Difference between revisions of "Magnesium"

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== Introduction ==
+
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.  
I take magnesium for three reasons - migraines, endurance and bone health. Magnesium is vital to life, being part of every cell<ref name="a6"/>. It is even a critical part of energy supply, being needed for ATP usage. I believe it is a critical micronutrient for runners.
+
* '''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.  
== Deficiency ==
+
* '''Heath'''. Magnesium is involved in over 300 enzymes and has far-reaching and profound impacts on human health.
Only 32% of the US population gets their RDA of magnesium, and only 27% in NC <ref name="a7"/> Magnesium levels in the blood fall after a marathon, which suggests that runners are more at risk for magnesium deficiency than sedentary people. There is even some suggestion<ref name="a5"/> that magnesium deficiency is related to the death of a marathon runner due to mitral valve prolapse.  
+
** '''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.
== Endurance ==
+
** '''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.
There is some evidence for magnesium supplementation for improving athletic performance. "That means that athletes wouldn't be able to work or train as long as they would if they had better magnesium levels" <ref name="a4"/>. There is evidence that magnesium deficiency can result in a significant reduction in exercise performance <ref name="a9"/>. There is increased loss of magnesium in athletes <ref name="a8"/> through sweat and urine. It seems a reasonable assumption to this author that the increased sweating that occurs in an NC summer would exacerbate this loss.
+
** '''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.
== Bone Health ==
+
** '''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.
Magnesium is a critical component of bones, making up about 1% of the structure. Lower levels of magnesium produce, more brittle bones with larger bone crystals <ref name="a1"/>. Inadequate magnesium results in lower blood calcium levels, resistance to hormone that control bone density and reduction of vitamin D effect; all result in reduced bone density <ref name="a1"/>. There is some evidence that magnesium supplementation on its own will help bone density <ref name="a10"/>. One study showed this in healthy older white subject, but not in black subjects <ref name="a11"/>. Magnesium is also believed to be critical to calcium absorption <ref name="a15"/>. (If you have concerns over bone density, don't forget to make sure you are getting enough Vitamin D.)
+
** '''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.
== Migraines ==
+
** '''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.
There is evidence for magnesium supplementation helping prevent migraines <ref name="a2"/><ref name="a3"/>. Personally I have seen a reduction in my migraines, and an improvement in my low light vision. If you suffer from migraines, I would strongly recommend reading the reference articles. I also found that the supplement [[MSM and Migraines|MSM]] caused me migraines, but vitamin B2 has reduced them.
+
* '''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.
== Cramps ==
+
* '''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. [http://www.amazon.com/BulkSupplements-Magnesium-Glycinate-Powder-grams/dp/B00F7OZJQE Magnesium Glycinate powder] will mix easily in a sports drink, but I generally use the more expensive [http://www.amazon.com/Nci-Hans-Nieper-Magnesium-Orotate/dp/B000FLLTLS Magnesium Orotate].
There is some very tenuous evidence that magnesium can help with muscle cramps <ref name="a12"/>. This is not a problem I suffer from, so I have no personal perspective.
+
* '''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.
+
=Deficiency=
== Other Impacts of 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<ref name="USDA-intake "/>. However, other studies suggest that the majority of the US population does not get sufficient magnesium<ref name="Ford-2003"/>.
There are studies that have linked magnesium deficiency with asthma, emphysema, Attention deficit/hyperactivity disorder (ADHD), Depression, type 2 diabetes, heart disease, high blood pressure in women, and several other problems. <ref name="a1"/><ref name="a16"/>
+
=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.
== Increasing Intake ==
+
* Triathlete given magnesium supplementation had lower blood insulin and cortisol levels, and higher blood glucose compared with controls<ref name="Golf-1998"/>.
Magnesium, is absorbed at about 30-40% efficiency <ref name="a13"/>. Good sources of magnesium in food include nuts, cereals, coffee, green leafy vegetables and especially chocolate <ref name="a13"/>. Cheap supplements use magnesium oxide, which is very hard to absorb; I use magnesium orotate, though chelated forms are also supposed to work well. Avoid taking Magnesium sulfate as it is used to treat constipation <ref name="a14"/>. Vitamin C can help absorption of minerals. Therefore I take magnesium with Vitamin C on an empty stomach. (Bathing in Epson Salts can also raise magnesium levels in the blood.)
+
* Rats fed a magnesium deficient diet have a reduced exercise capacity<ref name="Keen-1987"/>.
+
* Magnesium levels in the blood have been correlated with [[VO2max|V̇O<sub>2</sub>max]] in athletes but not in untrained subjects<ref name="Lukaski-1983"/>.
== Risks ==
+
* Magnesium deficiency which can result in a significant reduction in exercise performance<ref name="McDonald-1988"/>.
My research indicates that magnesium is generally a safe supplement at RDA type 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, but this seems to be linked to the type of supplement. As with all my advice, verify it independently. If you have any doubts, consult your physician.
+
* Magnesium levels in the blood of patients with type II diabetes are correlated with [[VO2max|V̇O<sub>2</sub>max]] <ref name="Kobayashi-1998"/>.
+
* Magnesium deficiency increases the energy cost of exercise in postmenopausal women<ref name="Lukaski-2002"/>.
== My Usage ==
+
* Six healthy males given 240mg/day of Potassium-magnesium-aspartate had 50% greater insurance on a bicycle ergometer compared with controls<ref name="Ahlborg-1968"/>.
I buy my Magnesium Orotate from Lucky Vitamin as they seem to have the best price I have found - http:://www.luckyvitamin.com/item/itemKey/55469. I generally take one tablet (500mg) with Vitamin C on rising, and another post run.
+
* Subjects given 314 mg/day of magnesium oxide had improved [[Running Economy]] and increased time to exhaustion during a treadmill run<ref name="Brilla-1995"/>.
+
* Some studies have shown no benefit from magnesium supplementation, even in those with a low blood magnesium levels<ref name="Finstad-2001"/><ref name="Newhouse-2000"/>. 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<ref name="Newhouse-2000"/>.
== References ==
+
* Untrained subjects given Magnesium supplementation during strength training developed greater quadriceps strength than controls<ref name="Brilla-1992"/>.
 +
* 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<ref name="WhangWelt1963"/><ref name="Dyckner-1978"/>. Therefore, magnesium may be important in maintaining normal electrolyte levels.
 +
=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 Training| heat acclimation]] reduces magnesium loss in sweat <ref name="Chinevere-2008"/>, but there are concerns that this reduction is an artifact of methodological errors <ref name="Ely-2011"/><ref name="Baker-2011"/>. (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<ref name="Costill-1977"/>.
 +
* Generally people lose about 2mg/100ml of urine<ref name="Heaton-1969"/>, or about 120 to 140 mg/day<ref name="Kazuo-1981"/>, but this is reduced during magnesium deficiency as the kidneys will reabsorb more<ref name="Heaton-1969"/>. Magnesium concentrations in the urine have been shown to drop during a marathon<ref name="Lijnen-1988"/>.
 +
* [[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<ref name="Deuster-1987"/>.
 +
* A study of runners at the Boston marathon showed a significant drop in serum magnesium levels after the race<ref name="Rose-1970"/>. 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<ref name="Franz-1985"/><ref name="Lijnen-1988"/>.
 +
* 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<ref name="Stendig-Lindberg-1987"/>. A follow-up study of 2 additional groups showed that the magnesium levels remained depressed for 10 to 11 months<ref name="Stendig-Lindberg-1991"/>. This could have important ramifications for ultrarunners, as longer ultras could produce protracted magnesium deficit.
 +
=Magnesium and Health=
 +
Magnesium is required for over 300 different enzymes in the body, as well as structures like the bones<ref name="Wacker-1968"/>.
 +
==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)<ref name="MaFolsom1995"/>.
 +
* Magnesium deficiency is also associated with the metabolic syndrome<ref name="Volpe2008"/>, 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<ref name="BarbagalloDominguez2007"/><ref name="Lopez-RidauraWillett2004"/><ref name="SongManson2004"/>
 +
* 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<ref name="Schulze2007"/>.
 +
* 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<ref name="Rodriguez-MoranGuerrero-Romero2003"/>.
 +
* 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<ref name="MoorenKrüger2011"/>.
 +
* Insulin regulates magnesium levels<ref name="BarbagalloDominguez2007"/>, creating some possible feedback.
 +
* Low cellular magnesium results in insulin resistance in skeletal muscle, heart muscle and fat tissue<ref name="BarbagalloDominguez2007"/>.
 +
==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<ref name="Aydın2013"/>.
 +
* Lower levels of magnesium produce more brittle bones with larger bone crystals<ref name="Sojka-1995"/>.
 +
* Magnesium deficiency is linked to osteoporosis<ref name="Durlach-1998"/><ref name="SahotaMundey2006"/><ref name="RudeGruber2004"/><ref name="Sojka2009"/><ref name="Freudenheim-1986"/>
 +
* There is some evidence that magnesium supplementation helps improve bone density and to prevent fractures <ref name="Sojka2009"/>.
 +
* One study showed that magnesium intake was correlated with bone density in healthy older white subject, but not in black subjects<ref name="Ryder-2005"/>. (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<ref name="Dawson-HughesHarris1997"/>.
 +
==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 and Migraines|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<ref name="Mauskop-2012"/>.
 +
* A study showed lower levels of magnesium within the blood cells of migraine sufferers, though the serum levels were the same<ref name="SchoenenSianard-Gainko1991"/>.
 +
* The level of magnesium within the brain of migraine sufferers is lower<ref name="RamadanHalvorson1989"/>.
 +
* 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<ref name="PeikertWilimzig1996"/>.
 +
* Giving 240 mg of magnesium as twice a day had no impact on a group of migraine sufferers<ref name="PfaffenrathWessely1996"/>. However, the form of magnesium was Magnesium Aspartate and Aspartate may have neurological effects of its own<ref name="Chen-2005"/>.
 +
* Intravenous magnesium does not appear to be effective for the acute treatment of migraine attacks<ref name="ChoiParmar2013"/>.
 +
* 500 mg per day of magnesium oxide produced a significant reduction in the number and severity of migraines<ref name="Talebi-2013"/>.
 +
==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<ref name="DeromSayón-Orea2013"/>.
 +
* 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<ref name="YaryAazami2012"/>.
 +
* There are a number of case studies of successful treatment of major depression with magnesium (typically 100-200mg per meal)<ref name="EbyEby2006"/>.
 +
* However, the treatment of depression with magnesium is still a hypothesis, with no large scale interventions yet complete<ref name="EbyEby2010"/>, though at least one is underway<ref name="clinicaltrials.gov"/>. 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<ref name="Barragán-Rodríguez-2008"/>.
 +
* Magnesium did not help with premenstrual depression<ref name="Walker-1998"/>.
 +
* 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<ref name="Bhudia-2006"/>.
 +
==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<ref name="Abbasi-2012"/>.
 +
* 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<ref name="RondanelliOpizzi2011"/>. 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 <ref name="HeldAntonijevic2002"/>.
 +
* Intravenous magnesium changed the sleep EEG of healthy men suggesting it may be useful in controlling depressive symptoms and seizures<ref name="MurckSteiger1998"/>
 +
* Magnesium levels in newborn babies is correlated to their sleep behavior<ref name="Dralle-1980"/>.
 +
* 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<ref name="Depoortere-1993"/>.
 +
* Most<ref name="Wilder-Smith-1998"/><ref name="Apan-2004"/><ref name="Kara-2002"/><ref name="MavrommatiGabopoulou2004"/><ref name="Tramer-1996"/><ref name="KoinigWallner1998"/><ref name="Bhatia-2004"/>, but not all<ref name="ZarauzaSez-Fernndez2000"/><ref name="Tramèr-2007"/> studies show that Magnesium helps with post-operative pain management, including its impact on sleep.
 +
==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<ref name="Rowe2012"/>.
 +
* Telomerase, an enzyme that protects DNA from degradation during cell replication<ref name="Olovnikov-1973"/>, has a critical role in anti-aging and cancer<ref name="FengFunk1995"/>.
 +
* A short term deficiency in magnesium has been shown to reduce Telomerase activity, and induce DNA damage in rats<ref name="Shah-2014"/>.
 +
* A study of isolated human cells showed that magnesium deficiency reduced their reproductive lifespan<ref name="KillileaAmes2008"/>.
 +
* Magnesium is related to DNA stability and repair<ref name="Hartwig-2001"/>.
 +
==Epilepsy==
 +
There are some initial indications that magnesium might help with epilepsy, but there is too little evidence to reach a conclusion<ref name="Yuen-2012"/><ref name="Gupta-1994"/>.
 +
* Animal studies on magnesium and epilepsy.
 +
** Animal brains that are perfused with a magnesium free solution result in seizure like activity<ref name="AndersonAnderson1986"/><ref name="TancrediAvoli1988"/><ref name="QuilichiniDiabira2002"/>.
 +
** Rats given a magnesium deficient diet had decreased seizure thresholds and latencies, but subsequent magnesium supplementation produced increasing seizure thresholds and latencies<ref name="SpasovIezhitsa2007"/>.
 +
** When seizures were provoked in rats (using [http://en.wikipedia.org/wiki/Pentylenetetrazol pentylenetetrazol] ), neither magnesium nor a low dose of the anticonvulsant valproate prevented the seizures, but the combination was effective<ref name="SafarAbdallah2010"/>.
 +
** Sheep made deficient in magnesium via dietary restriction have increased seizures<ref name="LeaverParkinson1987"/>.
 +
** Magnesium has anticonvulsant properties for some types of induced convulsions<ref name="Decollogne1997"/>.
 +
* Magnesium deficiency and epilepsy.
 +
** A 1965 study suggested a relationship between epilepsy and magnesium levels<ref name="CANELAS-1965"/>.
 +
** There are case studies of adults and babies with low magnesium related seizures<ref name="Fagan-2001"/><ref name="WeislederTobin2002"/>.
 +
** Recent studies have shown lower magnesium levels in people with epilepsy compared with controls<ref name="Oladipo-2003"/><ref name="SinertZehtabchi2007"/>.
 +
** A study of idiopathic epilepsy showed that magnesium levels fall on day one and 4 of the seizures, but not on day 7<ref name="Gupta-1994"/>.
 +
** Low magnesium levels were seen in 100 epileptic patients compared with controls, and levels of magnesium in the [http://en.wikipedia.org/wiki/Cerebrospinal_fluid cerebrospinal fluid] were correlated with increased frequency, poor control and longer duration of seizures<ref name="Sood-1993"/>.
 +
* Magnesium supplementation for epilepsy.
 +
** There are case reports of infants with low magnesium that had seizures responded to magnesium supplementation<ref name="VisudhiphanVisudtibhan2005"/><ref name="Prebble1995"/><ref name="Unachak-2002"/>.
 +
** 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<ref name="Pandey-2010"/>.
 +
** 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<ref name="ZouWang2010"/>.
 +
==Cramps==
 +
There is some very tenuous evidence that magnesium can help with [[Muscle|muscle]] [[Cramps]] <ref name="Bergeron-2007"/>.
 +
==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<ref name="UoM"/><ref name="MaFolsom1995"/><ref name="Hollifield-1987"/><ref name="Touyz-2003"/><ref name="Seelig-1974"/>.
 +
=Recommended Intake=
 +
The recommended daily intake of Magnesium varies with age, gender as well as pregnancy/lactation<ref name="IOM-1997"/>. 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<ref name="Siener-1995"/><ref name="Wisker-1991"/>, and as might high intakes of cola<ref name="Weiss-1992"/><ref name="Berrill-1992"/>.
 +
{| class="wikitable"
 +
! Age
 +
! Male
 +
! Female
 +
! Pregnancy
 +
! Lactation
 +
|-
 +
| Birth to 6 months
 +
| 30 mg*
 +
| 30 mg*
 +
 +
 +
|-
 +
| 7–12 months
 +
| 75 mg*
 +
| 75 mg*
 +
 +
 +
|-
 +
| 1–3 years
 +
| 80 mg
 +
| 80 mg
 +
 +
 +
|-
 +
| 4–8 years
 +
| 130 mg
 +
| 130 mg
 +
 +
 +
|-
 +
| 9–13 years
 +
| 240 mg
 +
| 240 mg
 +
 +
 +
|-
 +
| 14–18 years
 +
| 410 mg
 +
| 360 mg
 +
| 400 mg
 +
| 360 mg
 +
|-
 +
| 19–30 years
 +
| 400 mg
 +
| 310 mg
 +
| 350 mg
 +
| 310 mg
 +
|-
 +
| 31–50 years
 +
| 420 mg
 +
| 320 mg
 +
| 360 mg
 +
| 320 mg
 +
|-
 +
| 51+ years
 +
| 420 mg
 +
| 320 mg
 +
 +
 +
|}
 +
=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<ref name="NIHFact"/>, though in practice hard drinking water may contribute 9-27% of the US magnesium intake<ref name="Marier-1986"/>. 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!
 +
{| class="wikitable"
 +
! Food
 +
! Milligrams
 +
(mg) per
 +
serving
 +
! Percent
 +
DV*
 +
|-
 +
| Almonds, dry roasted, 1 ounce
 +
| 80
 +
| 20
 +
|-
 +
| Spinach, boiled, ½ cup
 +
| 78
 +
| 20
 +
|-
 +
| Cashews, dry roasted, 1 ounce
 +
| 74
 +
| 19
 +
|-
 +
| Peanuts, oil roasted, ¼ cup
 +
| 63
 +
| 16
 +
|-
 +
| Cereal, shredded wheat, 2 large biscuits
 +
| 61
 +
| 15
 +
|-
 +
| Soymilk, plain or vanilla, 1 cup
 +
| 61
 +
| 15
 +
|-
 +
| Black beans, cooked, ½ cup
 +
| 60
 +
| 15
 +
|-
 +
| Edamame, shelled, cooked, ½ cup
 +
| 50
 +
| 13
 +
|-
 +
| Peanut butter, smooth, 2 tablespoons
 +
| 49
 +
| 12
 +
|-
 +
| Bread, whole wheat, 2 slices
 +
| 46
 +
| 12
 +
|-
 +
| Avocado, cubed, 1 cup
 +
| 44
 +
| 11
 +
|-
 +
| Potato, baked with skin, 3.5 ounces
 +
| 43
 +
| 11
 +
|-
 +
| Rice, brown, cooked, ½ cup
 +
| 42
 +
| 11
 +
|-
 +
| Yogurt, plain, low fat, 8 ounces
 +
| 42
 +
| 11
 +
|-
 +
| Breakfast cereals, fortified with 10% of the DV for magnesium
 +
| 40
 +
| 10
 +
|-
 +
| Oatmeal, instant, 1 packet
 +
| 36
 +
| 9
 +
|-
 +
| Kidney beans, canned, ½ cup
 +
| 35
 +
| 9
 +
|-
 +
| Banana, 1 medium
 +
| 32
 +
| 8
 +
|-
 +
| Salmon, Atlantic, farmed, cooked, 3 ounces
 +
| 26
 +
| 7
 +
|-
 +
| Milk, 1 cup
 +
| 24–27
 +
| 6–7
 +
|-
 +
| Halibut, cooked, 3 ounces
 +
| 24
 +
| 6
 +
|-
 +
| Raisins, ½ cup
 +
| 23
 +
| 6
 +
|-
 +
| Chicken breast, roasted, 3 ounces
 +
| 22
 +
| 6
 +
|-
 +
| Beef, ground, 90% lean, pan broiled, 3 ounces
 +
| 20
 +
| 5
 +
|-
 +
| Broccoli, chopped and cooked, ½ cup
 +
| 12
 +
| 3
 +
|-
 +
| Rice, white, cooked, ½ cup
 +
| 10
 +
| 3
 +
|-
 +
| Apple, 1 medium
 +
| 9
 +
| 2
 +
|-
 +
| Carrot, raw, 1 medium
 +
| 7
 +
| 2
 +
|}
 +
 +
=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 [http://www.amazon.com/BulkSupplements-Magnesium-Glycinate-Powder-grams/dp/B00F7OZJQE 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 [http://www.amazon.com/Nci-Hans-Nieper-Magnesium-Orotate/dp/B000FLLTLS 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<ref name="Ranade-2001"/> unless otherwise noted.)
 +
{| class="wikitable"
 +
! Form
 +
! Mg oxide
 +
! Mg chloride
 +
! Mg carbonate
 +
! Mg citrate
 +
! Mg gluconate
 +
! Mg Glycinate (amino acid chelate)
 +
! Mg Orotate
 +
! Mg lactate
 +
! Mg aspartate
 +
|-
 +
| Elemental Mg per 100mg
 +
|
 +
|
 +
|
 +
|
 +
|
 +
| 10mg
 +
| 31g
 +
|
 +
|
 +
|-
 +
| Bioavailability
 +
| Extremely poor (~4%<ref name="Firoz-2001"/>, no better than placebo<ref name="Walker-2003"/>). (effervescent form is better<ref name="Siener-2011"/>)
 +
| Good
 +
| Good
 +
| Good<ref name="Lindberg-1990"/><ref name="Walker-2003"/>
 +
| Good
 +
| Good<ref name="Walker-2003"/>
 +
|
 +
| Good<ref name="Firoz-2001"/>
 +
| Goo<ref name="Firoz-2001"/>
 +
|-
 +
| Solubility in water
 +
| Extremely low (8.6mg/L)
 +
| High
 +
| Insoluble
 +
| High<ref name="Lindberg-1990"/>
 +
| Moderate
 +
| Good
 +
|
 +
|
 +
|
 +
|-
 +
| Percentage absorbed (Mg depleted rats)<ref name="Coudray-2005"/>
 +
| 48.4
 +
| 48.8
 +
| 43.8
 +
| 50.1
 +
| 56.8
 +
|
 +
|
 +
| 47.9
 +
| 46.8
 +
|-
 +
| Side effects
 +
| Diarrhea
 +
| GI Distress, Diarrhea
 +
| GI Distress, Diarrhea
 +
| GI Distress, Diarrhea
 +
| GI Distress, Diarrhea
 +
| Expensive
 +
|
 +
|
 +
|
 +
|}
 +
=Factors that Influence Magnesium Levels=
 +
Only 30-50% of consumed magnesium is typically absorbed<ref name="Stipanuk=2013"/>, though the absorption rate varies with the dose between 10-65%, with higher doses having lower absorption rates<ref name="FineSanta Ana1991"/>. Other factors that influence magnesium absorption include:
 +
* Lactose (milk) may improve magnesium absorption<ref name="GropperSmith2012"/>.
 +
* High-phosphate diets have decreased magnesium absorption<ref name="Itokawa1989"/>.
 +
** 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<ref name="Mcclanahan-1969"/>.
 +
* Vitamin D supplementation improves magnesium absorption even in those individuals with adequate levels of vitamin D<ref name="Hardwick-1991"/>.
 +
* Diuretics, including alcohol, increase magnesium losses in the urine<ref name="Wester-1987"/>.
 +
* Hard drinking water may contribute 9 to 27% of the magnesium intake in the US<ref name="Marier-1986"/>.
 +
=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.
 +
=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<ref name="Wester-1987"/>. 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<ref name="Wester-1987"/>.
 +
=Magnesium Testing=
 +
Testing for blood magnesium levels is reasonably cheap, [http://www.walkinlab.com/heart-health-tests/magnesiumserumtest.html 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<ref name="Tepper-2013"/>. In fact, while serum magnesium levels are controlled in a narrow range, intracellular magnesium deficiency can occur with normal serum magnesium levels<ref name="Wester-1987"/>. It has been suggested that a magnesium tolerance test may be a better indication of low magnesium<ref name="Rude-1993"/>. 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<ref name="Gullestad-1992"/><ref name="Holm-1987"/><ref name="Gullestad-1994"/>.
 +
=References=
 
<references>
 
<references>
<ref name="a1"> Linus Pauling Institute - Magnesium http:://lpi.oregonstate.edu/infocenter/minerals/magnesium/ http://lpi.oregonstate.edu/infocenter/minerals/magnesium/</ref>
+
<ref name="Walker-2003">AF. Walker, G. Marakis, S. Christie, M. Byng, Mg citrate found more bioavailable than other Mg preparations in a randomised, double-blind study., Magnes Res, volume 16, issue 3, pages 183-91, Sep 2003, PMID [http://www.ncbi.nlm.nih.gov/pubmed/14596323 14596323]</ref>
<ref name="a6">Magnesium deficiency (medicine) http:://en.wikipedia.org/wiki/Magnesium_deficiency_%28medicine%29 http://en.wikipedia.org/wiki/Magnesium_deficiency_%28medicine%29</ref>
+
<ref name="Sojka-1995">JE. Sojka, CM. Weaver, Magnesium supplementation and osteoporosis., Nutr Rev, volume 53, issue 3, pages 71-4, Mar 1995, PMID [http://www.ncbi.nlm.nih.gov/pubmed/7770187 7770187]</ref>
<ref name="a7"> USDA intake figures for NC http:://www.ars.usda.gov/Services/docs.htm?docid=11198 http://www.ars.usda.gov/Services/docs.htm?docid=11198</ref>
+
<ref name="USDA-intake">Human Nutrition : USDA intake figures, Accessed on 9 August 2014</ref>
<ref name="a13"> Magnesium in biology http:://en.wikipedia.org/wiki/Magnesium_in_biology http://en.wikipedia.org/wiki/Magnesium_in_biology</ref>
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<ref name="UoM">Magnesium, http://umm.edu/en/health/medical/altmed/supplement/magnesium, Accessed on 9 August 2014</ref>
<ref name="a14"> Epsom Salts http:://en.wikipedia.org/wiki/Epsom_salts http://en.wikipedia.org/wiki/Epsom_salts</ref>
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<ref name="Ryder-2005">KM. Ryder, RI. Shorr, AJ. Bush, SB. Kritchevsky, T. Harris, K. Stone, J. Cauley, FA. Tylavsky, Magnesium intake from food and supplements is associated with bone mineral density in healthy older white subjects., J Am Geriatr Soc, volume 53, issue 11, pages 1875-80, Nov 2005, doi [http://dx.doi.org/10.1111/j.1532-5415.2005.53561.x 10.1111/j.1532-5415.2005.53561.x], PMID [http://www.ncbi.nlm.nih.gov/pubmed/16274367 16274367]</ref>
<ref name="a16">University of Maryland Medical Center - Magnesium http:://www.umm.edu/altmed/articles/magnesium-000313.htm http://www.umm.edu/altmed/articles/magnesium-000313.htm</ref>
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<ref name="McDonald-1988">R. McDonald, CL. Keen, Iron, zinc and magnesium nutrition and athletic performance., Sports Med, volume 5, issue 3, pages 171-84, Mar 1988, PMID [http://www.ncbi.nlm.nih.gov/pubmed/3285436 3285436]</ref>
<ref name="a10">Magnesium supplementation and osteoporosis http:://www.ncbi.nlm.nih.gov/pubmed/7770187?dopt=Abstract http://www.ncbi.nlm.nih.gov/pubmed/7770187?dopt=Abstract</ref>
+
<ref name="Bergeron-2007">MF. Bergeron, Exertional heat cramps: recovery and return to play., J Sport Rehabil, volume 16, issue 3, pages 190-6, Aug 2007, PMID [http://www.ncbi.nlm.nih.gov/pubmed/17923724 17923724]</ref>
<ref name="a11">Magnesium intake from food and supplements is associated with bone mineral density in healthy older white subjects. http:://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16274367 http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16274367</ref>
+
<ref name="NIHFact">Magnesium Fact Sheet for Health Professionals, http://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional, Accessed on 7 July 2014</ref>
<ref name="a15"> Magnesium: A Key to Calcium Absorption http:://www.mgwater.com/calmagab.shtml http://www.mgwater.com/calmagab.shtml</ref>
+
<ref name="Tepper-2013">Tepper, D. (2013), Magnesium. Headache: The Journal of Head and Face Pain, 53: 1533–1534. doi: 10.1111/head.12220</ref>
<ref name="a2"> Magnesium Treatment for Migraines An Inexpensive but Equivocal Treatment http:://neurologicalillness.suite101.com/article.cfm/magnesium_treatment_for_migraines http://neurologicalillness.suite101.com/article.cfm/magnesium_treatment_for_migraines</ref>
+
<ref name="Lindberg-1990">JS. Lindberg, MM. Zobitz, JR. Poindexter, CY. Pak, Magnesium bioavailability from magnesium citrate and magnesium oxide., J Am Coll Nutr, volume 9, issue 1, pages 48-55, Feb 1990, PMID [http://www.ncbi.nlm.nih.gov/pubmed/2407766 2407766]</ref>
<ref name="a3">Are Migraine Headaches a Symptom of a Magnesium Deficiency? http:://www.ctds.info/magnesium-migraine.html http://www.ctds.info/magnesium-migraine.html</ref>
+
<ref name="Siener-2011">R. Siener, A. Jahnen, A. Hesse, Bioavailability of magnesium from different pharmaceutical formulations., Urol Res, volume 39, issue 2, pages 123-7, Apr 2011, doi [http://dx.doi.org/10.1007/s00240-010-0309-y 10.1007/s00240-010-0309-y], PMID [http://www.ncbi.nlm.nih.gov/pubmed/20862466 20862466]</ref>
<ref name="a4"> Lack Energy? Maybe It's Your Magnesium Level http:://www.ars.usda.gov/is/AR/archive/may04/energy0504.htm?pf=1 http://www.ars.usda.gov/is/AR/archive/may04/energy0504.htm?pf=1</ref>
+
<ref name="DeromSayón-Orea2013">Marie-Laure Derom, Carmen Sayón-Orea, José María Martínez-Ortega, Miguel A. Martínez-González, Magnesium and depression: a systematic review, Nutritional Neuroscience, volume 16, issue 5, 2013, pages 191–206, ISSN [http://www.worldcat.org/issn/1028-415X 1028-415X], doi [http://dx.doi.org/10.1179/1476830512Y.0000000044 10.1179/1476830512Y.0000000044]</ref>
<ref name="a5"> The dangers of magnesium deficiency in endurance athletes http:://findarticles.com/p/articles/mi_m0FDL/is_4_14/ai_n24940334/ http://findarticles.com/p/articles/mi_m0FDL/is_4_14/ai_n24940334/</ref>
+
<ref name="Firoz-2001">M. Firoz, M. Graber, Bioavailability of US commercial magnesium preparations., Magnes Res, volume 14, issue 4, pages 257-62, Dec 2001, PMID [http://www.ncbi.nlm.nih.gov/pubmed/11794633 11794633]</ref>
<ref name="a8">Micronutrients (magnesium, zinc, and copper): are mineral supplements needed for athletes? http:://www.ncbi.nlm.nih.gov/pubmed/7550259 http://www.ncbi.nlm.nih.gov/pubmed/7550259</ref>
+
<ref name="Coudray-2005">C. Coudray, M. Rambeau, C. Feillet-Coudray, E. Gueux, JC. Tressol, A. Mazur, Y. Rayssiguier, Study of magnesium bioavailability from ten organic and inorganic Mg salts in Mg-depleted rats using a stable isotope approach., Magnes Res, volume 18, issue 4, pages 215-23, Dec 2005, PMID [http://www.ncbi.nlm.nih.gov/pubmed/16548135 16548135]</ref>
<ref name="a9"> Iron, zinc and magnesium nutrition and athletic performance. http:://grande.nal.usda.gov/ibids/index.php?mode2=detail&origin=ibids_references&therow=268068 http://grande.nal.usda.gov/ibids/index.php?mode2=detail&origin=ibids_references&therow=268068</ref>
+
<ref name="Rude-1993">RK. Rude, Magnesium metabolism and deficiency., Endocrinol Metab Clin North Am, volume 22, issue 2, pages 377-95, Jun 1993, PMID [http://www.ncbi.nlm.nih.gov/pubmed/8325293 8325293]</ref>
<ref name="a12"> Exertional Heat Cramps: Recovery and Return to Play http:://www.sanfordhealth.org/ClassLibrary/Page/Images/files/ExertionalHeatCramps.pdf http://www.sanfordhealth.org/ClassLibrary/Page/Images/files/ExertionalHeatCramps.pdf</ref>
+
<ref name="Ranade-2001">VV. Ranade, JC. Somberg, Bioavailability and pharmacokinetics of magnesium after administration of magnesium salts to humans., Am J Ther, volume 8, issue 5, pages 345-57, Sept 2001, PMID [http://www.ncbi.nlm.nih.gov/pubmed/11550076 11550076]</ref>
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<ref name="IOM-1997">Institute of Medicine (IOM). Food and Nutrition Board. Dietary Reference Intakes: Calcium, Phosphorus, Magnesium, Vitamin D and Fluoride. Washington, DC: National Academy Press, 1997. http://www.nap.edu/openbook.php?record_id=5776</ref>
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<ref name="Wacker-1968">WE. Wacker, AF. Parisi, Magnesium metabolism., N Engl J Med, volume 278, issue 12, pages 658-63, Mar 1968, doi [http://dx.doi.org/10.1056/NEJM196803212781205 10.1056/NEJM196803212781205], PMID [http://www.ncbi.nlm.nih.gov/pubmed/4866353 4866353]</ref>
 +
<ref name="BarbagalloDominguez2007">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 [http://www.worldcat.org/issn/00039861 00039861], doi [http://dx.doi.org/10.1016/j.abb.2006.05.007 10.1016/j.abb.2006.05.007]</ref>
 +
<ref name="MaFolsom1995">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 [http://www.worldcat.org/issn/08954356 08954356], doi [http://dx.doi.org/10.1016/0895-4356(94)00200-A 10.1016/0895-4356(94)00200-A]</ref>
 +
<ref name="Lopez-RidauraWillett2004">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 [http://www.worldcat.org/issn/0149-5992 0149-5992], doi [http://dx.doi.org/10.2337/diacare.27.1.134 10.2337/diacare.27.1.134]</ref>
 +
<ref name="SongManson2004">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 [http://www.worldcat.org/issn/0149-5992 0149-5992], doi [http://dx.doi.org/10.2337/diacare.27.1.59 10.2337/diacare.27.1.59]</ref>
 +
<ref name="Schulze2007">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 [http://www.worldcat.org/issn/0003-9926 0003-9926], doi [http://dx.doi.org/10.1001/archinte.167.9.956 10.1001/archinte.167.9.956]</ref>
 +
<ref name="BarbagalloDominguez2007">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 [http://www.worldcat.org/issn/00039861 00039861], doi [http://dx.doi.org/10.1016/j.abb.2006.05.007 10.1016/j.abb.2006.05.007]</ref>
 +
<ref name="Siener-1995">R. Siener, A. Hesse, Influence of a mixed and a vegetarian diet on urinary magnesium excretion and concentration., Br J Nutr, volume 73, issue 5, pages 783-90, May 1995, PMID [http://www.ncbi.nlm.nih.gov/pubmed/7626596 7626596]</ref>
 +
<ref name="Wisker-1991">E. Wisker, R. Nagel, TK. Tanudjaja, W. Feldheim, Calcium, magnesium, zinc, and iron balances in young women: effects of a low-phytate barley-fiber concentrate., Am J Clin Nutr, volume 54, issue 3, pages 553-9, Sep 1991, PMID [http://www.ncbi.nlm.nih.gov/pubmed/1652199 1652199]</ref>
 +
<ref name="Weiss-1992">GH. Weiss, PM. Sluss, CA. Linke, Changes in urinary magnesium, citrate, and oxalate levels due to cola consumption., Urology, volume 39, issue 4, pages 331-3, Apr 1992, PMID [http://www.ncbi.nlm.nih.gov/pubmed/1557843 1557843]</ref>
 +
<ref name="Berrill-1992">Berrill, James, Umakant Dave, and John Doran. "Malabsorption due to excessive cola consumption." Scand J Gastroenterol 27 (1992): 819-28.</ref>
 +
<ref name="EbyEby2006">George A. Eby, Karen L. Eby, Rapid recovery from major depression using magnesium treatment, Medical Hypotheses, volume 67, issue 2, 2006, pages 362–370, ISSN [http://www.worldcat.org/issn/03069877 03069877], doi [http://dx.doi.org/10.1016/j.mehy.2006.01.047 10.1016/j.mehy.2006.01.047]</ref>
 +
<ref name="YaryAazami2012">Teymoor Yary, Sanaz Aazami, Kourosh Soleimannejad, Dietary Intake of Magnesium May Modulate Depression, Biological Trace Element Research, volume 151, issue 3, 2012, pages 324–329, ISSN [http://www.worldcat.org/issn/0163-4984 0163-4984], doi [http://dx.doi.org/10.1007/s12011-012-9568-5 10.1007/s12011-012-9568-5]</ref>
 +
<ref name="EbyEby2010">George A. Eby, Karen L. Eby, Magnesium for treatment-resistant depression: A review and hypothesis, Medical Hypotheses, volume 74, issue 4, 2010, pages 649–660, ISSN [http://www.worldcat.org/issn/03069877 03069877], doi [http://dx.doi.org/10.1016/j.mehy.2009.10.051 10.1016/j.mehy.2009.10.051]</ref>
 +
<ref name="Barragán-Rodríguez-2008">L. Barragán-Rodríguez, M. Rodríguez-Morán, F. Guerrero-Romero, Efficacy and safety of oral magnesium supplementation in the treatment of depression in the elderly with type 2 diabetes: a randomized, equivalent trial., Magnes Res, volume 21, issue 4, pages 218-23, Dec 2008, PMID [http://www.ncbi.nlm.nih.gov/pubmed/19271419 19271419]</ref>
 +
<ref name="Walker-1998">AF. Walker, MC. De Souza, MF. Vickers, S. Abeyasekera, ML. Collins, LA. Trinca, Magnesium supplementation alleviates premenstrual symptoms of fluid retention., J Womens Health, volume 7, issue 9, pages 1157-65, Nov 1998, PMID [http://www.ncbi.nlm.nih.gov/pubmed/9861593 9861593]</ref>
 +
<ref name="Bhudia-2006">SK. Bhudia, DM. Cosgrove, RI. Naugle, J. Rajeswaran, BK. Lam, E. Walton, J. Petrich, RC. Palumbo, AM. Gillinov, Magnesium as a neuroprotectant in cardiac surgery: a randomized clinical trial., J Thorac Cardiovasc Surg, volume 131, issue 4, pages 853-61, Apr 2006, doi [http://dx.doi.org/10.1016/j.jtcvs.2005.11.018 10.1016/j.jtcvs.2005.11.018], PMID [http://www.ncbi.nlm.nih.gov/pubmed/16580444 16580444]</ref>
 +
<ref name="clinicaltrials.gov">Magnesium Sulfate Versus 5% Dextrose With Treatment Resistant Depression - Full Text View - ClinicalTrials.gov, http://clinicaltrials.gov/show/NCT01597167, Accessed on 9 July 2014</ref>
 +
<ref name="Yuen-2012">AW. Yuen, JW. Sander, Can magnesium supplementation reduce seizures in people with epilepsy? A hypothesis., Epilepsy Res, volume 100, issue 1-2, pages 152-6, Jun 2012, doi [http://dx.doi.org/10.1016/j.eplepsyres.2012.02.004 10.1016/j.eplepsyres.2012.02.004], PMID [http://www.ncbi.nlm.nih.gov/pubmed/22406257 22406257]</ref>
 +
<ref name="Gupta-1994">SK. Gupta, AS. Manhas, VK. Gupta, R. Bhatt, Serum magnesium levels in idiopathic epilepsy., J Assoc Physicians India, volume 42, issue 6, pages 456-7, Jun 1994, PMID [http://www.ncbi.nlm.nih.gov/pubmed/7852227 7852227]</ref>
 +
<ref name="CANELAS-1965">HM. CANELAS, LM. DE ASSIS, FB. DE JORGE, DISORDERS OF MAGNESIUM METABOLISM IN EPILEPSY., J Neurol Neurosurg Psychiatry, volume 28, pages 378-81, Aug 1965, PMID [http://www.ncbi.nlm.nih.gov/pubmed/14338128 14338128]</ref>
 +
<ref name="AndersonAnderson1986">William W. Anderson, William W. Anderson, Darrell V. Lewis, H. Scott Swartzwelder, Wilkie A. Wilson, Magnesium-free medium activates seizure-like events in the rat hippocampal slice, Brain Research, volume 398, issue 1, 1986, pages 215–219, ISSN [http://www.worldcat.org/issn/00068993 00068993], doi [http://dx.doi.org/10.1016/0006-8993(86)91274-6 10.1016/0006-8993(86)91274-6]</ref>
 +
<ref name="TancrediAvoli1988">V. Tancredi, M. Avoli, G.G.C. Hwa, Low-magnesium epilepsy in rat hippocampal slices: Inhibitory postsynaptic potentials in the CA1 subfield, Neuroscience Letters, volume 89, issue 3, 1988, pages 293–298, ISSN [http://www.worldcat.org/issn/03043940 03043940], doi [http://dx.doi.org/10.1016/0304-3940(88)90542-3 10.1016/0304-3940(88)90542-3]</ref>
 +
<ref name="QuilichiniDiabira2002">P. P. Quilichini, D. Diabira, C. Chiron, Y. Ben-Ari, H. Gozlan, Persistent epileptiform activity induced by low Mg2+ in intact immature brain structures, European Journal of Neuroscience, volume 16, issue 5, 2002, pages 850–860, ISSN [http://www.worldcat.org/issn/0953-816X 0953-816X], doi [http://dx.doi.org/10.1046/j.1460-9568.2002.02143.x 10.1046/j.1460-9568.2002.02143.x]</ref>
 +
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Latest revision as of 12:29, 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].

Age Male Female Pregnancy Lactation
Birth to 6 months 30 mg* 30 mg*
7–12 months 75 mg* 75 mg*
1–3 years 80 mg 80 mg
4–8 years 130 mg 130 mg
9–13 years 240 mg 240 mg
14–18 years 410 mg 360 mg 400 mg 360 mg
19–30 years 400 mg 310 mg 350 mg 310 mg
31–50 years 420 mg 320 mg 360 mg 320 mg
51+ years 420 mg 320 mg

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!

Food Milligrams

(mg) per serving

Percent

DV*

Almonds, dry roasted, 1 ounce 80 20
Spinach, boiled, ½ cup 78 20
Cashews, dry roasted, 1 ounce 74 19
Peanuts, oil roasted, ¼ cup 63 16
Cereal, shredded wheat, 2 large biscuits 61 15
Soymilk, plain or vanilla, 1 cup 61 15
Black beans, cooked, ½ cup 60 15
Edamame, shelled, cooked, ½ cup 50 13
Peanut butter, smooth, 2 tablespoons 49 12
Bread, whole wheat, 2 slices 46 12
Avocado, cubed, 1 cup 44 11
Potato, baked with skin, 3.5 ounces 43 11
Rice, brown, cooked, ½ cup 42 11
Yogurt, plain, low fat, 8 ounces 42 11
Breakfast cereals, fortified with 10% of the DV for magnesium 40 10
Oatmeal, instant, 1 packet 36 9
Kidney beans, canned, ½ cup 35 9
Banana, 1 medium 32 8
Salmon, Atlantic, farmed, cooked, 3 ounces 26 7
Milk, 1 cup 24–27 6–7
Halibut, cooked, 3 ounces 24 6
Raisins, ½ cup 23 6
Chicken breast, roasted, 3 ounces 22 6
Beef, ground, 90% lean, pan broiled, 3 ounces 20 5
Broccoli, chopped and cooked, ½ cup 12 3
Rice, white, cooked, ½ cup 10 3
Apple, 1 medium 9 2
Carrot, raw, 1 medium 7 2

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.)

Form Mg oxide Mg chloride Mg carbonate Mg citrate Mg gluconate Mg Glycinate (amino acid chelate) Mg Orotate Mg lactate Mg aspartate
Elemental Mg per 100mg 10mg 31g
Bioavailability Extremely poor (~4%[116], no better than placebo[117]). (effervescent form is better[118]) Good Good Good[119][117] Good Good[117] Good[116] Goo[116]
Solubility in water Extremely low (8.6mg/L) High Insoluble High[119] Moderate Good
Percentage absorbed (Mg depleted rats)[120] 48.4 48.8 43.8 50.1 56.8 47.9 46.8
Side effects Diarrhea GI Distress, Diarrhea GI Distress, Diarrhea GI Distress, Diarrhea GI Distress, Diarrhea Expensive

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].

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