Magnesium
Magnesium is a mineral that must be obtained in the diet in relatively large quantities. Magnesium is required for the function of over 300 enzymatic reactions, including in energy metabolism where it plays a pivotal role. However, magnesium is deficient in many, perhaps most, diets. Neurodevelopmental disorders often are associated with an elevated excitatory-to-inhibitory neurotransmission balance, promoting increased excitatory behaviors (e.g., anxiety, loss of focus) and possibly regression. As magnesium is an agonist for (turns on) GABA receptors, one of the chief inhibitory pathways in the nervous system, and an antagonist for (turns off) NMDA glutamate receptors, one of the chief excitatory pathways in the nervous system, magnesium can help to re-normalize this balance. Magnesium glycinate is a highly bioavailable form of magnesium that is often recommended for anxiety and hyperactivity based on the additional calming effects of glycine. As anxiety and hyperactivity are common side effects of leucovorin, magnesium glycinate was added to FolinicNeeds® to prevent these effects. Side effects are rare at usual doses used in supplementation other than nausea and loose stools, which is unlikely given the low dosing in FolinicNeeds®.
Magnesium in FolinicNeeds®
Magnesium glycinate is added to FolinicNeeds® because of its calming nature, in order to counteract the hyperactivity that is a common side effect with leucovorin. Side effects are unexpected at the doses used in FolinicNeeds®.
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 glycinate). The absorption of magnesium from different kinds of supplements varies, with magnesium coupled with organic and amino acids (e.g., glycine) being absorbed better than magnesium coupled with oxide or sulfate. The glycinate form in particular is frequently used to treat anxiety and hyperactivity.
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 taking with a meal. In addition, the glycinate form is provided in FolinicNeeds®, which is less likely to 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) is oftentimes much higher (~1,000 mg/day in adults) than the 15 mg dose provided in each FolinicNeeds® chewable. 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 FolinicNeeds® if your child has or one of the conditions for which higher doses of magnesium supplementation is often recommended.
How and Why is Magnesium Used in FolinicNeeds®
Magnesium is added to FolinicNeeds® because of its calming nature, in order to counteract the hyperactivity that is a common side effect with leucovorin. This calming activity is likely in large part to magnesium’s effects with GABA and NMDA glutamate receptors. In FolinicNeeds®, magnesium is provided in the glycinate form as glycine is calming as well. Side effects are unexpected at the doses used in FolinicNeeds®.
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