Magnesium – an essential mineral for optimal health

Words: 1884

Reading time: 10 min

Although the importance of magnesium for overall health is often stated, statistics show that almost 20% of people in Europe do not get enough of this mineral, necessary for the proper functioning of the body, in their daily diet. Repeated restrictive dieting, unbalanced diets, skipping meals, and poor eating habits in general are all factors that can result in magnesium deficiency.

The body’s magnesium needs change over a lifetime. The latest recommendations state that an average healthy adult needs 375 mg of magnesium per day. However, at certain stages of life and in certain conditions, higher amounts of this mineral are needed. Pregnant women, professional and recreational athletes, the elderly, diabetics, and children often need more magnesium.

How is magnesium distributed in the body?

Magnesium is the fourth most abundant mineral in the human body, and is present throughout it. All the cells in the body contain it and need it to function. An adult human body contains about 25 g of magnesium, 50% to 60% of which is in the bones, while most of the rest is in soft tissues. Blood serum contains less than 1% of the total magnesium in the body, and its levels are strictly regulated by the body.

Magnesium availability in the body

Magnesium levels in the body are regulated by absorption and excretion. Magnesium is absorbed in ionised form, most commonly in the ileum, through paracellular transport. The percentage of magnesium absorbed is inversely proportional to the amount of magnesium consumed. With normal dietary intake, 40% to 50 % of magnesium is absorbed. Inorganic forms of magnesium have lower bioavailability than organic ones. Diets rich in phytic acid and phosphates reduce absorption, although the clinical relevance of this fact is unclear.

Roles of magnesium

One of the main roles of magnesium is that of a cofactor – an auxiliary molecule – in the biochemical reactions that are constantly being carried out by enzymes. Magnesium is involved in more than 600 reactions in the body, including:

Muscle and nerve function: magnesium is essential for the contraction and relaxation of muscles, the transmission of nerve impulses, and for keeping the nervous system healthy.
Energy production: magnesium participates in the metabolism of carbohydrates, fats, and proteins, as well as in the production of adenosine triphosphate (ATP), which is the main source of energy in cells.
Protein synthesis: magnesium is involved in the synthesis of proteins, which are the building blocks of all body tissues.
Blood sugar levels regulation: magnesium helps to regulate blood sugar levels and insulin sensitivity.
Maintaining bone health: magnesium is important for maintaining bone structure and strength, and the absorption of calcium.
Blood pressure regulation: magnesium aids blood vessel relaxation and helps maintain healthy blood pressure.
DNA and RNA synthesis: magnesium is essential for the synthesis of DNA and RNA, the genetic material in cells.
Nutrient metabolism: magnesium has an important role in the metabolic activation and utilisation of vitamin D, B vitamins (e.g. thiamine), and glutathione.

Who needs more magnesium?

The following groups of people are at higher risk of magnesium deficiency, as they usually do not consume enough or have medical conditions (or take medication) that inhibit the absorption of magnesium from the intestine, or increase the loss of magnesium from the body.

People with gastrointestinal diseases

Chronic diarrhoea and impaired fat absorption due to Crohn’s disease, gluten enteropathy, and enteritis can cause magnesium levels to decrease over time. Resection or gastric bypass, especially of the ileum, usually leads to malabsorption and loss of magnesium.

People with type 2 diabetes

People with insulin resistance and/or type 2 diabetes may also experience magnesium deficiency and increased urinary excretion of magnesium. The loss of magnesium is most likely caused by higher glucose concentrations in the kidneys, resulting in increased urinary excretion.

People with alcohol use disorder

Magnesium deficiency is common in people with chronic alcoholism. In this group, reduced magnesium levels may be due to poor diet and nutritional status, digestive problems including vomiting, diarrhoea, and steatorrhea (oily stools) resulting from pancreatitis, renal dysfunction with excessive urinary excretion of magnesium, phosphate deficiency, vitamin D deficiency, acute alcoholic ketoacidosis, and hyperaldosteronism following liver disease.

Older adults

The average dietary intake of magnesium is lower in older adults than in younger adults. Moreover, intestinal absorption of magnesium decreases with age, while renal excretion increases. Older adults are also more likely to have chronic diseases or take medications that affect magnesium levels, which may increase the risk of magnesium loss.

Important roles of magnesium

Magnesium and depression

Since magnesium plays a key role in brain function and mood, low levels of magnesium are associated with an increased risk of depression. A 2020 review study found that stress can deplete magnesium stores, increasing susceptibility to stress and depression. A six-week study with 126 participants found that a daily intake of 248 mg of magnesium reduced depression and anxiety symptoms, regardless of levels of magnesium in the body.

Magnesium and blood sugar levels

According to studies, around 48% of people with type 2 diabetes have low levels of magnesium in their blood, which can affect the body’s ability to regulate blood sugar levels effectively. Research also shows that people who consume more magnesium have a lower risk of developing type 2 diabetes.

Magnesium and sleep quality

Magnesium regulates several neurotransmitters that affect sleep, for example gamma-aminobutyric acid (GABA). A study of almost 4,000 adults linked increased intake of this mineral with improvements in sleep quality and duration. Other studies have also shown that magnesium can lower serum levels of the stress hormone cortisol, resulting in a calming effect on the central nervous system and potentially improving sleep.

Magnesium and ADHD

Attention deficit hyperactivity disorder (ADHD) is the most common mental disorder in clinical samples of children and adolescents referred to children’s mental health centres. Dietary factors may play an important role in the aetiology of this disorder. Several studies have shown that children with ADHD have reduced serum and erythrocyte magnesium levels and reduced Mg²⁺-ATPase activity. Findings from several studies suggest that magnesium supplementation (e.g. 6 mg/kg of bodyweight per day) may be beneficial in the management of ADHD.

Magnesium and Alzheimer’s disease

Alzheimer’s disease (AD) is the most common cause of dementia. It is characterised by significant synaptic loss and reduced cognitive function. Recent studies have shown that levels of brain magnesium, serum magnesium, and ionised magnesium are lower in AD patients. However, the exact role of magnesium in the pathogenesis of AD remains unclear. In mice, chronic dietary magnesium deficiency damages memory, while treating dementia patients with dietary magnesium improves memory.

Magnesium and osteoporosis

Magnesium is involved in bone formation and influences the function of osteoblasts and osteoclasts. It also affects the levels of parathyroid hormone and the active form of vitamin D, which are the main regulators of bone homeostasis. Several population studies have found a positive association between magnesium intake and mineral bone density in both men and women. Other studies have shown that women with osteoporosis have lower levels of serum magnesium than those with osteopenia and those without either osteoporosis or osteopenia. These and other findings suggest that magnesium deficiency may be a risk factor for osteoporosis.

How does magnesium reduce tiredness and fatigue?

Magnesium is a cofactor in the production of adenosine triphosphate (ATP), the primary energy source in our cells. Without sufficient magnesium, the energy production process is compromised, resulting in fatigue and lethargy. Magnesium is essential for the proper contraction and relaxation of muscles. Insufficient magnesium can lead to muscle cramps, weakness, and a general feeling of fatigue. The nervous system also needs magnesium to transmit signals between nerve cells. A lack of magnesium can disrupt this communication, contributing to feelings of tiredness and mental exhaustion. Magnesium is also involved in the regulation of neurotransmitters that influence sleep patterns. Its deficiency can worsen sleep quality, contributing to daytime fatigue. It helps regulate the body’s response to stress by regulating the release of stress hormones. In periods of chronic stress, magnesium levels can decrease, further contributing to feelings of tiredness and fatigue.

Magnesium deficiency

Magnesium deficiency is relatively common and can cause various health problems. Its most common symptoms include:

General symptoms: anxiety, lethargy, weakness, restlessness, depression, dysmenorrhoea, hyperactivity, headache, irritability, low stress tolerance, loss of appetite, nausea, sleep disturbances, reduced athletic performance.
Muscular system: muscle cramps, foot cramps, leg cramps, facial muscle cramps, jaw and calf cramps, back pain, neck pain, bladder cramps, tetany due to magnesium deficiency.
Nervous system: nervousness, migraine, depression, nystagmus, paresthesia, poor memory, seizures, tremor, dizziness.
Cardiovascular system: risk of arrhythmias, supraventricular or ventricular arrhythmias, hypertension, coronary spasm, reduced heart muscle function, sensitivity to digitalis.
Digestive system: constipation, sphincter of Oddi spasm.
Metabolism: dyslipoproteinaemia (elevated triglycerides and blood cholesterol levels), impaired glucose tolerance, insulin resistance, increased risk of metabolic syndrome, impaired bone and vitamin D metabolism, vitamin D resistance, low blood 25(OH)D levels, recurrence of calcium oxalate stones.
Other: asthma, chronic fatigue syndrome, osteoporosis, hypertension, altered glucose homeostasis.

Conclusion

Magnesium has numerous functions in the human body and is therefore an important factor in the prevention and treatment of many diseases. Low magnesium levels are associated with many chronic diseases, including Alzheimer’s disease, insulin resistance and type 2 diabetes, hypertension, cardiovascular diseases (e.g. stroke), migraine headaches, and attention deficit hyperactivity disorder (ADHD). Magnesium is an essential mineral that plays a key role in many physiological processes. A sufficient intake of magnesium is essential for maintaining optimal health and preventing various diseases.

Sources:

Zhang Y, Chen C, Lu L, Knutson KL, Carnethon MR, Fly AD, Luo J, Haas DM, Shikany JM, Kahe K. Association of magnesium intake with sleep duration and sleep quality: findings from the CARDIA study. Sleep. 2022 Apr 11;45(4):zsab276. doi: 10.1093/sleep/zsab276. PMID: 34883514; PMCID: PMC8996025.
Boyle NB, Lawton C, Dye L. The Effects of Magnesium Supplementation on Subjective Anxiety and Stress-A Systematic Review. Nutrients. 2017 Apr 26;9(5):429. doi: 10.3390/nu9050429. PMID: 28445426; PMCID: PMC5452159.
Tarleton EK, Littenberg B, MacLean CD, Kennedy AG, Daley C. Role of magnesium supplementation in the treatment of depression: A randomized clinical trial. PLoS One. 2017 Jun 27;12(6):e0180067. doi: 10.1371/journal.pone.0180067. PMID: 28654669; PMCID: PMC5487054.
Zhao B, Deng H, Li B, Chen L, Zou F, Hu L, Wei Y, Zhang W. Association of magnesium consumption with type 2 diabetes and glucose metabolism: A systematic review and pooled study with trial sequential analysis. Diabetes Metab Res Rev. 2020 Mar;36(3):e3243. doi: 10.1002/dmrr.3243. Epub 2019 Dec 11. PMID: 31758631.
Jeroen H. F. de Baaij. Joost G. J. Hoenderop, René J. M. Bindels. Magnesium in Man: Implications for Health and Disease. 2015. https://doi.org/10.1152/physrev.00012.2014
Magnesium – Health Professional Fact Sheet
Tarleton EK, Littenberg B. Magnesium intake and depression in adults. J Am Board Fam Med. 2015 Mar-Apr;28(2):249-56. doi: 10.3122/jabfm.2015.02.140176. PMID: 25748766.
Gröber U, Schmidt J, Kisters K. Magnesium in Prevention and Therapy. Nutrients. 2015 Sep 23;7(9):8199-226. doi: 10.3390/nu7095388. PMID: 26404370; PMCID: PMC4586582.
Volpe SL. Magnesium. In: Erdman JW, Macdonald IA, Zeisel SH, eds. Present Knowledge in Nutrition. 10th ed. Ames, Iowa; John Wiley & Sons, 2012:459-74.
Rude RK. Magnesium. In: Coates PM, Betz JM, Blackman MR, Cragg GM, Levine M, Moss J, White JD, eds. Encyclopedia of Dietary Supplements. 2nd ed. New York, NY: Informa Healthcare; 2010:527-37.
Chaudhary DP, Sharma R, Bansal DD. Implications of magnesium deficiency in type 2 diabetes: a review. Biol Trace Elem Res 2010;134:119–29.
Rivlin RS. Magnesium deficiency and alcohol intake: mechanisms, clinical significance and possible relation to cancer development (a review). J Am Coll Nutr 1994;13:416–23.