What you need to know about Magnesium Deficiency
Magnesium deficiency may sound like a rather benign problem, but in fact, it is a deficiency that can be potentially life threatening. Estimates show that 2/3 of the American population are consuming less than the RDA requirements, and 20% consume less than 50% of the RDA requirements. (1) Our SAD, or Standard American Diet, has become quite nutrient deficient, with processed foods, and fast foods being the go-to foods for many families. These foods are nutrient poor, and vital nutrients including minerals, vitamins, and other key nutrients have been stripped from foods through processing; are missing because they are not even real foods (that bag of orange colored salty crunchy snacks that is so hard to put down), or are low in whole foods due to a decline in nutrients in the soil itself.
Magnesium is involved in over 300 biochemical reactions (2) and one source evens mentions up to 1300! It is not produced by our body, so ingestion is necessary. Most of the magnesium is stored in our bones, followed by the muscles and tissue, leaving 1% to circulate in our blood.
So why is magnesium deficiency potentially life threatening?
Magnesium is needed to maintain electrical charge of cells, specifically muscles and nerve cells, along with potassium. Too little, and your heart can have irregular rhythms, that can be potentially life threatening, and even lead to a heart attack by causing spasms of the coronary arteries (the blood vessels that feed the heart itself). No need to panic, most people’s levels of deficiency are not to this point.
Who is most at risk?
- Those with a gastrointestinal disease are at high risk of deficiency due to loss through frequent loose stools, poor absorption in the gut from diseases like Crohns and Celiac’s, or gastric surgeries where parts of the small intestines have been removed (which is where most nutrient absorption occurs).
- Diabetics are also at high risk, partially due to loss from increased urination caused by high glucose levels. Low magnesium levels can lead to insulin resistance, and supplementation of 400-500 mg per day can improve response to insulin and glucose tolerance. (3) As much as 50% of diabetics are Mag deficient, and those with complications such as retinopathy and neuropathy are more likely to be deficient (3).
- Heavy daily alcohol use (especially alcoholics) can also cause a high risk of deficiency due to a combination of poor dietary intake of magnesium rich foods, poor absorption, and loss due to diarrhea and vomiting.
- The elderly are also at risk due to lower dietary intake of nutrient dense foods. Absorption of nutrients in the gut also decreases with age, and magnesium loss in the urine increases with age, all contributing to the higher risk of magnesium depletion (4).
Other causes of Magnesium depletion:
- Medications including diuretics (water pills), proton pump inhibitors, such as omeprazole, pantoprazole and esomeprazole, and birth control pills.
- Vitamin D, calcium, and Zinc supplementation all decrease magnesium absorption. So if you are supplementing with these minerals, try to add Magnesium to the mix. They work together in nature, so they should be consumed together.
- Anyone with frequent loose stools or acute diarrhea from an illness will become deficient, and if you have experienced this before, you are probably familiar with the muscle cramps that soon followed, caused by a drop in magnesium and potassium.
- Pancreatitis, either from alcohol consumption or high-fat diet, and kidney disease are also risk factors for magnesium deficiency. The kidneys play a major role in the regulation of magnesium in the blood, working to maintain a safe range. Elevated calcium and phosphorus in kidney disease can drive down magnesium levels. (Contrast with kidney failure where magnesium levels are either normal or high).
- Excessive sweating, drinking coffee, soda or alcohol can also play a part in deficiency.
Signs and Symptoms of Magnesium Deficiency
Signs and Symptoms can include muscle weakness and spasms, headaches, insomnia, restless leg syndrome, PMS (mag supplementation can relieve many PMS symptoms!), confusion, irritability, seizures, depression, chronic fatigue, constipation, loss of appetite, poor stress tolerance, asthma, high blood pressure and heart disturbances including palpitations, irregular rhythms and fast heartbeat. Osteopenia or osteoporosis can not only be a sign of vitamin D deficiency, but also magnesium deficiency. Remember, these minerals go together, and with so many people taking Calcium plus Vitamin D, and leaving out the magnesium, the body is just going to pull it from the bones, causing weakening of the bone cells or osteoblasts. So Calcium, Vitamin D, and Magnesium always go together.
Replacement through Food Sources
Whole food sources are always the best way to obtain any key nutrient. Here are some of the best sources of magnesium: Nuts and seeds are very high in magnesium and raw versions are higher, levels are a little lower from roasting. Of these, pumpkin seeds, sesame seeds, and brazil nuts are the highest. Leafy greens such as Swiss chard, collard greens, spinach, and beet greens. Legumes including soy, pinto, lima, and kidney beans. Other foods include kelp, wheat bran and wheat germ, avocados, molasses; whole grains such as brown rice, millet, and rye. Mineral water also contains magnesium; amounts vary depending on the source. There are many more whole foods that contain magnesium. For a complete listing along with their values, you can visit http://www.whfoods.com/genpage.php?tname=nutrient&dbid=75
Replacement through Supplementation
Not all forms of magnesium are created equal, nor do they have the exact same effect on the body. Some forms are absorbed better than others. The most common forms of magnesium at drug stores are Mag Oxide and Mag Sulfate, which are the poorest absorbed by the body. As a nurse, I have seen this first hand, having many patients on Mag Oxide supplementation and they would continue to have deficiencies. For most people, magnesium glycinate, maleate, and aspartate are the best absorbed. These should be purchased in capsule, gel cap or powder/liquid form for optimal absorption. Tablets, in general, are poorly absorbed due to binders. For someone that also has constipation, Magnesium Citrate is the best option. Mag Calm or Natural Calm are popular nighttime supplements containing Mag Citrate and come in a flavored powder to be mixed with water and consumed at night to help with sleep, muscle cramps, and constipation. This is also a good option for children. Milk of Magnesia is a common over the counter medication used for constipation. For those who have issues with headaches, anxiety, brain fog, poor memory and stress, Magnesium Taurate or L- Threonine are best options.
So what about those who are not absorbing well through their digestive systems? Mag Oil spray is an option. Mag Oil spray works well to rub directly on sore muscles, or muscle spasms, at the base of the head and neck for migraines or tension headaches, or just for those whose digestive systems are in rough shape and are not absorbing nutrients or unable to swallow pills. Amounts vary per brand, some are as much as 115 mg per spray, but please read labels carefully.
My favorite of all forms of magnesium is Epsom salts! Who doesn’t love a good long soak in the bath? 1 cup of Epsom salts, otherwise known as Mag Sulfate, blended into a warm bath is a relaxing way to soothe sore tight muscles, ease tension and stress, and absorb a little extra magnesium in the process. Generally, you should soak for about 20 minutes to absorb the magnesium. To make for a more relaxing experience, I add either Lavender essential oil for a calming effect or eucalyptus and marjoram essential oils for muscle pain and tightness to the Epsom salts. If using essential oils, always add them first to the salts and blend well, then add to the bath.
Now regardless of what form of magnesium you choose, there is one other key nutrient needed to aid in getting the magnesium into the cell, to actually get the job done, and that is vitamin B6. A minimum of 25 mg of B6 is needed, so either a good quality multivitamin or B-complex, or once again, a high-quality diet with whole foods and grains should provide enough. The foods high in Magnesium are pretty much the same foods high in Vitamin B6.
Testing for Magnesium Levels
Most blood tests test serum magnesium and since only 1% of our magnesium is in our blood, this is not the best test. However, within the blood are red blood cells and a more accurate blood test is RBC magnesium level, testing the magnesium in the red blood cells or erythrocyte magnesium level. Labs do run this test, but it may require a little more investigation. Normal range for an adult is 1.8-2.6 milligrams per deciliter, and 1.7-2.1 for a child for serum blood, the most standard lab run. (5).
How much do I need?
Here are the Recommended Dietary Allowances (RDAs)
Child 4-8: 130 mg
Youth 9-13: 240 mg
Teenage 14-18: 410 mg male, 360 mg female, 400 mg pregnant.
Adult age 19-30: 400 mg male, 310 mg female, 350 mg pregnant.
Adult age 31-50: 420 mg male, 320 mg female, 360 mg pregnant
Adult age 51+ : 420 mg male, 320 mg female.
Source for above: https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/
Keep in mind that RDA by definition is the minimum required to avoid disease and serious illness. It is not necessarily optimum levels. So if you have symptoms of low levels, or are among a high-risk group mentioned above, talk to your health care provider and have your levels checked. You can try some gentle supplementation if there is no kidney disease. If you have any of the mentioned risk factors, then you may benefit from supplementation. Try, and see how you feel. If you take too much and have good kidney function, your kidneys will filter it out in the urine. Ideal supplementation should start at 400 mg a day, and work up to 800 to 1200 mg per day if a significant deficiency is present, but these higher amounts should be monitored by healthcare provider. And don’t forget to eat a healthy whole food diet; supplementation should not be your only source!
Precautions for anyone on high blood pressure medication taking magnesium supplementation!
While magnesium supplementation is important for anyone with high blood pressure and/or heart disease, Magnesium may drop your blood pressure too low when combined with blood pressure medications. You should be monitoring your blood pressure daily and keeping a log, and consult your health care provider for further guidance regarding your medications.
Precautions with other medications including those used for osteoporosis, such as alendronate, some antibiotics including ciprofloxacin, levofloxacin, and doxycycline. These medications should be separated by at least 2 hours. There are also other medications that can interact when taken with magnesium so please read labels or check with your pharmacist.
Other Interesting Data:
Adults who consume less than the RDA dietary requirements were 1.5-1.75 times more likely to have elevated C – reactive protein (1), which is a marker for inflammation and heart disease. One study shows a 38% reduced risk of sudden cardiac death in individuals with higher levels of magnesium compared to those with suboptimal levels (4) Healthy magnesium levels also lowered risk of ischemic heart disease (4) and helped those with congestive heart failure live longer.
It seems like a whole lot of physical ailments can be treated with such a simple approach! That is the beauty of whole food nutrition, and eating a balanced diet, and avoiding heavily processed foods, coffee, soda and alcohol that interfere with absorption of magnesium and other key nutrients. Imagine how good people can feel with just changing their diet to whole foods. I don’t have to, I live it and am a firm believer in the healing power of food and key nutrients.