.au/reports/australias-health/overweight-and-obesity, viewed 12th May 2022.
[5] Pickering G, Mazur A, Trousselard M, et al. Magnesium Status and Stress: The Vicious Circle Concept Revisited. Nutrients. 2020;12(12):3672. Published 2020 Nov 28. doi:10.3390/nu12123672
[6] Elin RJ. Assessment of magnesium status for diagnosis and therapy. Magnes Res. 2010;23(4):S194-S198. doi:10.1684/mrh.2010.0213
[7] Ames BN. Low micronutrient intake may accelerate the degenerative diseases of aging through allocation of scarce micronutrients by triage. Proc Natl Acad Sci U S A. 2006;103(47):17589-17594. doi:10.1073/pnas.0608757103
[8] Nielsen FH. Magnesium deficiency and increased inflammation: current perspectives. J Inflamm Res. 2018;11:25-34. Published 2018 Jan 18. doi:10.2147/JIR.S136742
[9] Veronese N, Pizzol D, Smith L, Dominguez LJ, Barbagallo M. Effect of Magnesium Supplementation on Inflammatory Parameters: A Meta-Analysis of Randomized Controlled Trials. Nutrients. 2022;14(3):679. Published 2022 Feb 5. doi:10.3390/nu14030679
[10] Abbasi B, Kimiagar M, Sadeghniiat K, Shirazi MM, Hedayati M, Rashidkhani B. The effect of magnesium supplementation on primary insomnia in elderly: A double-blind placebo-controlled clinical trial. J Res Med Sci. 2012;17(12):1161-1169.
[11] Schwalfenberg GK, Genuis SJ. The Importance of Magnesium in Clinical Healthcare. Scientifica (Cairo). 2017;2017:4179326. doi:10.1155/2017/4179326
[12] Seelig MS. Consequences of magnesium deficiency on the enhancement of stress reactions; preventive and therapeutic implications (a review). J Am Coll Nutr. 1994;13(5):429-446. doi:10.1080/07315724.1994.10718432
[13] Jacka FN, Overland S, Stewart R, Tell GS, Bjelland I, Mykletun A. Association between magnesium intake and depression and anxiety in community-dwelling adults: the Hordaland Health Study. Aust N Z J Psychiatry. 2009;43(1):45-52. doi:10.1080/00048670802534408
[14] Tarleton EK, Littenberg B, MacLean CD, Kennedy AG, Daley C. Role of magnesium supplementation in the treatment of depression: A randomized clinical trial. PLoS One. 2017;12(6):e0180067. Published 2017 Jun 27. doi:10.1371/journal.pone.0180067
[15] Uwitonze AM, Razzaque MS. Role of Magnesium in Vitamin D Activation and Function. J Am Osteopath Assoc. 2018;118(3):181-189. doi:10.7556/jaoa.2018.037
[16] Uwitonze AM, Razzaque MS. Role of Magnesium in Vitamin D Activation and Function. J Am Osteopath Assoc. 2018;118(3):181-189. doi:10.7556/jaoa.2018.037
[17] Reddy P, Edwards LR. Magnesium Supplementation in Vitamin D Deficiency. Am J Ther. 2019;26(1):e124-e132. doi:10.1097/MJT.0000000000000538
[18] Krejs GJ, Nicar MJ, Zerwekh JE, Norman DA, Kane MG, Pak CY. Effect of 1,25-dihydroxyvitamin D3 on calcium and magnesium absorption in the healthy human jejunum and ileum. Am J Med. 1983;75(6):973-976. doi:10.1016/0002-9343(83)90877-x
[19] Blaszczyk U, Duda-Chodak A. Magnesium: its role in nutrition and carcinogenesis. Rocz Panstw Zakl Hig. 2013;64(3):165-171.
[20] Institute of Medicine (IOM). Food and Nutrition Board. Dietary Reference Intakes: Calcium, Phosphorus, Magnesium, Vitamin D and Fluoride. Washington, DC: National Academy Press, 1997, viewed 13th May 2022.
[21] https://www.pmda.go.jp/files/000208517.pdf, viewed 13th May 2002. PDF is in Japanese.
[22] https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/, viewed 13th May 2022.
