Magnesium is one of the most abundant and essential nutrients in the body. Most magnesium is in our bones, soft tissue, and muscles. Over 300 enzymatic reactions rely on magnesium as a cofactor, including glucose and blood pressure regulation, energy production, formation of DNA and RNA, and support detoxification. It also plays an active role in transporting calcium and potassium ions across the cell membrane and is, therefore, essential for nerve impulse conduction, muscle contraction, and normal heart rhythm.
Magnesium deficiency is common despite its availability in several dietary resources. Common food sources of magnesium include green leafy vegetables, legumes, seeds, nuts, and whole grains. Medications that can increase the risk of magnesium deficiency include proton pump inhibitors, loop and thiazide diuretics, nephrotoxic drugs (aminoglycoside antibiotics, cisplatin, and digoxin), corticosteroids, oral contraceptives, and macrolide antibiotics (azithromycin).
Certain conditions can increase the risk of magnesium deficiency by the following mechanisms: an increase in the amount of magnesium excreted in the urine, reduced magnesium absorption via the gut, or intracellular shift of magnesium. Individuals with inflammatory bowel disease, celiac disease, chronic diarrhea, chronic alcoholism, metabolic syndrome, diabetes, hypertension, and obesity all have an increased risk of magnesium deficiency.
Symptoms of magnesium deficiency can include:
- Loss of appetite
- Nausea or vomiting
- Fatigue
- Muscle weakness
- Numbness
- Tingling
- Muscle cramps or spasms
- Anxiety
- Heart palpitations
- Mood disorders.
These symptoms are broad, and it is possible to be magnesium deficient and not experience symptoms. The best way to evaluate your magnesium levels is to have a blood test. I prefer to order RBC magnesium on my patients because this provides a better picture of their magnesium level than serum labs. Hair, urine, and micronutrient analysis are other ways to evaluate magnesium levels.
There are several different forms of magnesium, each with its own unique benefits. I will briefly review some common ones here:
Magnesium Citrate – well absorbed, mostly used to treat constipation.
Magnesium Glycinate – gentle on the stomach and does not cause GI effects like other magnesium compounds. It has a relaxing effect and is commonly used to decrease stress, anxiety, and insomnia.
Magnesium oxide – this form is poorly absorbed and causes GI distress, such as diarrhea, heartburn, and indigestion. It is often used for constipation.
Magnesium chloride – easily absorbed and can help alleviate pain and digestive issues such as constipation and heartburn.
Magnesium maleate – easily absorbed, gentle on the digestive tract, also commonly used for chronic pain.
Magnesium Orotate – easily absorbed, can be used for indigestion or heartburn and demonstrates cardiovascular benefits. However, this form can be expensive.
Magnesium Taurate – is easily absorbed and has some benefits in treating those with hypertension, preeclampsia, and insulin resistance.
Magnesium Sulfate – commonly found in Epson Salt and has a relaxing benefit.
Magnesium Theronate – is unique in that it crosses the blood-brain barrier. It is being promoted for its benefits on memory and cognition.
Magnesium supplementation is generally safe and tolerated by most people. Individuals with kidney disease, heart block, bleeding disorders, and myasthenia gravis should speak with their doctors before using magnesium. Common symptoms of magnesium can include diarrhea, nausea, and abdominal cramping. Serious complications of excess magnesium can include irregular heartbeat, low blood pressure, and difficulty breathing.
Magnesium is essential to our health, and most people are magnesium deficient. Speak to your PCP about how magnesium can benefit you. If you want a clinician who utilizes an integrative approach to manage your health, call or text us at 813-669-3084.
