Magnesium

TL;DR

Magnesium is an essential mineral that supports sleep, muscle function, and energy production by participating in over 300 enzymatic reactions in the body. Research confidence for improving sleep is moderate, with typical doses of 200-400 mg of elemental magnesium daily. The Glycinate form is often recommended for sleep and is gentle on the stomach, while other forms like Citrate can have a laxative effect.

Why I'm Taking It

• Help with sleep regulation (fight that daily 2-3pm crash)
• Help with general inflammation, achiness and muscle cramps

Background

Magnesium is an essential mineral that the body needs to stay healthy. It is naturally present in many foods, particularly green leafy vegetables (like spinach), legumes, nuts, seeds, and whole grains; it is also added to some fortified foods like breakfast cereals. Magnesium is involved in over 300-600 enzymatic reactions in the body, playing a crucial role in regulating muscle and nerve function, energy production (ATP synthesis), blood sugar levels, blood pressure regulation, and the synthesis of protein, bone, and DNA. It also plays a role in the transport of calcium and potassium ions across cell membranes, a process important to nerve impulse conduction, muscle contraction, and normal heart rhythm.

Recommended Form of the Supplement

Magnesium supplements come in various forms with differing bioavailability and potential uses. It's often recommended to choose forms based on absorption and potential side effects:

• Magnesium Citrate: One of the most common forms, magnesium citrate appears to have high bioavailability. It can have a mild osmotic laxative effect at higher doses, which can be useful for constipation.
• Magnesium Glycinate (or Bisglycinate): This chelated form is generally considered to have good bioavailability and is often preferred for its gentleness on the stomach, making it less likely to cause diarrhea. It's often chosen for calming effects, anxiety, and sleep support.
• Magnesium Malate: Often suggested for energy support due to malate's role in the Krebs cycle (energy production). It may also be helpful for muscle soreness and fibromyalgia. Good bioavailability.
• Magnesium L-Threonate: This form is known for its ability to cross the blood-brain barrier more readily than other forms, and is primarily studied for cognitive benefits like learning and memory (though much research is still in animal models).
• Magnesium Chloride: Has good bioavailability and can be found in oral supplements as well as some topical (transdermal) preparations.
• Magnesium Lactate: Another form with good bioavailability, potentially gentler on the stomach than some others.
• Magnesium Taurate: A combination of magnesium and the amino acid taurine, this form is sometimes suggested for cardiovascular health, though more research is needed.
• Magnesium Oxide: Contains a high percentage of elemental magnesium but has relatively poor bioavailability compared to other forms. It is often used as a laxative due to its osmotic effect or for heartburn. Not generally recommended for correcting magnesium deficiency due to low absorption.
• Magnesium Sulfate: Commonly known as Epsom salt, it's often used in baths to soothe muscles. Oral intake is used medically but has strong laxative effects. Evidence for significant transdermal (skin) absorption of magnesium from Epsom salt baths is limited.
• Magnesium Carbonate: Has a high percentage of elemental magnesium but lower bioavailability; it converts to magnesium chloride in the stomach and can have antacid effects. Can cause digestive upset. Generally, organic salts of magnesium (like citrate, glycinate, malate, lactate) are more bioavailable than inorganic salts (like oxide, sulfate, carbonate).

Expected Effects

Magnesium is involved in a vast array of bodily functions, and supplementation may offer several benefits, particularly if dietary intake is insufficient:

• Supports Energy Production: Essential for the creation of ATP, the body's main energy molecule.
• Promotes Muscle and Nerve Function: Plays a key role in muscle contraction and relaxation, as well as nerve transmission. May help with muscle cramps in some individuals.
• Supports Bone Health: Crucial for bone formation and influences the activities of osteoblasts and osteoclasts. Also affects concentrations of parathyroid hormone and the active form of vitamin D, which are important for bone health.
• May Help Regulate Blood Sugar Levels: Involved in glucose metabolism and insulin action. Supplementation may improve insulin sensitivity, especially in those with magnesium deficiency or at risk for type 2 diabetes.
• May Support Cardiovascular Health: Contributes to heart muscle function and blood pressure regulation. May help lower blood pressure, particularly in individuals with hypertension.
• May Reduce Frequency of Migraine Headaches: Some studies suggest magnesium supplementation can reduce the frequency and intensity of migraines, possibly due to its role in neurotransmitter function and vasodilation.
• May Alleviate Symptoms of Premenstrual Syndrome (PMS): Some research indicates magnesium can help reduce PMS symptoms like bloating, mood swings, and breast tenderness.
• May Improve Sleep Quality: Due to its role in regulating neurotransmitters and its muscle-relaxing properties, magnesium is often used to promote better sleep, particularly forms like magnesium glycinate.
• May Help Reduce Stress and Anxiety: Magnesium plays a role in the body's stress-response system, and supplementation may help promote relaxation and reduce feelings of anxiety in some individuals.
• Anti-inflammatory Effects: Low magnesium levels are linked to chronic inflammation. Supplementation may help reduce inflammatory markers like C-reactive protein (CRP).

Dosage Recommendations

1. Dosage recommendations for magnesium are typically given in terms of elemental magnesium.
   • Recommended Dietary Allowances (RDAs) for adults:
   • Men (19-30 years): 400 mg/day
   • Men (31+ years): 420 mg/day
   • Women (19-30 years): 310 mg/day
   • Women (31+ years): 320 mg/day
   • Pregnancy: 350-400 mg/day depending on age
2. Supplemental Dosage: For general supplementation, doses often range from 200-400 mg of elemental magnesium per day. Therapeutic doses used in clinical trials for specific conditions can vary, sometimes higher, but should be guided by a healthcare professional. The amount of elemental magnesium varies widely by form (e.g., magnesium oxide has a high percentage of elemental magnesium but is poorly absorbed, while magnesium glycinate has less elemental magnesium by weight but is better absorbed).
3. Tolerable Upper Intake Level (UL): The UL for magnesium from supplements and medications for adults (19+ years) and children (9-18 years) is 350 mg/day of elemental magnesium. This UL does not include magnesium obtained from food and water. Consuming supplemental magnesium above this level increases the risk of adverse effects like diarrhea, nausea, and abdominal cramping.
4. Timing:
   • Magnesium supplements are generally best taken with food to enhance absorption and reduce the risk of gastrointestinal side effects like diarrhea.
   • Doses can be taken at once or divided throughout the day. Some people prefer taking magnesium in the evening, especially forms like glycinate, for its potential calming and sleep-promoting effects.
   • Consistency is key for optimal benefits.

My Current Dosage & Timing

Dosage: (e.g., 400mg elemental Magnesium) Form: (e.g., Glycinate) Brand: (e.g., Thorne) Timing: (e.g., 200mg with breakfast, 200mg 1 hour before bed) (User to complete with their specific regimen.)

Usage Notes, Best Practices & Important Considerations

Take with Food: To minimize potential gastrointestinal side effects like diarrhea and potentially improve absorption, take magnesium supplements with a meal or snack. Consistency is Key: For sustained benefits, take magnesium supplements consistently at the same time(s) each day. Divide Doses: If taking a higher daily amount, consider dividing it into 2-3 smaller doses throughout the day for better absorption and tolerance. Hydration: Ensure adequate fluid intake, especially if a magnesium form causes a laxative effect. Separation from Certain Medications: Magnesium can interfere with the absorption of several medications. It's generally recommended to take magnesium supplements at least 2 hours before or 4-6 hours after certain antibiotics (fluoroquinolones, tetracyclines) and at least 2 hours apart from bisphosphonates. Consult a healthcare provider for specific timing with other medications. Dietary Inhibitors: High intake of phytates (in grains, legumes) and oxalates (in spinach, rhubarb) can slightly reduce magnesium absorption. Soaking, sprouting, or fermenting foods high in phytates can help. Enhancers: Adequate protein intake and some types of fiber (like fructooligosaccharides) may enhance magnesium absorption. Kidney Function: Individuals with impaired kidney function should be cautious with magnesium supplements and only use them under medical supervision, as their kidneys may not be able to effectively excrete excess magnesium, leading to a risk of hypermagnesemia (too much magnesium in the blood). Transdermal Magnesium: Products like magnesium oils, lotions, and bath flakes (Epsom salts) are used for transdermal absorption. While many users report benefits for muscle soreness or relaxation, scientific evidence for significant magnesium absorption through the skin is limited and inconsistent. There is no established UL for transdermal magnesium. Listen to Your Body: If gastrointestinal upset occurs, try a different form of magnesium (e.g., glycinate instead of citrate or oxide) or reduce the dose. Contraindications/Interactions Magnesium supplements can interact with various medications and may not be suitable for everyone. Contraindications:

Severe Kidney Disease/Impairment: Individuals with kidney failure or significantly impaired kidney function should avoid magnesium supplements unless specifically prescribed and monitored by a doctor, due to the risk of magnesium accumulation and toxicity (hypermagnesemia). Myasthenia Gravis: Magnesium can exacerbate muscle weakness in individuals with this condition. Slow Heart Rate (Bradycardia) or Heart Block: High doses of magnesium can affect heart rhythm and should be used with caution. Significant Interactions:

Bisphosphonates: (e.g., Alendronate, Risedronate) Magnesium can decrease the absorption of oral bisphosphonates. Take magnesium at least 2 hours before or 2 hours after these medications. Antibiotics: Tetracyclines: (e.g., Doxycycline, Minocycline) Magnesium binds to tetracyclines and reduces their absorption. Take magnesium 2 hours before or 4-6 hours after tetracyclines. Fluoroquinolones: (e.g., Ciprofloxacin, Levofloxacin) Magnesium reduces absorption. Take magnesium 2 hours before or 4-6 hours after fluoroquinolones. Thyroid-Hormones: (e.g., Levothyroxine) Magnesium can interfere with the absorption of levothyroxine. Separate doses by at least 4 hours. Gabapentin: Magnesium may reduce the absorption of gabapentin. Take gabapentin at least 2 hours after magnesium. Proton Pump Inhibitors (PPIs): (e.g., Omeprazole, Lansoprazole) Long-term use of PPIs can lead to low magnesium levels. Diuretics: Loop Diuretics (e.g., Furosemide) and Thiazide Diuretics (e.g., Hydrochlorothiazide) can increase the loss of magnesium in urine, potentially leading to deficiency over time. Potassium-Sparing Diuretics (e.g., Spironolactone, Amiloride) can reduce magnesium excretion, potentially increasing magnesium levels, especially if taking supplements. Digoxin: Low magnesium levels can increase the risk of digoxin toxicity. High Doses of Supplements/Zinc: Very high zinc intake (e.g., >140 mg/day) may interfere with magnesium absorption. Calcium Channel Blockers: (e.g., Amlodipine, Diltiazem) Magnesium has mild calcium channel blocking activity; high doses taken with these medications could theoretically have additive effects on blood pressure. Monitor blood pressure. Sulfonylureas (Diabetes medication): (e.g., Glipizide, Glyburide) Magnesium may increase the absorption of these drugs, potentially increasing the risk of hypoglycemia. Monitor blood sugar. Always consult with a healthcare provider before starting magnesium supplements, especially if you have any medical conditions or are taking other medications or supplements.

Reputability/Trustworthiness of Studies The scientific evidence for magnesium's role in health is extensive, as it's an essential mineral involved in countless physiological processes.

Strong Evidence: There is strong evidence supporting magnesium's fundamental roles in enzymatic reactions, energy metabolism, muscle and nerve function, protein synthesis, and bone health. Its necessity for these functions is well-established. The benefits of magnesium for correcting documented deficiency are clear. Moderate to Strong Evidence: For conditions like hypertension and type 2 diabetes, numerous studies, including meta-analyses of RCTs, suggest that magnesium supplementation can have beneficial effects, particularly in individuals with low magnesium status or those with the condition. Its use in pre-eclampsia and eclampsia (typically IV magnesium sulfate) is a well-established medical practice. There is also good evidence for its role in reducing inflammation. Moderate Evidence: For migraine prevention, several clinical trials and reviews suggest a benefit, leading to recommendations by some professional organizations. Evidence for improving sleep quality and reducing PMS symptoms is also considered moderate and promising, though some studies may be smaller or older. Limited or Mixed Evidence: For enhancing exercise performance in individuals with adequate magnesium levels, the evidence is mixed. While some studies show benefits, others do not. For anxiety and depression, while there's a strong biochemical rationale and some positive studies, the overall evidence base is still developing, with calls for more high-quality, larger, and longer-term trials. The efficacy of transdermal magnesium absorption is also an area with limited and inconsistent scientific backing. Context-Dependent Benefits: Many benefits of magnesium supplementation are more pronounced in individuals who are deficient or have insufficient intake. Challenges in Research: Accurately assessing magnesium status in individuals can be challenging, as serum magnesium levels (the most common test) do not always reflect total body magnesium stores or intracellular levels. This can complicate the interpretation of some research findings. Reputable health organizations like the NIH Office of Dietary Supplements and evidence-based aggregators like Examine.com provide comprehensive summaries of magnesium research, generally confirming its importance and highlighting areas with strong versus emerging evidence. Organic forms (e.g., citrate, glycinate) are generally considered more bioavailable than inorganic forms (e.g., oxide), although many studies have used various forms.

Sources/Links to Research: National Institutes of Health (NIH) - Office of Dietary Supplements - Magnesium Fact Sheet for Consumers Examine.com - Magnesium Supplementation Guide Linus Pauling Institute - Micronutrient Information Center - Magnesium NMI (Nutritional Medicine Institute) - Magnesium: A Review of Clinical Use and Efficacy