Latest revision as of 11:29, 17 August 2014

Magnesium deficiency is common, and may result in poor performance, diabetes, and many other health problems. Magnesium supplementation is generally safe with little risk of excessive intake, though some forms can cause GI problems. Magnesium Glycinate or Magnesium Orotate are the best forms of supplementation, but they are more expensive. Food sources of magnesium include nuts, cereals, coffee, green leafy vegetables, chocolate and tap water in hard water areas. Exercise may exacerbate magnesium deficiency, and Ultrarunning may impact magnesium levels for up to a year.

• Deficiency. About 30-50+% of the US population are magnesium deficient, but exercise is likely to exacerbate magnesium deficiency. While this may be due to increased losses, longer duration (20+ hours) has been shown to create a far more protracted deficiency that is still present 10-11 months later.
• Running. There is good evidence that magnesium deficiency can result in impaired running performance. This may be due to the role of magnesium in glucose metabolism, but magnesium is involved in over 300 enzymes so there could be many other mechanisms. There is good evidence that magnesium supplementation improves athletic performance in those that are deficient.
• Heath. Magnesium is involved in over 300 enzymes and has far-reaching and profound impacts on human health.
  • Diabetes. There is excellent evidence that magnesium is related to Type 2 diabetes and that magnesium supplementation helps with the insulin resistance of diabetes and pre-diabetes.
  • Bones. There is good evidence that magnesium is critical for bone health and preventing osteoporosis, along with calcium and Vitamin D.
  • Migraine. There is reasonable evidence that magnesium can help reduce the frequency and severity of migraines in some individuals, but given the safety and cheapness, magnesium is recommended for all migraine sufferers.
  • Depression. There is limited evidence that magnesium can help with depression, but given the impact of depression combined with the low cost and safety of magnesium, supplementation is highly recommended.
  • Insomnia. There is some evidence that magnesium can be useful in the treatment of insomnia and magnesium supplementation is recommended for insomniacs.
  • Aging. There are some interesting initial indications that magnesium deficiency may play a role in the aging process, and that magnesium is important for protecting DNA.
  • Epilepsy. The research into magnesium and epilepsy is too limited to reach any conclusion. However, given the safety and cost of magnesium combined with the potentially devastating impact of epilepsy that it would be prudent to try magnesium supplementation.
  • Cramps. There is only the most tenuous of evidence that magnesium might help with cramps.
  • Other Health Implications. Magnesium deficiency has also been linked to a wide variety of other conditions including asthma, emphysema, ADHD, cardiac dysrhythmias, cardiovascular disease, myocardial infarction, myocardial ischemia, high blood pressure.
• Recommended Intake. The recommended intake is 400 mg for men and 320 mg for women, though this recommendation varies with age.
• Food Sources. The most common source of magnesium tends to be cereals and tap water in hard water areas. While nuts are a good source of magnesium, it is impractical to get your RDA without excessive calorie intake. Other sources include green leafy vegetables, and chocolate.
• Supplementation. Cheaper forms of magnesium tend to cause diarrhea, so check the ingredients list of any magnesium containing supplements. I use Magnesium Glycinate or Magnesium Orotate. Magnesium Glycinate powder will mix easily in a sports drink, but I generally use the more expensive Magnesium Orotate.
• Deficiency testing. Testing the magnesium levels in blood is an ineffective approach, as applied to levels do not reflect overall magnesium status. Instead, a magnesium load test is required which looks at the level of magnesium absorbed when a supplement is provided.

1 Deficiency

Magnesium deficiency is a remarkably common, and may be more prevalent amongst athletes than the general population. The USDA reports show that only 32% of the US population gets their RDA of magnesium, and only 23% in Georgia, 24% in Arkansas, 26% in Tennessee, 27% in North Carolina, 28% in South Carolina, Texas, Louisiana & Mississippi^[1]. However, other studies suggest that the majority of the US population does not get sufficient magnesium^[2].

2 Magnesium and Running

Magnesium deficiency can result in a significant reduction in exercise performance and magnesium supplementation can improve athletic performance in those that are magnesium deficient. The benefits of magnesium supplementation in insulin resistance and diabetes may be linked to the benefits seen in athletes.

• Triathlete given magnesium supplementation had lower blood insulin and cortisol levels, and higher blood glucose compared with controls^[3].
• Rats fed a magnesium deficient diet have a reduced exercise capacity^[4].
• Magnesium levels in the blood have been correlated with V̇O₂max in athletes but not in untrained subjects^[5].
• Magnesium deficiency which can result in a significant reduction in exercise performance^[6].
• Magnesium levels in the blood of patients with type II diabetes are correlated with V̇O₂max ^[7].
• Magnesium deficiency increases the energy cost of exercise in postmenopausal women^[8].
• Six healthy males given 240mg/day of Potassium-magnesium-aspartate had 50% greater insurance on a bicycle ergometer compared with controls^[9].
• Subjects given 314 mg/day of magnesium oxide had improved Running Economy and increased time to exhaustion during a treadmill run^[10].
• Some studies have shown no benefit from magnesium supplementation, even in those with a low blood magnesium levels^[11][12]. However, it is possible that this is because blood magnesium levels do not adequately reflect overall magnesium deficiency, and none of the studies used magnesium load test. There are also many other confounding factors^[12].
• Untrained subjects given Magnesium supplementation during strength training developed greater quadriceps strength than controls^[13].
• Subjects who are deficient in both Potassium and Magnesium who are given just potassium supplements have normalized serum potassium levels, but not normalized muscle potassium until magnesium supplementation is also given^[14][15]. Therefore, magnesium may be important in maintaining normal electrolyte levels.

3 Exercise and Magnesium Loss

Exercise, especially in hot or humid conditions, can exacerbate magnesium losses, making magnesium deficiency even more likely. Protracted, strenuous exercise such as a longer ultramarathon could result in reduced magnesium levels that last for up to a year.

• There are indications that heat acclimation reduces magnesium loss in sweat ^[16], but there are concerns that this reduction is an artifact of methodological errors ^[17][18]. (It seems reasonable to me that the reduction in magnesium in the sweat may be due to the migration of magnesium from plasma to the erythrocytes that occurs during exercise. It also seems plausible that this migration may be a way for the body to conserve magnesium during exercise.)
• Estimates of magnesium losses in sweat with sweat rates of 2.8L/hr have been as high as 18-60mg/liter^[19].
• Generally people lose about 2mg/100ml of urine^[20], or about 120 to 140 mg/day^[21], but this is reduced during magnesium deficiency as the kidneys will reabsorb more^[20]. Magnesium concentrations in the urine have been shown to drop during a marathon^[22].
• High Intensity Interval Training increases urinary magnesium losses by 30% on the day of exercise, as well as a temporary (2 hour) reduction in plasma magnesium levels due to a shift of the magnesium into the red blood cells^[23].
• A study of runners at the Boston marathon showed a significant drop in serum magnesium levels after the race^[24]. Other studies showed a similar drop in magnesium levels after a marathon, along with a rebound to pre-price levels some hours after the finish^[25][22].
• In one study, 20 highly trained male subjects underwent 120 km/76 mile hike in 22 hours, and their magnesium levels remained depleted 3 months later^[26]. A follow-up study of 2 additional groups showed that the magnesium levels remained depressed for 10 to 11 months^[27]. This could have important ramifications for ultrarunners, as longer ultras could produce protracted magnesium deficit.

4 Magnesium and Health

Magnesium is required for over 300 different enzymes in the body, as well as structures like the bones^[28].

4.1 Type 2 Diabetes

Magnesium supplementation may provide both protection from diabetes and help in treatment of the disease. Magnesium may also help with prediabetic insulin resistance, and the metabolic syndrome. Normal magnesium serum levels do not preclude the benefit from magnesium supplementation.

• The ARIC study of 15,800 people, aged 45 to 64 between 1986 and 1990 showed that lower magnesium intake is associated with higher insulin levels, as well as higher cholesterol and blood pressure (adjusted for age, race, BMI, smoking)^[29].
• Magnesium deficiency is also associated with the metabolic syndrome^[30], which is defined as two or more of high blood glucose, high blood pressure, high triglycerides or cholesterol, and obesity.
• Studies have shown a strong link between Type 2 diabetes and magnesium intake/serum levels^[31][32][33]
• A study of 27,548 people between 1994 and 1998 showed that higher cereal fiber and magnesium intakes are associated with lower rates of diabetes risk^[34].
• A double-blind, placebo-controlled trial of magnesium supplementation on subjects with type II diabetes and low serum magnesium showed improved insulin sensitivity and metabolic control^[35].
• A double-blind, placebo-controlled trial of magnesium supplementation on subjects who had normal blood magnesium levels, were non-diabetic, but were overweight and had insulin resistance showed that the magnesium significantly improved insulin sensitivity and fasting blood glucose levels^[36].
• Insulin regulates magnesium levels^[31], creating some possible feedback.
• Low cellular magnesium results in insulin resistance in skeletal muscle, heart muscle and fat tissue^[31].

4.2 Bone Health

Magnesium is a critical for the long-term health of the bones and magnesium deficiency is linked to osteoporosis.

• Magnesium is a critical component of bones, making up about 1% of the structure^[37].
• Lower levels of magnesium produce more brittle bones with larger bone crystals^[38].
• Magnesium deficiency is linked to osteoporosis^{[39][40][41][42][43]}
• There is some evidence that magnesium supplementation helps improve bone density and to prevent fractures ^[42].
• One study showed that magnesium intake was correlated with bone density in healthy older white subject, but not in black subjects^[44]. (This is in keeping with the research that indicates racial differences in the effect of nutrition on bone density.)
• Supplementation with calcium and vitamin D may also be important for maintaining healthy bone density^[45].

4.3 Migraines

There is reasonable evidence for magnesium supplementation helping reduce the frequency and severity of migraines in some individuals. Personally I have seen a reduction in my migraines with Magnesium supplementation, as well as an improvement in my low light vision. I also found that the supplement MSM caused me migraines, but vitamin B2 has reduced them.

• It has been suggested that all migraine sufferers should be treated with magnesium supplementation. This recommendation is based on the safety, cost, and effectiveness of magnesium supplementation, with an estimate that about half of all migraine sufferers would benefit^[46].
• A study showed lower levels of magnesium within the blood cells of migraine sufferers, though the serum levels were the same^[47].
• The level of magnesium within the brain of migraine sufferers is lower^[48].
• 600 mg of magnesium per day significantly reduced the number of days with migraines, reduced the consumption of migraine medication, as well as tending to reduce the duration and intensity of the migraines though this tendency was not significant^[49].
• Giving 240 mg of magnesium as twice a day had no impact on a group of migraine sufferers^[50]. However, the form of magnesium was Magnesium Aspartate and Aspartate may have neurological effects of its own^[51].
• Intravenous magnesium does not appear to be effective for the acute treatment of migraine attacks^[52].
• 500 mg per day of magnesium oxide produced a significant reduction in the number and severity of migraines^[53].

4.4 Depression

While trials have not been completed to show that Magnesium supplementation is an effective treatment for depression, the evidence so far is highly encouraging. Given the low cost and safety of magnesium supplementation, I believe that it is a viable approach to try.

• A systematic review of twenty-one cross-sectional studies and three intervention trials indicated that there higher intakes of magnesium seems to be associated with lower depression symptoms^[54].
• A study of 402 students living abroad showed the relationship between magnesium and depression persists after even after adjustments for sex, age, body mass index, monthly expenses, close friends, living on campus, smoking (current and former), education, physical activity, and marital status^[55].
• There are a number of case studies of successful treatment of major depression with magnesium (typically 100-200mg per meal)^[56].
• However, the treatment of depression with magnesium is still a hypothesis, with no large scale interventions yet complete^[57], though at least one is underway^[58]. Of the three interventions I found:
• Magnesium was as effective as an antidepressant (Imipramine/Tofranil) in the treatment of depressed elderly type 2 diabetics with low magnesium levels^[59].
• Magnesium did not help with premenstrual depression^[60].
• A study of 350 patients undergoing cardiac surgery with cardiopulmonary bypass who were giving magnesium or a placebo. Postoperatively the magnesium group did better than the placebo group who had prolonged declines in short-term memory and reemergence of primitive reflexes. However, at 3 months other factors (older age, previous stroke, and lower education level) were associated with depression, not the administration of magnesium^[61].

4.5 Insomnia

The limited studies that have been completed indicate that magnesium may be a useful approach to treating insomnia. Given its cheapness and safety, combined with numerous other health benefits, it seems reasonable for insomniacs to try magnesium supplementation.

• A study of the elderly subjects showed that 500mg magnesium increased sleep time, increased sleep efficiency, reduced insomnia scores, reduced sleep onset latency, but it did not change total sleep time^[62].
• Residents in a long term care facility in Italy that suffer from insomnia were given a supplement containing magnesium that improved the quality of sleep and the quality of life^[63]. The supplement contained 5 mg melatonin, 225 mg magnesium, and 11.25 mg zinc.
• Magnesium supplementation partially reversed the age related changes in sleep EEG and sleep hormones in elderly subjects ^[64].
• Intravenous magnesium changed the sleep EEG of healthy men suggesting it may be useful in controlling depressive symptoms and seizures^[65]
• Magnesium levels in newborn babies is correlated to their sleep behavior^[66].
• Rats fed a magnesium deficient diet had poor quality sleep, with increased wakefulness and reduced slow wave (deep) sleep. The rats sleep pattern was returned to normal when magnesium was reintroduced to the diet^[67].
• Most^{[68][69][70][71][72][73][74]}, but not all^[75][76] studies show that Magnesium helps with post-operative pain management, including its impact on sleep.

4.6 Aging

There are promising indications that magnesium deficiency may accelerate aging. While the research is at an early stage, the results so far look promising.

• There are suggestions in the scientific community that magnesium may play a role in the aging process^[77].
• Telomerase, an enzyme that protects DNA from degradation during cell replication^[78], has a critical role in anti-aging and cancer^[79].
• A short term deficiency in magnesium has been shown to reduce Telomerase activity, and induce DNA damage in rats^[80].
• A study of isolated human cells showed that magnesium deficiency reduced their reproductive lifespan^[81].
• Magnesium is related to DNA stability and repair^[82].

4.7 Epilepsy

There are some initial indications that magnesium might help with epilepsy, but there is too little evidence to reach a conclusion^[83][84].

• Animal studies on magnesium and epilepsy.
  • Animal brains that are perfused with a magnesium free solution result in seizure like activity^[85][86][87].
  • Rats given a magnesium deficient diet had decreased seizure thresholds and latencies, but subsequent magnesium supplementation produced increasing seizure thresholds and latencies^[88].
  • When seizures were provoked in rats (using pentylenetetrazol ), neither magnesium nor a low dose of the anticonvulsant valproate prevented the seizures, but the combination was effective^[89].
  • Sheep made deficient in magnesium via dietary restriction have increased seizures^[90].
  • Magnesium has anticonvulsant properties for some types of induced convulsions^[91].
• Magnesium deficiency and epilepsy.
  • A 1965 study suggested a relationship between epilepsy and magnesium levels^[92].
  • There are case studies of adults and babies with low magnesium related seizures^[93][94].
  • Recent studies have shown lower magnesium levels in people with epilepsy compared with controls^[95][96].
  • A study of idiopathic epilepsy showed that magnesium levels fall on day one and 4 of the seizures, but not on day 7^[84].
  • Low magnesium levels were seen in 100 epileptic patients compared with controls, and levels of magnesium in the cerebrospinal fluid were correlated with increased frequency, poor control and longer duration of seizures^[97].
• Magnesium supplementation for epilepsy.
  • There are case reports of infants with low magnesium that had seizures responded to magnesium supplementation^{[98][99][100]}.
  • A 18-year-old woman with refractory status epilepticus (RSE) was treated with magnesium which resulted in neurologic recovery but there was some degree of retrograde amnesia^[101].
  • Infantile spasms (IS) is an age-specific and severe epileptic condition that does not normally respond to conventional antiepileptic drugs. ACTH has been used for IS, but it is associated with infection and hypertension. The use of ACTH alone and in conjunction with Magnesium showed a greater response to the combination^[102].

4.8 Cramps

There is some very tenuous evidence that magnesium can help with muscle Cramps ^[103].

4.9 Other Impacts of Deficiency

There are studies that have linked magnesium deficiency with asthma, emphysema, attention deficit/hyperactivity disorder (ADHD), cardiac dysrhythmias, cardiovascular disease, myocardial infarction, myocardial ischemia, high blood pressure, and several other problems^{[104][29][105][106][107]}.

5 Recommended Intake

The recommended daily intake of Magnesium varies with age, gender as well as pregnancy/lactation^[108]. Note that these values are the intakes in milligrams of the elemental Magnesium and some supplements specify the weight of the compound. For instance, 2,000mg of Magnesium Glycinate (an amino acid chelate) provides 200 mg of elemental Magnesium. Also, higher fiber intakes can reduce the absorption of magnesium^[109][110], and as might high intakes of cola^[111][112].

6 Magnesium from Food

Good sources of magnesium in food include nuts, cereals, coffee, green leafy vegetables and especially chocolate. Below is a list of common food sources of magnesium^[113], though in practice hard drinking water may contribute 9-27% of the US magnesium intake^[114]. Note that some of these sources would require higher than normal intake. For instance, getting 400mg of Magnesium from Almonds would require 5oz, which is 810 Calories!

7 Magnesium Supplementation

There are a variety of forms of magnesium supplementation, and while Magnesium Oxide is cheap and commonly used, it's poorly absorbed. The best sources are Magnesium Glycinate or Magnesium Orotate. You can get Magnesium Glycinate in pure powder form relatively cheaply, and it will mix easily in a sports drink. The taste is slightly sweet and I find it is not unpleasant. However, I generally prefer Magnesium Orotate, which is more expensive but I've never had any G.I. problems from it even at high doses. The table below lists some of the characteristics of various magnesium formulations. (From Ranade-2001^[115] unless otherwise noted.)

8 Factors that Influence Magnesium Levels

Only 30-50% of consumed magnesium is typically absorbed^[121], though the absorption rate varies with the dose between 10-65%, with higher doses having lower absorption rates^[122]. Other factors that influence magnesium absorption include:

• Lactose (milk) may improve magnesium absorption^[123].
• High-phosphate diets have decreased magnesium absorption^[124].
  • Note that many foods high in Fiber are also high in phosphate, but high fiber vegetables are generally magnesium rich and may offset the reduction in absorption.
• Low protein intake (<30g/day) may exacerbate magnesium deficiency^[125].
• Vitamin D supplementation improves magnesium absorption even in those individuals with adequate levels of vitamin D^[126].
• Diuretics, including alcohol, increase magnesium losses in the urine^[127].
• Hard drinking water may contribute 9 to 27% of the magnesium intake in the US^[114].

9 Risks

My research indicates that magnesium is generally a safe supplement at RDA levels. Excess magnesium is filtered by the kidneys, so overdose is normally only an issue for people with kidney issues. Magnesium supplements can cause diarrhea, and this is common in many of the compounds except for Magnesium Oratate. If you have any doubts, consult your physician.

10 Magnesium in the Body

The adult human contains about 24 g of magnesium, 60% in the skeleton, 39% intracellular (20% in skeletal muscle), and only one percent extracellular^[127]. The extracellular pool of magnesium has the quickest turnover, the intracellular pool turnover is half as quick, and the skeletal pool has a very slow turnover^[127].

11 Magnesium Testing

Testing for blood magnesium levels is reasonably cheap, costing $32 at walkinlabs (July 2014). However, there are concerns that testing for blood levels of magnesium will not detect the levels in the brain which may be responsible for headaches and migraines^[128]. In fact, while serum magnesium levels are controlled in a narrow range, intracellular magnesium deficiency can occur with normal serum magnesium levels^[127]. It has been suggested that a magnesium tolerance test may be a better indication of low magnesium^[129]. Another approach is the magnesium load test, where subjects' urine magnesium levels are compared before and after magnesium supplementation; magnesium deficient subjects will retain more of the magnesium and have relatively lower urinary magnesium concentrations^{[130][131][132]}.

12 References

1. ↑ Human Nutrition : USDA intake figures, Accessed on 9 August 2014
2. ↑ ES. Ford, AH. Mokdad, Dietary magnesium intake in a national sample of US adults., J Nutr, volume 133, issue 9, pages 2879-82, Sep 2003, PMID 12949381
3. ↑ SW. Golf, S. Bender, J. Grüttner, On the significance of magnesium in extreme physical stress., Cardiovasc Drugs Ther, volume 12 Suppl 2, pages 197-202, Sep 1998, PMID 9794094
4. ↑ CL. Keen, P. Lowney, ME. Gershwin, LS. Hurley, JS. Stern, Dietary magnesium intake influences exercise capacity and hematologic parameters in rats., Metabolism, volume 36, issue 8, pages 788-93, Aug 1987, PMID 3600291
5. ↑ HC. Lukaski, WW. Bolonchuk, LM. Klevay, DB. Milne, HH. Sandstead, Maximal oxygen consumption as related to magnesium, copper, and zinc nutriture., Am J Clin Nutr, volume 37, issue 3, pages 407-15, Mar 1983, PMID 6829484
6. ↑ R. McDonald, CL. Keen, Iron, zinc and magnesium nutrition and athletic performance., Sports Med, volume 5, issue 3, pages 171-84, Mar 1988, PMID 3285436
7. ↑ T. Kobayashi, Plasma and erythrocyte magnesium levels are correlated with oxygen uptake in patients with non-insulin dependent diabetes mellitus., Endocr J, volume 45, issue 2, pages 277-83, Apr 1998, PMID 9700483
8. ↑ HC. Lukaski, FH. Nielsen, Dietary magnesium depletion affects metabolic responses during submaximal exercise in postmenopausal women., J Nutr, volume 132, issue 5, pages 930-5, May 2002, PMID 11983816
9. ↑ B. Ahlborg, LG. Ekelund, CG. Nilsson, Effect of potassium-magnesium-aspartate on the capacity for prolonged exercise in man., Acta Physiol Scand, volume 74, issue 1, pages 238-45, doi 10.1111/j.1748-1716.1968.tb04231.x, PMID 5721821
10. ↑ Brilla, L. R. and Gunther, K. B., Effect of magnesium supplementation on exercise time to exhaustion, Med. Exerc. Nutr. Health., 1995; 4:230–233.
11. ↑ EW. Finstad, IJ. Newhouse, HC. Lukaski, JE. Mcauliffe, CR. Stewart, The effects of magnesium supplementation on exercise performance., Med Sci Sports Exerc, volume 33, issue 3, pages 493-8, Mar 2001, PMID 11252079
12. ↑ ^{12.0 12.1} IJ. Newhouse, EW. Finstad, The effects of magnesium supplementation on exercise performance., Clin J Sport Med, volume 10, issue 3, pages 195-200, Jul 2000, PMID 10959930
13. ↑ LR. Brilla, TF. Haley, Effect of magnesium supplementation on strength training in humans., J Am Coll Nutr, volume 11, issue 3, pages 326-9, Jun 1992, PMID 1619184
14. ↑ R. Whang, L. G. Welt, Observations In Experimental Magnesium Depletion*, Journal of Clinical Investigation, volume 42, issue 3, 1963, pages 305–313, ISSN 0021-9738, doi 10.1172/JCI104717
15. ↑ T. Dyckner, PO. Wester, Ventricular extrasystoles and intracellular electrolytes in hypokalemic patients before and after correction of the hypokalemia., Acta Med Scand, volume 204, issue 5, pages 375-9, 1978, PMID 82374
16. ↑ TD. Chinevere, RW. Kenefick, SN. Cheuvront, HC. Lukaski, MN. Sawka, Effect of heat acclimation on sweat minerals., Med Sci Sports Exerc, volume 40, issue 5, pages 886-91, May 2008, doi 10.1249/MSS.0b013e3181641c04, PMID 18408609
17. ↑ MR. Ely, RW. Kenefick, SN. Cheuvront, TD. Chinevere, CP. Lacher, HC. Lukaski, SJ. Montain, Surface contamination artificially elevates initial sweat mineral concentrations., J Appl Physiol (1985), volume 110, issue 6, pages 1534-40, Jun 2011, doi 10.1152/japplphysiol.01437.2010, PMID 21512152
18. ↑ LB. Baker, JR. Stofan, HC. Lukaski, CA. Horswill, Exercise-induced trace mineral element concentration in regional versus whole-body wash-down sweat., Int J Sport Nutr Exerc Metab, volume 21, issue 3, pages 233-9, Jun 2011, PMID 21719904
19. ↑ DL. Costill, Sweating: its composition and effects on body fluids., Ann N Y Acad Sci, volume 301, pages 160-74, 1977, PMID 270913
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21. ↑ Jerry Kazuo Aikawa, Magnesium : its biologic significance, date 1981, publisher CRC Press, location Boca Raton, Fla., isbn 084935871X
22. ↑ ^{22.0 22.1} P. Lijnen, P. Hespel, R. Fagard, R. Lysens, E. Vanden Eynde, A. Amery, Erythrocyte, plasma and urinary magnesium in men before and after a marathon., Eur J Appl Physiol Occup Physiol, volume 58, issue 3, pages 252-6, 1988, PMID 3220063
23. ↑ PA. Deuster, E. Dolev, SB. Kyle, RA. Anderson, EB. Schoomaker, Magnesium homeostasis during high-intensity anaerobic exercise in men., J Appl Physiol (1985), volume 62, issue 2, pages 545-50, Feb 1987, PMID 3558215
24. ↑ LI. Rose, DR. Carroll, SL. Lowe, EW. Peterson, KH. Cooper, Serum electrolyte changes after marathon running., J Appl Physiol, volume 29, issue 4, pages 449-51, Oct 1970, PMID 5459911
25. ↑ KB. Franz, H. Rüddel, GL. Todd, TA. Dorheim, JC. Buell, RS. Eliot, Physiologic changes during a marathon, with special reference to magnesium., J Am Coll Nutr, volume 4, issue 2, pages 187-94, 1985, PMID 4019941
26. ↑ G. Stendig-Lindberg, Y. Shapiro, Y. Epstein, E. Galun, E. Schonberger, E. Graff, WE. Wacker, Changes in serum magnesium concentration after strenuous exercise., J Am Coll Nutr, volume 6, issue 1, pages 35-40, Feb 1987, PMID 3453693
27. ↑ G. Stendig-Lindberg, WE. Wacker, Y. Shapiro, Long term effects of peak strenuous effort on serum magnesium, lipids, and blood sugar in apparently healthy young men., Magnes Res, volume 4, issue 1, pages 59-65, Mar 1991, PMID 1863536
28. ↑ WE. Wacker, AF. Parisi, Magnesium metabolism., N Engl J Med, volume 278, issue 12, pages 658-63, Mar 1968, doi 10.1056/NEJM196803212781205, PMID 4866353
29. ↑ ^{29.0 29.1} Jing Ma, Aaron R. Folsom, Sandra L. Melnick, John H. Eckfeldt, A.Richey Sharrett, Azmi A. Nabulsi, Richard G. Hutchinson, Patricia A. Metcalf, Associations of serum and dietary magnesium with cardiovascular disease, hypertension, diabetes, insulin, and carotid arterial wall thickness: The aric study, Journal of Clinical Epidemiology, volume 48, issue 7, 1995, pages 927–940, ISSN 08954356, doi 10.1016/0895-4356(94)00200-A
30. ↑ Stella Lucia Volpe, Magnesium, the Metabolic Syndrome, Insulin Resistance, and Type 2 Diabetes Mellitus, Critical Reviews in Food Science and Nutrition, volume 48, issue 3, 2008, pages 293–300, ISSN 1040-8398, doi 10.1080/10408390701326235
31. ↑ ^{31.0 31.1 31.2} Mario Barbagallo, Ligia J. Dominguez, Magnesium metabolism in type 2 diabetes mellitus, metabolic syndrome and insulin resistance, Archives of Biochemistry and Biophysics, volume 458, issue 1, 2007, pages 40–47, ISSN 00039861, doi 10.1016/j.abb.2006.05.007
32. ↑ R. Lopez-Ridaura, W. C. Willett, E. B. Rimm, S. Liu, M. J. Stampfer, J. E. Manson, F. B. Hu, Magnesium Intake and Risk of Type 2 Diabetes in Men and Women, Diabetes Care, volume 27, issue 1, 2004, pages 134–140, ISSN 0149-5992, doi 10.2337/diacare.27.1.134
33. ↑ Y. Song, J. E. Manson, J. E. Buring, S. Liu, Dietary Magnesium Intake in Relation to Plasma Insulin Levels and Risk of Type 2 Diabetes in Women, Diabetes Care, volume 27, issue 1, 2004, pages 59–65, ISSN 0149-5992, doi 10.2337/diacare.27.1.59
34. ↑ Matthias B. Schulze, Fiber and Magnesium Intake and Incidence of Type 2 Diabetes, Archives of Internal Medicine, volume 167, issue 9, 2007, pages 956, ISSN 0003-9926, doi 10.1001/archinte.167.9.956
35. ↑ M. Rodriguez-Moran, F. Guerrero-Romero, Oral Magnesium Supplementation Improves Insulin Sensitivity and Metabolic Control in Type 2 Diabetic Subjects: A randomized double-blind controlled trial, Diabetes Care, volume 26, issue 4, 2003, pages 1147–1152, ISSN 0149-5992, doi 10.2337/diacare.26.4.1147
36. ↑ F. C. Mooren, K. Krüger, K. Völker, S. W. Golf, M. Wadepuhl, A. Kraus, Oral magnesium supplementation reduces insulin resistance in non-diabetic subjects - a double-blind, placebo-controlled, randomized trial, Diabetes, Obesity and Metabolism, volume 13, issue 3, 2011, pages 281–284, ISSN 14628902, doi 10.1111/j.1463-1326.2010.01332.x
37. ↑ Hasan Aydın, Magnesium Supplementation and Bone, 2013, pages 149–157, doi 10.1007/978-1-62703-044-1_10
38. ↑ JE. Sojka, CM. Weaver, Magnesium supplementation and osteoporosis., Nutr Rev, volume 53, issue 3, pages 71-4, Mar 1995, PMID 7770187
39. ↑ J. Durlach, P. Bac, V. Durlach, Y. Rayssiguier, M. Bara, A. Guiet-Bara, Magnesium status and ageing: an update., Magnes Res, volume 11, issue 1, pages 25-42, Mar 1998, PMID 9595547
40. ↑ O. Sahota, M. K. Mundey, P. San, I. M. Godber, D. J. Hosking, Vitamin D insufficiency and the blunted PTH response in established osteoporosis: the role of magnesium deficiency, Osteoporosis International, volume 17, issue 12, 2006, pages 1825–1826, ISSN 0937-941X, doi 10.1007/s00198-006-0219-6
41. ↑ Robert K. Rude, Helen E. Gruber, Magnesium deficiency and osteoporosis: animal and human observations, The Journal of Nutritional Biochemistry, volume 15, issue 12, 2004, pages 710–716, ISSN 09552863, doi 10.1016/j.jnutbio.2004.08.001
42. ↑ ^{42.0 42.1} J. E. Sojka, Magnesium Supplementation and Osteoporosis, Nutrition Reviews, volume 53, issue 3, 2009, pages 71–74, ISSN 00296643, doi 10.1111/j.1753-4887.1995.tb01505.x
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