Magnesium

Magnesium is a mineral that must be obtained in the diet and is required for life. It is one of the seven essential “macrominerals” that need to be provided by the diet in quantities of at least 100 milligrams per day.

Magnesium is required for the function of over 300 enzymatic reactions, including in energy metabolism where it plays a pivoted role. Magnesium is also required for the synthesis of fatty acids and proteins, proper insulin response, and the transmission of nerve impulses.

Magnesium deficiency is not rare. Dietary surveys consistently show that intakes of magnesium are lower than recommended amounts in the majority of Americans. Magnesium deficiency is particularly common in vulnerable populations, including people with gastrointestinal disease, pancreas infections, and liver disease. High doses of supplemented zinc without magnesium supplementation can also provoke a magnesium deficiency. Early signs of magnesium deficiency include fatigue, loss of appetite, nausea, vomiting, weakness, anxiety, and memory problems. Additional findings can include numbness and tingling, tics, cramps, insomnia, seizures, personality changes, and abnormal heart rhythms.

Magnesium is a very frequent therapy used for constipation. Magnesium is frequently used as a laxative for constipation, where it is often given at very-high dosing. Other gastrointestinal uses include “clean-outs” in preparation of the bowel for surgical or diagnostic procedures, and as an antacid for acid indigestion. Magnesium is also frequently recommended for the prevention of migraine headache. Three of four small, short-term, placebo-controlled trials found modest reductions in the frequency of migraines in patients given up to 600 mg per day of magnesium (https://www.ncbi.nlm.nih.gov/pubmed/19271946?dopt=Abstract). The authors of a review on migraine prophylaxis suggested that taking 300 mg magnesium twice a day, either alone or in combination with medication, can prevent migraines (https://www.ncbi.nlm.nih.gov/pubmed/18325296?dopt=Abstract).
Some people use magnesium for diseases of the heart and blood vessels including chest pain, irregular heartbeat, high blood pressure, high levels of “bad” cholesterol called low-density lipoprotein (LDL) cholesterol, low levels of “good” cholesterol called high-density lipoprotein (HDL) cholesterol, heart valve disease (mitral valve prolapse), metabolic syndrome, clogged arteries (coronary artery disease), stroke, and heart attack. Magnesium is also used for treating autism, seizures, attention deficit-hyperactivity disorder (ADHD), anxiety, chronic fatigue syndrome (CFS), Lyme disease, fibromyalgia, cystic fibrosis, alcoholism, mania, recovery after surgery, leg cramps at night and during pregnancy, diabetes, kidney stones, a long-term pain condition called complex regional pain syndrome, weak bones (osteoporosis), premenstrual syndrome (PMS), altitude sickness, urinary incontinence, a condition that causes burning pain and redness called erythromelalgia, restless leg syndrome, asthma, hay fever, and multiple sclerosis. Additional uses include high blood pressure during pregnancy and other pregnancy complications, to induce more rapid wound healing, and for preventing hearing loss and cancer. Athletes sometimes use magnesium to increase energy and endurance. This is only a partial list, as the use of magnesium is in very wide spread use in medicine.

Magnesium supplements are available over-the-counter in a variety of forms, including coupled with oxide, sulfate, chloride, carbonate, lactate, orotate, citrate, malate, glycinate, threonate, glutamate, aspartate, argininate, and taurate. The Supplement Facts panel on product labels declares the amount of only the magnesium in the product (elemental magnesium), not the weight of the entire magnesium-containing compound (e.g., magnesium oxide). The absorption of magnesium from different kinds of supplements varies, with magnesium coupled with organic and amino acids being absorbed better than magnesium coupled with oxide or sulfate. The glycinate form in particular is frequently used in many conditions, including to reduce anxiety, improve the quality of sleep and reduce fatigue. Glycine also conjugates a variety of toxic compounds, and hence facilitate their removal; see the section on glycine, itself an active ingredient in ActivNeeds.

Very-high doses of magnesium are routinely recommended for bowel conditions, and this mineral is considered to be generally non-toxic. Side effects are rare at usual doses used in supplementation other than nausea and/or loose stools. These issues usually are avoided by starting low and ramping up the dose, as well as taking with a meal. In addition, the oxide and glycine forms of magnesium rarely cause diarrhea.

Laboratory testing can reveal the presence of a magnesium deficiency, and this test is indicated in specific situations where magnesium deficiency is likely or suspected.

Therapeutic dosages of magnesium in functional bowel obstruction (pseudo-obstruction, severe functional constipation, obstipation) are oftentimes much higher (~900-1,000 mg/day in adults) than the dose provided in ActivNeeds (75 mg). A common dose used for migraine is 400-500 mg/day in adults. Thus, you may wish to speak to your health care provider regarding additional magnesium supplementation beyond ActivNeeds if you have or one of the conditions for which higher doses of magnesium supplementation is often recommended.