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PK

Magnesium Supplements: Benefits, Deficiency Symptoms, Types, and More

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Magnesium is one of my favorite minerals. I regularly recommend it to my patients for many common health conditions, including muscle cramps, migraine headaches, tension headaches, heart palpitations, overactive bladder, and constipation. Those who suffer from these ailments are commonly deficient in magnesium. Over the last decade, magnesium has continuously been among the top 10 nutritional supplements.  

In my 20 years as a physician, I have seen magnesium help more people than any other nutritional supplement on the market. The benefits are often quick, and the results are life-improving for many who take it.

Common conditions that magnesium may help:

  • Muscle and leg cramps 
  • Facial twitches and teeth grinding
  • Heart palpitations and heart conditions
  • Anxiety and depression
  • Elevated blood pressure
  • Migraine and tension headaches
  • Bladder spasms and overactive bladder (bladder is a smooth muscle)
  • Constipation
  • Poor glucose control

Why Does The Body Need Magnesium?

Magnesium is involved in over 350 chemical reactions in the human body. The average human has about 25 grams (~6 teaspoons) of magnesium dispersed throughout the body. One percent of that magnesium is in the blood and red blood cells, while 99 percent of the magnesium is present in bones and muscles, which is where it is needed most.  

Magnesium is required for the body to manufacture DNA and RNA and is also essential for synthesizing minerals for protein. Without magnesium, our muscles could not contract and relax, including the cardiac muscle, which is necessary for the daily 100,000 beats the heart performs. Our blood vessels and nerves also require magnesium to conduct cellular communication efficiently. 

Low blood levels of magnesium indicate a deficiency. It is estimated that up to 75 percent of the world consumes inadequate amounts of magnesium required for peak health.

An adequate intake of magnesium-rich foods, like green leafy vegetables, is essential. Frequently diet is not enough, and a supplement is required. 

Can Medications Lower Magnesium?

Certain medications increase the risk of magnesium deficiency, including acid reducers (i.e., omeprazole, pantoprazole, ranitidine, famotidine, etc.) and diuretic water pills (i.e., furosemide, triamterene, hydrochlorothiazide, chlorthalidone). Worldwide, over 100 million people take acid reducers, while more than 200 million take diuretics as they are inexpensive and efficient for treating high blood pressure. The majority who take these pharmaceuticals daily are magnesium deficient. 

Common Causes Of Magnesium Deficiency

  • Inadequate intake through diet (a diet low in green leafy vegetables)
  • Weight-loss surgery (gastric bypass, gastric sleeve, etc.)
  • Malabsorption syndrome
  • Intestinal diseases
  • Chronic stress (the body burns through magnesium when we are overstressed)
  • High intake of processed foods and sugars

Food Sources Of Magnesium

Obtaining magnesium through diet is best. However, as mentioned before, that is frequently not enough, even for those who consume healthy, well-rounded diets. 

What Are Some Common Symptoms Of Magnesium Deficiency?

1. Muscle and Leg Cramps

Muscle cramps, especially leg cramps, are one of the most common reasons I recommend a magnesium supplement. Patients who come to me with these types of cramps are commonly prescribed medications such as diuretics and acid reducers, which deplete our magnesium stores. 

Some scientific research has supported what I have personally noticed in my clinic. A 2021 randomized, double-blind, placebo-controlled trial showed benefit from magnesium supplementation in those with leg cramps, while a 2002 study concluded that magnesium might help prevent leg cramps. However, a more recent 2008 study of pregnant women experiencing leg cramps did not find a reduction in leg cramps when magnesium was given. There were no negative side effects noticed in this study. 

I have been recommending magnesium for leg cramps for almost 20 years. In the majority of these patients, benefit has been seen. Sometimes low potassium and chronic dehydration can also result in leg cramps, so if magnesium does not work for you, consider these other options and discuss them with your healthcare physician.

2. Facial Twitches And Teeth Grinding

Over the years, I have noticed that those with eyelid twitches and spasms of cheek muscles are also commonly low in magnesium. While I could not find any scientific studies on this, my patients' outcomes have been reassuring. A 1990 article documented doctors seeing beneficial outcomes when patients with nighttime teeth grinding, a condition called bruxism, were given magnesium replacement. This would make sense since stress and tension are also common reasons one grinds their teeth.

3. Heart Palpitations And Heart Conditions

While there are many causes of heart palpitations, such as heart disease, a person who lacks magnesium frequently will notice them more. It is always important to check with your physician to make sure nothing serious is happening if you have heart palpitations.  

A 2019 study showed that patients with atrial fibrillation, a type of irregular heart rate that increases the risk of stroke, who were given magnesium intravenously, experienced better results than those who did not receive magnesium. The researchers showed that the magnesium had a synergistic effect with the patients' usual heart medications.

A 2005 study also showed magnesium to be helpful in controlling the heart rate and rhythm in those with atrial fibrillation and mitral valve prolapse (MVP), a leaky heart valve with symptoms that included dizziness, heart palpitation, shortness of breath, and fatigue. Those with MVP benefited when magnesium supplementation was given, according to a 1986 study. Another 2005 study showed magnesium could be beneficial in those with MVP.

4. Anxiety And Depression

Magnesium was helpful when those taking anti-depressant medications added it to their treatment regimen, according to a 2016 study. The mechanism by which this helps may be through its positive effect on the gut microbiome. The authors of a 2015 study proposed that a magnesium-deficient diet negatively affects gut-brain access. 

A 2015 study also discussed the association between low magnesium levels and anxiety. This association likely explains why those with panic attacks also commonly have heart palpitations and muscle spasms.

In addition to regular physical activity, optimizing diet is important to improving mental and physical health, and magnesium supplementation should be considered.

5. Elevated Blood Pressure

High blood pressure is common as we age, and there are many reasons why a person may develop hypertension. Low magnesium levels are frequent in those with high blood pressure, and regular consumption of magnesium-rich foods and magnesium supplements can be a beneficial approach.

The findings of a 2016 meta-analysis study showed "… a causal effect of magnesium supplementation on lowering Blood Pressure (BPs) in adults." Similarly, a 2021 study concluded that "an average magnesium dietary intake is below the recommended values, and magnesium supplementation in the prevention and treatment of hypertension might be justified." 

Those taking high blood pressure medications mustn't stop unless directed to do so by their physician. I have had many patients add magnesium to their usual treatment program and achieve better control.

6. Migraine Headaches

Migraines are often experienced as painful, throbbing headaches that can cause nausea and light sensitivity, affecting 1 billion people worldwide. Some studies suggest that one in seven people will experience a migraine at some point in their life — almost one in five women and one in 15 men. In the United States, managing migraine headaches costs the healthcare system $78 billion annually. 

For over a decade, I have recommended magnesium to patients afflicted with migraines. In my experience, it works for four in five people by preventing migraine headaches from starting. The scientific research supports my doctoring experience. 

A 2017 study in The Journal of Head and Face Pain concluded that magnesium could prevent migraines. Other studies show similar findings, including that women who suffer from menstrual migraines also appear to benefit from magnesium supplementation. The reason magnesium may help with migraines may be due to its ability to help improve mitochondrial function and energy production. 

7. Bladder Spasms

Magnesium works well for many patients with bladder spasms or an overactive bladder. I had one patient in particular who told me the magnesium worked better than her prescription medication – as a result, we stopped her medication. 

The bladder is made up of "smooth muscle." When muscles are low in magnesium, they contract, giving one the urge to urinate more frequently. A 2020 study showed that patients given magnesium were half as likely to have bladder spasms after bladder tumor removal compared to those not given magnesium. 

Dosing Suggestions For Magnesium

The main types of magnesium formulations are: 

Magnesium Chelate

These are better absorbed as they are usually bound to easy-to-absorb metabolites. Magnesium chelates include magnesium citrate, magnesium L- threonate, magnesium bisglycinate, magnesium taurate, magnesium malate, magnesium fumarate, and others. 

Most people will consume a dose as low as 100 mg to as high as 500 mg. If you are taking too much, a laxative effect may occur. Magnesium can be consumed as a powder, capsule, or tablet. I add a scoop of magnesium citrate powder to my reusable water bottle on a regular basis. 

Magnesium Oxide

Magnesium oxide is also a good option and is generally less expensive than magnesium chelate. However, this formulation has a lower absorption rate. 

As a result, it tends to have more of a laxative effect if consumed at a dosage higher than the "suggested dose" as advised on the label. Most magnesium oxides come in doses of 250 mg, 400 mg, or 500 mg. 

References:

  1. Mineral and Electrolyte Metabolism. 1993;19(4-5):314-22. Low magnesium is associated with glucose abnormalities
  2. Wacker WE, Parisi AF N Engl J Med. 1968 Mar 21; 278(12):658-63. (Average human has 25 grams of magnesium in their body)
  3. DiNicolantonio JJ, O'Keefe JH, Wilson W. Subclinical magnesium deficiency: a principal driver of cardiovascular disease and a public health crisis [published correction appears in Open Heart. 2018 Apr 5;5(1):e000668corr1]. Open Heart. 2018;5(1):e000668. Published 2018 Jan 13. 
  4. Lima Mde L, Pousada J, Barbosa C, Cruz T Arq Bras Endocrinol Metabol. 2005 Dec; 49(6):959-63 [Magnesium deficiency and insulin resistance in patients with type 2 diabetes mellitus]. Up to 75% of people are deficient
  5. Barna O, Lohoida P, Holovchenko Y, Bazylevych A, Velychko V, Hovbakh I, Bula L, Shechter M. A randomized, double-blind, placebo-controlled, multicenter study assessing the efficacy of magnesium oxide monohydrate in the treatment of nocturnal leg cramps. Nutr J. 2021 Oct 31;20(1):90. 
  6. Roffe C, Sills S, Crome P, Jones P. Randomised, cross-over, placebo controlled trial of magnesium citrate in the treatment of chronic persistent leg cramps. Med Sci Monit. 2002 May;8(5):CR326-30. 
  7. Nygaard IH, Valbø A, Pethick SV, Bøhmer T. Does oral magnesium substitution relieve pregnancy-induced leg cramps? Eur J Obstet Gynecol Reprod Biol. 2008 Nov;141(1):23-6. 
  8. Ploceniak C. Bruxisme et magnésium, mon expérience clinique depuis 1980 [Bruxism and magnesium, my clinical experiences since 1980]. Rev Stomatol Chir Maxillofac. 1990;91 Suppl 1:127. French. 
  9. Bouida W, Beltaief K, Msolli MA, Azaiez N, et. Al, Low-dose Magnesium Sulfate Versus High Dose in the Early Management of Rapid Atrial Fibrillation: Randomized Controlled Double-blind Study (LOMAGHI Study). Acad Emerg Med. 2019 Feb;26(2):183-191. 
  10. Davey MJ, Teubner D. A randomized controlled trial of magnesium sulfate, in addition to usual care, for rate control in atrial fibrillation. Ann Emerg Med. 2005 Apr;45(4):347-53. 
  11. Galland LD, Baker SM, McLellan RK. Magnesium deficiency in the pathogenesis of mitral valve prolapse. Magnesium. 1986;5(3-4):165-74. 
  12. Bobkowski W, Nowak A, Durlach J. The importance of magnesium status in the pathophysiology of mitral valve prolapse. Magnes Res. 2005 Mar;18(1):35-52. 
  13. Serefko A, Szopa A, Poleszak E. Magnesium and depression. Magnes Res. 2016 Mar 1;29(3):112-119. 
  14. Winther G, Pyndt Jørgensen BM, Elfving B, Nielsen DS, Kihl P, Lund S, Sørensen DB, Wegener G. Dietary magnesium deficiency alters gut microbiota and leads to depressive-like behaviour. Acta Neuropsychiatr. 2015 Jun;27(3):168-76.
  15. Pyndt Jørgensen B, Winther G, Kihl P, Nielsen DS, Wegener G, Hansen AK, Sørensen DB. Dietary magnesium deficiency affects gut microbiota and anxiety-like behaviour in C57BL/6N mice. Acta Neuropsychiatr. 2015 Oct;27(5):307-11. 
  16. Dominguez L, Veronese N, Barbagallo M. Magnesium and Hypertension in Old Age. Nutrients. 2020 Dec 31;13(1):139. 
  17. Banjanin N, Belojevic G. Relationship of dietary magnesium intake and serum magnesium with hypertension: a review. Magnes Res. 2021 Nov 1;34(4):166-171. 
  18. Peikert A, Wilimzig C, Köhne-Volland R. Prophylaxis of migraine with oral magnesium: results from a prospective, multi-center, placebo-controlled and double-blind randomized study. Cephalalgia. 1996 Jun;16(4):257-63. 
  19. Maier JA, Pickering G, Giacomoni E, Cazzaniga A, Pellegrino P. Headaches and Magnesium: Mechanisms, Bioavailability, Therapeutic Efficacy and Potential Advantage of Magnesium Pidolate. Nutrients. 2020 Aug 31;12(9):2660. 
  20. Mauskop A, Altura BT, Altura BM. Serum ionized magnesium levels and serum ionized calcium/ionized magnesium ratios in women with menstrual migraine. Headache. 2002 Apr;42(4):242-8. 
  21. https://pubs.asahq.org/anesthesiology/article/133/1/64/109148/Magnesium-and-Bladder-Discomfort-after

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