Many ardent dietary supplement users are aware there is a widespread deficiency of magnesium in the American diet. Upon learning this they often visit a local vitamin shop and obtain the most economical type of this mineral – magnesium oxide. But mag-oxide is not very soluble and only 4% is absorbed. [Magnesium Research Dec 2001]
Poor absorption is likely the reason why provision of magnesium oxide only slightly improved magnesium content in the hips of growing young girls; [Journal Clinical Endocrinology Metabolism Dec 2006
… and why it didn’t significantly reduce inflammation in another study. [Journal Research Medical Sciences July 2012]
… and why mag-oxide did not increase muscle strength in middle-aged women. Biological Trace Element Research June 2013]
… and why magnesium supplementation didn’t reduce atherosclerotic plaque in neck (carotid) arteries. [European Neurology 2013]
… and why mega-doses (35,000 milligrams human equivalent dose) in laboratory rats had to be used to reduce experimentally-induced seizures in laboratory mice. [Indian Journal Pharmacology Dec 2009]
…and why 300 mg/day of mag-oxide failed to increase red-blood cell magnesium levels in healthy adults. [Magnesium Research Sept 2003]
… and why it took up to 1200 mg mag-oxide per day to inhibit blood clots by 35% among patients with coronary artery disease. [American Journal Cardiology July 1999]
… and why 500 mg of mag-oxide failed to improve muscle weakness and cramping in humans. [Medicine & Science Sports Exercise Nov 1998]
.. and why 1000 mg of mag-oxide only slightly increased blood serum levels of magnesium among patients with high-cholesterol. [Magnesium Research June 1996]
Why do researchers even use mag-oxide in human clinical studies but to intentionally disparage the use of dietary supplements.
Mag-oxide is only slightly soluble in water. [Chemistry World]
Mag-oxide is such an embarrassment to the dietary supplement industry it shouldn’t even be sold.
ConsumerLab gave its approval for magnesium-oxide supplements that gives consumers the false impression they are adequate. It only means their labels were accurate for mineral content in the pills. [ConsumerLab.com]
Mistaken calcium/magnesium ratio
Many dietary supplement users obtain their magnesium within a calcium-magnesium formula for bone health. But again, a big error is made here. The archaic calcium-to-magnesium ratio in these formulas is usually 2-to-1, that is, the recommended 1000 mg calcium and 500 mg magnesium based upon their ratio found in bone. But doctors and dietary supplement makers forgot that the recommended 1000 mg/day intake of calcium was supposed to be comprised of what is consumed from DIET + SUPPLEMENTS, not supplements alone.
Since the typical dairy-rich American diet provides somewhere around 600-1200 mg of calcium and 260-350 mg of magnesium per day, a person taking a 1000/500 mg cal-mag supplement could consume, in total, ~1600-2200 mg of calcium and maybe 800-900 mg magnesium. The tolerable upper limit for calcium is 2000 mg/day.
The Recommended Daily Allowance for magnesium is 320 mg for women and 420 mg for men.
However, that 500 mg of supplemental magnesium is likely to be mag-oxide, which is only 4% absorbed. Since only about 30% (300 mg) of a 1000 mg calcium supplement is orally absorbed [Food & Agriculture Organization] we can estimate the amount of absorbed calcium and magnesium from dietary supplements.
With all of the factors blocking absorption or depleting magnesium it is clear that a major effort must be made to get enough magnesium, a problem that is exacerbated by the most commonly sold but poorly absorbed form of supplemental magnesium.
Four types of deficiencies
There are four types of magnesium deficiency:
(1) Absolute deficiency emanating from food choices that minimize its intake; (2) A deficiency that results from poor absorption of magnesium; (3) A shortage as a result of depletion by various factors; and (4) Relative deficiency in relation to achieving an adequate ratio of magnesium to calcium.
Food fortification impractical
The Recommended Dietary Allowance (RDA) was established to indicate the average daily intake sufficient to meet the nutrient requirements of nearly all (97%–98%) healthy individuals. When the RDA is not achieved, health authorities generally elect to fortify foods for essential nutrients like they have for folic acid, iodine, vitamin A and zinc.
But magnesium is a bulky mineral. Its shortage in the diet is too large to be rectified by adding a few hundred milligrams of magnesium to every portion of food. Food fortification of magnesium is impractical. Dietary supplements are in order.
However, many people are suspicious they are being oversold on magnesium pills and are wary of dietary supplements altogether and mistakenly believe they can get sufficient amounts of magnesium from their diet.
Here are some magnesium-rich foods:
Roaster almonds (1 oz) 80 mg
Spinach, frozen/cooked (1/2 cup) 78 mg
Bran flakes (3/4 cup) 54 mg
Potato, baked 48 mg
Kidney beans (1/2 cup) 35 mg Source: Harvard Medical School
It is obvious a lot of food would have to be consumed to make up for the shortage of magnesium in the American diet if attempting to achieve a 2-to-1 or 1-to-1 calcium/magnesium intake ratio.
Fallacy of blood testing
While voluminous evidence points to dietary supplements as the only practical way to restore magnesium balance in the human body there are still others, including misdirected physicians [MD Prevent], who mistakenly believe there is no need for any dietary supplement unless a deficiency is proven by a blood test. However, only 1% of magnesium is found in the blood, the rest residing in bone and soft tissues. [International Journal Pharmacy Compounding July 2008] Blood levels are not indicative of tissue levels.
Blood serum levels of magnesium are notoriously inaccurate in regard to determination of mineral adequacy. The perception that a normal blood serum magnesium level excludes deficiency is common among physicians. [Clinical Chemistry Laboratory Medicine March 2010]
One of the fallacies of blood testing is the so-called reference range that is provided when patients read the results of their blood test. The reference range is the normally occurring range that may be misleading when there is a widespread deficiency in the population, as there is for magnesium. Normal = deficient.
The numbers tell the sad story:
One study finds magnesium intake in women is 68% of the Recommended Dietary Allowance. (Journal American College Nutrition April 2009]
Another report says 68% of American adults who don’t take dietary supplements consume less than the Recommended Daily Allowance of magnesium and 19% consumed less than 50% of the RDA. [Journal American College Nutrition June 2005]
Direct result of shortage: inflammation
Those who consumed less than the RDA for magnesium were 1.48-2.25 times more likely to have an elevated marker for inflammation (C-reactive protein) than adults who consume the RDA. Low-grade inflammation is a hallmark of aging. [Journal American College Nutrition June 2005]
Magnesium doomsday: estrogen + calcium
But wait. There is one more major factor that results in a shortage of magnesium. It was the late Mildred Seelig MD who educated everyone about the many factors that induce magnesium deficiency, in particular, estrogen in the form of oral contraceptives or estrogen replacement in menopause.
It is estrogen that sends a signal to hold calcium in bone. Menopause results in a decline of that signal as the ovaries shut down and women begin to lose calcium from bone. Then, in a major confusion, women mistakenly believe they have a calcium shortage instead of an estrogen shortage.
Unless women replace that estrogen signal to hold calcium in their bones, calcium is going to be lost into the blood circulation where it is deposited in heart valves, kidneys (stones), joints (arthritis), and other organs.
Then to make matters worse, women supplement their diet in their post-menopausal years with high-dose calcium without restoring the estrogen signal to hold the calcium in bone. So even more calcium is deposited in arteries. Calcium supplementation without estrogen replacement in menopause is akin to pouring calcium in a barrel that has a hole in the bottom.
This is precisely why post-menopausal women supplementing their diet with mega-dose calcium combined with estrogen replacement are reported to experience more mortal heart attacks. [Journal Internal Medicine Oct 2015; Nutrients July 2013]
Magnesium, being a natural calcium blocker, would be a first-line antidote to this problem, but is overwhelmed by calcium supplementation.
So we begin to learn that a shortage of magnesium and an overload of calcium can be a deadly combination particularly with estrogen replacement.
As Mildred Seelig pointed out, high dietary/supplemental intake of calcium over magnesium then increases blood coagulation and results in women becoming prone to blood clots and resultant strokes and heart attacks. [Magnesium Research Sept 1990]
Is there evidence that corroborates magnesium deficiency increases mortality? There certainly is.
As misleading as blood serum levels of magnesium may be, one large long-term study did find that those individuals with the highest magnesium blood concentrations were 85% less likely to die from all-causes of death! [Atherosclerosis Nov 2011]
One of the other maladies that strikes magnesium deficient individuals is arterial spasm that can induce migraine headaches or more direly, mimic a stroke. [Drugs Oct 1984] An elderly woman taking an acid blocker for heartburn, which impairs the absorption of magnesium exhibited right-sided paralysis that was completely normalized with an infusion of magnesium. [International Medical Case Reports June 2016]
The consumption of 350 mg of supplemental magnesium reduced arterial stiffness in overweight adults. [American Journal Clinical Nutrition May 2016]
If you wonder why your circulating “bad” LDL cholesterol is high and your “bad” HDL cholesterol is low and your triglycerides are also high, this may emanate from a magnesium deficiency. In fact, magnesium inhibits the same enzyme (HMB coenzyme A) required to produce cholesterol in the liver) that statin cholesterol-lowering drugs inhbit. Magnesium is a statin. [Journal American College Nutrition Oct 2004]
Sudden death heart attacks
Another startling fact is that most sudden-death heart attacks are not caused by cholesterol plaque buildup in arteries but by electrical storms in heart muscle among individuals who have no prior symptoms or other known risk factors. In fact, sudden-death heart attacks occur in lower-risk populations. [Medscape] Almost 3 of every 4 heart attacks reported in 1998 were of the sudden-death variety. [Circulation Oct 30, 2001]
The risk of death from a sudden heart muscle spasm is reduced by 40% or more with maintenance of adequate magnesium levels. [American Heart Journal Sept 2010]
Magnesium is one of the four minerals (potassium, sodium, calcium) called electrolytes that set up the electrical charge in your heart to pump your blood. Sudden cardiac death is more common in areas where the drinking water is magnesium deficient. [American Heart Journal Aug 1992]
In the late 1990s there was a considerable stir in cardiology that heart attacks might be allayed by magnesium, which would upset the cholesterol paradigm of heart disease. Short-term trials showed mortality from heart attacks was reduced by 25-50% with magnesium therapy. But the infamous 4th International Study of Infarct Survival mega-study failed to confirm these earlier reports and concluded magnesium has no place in the treatment of hear attacks.
However, as Dr. Mildred Seelig noted, magnesium infusions were withheld until circulation (reperfusion) was reinstated in coronary arteries rather than prior to reperfusion, which was shown to be protective in animal studies. Damage to the heart occurs when circulation is reestablished as the provision of oxygen induces tissue damaging oxygen free radicals. Magnesium was infused after the damage had take place. In other words, the study was rigged to fail. [Canadian Journal Cardiology Nay 1998]
One of the gnawing realities of growing old is the discovery your hands are beginning to shake. It’s called essential tremor and often affects the hands but may also affect the head, arms or legs (it is not related to Parkinson’s disease). Over 200,000 new cases of hand tremor are newly diagnosed each year.
A clue to this autonomic system nervous disorder is traced to the Pacific Island of Guam where cases of Parkinson’s-like movement disorder were widely reported. The drinking water there contained low levels of calcium and magnesium and high levels of aluminum. [Neuropathology April 2006] What was eventually concluded is that low magnesium intake over two generations induces loss of brain cells that secrete dopamine. [Parkinsonism Related Disorders June 2005] Low calcium/magnesium levels in laboratory mice induce movement disorders and motor deficits. [Bioscience Biotechnology Biochemistry 2013]
Sensitivity to physical or emotional stress
One of the lessons taught by Mildred Seelig was a shortage of magnesium, particularly a relative deficiency compared to overwhelming amounts of calcium, increases the release of adrenal stress hormones (catecholamines) which further reduces magnesium levels. This results in vulnerability to physical stress (exertion, heat, cold, trauma, accidental or surgical trauma) or emotional stress (pain, anxiety, excitement or depression). [Journal American College Nutrition Oct 1994]
This suggests magnesium should be front-line therapy for chronic or periodic bouts of anxiety or mental depression. The first published information regarding the beneficial effect of magnesium for mental depression was published 100 years ago. [Pharmacological Reports 2013]
Magnesium and antioxidants
While there has been much discussion over the need for antioxidants from the diet and supplements to allay the maladies of old age, magnesium deficiency itself contributes to the aging process itself by increased susceptibility to oxidative damage. In other words, not only would magnesium adequacy eliminate the need for many drugs it would also reduce the need for dietary or supplemental antioxidants. [Magnesium Research Dec 1993]
Over a decade ago the following was said about magnesium:
“It is highly regrettable that the deficiency of such an inexpensive, low-toxicity nutrient results in diseases that cause incalculable suffering and expense throughout the world. The range of pathologies associated with magnesium deficiency is staggering.” [Medical Hypotheses Feb 2001]
Unequivocally there is an epidemic-like dietary shortage of magnesium. And it is clear that it is financially advantageous for a self-serving anti-dietary supplement medical industry to allow this mineral deficiency to remain prevalent.
It can be said that many of the profit centers of modern medicine are largely reliant upon a magnesium deficiency. The many drugs, surgical procedures and other therapies that rely upon a shortage of magnesium suggests modern medicine may never want to face up to the fact a deficiency of this essential mineral ensures a demand for modern medicines.
A clueless dietary supplement industry continues to peddle poorly absorbed insoluble magnesium oxide and ignorantly sells $6 billion a year of calcium supplements globally under the mistaken idea bone loss and resultant fractures among postmenopausal women emanates from a calcium deficiency when its origin is an estrogen deficiency. Supplemental calcium does not prevent bone fractures among older men and women. [Therapeutic Advances Drug Safety Oct 2013; MinnPost July 24, 2015; British Medical Journal July 21, 2015]
The dietary supplement industry is in denial and ignores the fact that the calculations used to fashion the recommended 1000 milligram daily calcium intake for postmenopausal females as advocated by the National Osteoporosis Foundation includes dietary plus supplemental sources, not supplements alone. [National Osteoporosis Foundation] The dairy-rich American diet meets most of that requirement alone. This results in American women overdosing on calcium, a practice the results in more mortal heart attacks. [Journal Internal Medicine Oct 2015; Nutrients July 2013] Studies that allegedly disprove the connection between heart attacks and calcium supplements have included women who are not fully menopausal which skews the data and conclusions drawn.
What a price modern society pays for the lack of magnesium.
How much magnesium?
Bottom line: obtain calcium from the diet, not supplements. Use magnesium supplements (not mag –oxide) to achieve adequacy and calcium-magnesium balance.
Dr. Seelig advised magnesium intake of 6 milligrams per kilogram (2.2 lbs.) of body weight or a negative magnesium balance is likely to develop, particularly in males. A 90- kilogram male (198 lbs.) would need 540 mg of dietary + supplemental magnesium per day. A 60 kilogram (132-lb.) adult female would need 360 milligrams of calcium from their diet + supplements.
Dr. Seelig noted that the Asian diet provides ~6-10 mg magnesium per kilogram of body weight while Western diets provide less than 5 mg per kilogram. [American Journal Clinical Nutrition June 1964]
Magnesium depleting agents:
Drugs needlessly used in lieu of magnesium
Symptoms, signs, diseases associated with magnesium deficiency
Primary side effect from excessive magnesium: