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Magnesium Deficiency: An under-recognised problem


Few people are aware of the enormous role magnesium plays in our bodies. Emerging evidence confirms that nearly two-thirds of the population in the western world is not achieving the recommended daily allowance for magnesium, a deficiency problem contributing to various health conditions [1].

Deficiencies also impact kids and even kids with obesity who may consume an excess of energy but still not be meeting all of their micronutrient needs’ [4].

Magnesium is the fourth most common mineral in the human body after calcium, sodium, and potassium and is the second most common intracellular cation after potassium.

Magnesium is an essential element required as a cofactor for over 300 enzymatic reactions and is thus necessary for the biochemical functioning of numerous metabolic pathways, including energy production, protein synthesis, muscle contractions, nerve function, blood glucose control, synthesis of our DNA [2].

Magnesium is required for conversion of vitamin D into its active form which, in turn, supports calcium absorption and metabolism, as well as normal parathyroid hormone function.

Recommended Daily Allowance (RDA) of magnesium is 400-420 mg/day for adult males, 310-320 mg/day for non-pregnant adult females, and 350 mg/day for pregnant females [2].

Many nutritional experts though feel the ideal intake for magnesium should be based on the body weight (e.g., 4–6 mg per kg/day).

Signs and Symptoms of low levels of Mg:

Low levels of magnesium have been associated with a number of chronic and inflammatory diseases, such as Alzheimer’s disease, asthma, attention deficit hyperactivity disorder (ADHD), insulin resistance, type-2 diabetes mellitus, hypertension, cardiovascular disease (e.g., stroke), migraine headaches, and osteoporosis [3]

Clinical signs of Mg deficiency are usually totally absent (chronic latent, intracellular deficit).

When present they can include anxiety, fatigue, body weakness, tremor; muscle twitch, difficulty in swallowing, poor memory, constipation, abnormal heartbeat, depression, agitation, psychosis, rapid involuntary movements of the eye, and seizures.

How to measure Mg level:

The most commonly used test to measure magnesium level is the total serum magnesium concentration (SMC). However with less than 1% of total body Mg found in the serum (53% in bone, 27% in muscle, 19% in soft tissues) and as the body tries to maintain a constant level of Mg in the serum, an individual can have a SMC within normal range and still be profoundly deficient.

Causes of deficiency:

Chronic diseases, medications, decreases in food crop magnesium contents, and the availability of refined and processed foods causes the vast majority of people in modern societies are at risk for magnesium deficiency.

  • Since 1940 there has been a tremendous decline in the content of magnesium in our foods. In the UK for example, there has been loss of magnesium in beef (−4 to −8%), bacon (−18%), chicken (−4%), cheddar cheese (−38%), parmesan cheese (−70%), whole milk (−21%) and vegetables (−24%) [6-7].

  • Refined foods are depleted of magnesium during their processing: white flour (−82%), polished rice (−83%), starch (−97%) and white sugar (−99%).[8]

  • Since 1968 the magnesium content in wheat has dropped almost 20%, which may be due to acidic soil, yield dilution and unbalanced crop fertilisation (high levels of nitrogen, phosphorus and potassium, the latter of which antagonises the absorption of magnesium in plants). [7-8] Also the expansion of monoculture agricultural techniques consuming specific nutrients and usage of pesticides have the propensity to chelate minerals also contribute to the decrease of content of Mg in soil and some crops.

  • Cooking and boiling of produce result in a significant decline of the food's Mg content

  • Reduced gastrointestinal absorption of Mg occurs in the face of vitamin D deficiency, a common problem in western cultures.

  • Medications in common usage (e.g., some antibiotics, antacids, and hypertensive drugs) diminish absorption of Mg.

  • There is excess excretion of Mg with alcohol use and the presence of type 1 or type 2 diabetes.

  • Smoking cigarettes reduces plasma Mg concentration

  • Magnesium absorption is reduced with aging by as much as 30%

  • Excessive sweating, vomiting or chronic diarrhea

  • Increased requirements (pregnancy, stress)

Food rich in Magnesium [9]:

Bottom line, seeds and nuts, leafy greens (e.g kale, spinach, collard greens, turnip greens and mustard greens) and legumes contains substantial amount of Magnesium.

Make sure to eat a balanced diet and up your intake of the foods listed above to keep your health robust and your body satisfied.

Supplements:

There are so many different forms of Magnesium available on the market that it can be a bit confusing in which supplement to take.

Common forms are magnesium oxide, magnesium hydroxide, magnesium chloride, magnesium citrate, magnesium taurate, magnesium orotate, glycinate, L-Threonate as well as other amino acid chelates.

Not all forms are absorbed in the same proportion (vary in bioavailability) and have the same effects.

Magnesium Threonate:

Created to cross the blood-brain barrier

May be the best magnesium supplement for improving brain function. Research published in The Journal of Neuroscience shows it may effectively treat memory loss and cognitive impairment associated with Alzheimer’s [10]

May help to diminish symptoms of hyperactivity, anxiety, depression.

Low bioavailability

Magnesium Glycinate:

Easily absorbed, made from magnesium and the amino acid glycine

One of the gentlest supplements on the stomach

Research shows benefit in depression

Promotes relaxation and sleep

May reduce nerve pain

Magnesium Orotate :

Well absorbed

Contains orotic acid and may be useful in heart failure

Magnesium Citrate

Magnesium combined with citric acid. This may have a laxative effect in some cases when taken in high doses but is otherwise safe to use for improving digestion and preventing constipation.

May help prevent kidney stone

Magnesium Malate

Magnesium combined to malic acid.

For those having issues with energy production, a magnesium malate supplement may be effective for helping with chronic fatigue syndrome and/or fibromyalgia.

Not to be taken at night

Magnesium Oxide

bioavailability is poor. Contains a lot of magnesium by weight but has a bioavailability of only 4% in tablet form.

This form is found in many magnesium supplements and should be avoided.

Magnesium Chloride

is a form of magnesium for topical use. The skin is a great way to increase magnesium levels and bypass using the gut

Magnesium Sulfate (epsom salts)

Added to the bath (epsom salts) soothe sore muscles.

A relaxing epsom soak also draws toxins out of your pores.

Though these are generally well-tolerated, they may not be safe for people who take certain diuretics, heart medications or antibiotics.

Only use supplements under guidance of a qualified professional.

Conclusion:

Magnesium is an essential mineral necessary for the proper functioning of body cells.

In order to prevent chronic diseases, we need to change our mindset away from exclusively treating acute illness and instead focus more on treating the underlying causes of chronic diseases, such as magnesium deficiency.

References:

[1] R. Horton, “The neglected epidemic of chronic disease,” The Lancet, vol. 366, no. 9496, article 1514, 2005.

[2] Schwalfenberg GK, Genuis SJ. The Importance of Magnesium in Clinical Healthcare. Scientifica (Cairo). 2017; 2017:4179326.

[3] Gröber U, Schmidt J, Kisters K. Magnesium in Prevention and Therapy. Nutrients. 2015;7(9):8199-226. Published 2015 Sep 23. doi:10.3390/nu7095388

[4] Gillis L, Gillis A. Nutrient inadequacy in obese and non-obese youth. Can J Diet Pract Res2005;66:237–42. doi:10.3148/66.4.2005.237

[5] DiNicolantonio JJ, O'Keefe JH, Wilson W. Subclinical magnesium deficiency: a principal driver of cardiovascular disease and a public health crisis. Open Heart. 2018;5(1):e000668. Published 2018 Jan 13. doi:10.1136/openhrt-2017-000668

[6] Nutrition and Health. The mineral depletion of foods available to us as a nation (1940–2002) – a review of the 6th edition of mccance and widdowson*. UK: A B Academic Publishers, 2007;19:21–

[7] http://www.mineralresourcesint.co.uk/pdf/Mineral_Depletion_of_Foods_1940_2002.pdf

[8] 62. Guo W, Nazim H, Liang Z, et al. Magnesium deficiency in plants: an urgent problem. Crop J2016;4:83 91. doi:10.1016/j.cj.2015.11.003

[9] https://ods.od.nih.gov/factsheets/%20magnesium-HealthProfessional/

[10] Li et al., Elevation of Brain Magnesium Prevents and Reverses Cognitive Deficits and Synaptic Loss in Alzheimer's Disease Mouse Model, Journal of Neuroscience 16 April 2014, 34 (16) 5733

#Magnesium #chronicdisease #supplements

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