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Magnesium is a dietary mineral vital for healing & repair. Deficiencies of magnesium in developed countries is common and can result in a variety of symptoms from headache, muscle pain and tightness to fatigue, insomnia, and osteoporosis.
“Subclinical magnesium deficiency increases the risk of numerous types of cardiovascular disease, costs nations around the world an incalculable amount of healthcare costs and suffering, and should be considered a public health crisis“DiNicolantonio, 2018
Symptoms of magnesium deficiency
Deficiency in magnesium can cause a range of muscle, joint and nerve symptoms [Hashizume,1990] such as:
- Migraine / headaches / dizziness
- Muscle pain
- Muscle tightness/ rigidity, cramps, twitching and restless leg syndrome
- Muscle weakness
- Numbness / sensory disturbance (e.g. pins and needles)
Deficiency can also cause other symptoms such as constipation, fatigue, and insomnia and has been linked to a variety of health conditions including:
- Chronic fatigue syndrome
- Tremors, convulsions, seizures
IMPORTANT: Even in patients with severe magensium deficiencgy, clinical
signs and symptoms may be absent.
Am I deficient?
The intake of magnesium in people eating a western-style diet is consistently shown to be lower than recommended. In one study, 50-80% of US adults were shown to have a suboptimal magnesium intake [Costello 2016].
“because of chronic diseases, medications, decreases in food crop magnesium contents, and the availability of refined and processed foods, the vast majority of people in modern societies are at risk for magnesium deficiency“DiNicolantonio, 2018
Deficiency is more likely in the elderly and those with chronic diseases (such as diabetes, hypertension, coronary heart disease, and osteoporosis.
The use of some medications can also result in decreased levels of magnesium. These include antacids, antibiotics, anti-hypertensives (for high blood pressure), Digoxin (heart medication), oral contraceptives and HRT.
The likelihood that you are deficient in magnesium increases if you suffer with more than one sign of deficiency (see list of symptoms above) but remember, even in patients with severe magensium deficiencgy, clinical
signs and symptoms may be absent.
Magnesium and pain
Magnesium and low back pain
In 2013, a study was conducted to assess the effects of magnesium on patients with chronic back pain with a neuropathic component (nerve involvement). Patients were given 2-weeks of intravenous magnesium infusion followed by 4 weeks of oral magnesium supplementation. After 6 months it was found that not only was pain reduced (37% average decrease) but movement of the lumbar spine (low back) was also increased [Yousef, 2013].
Magnesium and migraine
Multiple studies have shown that magnesium supplementation may be useful for the management or prophylaxis of migraine headaches [Peikert, 1996; Koseoglu; 2008, Shin, 2020].
Magnesium and tension headache
Magnesium treatment has also been reported to improve the symptoms of episodic or chronic tension-type headaches for at least one year [Grazzi, 2005; 2007].
Magnesium for bone health and osteoporosis
Magnesium is an important mineral in bone health and some studies suggest that increasing magnesium intakes from food and supplements may increase bone mineral density. For example, in a study of postmenopausal women with osteoporosis it was found that 290 mg/day of magnesium citrate for 30 days suppressed bone turnover compared with placebo, suggesting that bone loss decreased [Aydın, 2010]. Another study showed that 300mg magnesium oxide daily for one-year, increased bone mineral content in girls with low dietary magnesium intake [Carpenter, 2006].
Magnesium for pain relief and injury recovery
If you suffer with one or more of signs of magnesium deficiency try a 1-month trial of increased magnesium-rich food intake (see below) along with magnesium supplementation and review your symptoms. You can download the ‘Modified Multiple Symptoms Questionnaire’ and complete it before and after your trial to help you do this.
Best food sources of magnesium
The best food sources of magnesium are:
- Whole grains
- Nuts and Seeds
- Green leafy vegetables
Magnesium is ‘bulky’ meaning most multivitamins only contain a small amount. It is therefore usually better to supplement magnesium separately.
Chelated forms like glycinate, malate and citrate are better absorbed. Oxide, chloride, and sulphate have lower absorption and have a greater risk of gastrointestinal side effects. Citrate was found to have a three-fold higher bioavailability relative to oxide [Lindberg, 1990; Walker, 2003].
As with any dietary supplement, the quality of the product is important. Some magnesium products were found to contain lead [ConsumerLab.com]. Look for supplements that have been third party tested for contaminants.
Start with 100-200mg per day with food. Increase to 400-500mg per day (ideally split between meals) if tolerated. If you experience loose stools / diarrhoea reduce the dose.
Who shouldn’t take magnesium
Magnesium supplementation is usually safe but may be problematic in those with kidney or heart disease.
- , R. B., Elin, R. J., Rosanoff, A., Wallace, T. C., Guerrero-Romero, F., Hruby, A., … & Van Horn, L. V. (2016). Perspective: the case for an evidence-based reference interval for serum magnesium: the time has come. Advances in Nutrition, 7(6), 977-993.
- DiNicolantonio, J. J., O’Keefe, J. H., & Wilson, W. (2018). Subclinical magnesium deficiency: a principal driver of cardiovascular disease and a public health crisis. Open heart, 5(1), e000668.
- Lindberg, J. S., Zobitz, M. M., Poindexter, J. R., & Pak, C. Y. (1990). Magnesium bioavailability from magnesium citrate and magnesium oxide. Journal of the American college of nutrition, 9(1), 48-55.
- Hashizume, N., & MORI, M. (1990). An analysis of hypermagnesemia and hypomagnesemia. Japanese journal of medicine, 29(4), 368-372.
- Rosanoff, A., Weaver, C. M., & Rude, R. K. (2012). Suboptimal magnesium status in the United States: are the health consequences under-estimated? Nutrition reviews, 70(3), 153-164.
- Scopacasa, F., Horowitz, M., Wishart, J. M., Need, A. G., Morris, H. A., Wittert, G., & Nordin, B. E. C. (1998). Calcium supplementation suppresses bone resorption in early postmenopausal women. Calcified tissue international, 62(1), 8-12.
- Shin, H. J., Na, H. S., & Do, S. H. (2020). Magnesium and pain. Nutrients, 12(8), 2184.
- Yousef, A. A., & Al‐deeb, A. E. (2013). A double‐blinded randomised controlled study of the value of sequential intravenous and oral magnesium therapy in patients with chronic low back pain with a neuropathic component. Anaesthesia, 68(3), 260-266.
- Walker, A. F., Marakis, G., Christie, S., & Byng, M. (2003). Mg citrate found more bioavailable than other Mg preparations in a randomised, double‐blind study. Magnesium research, 16(3), 183-191.
This post was written by Steffen Toates. Steffen is a chiropractor at Dynamic Health Chiropractic in Jersey CI. For more information about Steffen click here.