Home > Diabetes, Heart Health, Nutritional Supplements > Prescription 2014: More Magnesium

Prescription 2014: More Magnesium

October 20, 2014 Written by JP    [Font too small?]

Many people aren’t getting enough magnesium (Mg) in their daily diets and through basic supplementation. Now, you might think you’re not one of those people. But, recent studies reveal that magnesium deficiency is surprisingly common. Sometimes it’s even present in otherwise healthy young adults and in those who take multivitamin/mineral supplements. What’s more, certain popular medications, including those used to treat gastric reflux or GERD often contribute to a lack of magnesium or hypomagnesemia.

When attempting to address sub-optimal magnesium levels, it’s vital to be aware of the richest food sources of this essential mineral. Simply put, unless you make it a point to seek out foods abundant in magnesium, you’ll likely fall short of the recommended daily value (DV) of 400 mg. To that end, I suggest you include more of the following items in your eating plan: almonds (20% DV/oz), black beans (30% DV/cup), cashews (19% DV/oz), chia seeds (23% DV/oz), flax seeds (21% DV/oz), pumpkin seeds (18% DV/oz), pure cocoa powder (35% DV/oz), Swiss chard (38% DV/cup), spinach (39% DV/cup) and sunflower seeds (23% DV/oz). Also of note, the legumes, nuts, seeds and vegetables mentioned above are all excellent sources of antioxidants, dietary fiber and numerous minerals and vitamins.

At one point or another, most of you have probably read about the countless health benefits associated with magnesium intake. But, it’s easy to forget why any given nutrient is essential for wellness. So, I want to highlight several recent publications that act as reminders about why we should strive to get enough Mg every single day. On the one hand, three current studies report that those who lack adequate magnesium are more likely candidates for bone fractures, heart disease and ischemic stroke. This points to the importance of addressing any latent deficiency. With respect to addressing deficiencies, four other trials report that normalizing magnesium levels via supplementation addresses multiple health risks such as excessive inflammation, high blood pressure, insulin resistance and poor physical capacity. In addition, supplementing with magnesium can, likewise, help with a broad range of chronic health conditions, including migraine headaches.

In closing, I want to address a question that is frequently posed to me. Which form of magnesium is best? There is no definitive answer. Generally speaking, I consider magnesium citrate an affordable, accessible and well-absorbed option. If cardiovascular health is a primary concern, I usually recommend magnesium taurate – a form of magnesium bound to taurine, an amino acid which may help regulate blood pressure and heart rhythm. Lately, there has also been a considerable amount of interest paid to a newly developed magnesium chelate known as magnesium threonate. This intriguing nutraceutical may support healthier age-related cognitive functioning. It’s expensive, but possibly worth the added cost for those in need. If you’re in good general health, no matter which form of magnesium you opt for, you should always strive to reach or surpass the 400 mg/day guideline. However, those with kidney disease or other serious medical conditions should always consult with their health care providers prior to supplementing with minerals such as magnesium and potassium.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

To learn more about the studies referenced in today’s column, please click on the following links:

Study 1 – There Is Chronic Latent Magnesium Deficiency in Apparently Healthy (link)

Study 2 – Multivitamin/Mineral Supplement Contribution to Micronutrient Intakes (link)

Study 3 – The Association of Proton Pump Inhibitors and Hypomagnesemia In the(link)

Study 4 – Magnesium Intake, Bone Mineral Density, and Fractures: Results from (link)

Study 5 – Serum Magnesium, Phosphorus, and Calcium Are Associated with Risk of (link)

Study 6 – Plasma Magnesium and Risk of Ischemic Stroke Among Women (link)

Study 7 – Oral Magnesium Supplementation Decreases C-Reactive Protein Levels ... (link)

Study 8 – Oral Magnesium Supplementation Improves the Metabolic Profile of (link)

Study 9 – Effect of Oral Magnesium Supplementation on Physical Performance In (link)

Study 10 – Comparison of Therapeutic Effects of Magnesium Sulfate vs. (link)

Higher Magnesium Intake May Lower Inflammation (CRP)

Source: Eur J Clin Nutr. 2014 Apr;68(4):510-6. (link)

Tags: , ,
Posted in Diabetes, Heart Health, Nutritional Supplements

24 Comments & Updates to “Prescription 2014: More Magnesium”

  1. JP Says:

    In the news!


    “Getting enough magnesium in the diet may reduce the risk of diabetes, especially for those who already show signs of heading that way.

    A Tufts study led by Adela Hruby, N10, MPH10, N13, found that healthy people with the highest magnesium intake were 37 percent less likely to develop high blood sugar or excess circulating insulin, common precursors to diabetes.

    Among people who already had those conditions, those who consumed the most magnesium were 32 percent less likely to develop diabetes than those consuming the least.

    The second association held true even when researchers accounted for other healthful factors, such as fiber, that often go along with magnesium-rich foods.

    The study, published in Diabetes Care, followed 2,582 participants in the Framingham Heart Study Offspring cohort for seven years. The study subjects had an average age of 54.

    Only half of Americans get the recommended daily amount of magnesium in their diet, which is 400 to 420 milligrams for adult men and 310 to 320 milligrams for adult women. You can find it in whole grains, vegetables, fish, nuts and seeds and dark chocolate.”

    Be well!


  2. liverock Says:

    Hans Seyle, a Hungarian doctor, did a lot of research on what happens to people’s mineral status when their central nervous system goes into the’fight or flight’ stress mode. It appears the body starts excreting magnesium and zinc (among other mineral reactions) as these are calming minerals on the CNS, which are the last things you need when getting ready to fight or flee.

    I think most people today are spending a lot of their lives in the high stress mode, which is depleting a lot of these minerals and coupled with the amount of sugar in the diet, is causing a substantial lowering of magnesium.

    Magnesium also binds to heavy metals including cadmium and lead so these can also substantially reduce magnesium levels


  3. JP Says:

    Excellent points, Liverock! IMO, Dr. Syle’s research is invaluable!

    Be well!


  4. JP Says:

    Update: Magnesium citrate protects against potentially dangerous elevations in blood pressure during pregnancy …


    Arch Gynecol Obstet. 2013 Dec;288(6):1269-74.

    Magnesium supplementation to prevent high blood pressure in pregnancy: a randomised placebo control trial.

    PURPOSE: To assess if hypertension during the last part of pregnancy could be prevented by magnesium supplementation.

    METHODS: Pregnant primagravida women from a local antenatal care unit were given an oral supply of 300 mg magnesium as citrate or placebo from pregnancy week 25 in a randomised double-blind setup. Blood pressure was recorded during pregnancy as well as pregnancy outcome.

    RESULTS: In the magnesium-supplemented group, the average diastolic blood pressure at week 37 was significantly lower than in the placebo group (72/1.4 mean/SEM vs 77/1.4, p = 0.031). The number of women with an increase in diastolic blood pressure of ≥15 mmHg was significantly lower in the magnesium group compared with the women who received placebo (p = 0.011). There was an inverse relation between the urinary excretion of magnesium during pregnancy and the diastolic blood pressure (p = 0.005).

    CONCLUSIONS: Magnesium supplementation prevented an increase in diastolic blood pressure during the last weeks of pregnancy. The relation between diastolic blood pressure and urinary excretion of magnesium suggests that magnesium is involved in the regulation of blood pressure and that the increase in diastolic blood pressure in pregnancy could be due to a lack of magnesium.

    Be well!


  5. JP Says:

    Update: Shelled hemp seeds are an excellent source of magnesium – about 45% of the RDA per ounce.


    Be well!


  6. JP Says:

    Update 05/06/15:


    Diabetes Metab. 2015 Apr 27. pii: S1262-3636(15)00058-0.

    Oral magnesium supplementation improves glycaemic status in subjects with prediabetes and hypomagnesaemia: A double-blind placebo-controlled randomized trial.


    This study evaluated the efficacy of oral magnesium supplementation in the reduction of plasma glucose levels in adults with prediabetes and hypomagnesaemia.


    A total of 116 men and non-pregnant women, aged 30 to 65years with hypomagnesaemia and newly diagnosed with prediabetes, were enrolled into a randomized double-blind placebo-controlled trial to receive either 30mL of MgCl2 5% solution (equivalent to 382mg of magnesium) or an inert placebo solution once daily for four months. The primary trial endpoint was the efficacy of magnesium supplementation in reducing plasma glucose levels.


    At baseline, there were no significant statistical differences in terms of anthropometric and biochemical variables between individuals in the supplement and placebo groups. At the end of follow-up, fasting (86.9±7.9 and 98.3±4.6mg/dL, respectively; P=0.004) and post-load glucose (124.7±33.4 and 136.7±23.9mg/dL, respectively; P=0.03) levels, HOMA-IR indices (2.85±1.0 and 4.1±2.7, respectively; P=0.04) and triglycerides (166.4±90.6 and 227.0±89.7, respectively; P=0.009) were significantly decreased, whereas HDL cholesterol (45.6±10.9 and 46.8±9.2mg/dL, respectively; P=0.04) and serum magnesium (1.96±0.27 and 1.60±0.26mg/dL, respectively; P=0.005) levels were significantly increased in those taking MgCl2 compared with the controls. A total of 34 (29.4%) people improved their glucose status (50.8% and 7.0% in the magnesium and placebo groups, respectively; P<0.0005).


    Our results show that magnesium supplementation reduces plasma glucose levels, and improves the glycaemic status of adults with prediabetes and hypomagnesaemia.

    Be well!


  7. JP Says:

    Update 06/12/15:


    PLoS ONE 10(5): e0127666.

    Association between Dietary Magnesium Intake and Radiographic Knee Osteoarthritis.

    Objective: To examine the cross-sectional associations between dietary magnesium (Mg) intake and radiographic knee osteoarthritis (OA), joint space narrowing (JSN), and osteophytes (OST) respectively.

    Methods: A total of 1626 subjects were included in the study. Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire. Radiographic knee OA was defined as Kellgren-Lawrence (K-L) Grade 2 in at least one leg. JSN and OST were assessed individually according to the Osteoarthritis Research Society International (OARSI) atlas. A multivariable logistic analysis model was applied to test the various associations after adjusting for potentially confounding factors.

    Results: The relative odds of radiographic knee OA were decreased by 0.53 times in the third quintile of Mg intake [odds ratio (OR) 0.53, 95% confidence interval (CI) 0.28–1.01], 0.40 times in the fourth quintile (OR 0.40, 95% CI 0.17–0.94) and 0.34 times in the fifth quintile (OR 0.34, 95% CI 0.11–1.00) compared with those in the lowest quintile, while P for trend was 0.111. The relative odds of JSN were decreased by 0.49 times in the third quintile of Mg intake (OR 0.49, 95% CI 0.28–0.88) and 0.37 times in the fifth quintile (OR 0.37, 95% CI 0.14–0.98) compared with those in the lowest quintile, while P for trend was 0.088. There was no significant relationship between dietary Mg intake and the presence of OST.

    Conclusions: The findings of this cross-sectional study indicate that Mg intake is inversely associated with radiographic knee OA and JSN. It supports potential role of Mg in the prevention of knee OA.

    Be well!


  8. JP Says:

    Update 06/13/15:


    J Rheumatol. 2015 Jun 1.

    Relationship between Serum Magnesium Concentration and Radiographic Knee Osteoarthritis.

    OBJECTIVE: To establish whether there is a relationship between serum magnesium (Mg) concentration and radiographic knee osteoarthritis (OA).

    METHODS: There were 2855 subjects in this cross-sectional study. Serum Mg concentration was measured using the chemiluminescence method. Radiographic OA of the knee was defined as changes consistent with Kellgren-Lawrence (K-L) grade 2 on at least 1 side. Mg concentration was classified into 1 of 4 quartiles: ≤ 0.87, 0.88-0.91, 0.92-0.96, or ≥ 0.97 mmol/l. Multivariable logistic analysis was used to test the association between serum Mg and radiographic knee OA after adjustment for potentially confounding factors. The OR with 95% CI for the association between radiographic knee OA and serum Mg concentration were calculated for each quartile. The quartile with the lowest value was regarded as the reference category.

    RESULTS: Significant association between serum Mg concentration and radiographic knee OA was observed in the model after adjustment for age, sex, and body mass index, as well as in the multivariable model. The multivariable-adjusted OR (95% CI) for radiographic knee OA in the second, third, and fourth serum Mg concentration quartiles were 0.90 (95% CI 0.71-1.13), 0.92 (95% CI 0.73-1.16), and 0.72 (95% CI 0.57-0.92), respectively, compared with the lowest (first) quartile. A clear trend (p for trend was 0.01) was observed. The relative odds of radiographic knee OA was decreased by 0.72 times in the fourth serum Mg quartile compared with the lowest quartile.

    CONCLUSION: Serum Mg concentration may have an inverse relationship with radiographic OA of the knee.

    Be well!


  9. JP Says:

    Update 06/30/15:


    Magnes Res. 2015 Jun 24. [Epub ahead of print]

    Association between low serum magnesium concentration and hyperuricemia.

    OBJECTIVES: To examine the cross-sectional associations between serum magnesium (Mg) and hyperuricemia (HU).

    METHODS: 2904 subjects were included in this study. HU was defined as uric acid ≥416 mmol/L for the male population and ≥360 mmol/L for the female population. A multivariable logistic analysis model was applied to test the associations after adjusting for a number of potential confounding factors.

    RESULTS: The relative odds of the prevalence of HU were significantly decreased by 0.65 times in the third quintile of serum Mg (OR 0.65, 95% CI 0.47-0.89), and 0.61 times in the fifth quintile (OR 0.61, 95% CI 0.45-0.83), compared with the lowest quintile: P for trend was 0.002. For males, the relative odds for HU were significantly decreased by 0.61 times in the third quintile of serum Mg (OR 0.61, 95% CI 0.42-0.89), 0.68 times in the fourth quintile (OR 0.68, 95% CI 0.47-0.97), and 0.59 times in the fifth quintile (OR 0.59, 95% CI 0.41-0.84) compared with the lowest quintile: P for trend was 0.003. However, no significant association was observed between serum Mg and HU for females.

    CONCLUSION: Serum Mg is inversely associated with HU. This association remains valid for the male subgroup, but not for the female subgroup.

    Be well!


  10. JP Says:

    Updated 08/12/15:


    Br J Nutr. 2015 Aug 11:1-12.

    Dietary intake of calcium and magnesium and the metabolic syndrome in the National Health and Nutrition Examination (NHANES) 2001-2010 data.

    Higher dietary intakes of Mg and Ca, individually, have been associated with a decreased risk for the metabolic syndrome (MetSyn). Experimental studies suggest that a higher intra-cellular ratio of Ca:Mg, which may be induced by a diet high in Ca and low in Mg, may lead to hypertension and insulin resistance. However, no previous epidemiological studies have examined the effects of the combined intake of Mg and Ca on MetSyn. Thus, we evaluated the association between dietary intakes of Ca and Mg (using 24-h recalls), independently and in combination, and MetSyn in the National Health and Nutrition Examination Study 2001-2010 data, which included 9148 adults (4549 men and 4599 women), with complete information on relevant nutrient, demographic, anthropometric and biomarker variables. We found an inverse association between the highest (>355 mg/d) v. the lowest (<197 mg/d) quartile of Mg and MetSyn (OR 0·70; 95 % CI 0·57, 0·86). Women who met the RDA for both Mg (310-320 mg/d) and Ca (1000-1200 mg/d) had the greatest reduced odds of MetSyn (OR 0·59; 95 % CI 0·45, 0·76). In men, meeting the RDA for Mg (400-420 mg/d) and Ca (1000-1200 mg/d), individually or in combination, was not associated with MetSyn; however, men with intakes in the highest quartile for Mg (≥386 mg/d) and Ca (≥1224 mg/d) had a lower odds of MetSyn (OR 0·74; 95 % CI 0·59, 0·93). Our results suggest that women who meet the RDA for Mg and Ca have a reduced odds of MetSyn but men may require Ca levels higher than the RDA to be protected against MetSyn.

    Be well!


  11. JP Says:

    Updated 08/12/15:


    N Am J Med Sci. 2015 Jun;7(6):271-4.

    Inverse Correlation between Serum C-Reactive Protein and Magnesium Levels in Smokers and Nonsmokers.

    BACKGROUND: Smoking plays a key role in increasing the inflammatory marker C-reactive protein (CRP).

    AIMS: To examine inverse correlation between CRP and magnesium levels in smokers and nonsmokers.

    MATERIALS AND METHODS: A total of 192 healthy adult male subjects were included in the present study, out of which 96 were smokers and the remaining 96 were nonsmokers having age range from 20 to 40 years, and all the subjects belonged to District Matyari of Hyderabad. Serum CRP was measured by NycoCard standard kit method and magnesium levels by DiaSys standard kit method in smokers and nonsmokers.

    RESULTS: The levels of serum CRP in smokers (14.62 ± 0.16 mg/L) is high as compared to nonsmokers (4.81 ± 0.38 mg/L), which is highly significant (P < 0.001). However, inverse results were seen for serum magnesium levels which were significantly higher (P < 0.001) in nonsmokers (2.52 ± 0.18 mg/L) as compared to the smokers (1.09 ± 0.38 mg/dL). A significant (P < 0.001) inverse relationship between serum CRP and magnesium concentrations were seen in smokers. CONCLUSION: This result shows that smoking increases serum CRP, an inflammatory marker parallel to decrease in serum magnesium levels in smokers having 20-40 years of age. Be well! JP

  12. JP Says:

    Updated 08/21/15:


    J Bone Miner Res. 2015 Aug 19.

    Dietary Magnesium Is Positively Associated with Skeletal Muscle Power and Indices of Muscle Mass and May Attenuate the Association Between Circulating C-Reactive Protein and Muscle Mass in Women.

    Age-related loss of skeletal muscle mass and strength are risk factors for sarcopenia, osteoporosis, falls, fractures, frailty and mortality. Dietary magnesium (Mg) could play a role in prevention of age-related loss of skeletal muscle mass, power and strength directly through physiological mechanisms or indirectly through an impact on chronic low-grade inflammation, itself a risk factor for loss of skeletal muscle mass and strength. In a cross-sectional study of 2570 women aged 18-79 years we examined associations between intakes of Mg, estimated using an FFQ, DXA-derived measures of muscle mass (fat free mass as a percentage of body weight (FFM%), fat free mass index (FFMI, kg/m2 )), leg explosive power (LEP) and grip-strength (n = 949 only). We also examined associations between circulating hs-CRP (C-reactive protein) and muscle mass and LEP, and explored the potential attenuation of these relationships by Mg. We compared our findings with those of age and protein intake. Endpoints were calculated by quintile of Mg and adjusted for relevant confounders. Significant positive associations were found between a higher Mg and indices of skeletal muscle mass and LEP, and also with hs-CRP, after adjustment for covariates. Contrasting extreme quintiles of Mg intake showed differences of 2.6% for FFM% (P trend <0.001), 0.4 kg/m2 for FFMI (P trend = 0.005), and 19.6 watts/kg for LEP (P trend < 0.001). Compared to protein these positive associations were 7 times greater for FFM% and 2.5 times greater for LEP. We also found that higher hs-CRP was negatively associated with skeletal muscle mass and, in statistical modelling, that a higher dietary Mg attenuated this negative relationship by 6.5%, with greater attenuation in women aged over 50 years. No association was found between Mg and grip strength. Our results suggest that dietary magnesium may aid conservation of age-related loss of skeletal muscle mass and power in women of all ages. Be well! JP

  13. JP Says:

    Updated 09/06/15:


    World J Diabetes. 2015 Aug 25;6(10):1152-7.

    Magnesium and type 2 diabetes.

    Type 2 diabetes is frequently associated with both extracellular and intracellular magnesium (Mg) deficits. A chronic latent Mg deficit or an overt clinical hypomagnesemia is common in patients with type 2 diabetes, especially in those with poorly controlled glycemic profiles. Insulin and glucose are important regulators of Mg metabolism. Intracellular Mg plays a key role in regulating insulin action, insulin-mediated-glucose-uptake and vascular tone. Reduced intracellular Mg concentrations result in a defective tyrosine-kinase activity, postreceptorial impairment in insulin action and worsening of insulin resistance in diabetic patients. A low Mg intake and an increased Mg urinary loss appear the most important mechanisms that may favor Mg depletion in patients with type 2 diabetes. Low dietary Mg intake has been related to the development of type 2 diabetes and metabolic syndrome. Benefits of Mg supplementation on metabolic profiles in diabetic patients have been found in most, but not all clinical studies and larger prospective studies are needed to support the potential role of dietary Mg supplementation as a possible public health strategy in diabetes risk. The aim of this review is to revise current evidence on the mechanisms of Mg deficiency in diabetes and on the possible role of Mg supplementation in the prevention and management of the disease.

    Be well!


  14. JP Says:

    Updated 10/03/15:


    J Lab Physicians. 2015 Jul-Dec;7(2):75-8.

    Association of Serum Magnesium Deficiency with Insulin Resistance in Type 2 Diabetes Mellitus.

    BACKGROUND: Insulin resistance (IR) is the key pathophysiological defect that leads to the development of type 2 diabetes mellitus. The purpose of this study was to estimate serum magnesium level and insulin sensitivity indices among type 2 diabetes mellitus patients and to see an association between them.

    METHODS: This study was carried out among 38 type 2 diabetic patients and forty age and sex matched controls. Serum fasting glucose, magnesium, insulin, urea, and creatinine levels were estimated. Insulin sensitivity indices, homeostasis model assessment for insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI) levels were calculated as per formulae.

    RESULTS: A highly significant low serum magnesium level was found in diabetic subjects as compared to the controls. Statistically significant high HOMA levels (>2.6) and low QUICKI levels (<0.33) were found among the case group. An inverse, statistically significant correlation was found between serum magnesium and fasting insulin level. A highly statistically significant inverse correlation was found between serum magnesium and HOMA level, and a positive correlation was found between serum magnesium and QUICKI level, that is, serum magnesium level decreases with increase in IR. A strong association was also found between fasting serum insulin level and insulin sensitivity indices.

    CONCLUSION: This study showed a lower serum magnesium level in diabetic patients compared to control. A strong association was also found between serum magnesium level and insulin sensitivity indices. For proper management of type 2 diabetes, it may, therefore, be necessary to treat hypomagnesemia in these patients.

    Be well!


  15. JP Says:

    Updated 10/17/15:


    Nutr Metab Cardiovasc Dis. 2015 Aug 13.

    Low serum magnesium is associated with coronary artery calcification in a Korean population at low risk for cardiovascular disease.

    BACKGROUND AND AIMS: Previous studies suggested an association between low serum magnesium levels and metabolic or cardiovascular disease. Additionally, several studies have shown that low serum magnesium is associated with vascular calcification, but there are no studies exploring its relation to coronary artery calcification (CAC). We investigated the relationship between low serum magnesium and CAC by using health examination data.

    METHODS AND RESULTS: We cross-sectionally analyzed 34,553 participants who underwent coronary multi-detector computed tomography and serum magnesium level measurement in 2010-2012 as part of a health examination program at a tertiary hospital in Korea. CAC was defined as a coronary artery calcium score > 100. Participants were divided into three groups according to their serum magnesium level as follows: low < 1.9 mg/dL (n = 931), normal = 1.9-2.3 mg/dL (n = 32,341), and high > 2.3 mg/dL (n = 1281). The percentages of participants with CAC were 3.7, 1.5, and 2.3 in each group, respectively. According to multivariate analysis, low serum magnesium was associated with CAC after adjustment for age, sex, BMI, diabetes, hypertension, cardiovascular disease, systolic BP, LDL cholesterol, HDL cholesterol, eGFR, serum calcium and phosphorus, hsCRP, current smoking status, alcohol intake and vigorous exercise frequency. The odds ratio for CAC in the low serum magnesium group compared to the normal group was 2.10 (1.40-3.15, P < 0.001). CONCLUSION: Low serum magnesium level is associated with CAC in a Korean population at low risk for cardiovascular disease. Further studies are needed to generalize this finding and to verify the causal relationship between low serum magnesium and CAC. Be well! JP

  16. JP Says:

    Updated 2/2/16:


    J Am Heart Assoc. 2016 Jan 22;5(1).

    Serum Magnesium and the Risk of Death From Coronary Heart Disease and Sudden Cardiac Death.

    BACKGROUND: Low serum magnesium has been implicated in cardiovascular mortality, but results are conflicting and the pathway is unclear. We studied the association of serum magnesium with coronary heart disease (CHD) mortality and sudden cardiac death (SCD) within the prospective population-based Rotterdam Study, with adjudicated end points and long-term follow-up.

    METHODS AND RESULTS: Nine-thousand eight-hundred and twenty participants (mean age 65.1 years, 56.8% female) were included with a median follow-up of 8.7 years. We used multivariable Cox proportional hazard models and found that a 0.1 mmol/L increase in serum magnesium level was associated with a lower risk for CHD mortality (hazard ratio: 0.82, 95% CI 0.70-0.96). Furthermore, we divided serum magnesium in quartiles, with the second and third quartile combined as reference group (0.81-0.88 mmol/L). Low serum magnesium (≤0.80 mmol/L) was associated with an increased risk of CHD mortality (N=431, hazard ratio: 1.36, 95% CI 1.09-1.69) and SCD (N=217, hazard ratio: 1.54, 95% CI 1.12-2.11). Low serum magnesium was associated with accelerated subclinical atherosclerosis (expressed as increased carotid intima-media thickness: +0.013 mm, 95% CI 0.005-0.020) and increased QT-interval, mainly through an effect on heart rate (RR-interval: -7.1 ms, 95% CI -13.5 to -0.8). Additional adjustments for carotid intima-media thickness and heart rate did not change the associations with CHD mortality and SCD.

    CONCLUSIONS: Low serum magnesium is associated with an increased risk of CHD mortality and SCD. Although low magnesium was associated with both carotid intima-media thickness and heart rate, this did not explain the relationship between serum magnesium and CHD mortality or SCD. Future studies should focus on why magnesium associates with CHD mortality and SCD and whether intervention reduces these risks.

    Be well!


  17. JP Says:

    Updated 03/17/16:

    Note: MMFS-01 is magnesium threonate.


    J Alzheimers Dis. 2015 Oct 27;49(4):971-90.

    Efficacy and Safety of MMFS-01, a Synapse Density Enhancer, for Treating Cognitive Impairment in Older Adults: A Randomized, Double-Blind, Placebo-Controlled Trial.

    BACKGROUND: Cognitive impairment is a major problem in elderly, affecting quality of life. Pre-clinical studies show that MMFS-01, a synapse density enhancer, is effective at reversing cognitive decline in aging rodents.

    OBJECTIVE: Since brain atrophy during aging is strongly associated with both cognitive decline and sleep disorder, we evaluated the efficacy of MMFS-01 in its ability to reverse cognitive impairment and improve sleep.

    METHODS: We conducted a randomized, double-blind, placebo-controlled, parallel-designed trial in older adult subjects (age 50-70) with cognitive impairment. Subjects were treated with MMFS-01 (n = 23) or placebo (n = 21) for 12 weeks and cognitive ability, sleep quality, and emotion were evaluated. Overall cognitive ability was determined by a composite score of tests in four major cognitive domains.

    RESULTS: With MMFS-01 treatment, overall cognitive ability improved significantly relative to placebo (p = 0.003; Cohen’s d = 0.91). Cognitive fluctuation was also reduced. The study population had more severe executive function deficits than age-matched controls from normative data and MMFS-01 treatment nearly restored their impaired executive function, demonstrating that MMFS-01 may be clinically significant. Due to the strong placebo effects on sleep and anxiety, the effects of MMFS-01 on sleep and anxiety could not be determined.

    CONCLUSIONS: The current study demonstrates the potential of MMFS-01 for treating cognitive impairment in older adults.

    Be well!


  18. JP Says:

    Updated 04/04/16:


    Oxid Med Cell Longev. 2016;2016:2019643.

    Magnesium Supplementation Diminishes Peripheral Blood Lymphocyte DNA Oxidative Damage in Athletes and Sedentary Young Man.

    Sedentary lifestyle is highly associated with increased risk of cardiovascular disease, obesity, and type 2 diabetes. It is known that regular physical activity has positive effects on health; however several studies have shown that acute and strenuous exercise can induce oxidative stress and lead to DNA damage. As magnesium is essential in maintaining DNA integrity, the aim of this study was to determine whether four-week-long magnesium supplementation in students with sedentary lifestyle and rugby players could prevent or diminish impairment of DNA. By using the comet assay, our study demonstrated that the number of peripheral blood lymphocytes (PBL) with basal endogenous DNA damage is significantly higher in rugby players compared to students with sedentary lifestyle. On the other hand, magnesium supplementation significantly decreased the number of cells with high DNA damage, in the presence of exogenous H2O2, in PBL from both students and rugby players, and markedly reduced the number of cells with medium DNA damage in rugby players compared to corresponding control nonsupplemented group. Accordingly, the results of our study suggest that four-week-long magnesium supplementation has marked effects in protecting the DNA from oxidative damage in both rugby players and in young men with sedentary lifestyle.

    Be well!


  19. JP Says:

    Updated 03/01/17:


    Nutrition. 2017 Mar;35:56-60.

    Effect of magnesium supplementation on depression status in depressed patients with magnesium deficiency: A randomized, double-blind, placebo-controlled trial.

    OBJECTIVES: The aim of this study was to determine the effect of magnesium supplementation on the depression status of depressed patients suffering from magnesium deficiency.

    METHODS: Sixty depressed people suffering from hypomagnesemia participated in this trial. The individuals were randomly categorized into two groups of 30 members; one receiving two 250-mg tablets of magnesium oxide (MG) daily and the other receiving placebo (PG) for 8 wk. The Beck Depression Inventory-II was conducted and the concentration of serum magnesium was measured.

    RESULTS: At the end of intervention, 88.5% of the MG and 48.1% of the PG (P = 0.002) had a normal level of magnesium. The mean changes of serum magnesium were significantly different across the two groups. After the intervention, the mean Beck score significantly declined. However, in the MG, this reduction was more significant than in the PG (P = 0.02), so that the mean changes in this group experienced 15.65 ± 8.9 reduction, but in the PG, it declined by 10.40 ± 7.9.

    CONCLUSIONS: Daily consumption of 500 mg magnesium oxide tablets for ≥8 wk by depressed patients suffering from magnesium deficiency leads to improvements in depression status and magnesium levels. Therefore, assessment of the magnesium serum and resolving this deficiency positively influence the treatment of depressed patients.

    Be well!


  20. JP Says:

    Updated 03/18/17:


    Nutrients 2017, 9(3), 296

    Serum Magnesium Concentrations in the Canadian Population and Associations with Diabetes, Glycemic Regulation, and Insulin Resistance

    Total serum magnesium (Mg) concentration (SMC) is commonly used to assess Mg status. This study reports current SMCs of Canadians and their associations with demographic factors, diabetes, and measures of glycemic control and insulin resistance using results from the Canadian Health Measures Survey cycle 3 (2012–2013). Associations were examined in adults aged 20–79 years using linear mixed models. Mean SMCs and percentile distributions for 11 sex-age groups between 3 and 79 years (n = 5561) are reported. SMCs were normally distributed and differences (p < 0.05) among sex and age groups were small. Between 9.5% and 16.6% of adult sex-age groups had a SMC below the lower cut-off of a population-based reference interval (0.75–0.955 mmol·L−1) established in the United States population as part of the NHANES I conducted in 1971–1974. Having diabetes was associated with 0.04 to 0.07 mmol·L−1 lower SMC compared to not having diabetes in the various models. Body mass index, glycated hemoglobin, serum glucose and insulin concentrations, and homeostatic model assessment of insulin resistance were negatively associated with SMC. This is the first study to report SMCs in a nationally representative sample of the Canadian population. A substantial proportion of Canadians are hypomagnesaemic in relation to a population-based reference interval, and SMC was negatively associated with diabetes and indices of glycemic control and insulin resistance. Be well! JP

  21. JP Says:

    Updated 06/28/17:


    PLoS One. 2017 Jun 27;12(6):e0180067.

    Role of magnesium supplementation in the treatment of depression: A randomized clinical trial.

    Current treatment options for depression are limited by efficacy, cost, availability, side effects, and acceptability to patients. Several studies have looked at the association between magnesium and depression, yet its role in symptom management is unclear. The objective of this trial was to test whether supplementation with over-the-counter magnesium chloride improves symptoms of depression. An open-label, blocked, randomized, cross-over trial was carried out in outpatient primary care clinics on 126 adults (mean age 52; 38% male) diagnosed with and currently experiencing mild-to-moderate symptoms with Patient Health Questionnaire-9 (PHQ-9) scores of 5-19. The intervention was 6 weeks of active treatment (248 mg of elemental magnesium per day) compared to 6 weeks of control (no treatment). Assessments of depression symptoms were completed at bi-weekly phone calls. The primary outcome was the net difference in the change in depression symptoms from baseline to the end of each treatment period. Secondary outcomes included changes in anxiety symptoms as well as adherence to the supplement regimen, appearance of adverse effects, and intention to use magnesium supplements in the future. Between June 2015 and May 2016, 112 participants provided analyzable data. Consumption of magnesium chloride for 6 weeks resulted in a clinically significant net improvement in PHQ-9 scores of -6.0 points (CI -7.9, -4.2; P<0.001) and net improvement in Generalized Anxiety Disorders-7 scores of -4.5 points (CI -6.6, -2.4; P<0.001). Average adherence was 83% by pill count. The supplements were well tolerated and 61% of participants reported they would use magnesium in the future. Similar effects were observed regardless of age, gender, baseline severity of depression, baseline magnesium level, or use of antidepressant treatments. Effects were observed within two weeks. Magnesium is effective for mild-to-moderate depression in adults. It works quickly and is well tolerated without the need for close monitoring for toxicity.

    Be well!


  22. JP Says:

    Updated 12/22/17:


    Sci Rep. 2017 Dec 20;7(1):17913.

    Magnesium intake and mortality due to liver diseases: Results from the Third National Health and Nutrition Examination Survey Cohort.

    People with fatty liver disease are at high risk of magnesium deficiency. Meanwhile, low magnesium status is linked to both chronic inflammation and insulin resistance. However, no study has investigated the association between intake of magnesium and risk of mortality due to liver diseases. We evaluated the association between total magnesium intake and mortality due to liver diseases in the Third National Health and Nutrition Examination Study (NHANES III) cohort, which included 13,504 participants who completed liver ultrasound examination for hepatic steatosis. Overall magnesium intake was associated with a reduced risk of mortality due to liver disease at borderline significance (P = 0.05). In fully-adjusted analyses, every 100 mg increase in intake of magnesium was associated with a 49% reduction in the risk for mortality due to liver diseases. Although interactions between magnesium intake and alcohol use and hepatic steatosis at baseline were not significant (P > 0.05), inverse associations between magnesium intake and liver disease mortality were stronger among alcohol drinkers and those with hepatic steatosis. Our findings suggest higher intakes of magnesium may be associated with a reduced risk of mortality due to liver disease particularly among alcohol drinkers and those with hepatic steatosis. Further studies are warranted to confirm the findings.

    Be well!


  23. JP Says:

    Updated 03/06/18:


    Osteoarthritis Cartilage. 2018 Feb 15.

    Low magnesium intake is associated with increased knee pain in subjects with radiographic knee osteoarthritis: data from the Osteoarthritis Initiative.

    OBJECTIVE: As magnesium mediates bone and muscle metabolism, inflammation, and pain signaling, we aimed to evaluate whether magnesium intake is associated with knee pain and function in radiographic knee osteoarthritis (OA).

    METHODS: We investigated the associations between knee pain/function metrics and magnesium intake from food and supplements in 2548 Osteoarthritis Initiative cohort participants with prevalent radiographic knee OA (Kellgren-Lawrence score ≥2). Magnesium intake was assessed by Food Frequency Questionnaire (FFQ) at baseline. WOMAC and Knee Injury and Osteoarthritis Outcome Score (KOOS) scores were reported annually with total follow up of 48 months. Analyses used linear mixed models.

    RESULTS: Among participants with baseline radiographic knee OA the mean total magnesium intake was 309.9 mg/day (SD 132.6) for men, and 287.9 mg/day (SD 118.1) for women, with 68% of men and 44% of women below the estimated average requirement. Subjects with lower magnesium intake had worse knee OA pain and function scores, throughout the 48 months (P < 0.001). After adjustment for age, sex, race, body mass index (BMI), calorie intake, fiber intake, pain medication use, physical activity, renal insufficiency, smoking, and alcohol use, lower magnesium intake remained associated with worse pain and function outcomes (1.4 points higher WOMAC and 1.5 points lower KOOS scores for every 50 mg of daily magnesium intake, P < 0.05). Fiber intake was an effect modifier (P for interaction <0.05). The association between magnesium intake and knee pain and function scores was strongest among subjects with low fiber intake. CONCLUSION: Lower magnesium intake was associated with worse pain and function in knee OA, especially among individuals with low fiber intake. Be well! JP

  24. JP Says:

    Updated 12/19/18:


    PLoS One. 2018 Dec 18;13(12):e0208454.

    Superiority of magnesium and vitamin B6 over magnesium alone on severe stress in healthy adults with low magnesemia: A randomized, single-blind clinical trial.

    INTRODUCTION: Animal and clinical studies suggest complementary effects of magnesium and high-dose pyridoxine (vitamin B6) on stress reduction. This is the first randomized trial evaluating the effects of combined magnesium and vitamin B6 supplementation on stress in a stressed population with low magnesemia using a validated measure of perceived stress.

    METHODS: In this Phase IV, investigator-blinded trial (EudraCT: 2015-003749-24), healthy adults with Depression Anxiety Stress Scales (DASS-42) stress subscale score >18 and serum magnesium concentration 0.45 mmol/L-0.85 mmol/L, were randomized 1:1 to magnesium-vitamin B6 combination (Magne B6 [Mg-vitamin B6]; daily dose 300 mg and 30 mg, respectively) or magnesium alone (Magnespasmyl [Mg]; daily dose 300 mg). Outcomes included change in DASS-42 stress subscale score from baseline to Week 8 (primary endpoint) and Week 4, and incidence of adverse events (AEs).

    RESULTS: In the modified intention-to-treat analysis (N = 264 subjects), both treatment arms substantially reduced DASS-42 stress subscale score from baseline to Week 8 (Mg-vitamin B6, 44.9%; Mg 42.4%); no statistical difference between arms was observed (p>0.05). An interaction (p = 0.0097) between baseline stress level and treatment warranted subgroup analysis (as per statistical plan); adults with severe/extremely severe stress (DASS-42 stress subscale score ≥25; N = 162) had a 24% greater improvement with Mg-vitamin B6 versus Mg at Week 8 (3.16 points, 95% CI 0.50 to 5.82, p = 0.0203). Consistent results were observed in the per protocol analysis and at Week 4. Overall, 12.1% of Mg-vitamin B6 treated and 17.4% of Mg-treated subjects experienced AEs potentially treatment related.

    CONCLUSIONS: These findings suggest oral Mg supplementation alleviated stress in healthy adults with low magnesemia and the addition of vitamin B6 to Mg was not superior to Mg supplementation alone. With regard to subjects with severe/extremely severe stress, this study provides clinical support for greater benefit of Mg combined with vitamin B6.

    Be well!


Leave a Comment