Magnificent Magnesium Supplements

Magnesium supplements have become a favorite of mine in clinical practice.  Because of its wide action throughout the body, it quickly and effectively treats many medical conditions, and soothes many life situations.  Despite its importance, the USDA estimated in 2009 that 57% of Americans do not meet the recommended daily intake (RDI) of magnesium (here)—a deficiency level that has been increasing consistently in the past 100 years.

Importance of Magnesium

To help understand the importance of magnesium, we look at what happens when we do not get enough of it.  Symptoms of magnesium deficiency include: fatigue, anxiety, insomnia, muscle cramping, generalized pain, and susceptibility to stress.  Long term deficiency can result in frank disease processes such as heart disease, high blood pressure, diabetes, kidney stones, PMS, and dysmenorrhea.

Looking deeper in to some of the pharmacologic actions of magnesium in the body, we can better understand its usefulness:

[toggle_box] [toggle_item title=”Relaxes Smooth Muscle” active=”false”]Smooth muscle is a type of muscle that is automatically controlled by the nervous system, meaning that it cannot be controlled consciously.  It lines the blood vessels, the bronchioles in the lungs, the uterus, and the kidneys, among other organs.  Because of smooth muscle relaxation, magnesium is beneficial in improving asthma, lowering blood pressure, preventing/treating migraines, and easing pain caused by PMS/dysmenorrhea.  Further, it is an effective treatment for angina, and be useful after a heart attack or stroke.[/toggle_item] [toggle_item title=”Relaxes Skeletal Muscle” active=”false”]As opposed to smooth muscle, skeletal muscle is the muscle in the body under conscious control.  Magnesium is effective at treating muscle cramps, muscle pain, and poor sleep caused by restless legs.[/toggle_item] [toggle_item title=”Regulates Cardiac Muscle” active=”false”]The concentration of magnesium around the heart is 20x higher than in the blood stream.  It allows the heart to pump more efficiently and control blood pressure.[/toggle_item] [toggle_item title=”Required for Energy Production” active=”false”]Magnesium is involved in over 300 energy producing reactions in the body, and is vital to the production of ATP in the Kreb Cycle.  As such, it can greatly improve susceptibility to stress and fatigue, and is beneficial for fibromyalgia.[/toggle_item] [toggle_item title=”Cleans the Bowel” active=”false”]When too much magnesium is ingested, the non-absorbed fraction causes the bowels to move forward, which can be beneficial for treating constipation.  Too much unabsorbed magnesium in the body however will cause an unpleasant laxative effect.[/toggle_item] [toggle_item title=”Regulates Calcium Absorption” active=”false”]Calcium is synonymous with bone health, however too much of it can be a bad thing for the bones.  Calcium gives bone its hardness, but it does not provide any flexibility.  Hard bone without any flexibility would be synonymous with chalk—hard, but brittle, and breaks easily.  Magnesium is crucial in giving bone flexibility.  In fact, 60% of total magnesium in the body can be found in the bone.  Calcium and magnesium compete for absorption, and therefore too much of one will cause a deficiency in the other.  It is for this reason that countries, such as Finland, with the highest consumption of calcium to magnesium (4:1) have the highest rates of osteoporosis in the world![/toggle_item] [/toggle_box]

Magnesium Deficiency – Why so Common?

Countless medical conundrums exist; this is not one of them!  Most people are magnesium deficient simply because they do not eat enough of it.  Magnesium is found mainly in unprocessed foods.  When we peek in to the shopping carts across North America, what do we see?  Processed, processed, PROCESSED!  The same logic can be applied to most of the other important nutritional components in our diets.  For a list of the best magnesium containing foods, check out our Magnesium Infographic.

When we look at the trends in the past century, alarm bells should be sounding off.  In 1900, we consumed 500 mg/day, by 1950 it had dropped to 370 mg/day, and by 1990 it had dwindled to 175 mg/day (Magnesium Trace Element Research, 1997).  A true hunter-gatherer diet probably contained closer to 800 mg/day.  When we consider that the RDI of magnesium is 350 mg/day in adult males, and 280 mg/day in females, our average intake is far too low.  Further, mounting evidence is showing that the optimal intake for adults is more likely in the 600-800 mg/day range!

In addition to poor diet, other factors influence magnesium levels in the body.  Diuretics, oral contraceptives, intestinal malabsorption syndromes, liver disease, and kidney disease all deplete magnesium.  People who fit any of these criteria are especially vulnerable to deficiency, and should strongly consider magnesium supplements.

Magnesium Deficiency Goes Unnoticed

How are so many people deficient, yet slipping through the cracks?  It comes down to how magnesium is commonly tested.  The human body, in all of its infinite wisdom, compartmentalizes ‘things,’ and stores them where they are most apt to be used.  For magnesium this means 60% in bone, 25% in muscle, and 15% in the remainder of the body.  And no matter where in the body it exists, the overwhelming majority is found within cells.  This is important because the standard test for magnesium levels is serum analysis, and serum is a measurement of all the ‘stuff’ between cells, not within them!  So, we should not be surprised to have a poor indicator of magnesium levels if we are measuring something that really does not contain what we were looking for in the first place!

The proper test for magnesium looks at levels inside cells, where it actually accumulates.  If you are concerned about your magnesium levels, have your doctor run an erythrocyte magnesium level test, which investigates the amount of magnesium inside red blood cells.

 Magnesium Supplements

Magnesium comes in many forms, with some far better than others.  In order to be absorbed, elemental magnesium must be bound to a carrier (see infographic):

[toggle_box] [toggle_item title=”Magnesium Bound to Kreb Cycle Intermediates” active=”false”]These forms of magnesium have the highest percentage of magnesium with a high absorbability.  Most people tolerate these forms really well, with the added benefit that they feed directly in to energy production in the body.  Examples include magnesium citrate, magnesium malate, magnesium fumarate, and magnesium succinate.  Magnesium citrate is widely available, and cost effective.  Magnesium malate has been shown promising in treating fibromyalgia. Highly recommend for use.[/toggle_item] [toggle_item title=”Magnesium Bound to Amino Acids” active=”false”]These tend to be the best tolerated in the body, and are the best choice for people with very sensitive bowels.  Examples include magnesium glycinate and magnesium taruate.  Recommend for Sensitive Bowels.[/toggle_item] [toggle_item title=”Magnesium Bound to Inorganic Substances” active=”false”]Despite a high fraction of magnesium, these supplements are poorly absorbed and poorly handled by the bowels, causing rapid diarrhea at low dose.  These forms of magnesium are very common in cheaply made supplements.  Examples include magnesium oxide, magnesium chloride, and magnesium carbonate.  Not recommended for use.[/toggle_item] [/toggle_box]