Magnesium — the mineral for digestion, anxiety, and blood sugar

Magnesium is an often-overlooked mineral that can improve numerous health conditions. It plays a surprisingly large role in the human body, as it is used as a cofactor in over 300 enzymatic reactions and is crucial in several detoxification pathways [1].

Magnesium deficiency is more common than you think

Magnesium is an essential mineral in that it is not synthesizable - it must be continually replenished through foods and water intake. It also happens to be deficient in the diets of many Canadians [2].

While many of us do not obtain enough from our diet, magnesium may become further depleted in digestive disorders like irritable bowel syndrome (IBS), small intestinal bacterial overgrowth (SIBO), Crohn’s, colitis, and celiac disease.

Those with hormonal conditions may also suffer from hypo-magnesemia. For example, diabetes (both type 1 and type 2) is the most common metabolic disorder associated with magnesium deficiency [2]. In fact, up to 47 percent of diabetics may be deficient in magnesium [2,3].

Many pharmaceutical drugs also deplete magnesium. One such drug class is the over-prescribed proton pump inhibitors (PPIs), which treat acid reflux and ulcers by reducing stomach acid production [4]. PPIs include commonly-prescribed drugs like esomeprazole (Nexium), dexlansoprazole (Dexilent), and omeprazole (Prilosec).

Magnesium can help…

Low magnesium intakes and/or blood magnesium concentrations have been associated with a number of diseases and health conditions including high blood pressure, reduced bone mineral density, cardiovascular disease, and colorectal cancer [2].

Not only does magnesium defend against type 2 diabetes and cardiovascular disease; its biological activity makes it effective in addressing other chronic conditions like painful periods, headaches and migraines, fibromyalgia, and musculoskeletal pain. It is also one of my top supplements that I recommend as a natural laxative to promote regular bowel movements in constipation-prone patients with irritable bowel syndrome.

Sufficient levels do not = optimal levels

As with all minerals, it is best to obtain them from diet rather than from supplements. Foods rich in magnesium include whole grains, legumes, nuts, green leafy vegetables, and soy.

But the nutrient profile of our soils today is not the same as 50 years ago. A gradual depletion of nutrients from agricultural soils over time has resulted in lower magnesium levels in many vegetables [5].

So, while (theoretically) one should be able to obtain an optimal daily intake of magnesium from food sources, supplementing with magnesium may be an effective way to achieve optimal magnesium levels.

Are you taking the right form of magnesium?

Taking the right magnesium supplement specific to one’s condition and health goals can make a world of difference in addressing symptoms.

There are several forms of magnesium available. The three most common I recommend are citrate, glycinate (or bisglycinate), and malate.

If you’re thinking, “I’ve got this covered — I’m already taking magnesium!” then check your supplement label. Magnesium oxide is the cheapest and least effective form of magnesium, and you will typically find it in low quality supplements or multivitamins. Oxide has about a 4 percent absorption rate, so it is less soluble and less bioavailable than the other forms of magnesium [1].

Magnesium citrate is excellent at moving the bowels. I typically recommend this to my patients with irritable bowel syndrome to support digestion, sleep, and anxiety. Magnesium is special in that it activates enzymes that control digestion, absorption, and the utilization of macronutrients (proteins, fats and carbohydrates). Magnesium citrate is highly absorbed and bioavailable, but also acts as a natural, mild laxative at higher doses.

Magnesium bis-glycinate (or bis-glycine) contains the amino acid glycinate, which is well-known for having a calming effect on the body.  This form has less of a laxative effect compared to citrate.

Magnesium malate has been studied in individuals with fibromyalgia and chronic fatigue syndrome [6,7]. Malate is a substrate used in our cellular energy cycle and can help improve ATP production - our chief energy storage molecule in the body.

Magnesium aspartate is a less common form of magnesium. It is more bioavailable than oxide but less than citrate [8]. Dated research found that a combination of potassium and magnesium aspartates improved fatigue and reduced muscle hyper-excitability [9], and may also be helpful in reducing blood pressure in individuals with mild-to-moderate hypertension [10].

I consider magnesium taurate as the preferred form for the heart. Magnesium taurate has protective actions on the vasculature, and has been studied to help lower elevated blood pressure, slow cholesterol-induced atherogenesis (the formation of fatty “plaques” in the arteries), prevent arrhythmias, and stabilize platelets [11].

I often requisition blood work for my patients to determine if they’re deficient in vitamins and minerals. Are you wondering if you’re deficient in magnesium or other nutrients? Book a free consult with me to discuss more.

- Dr. Dominique Vanier is a registered naturopath in Burlington with a clinical focus on digestion and women’s hormones. Naturopath Burlington. This article is for information purposes only. It is not intended to treat or diagnose any health conditions.

References:

[1] Firoz, M. and Graber, M. (2001). Bioavailability of US commercial magnesium preparations. Magnesium Research, [online] 14(4), pp.257-62. Available at: https://www.ncbi.nlm.nih.gov/pubmed/11794633.

[2] Bertinato, J., Wang, K. and Hayward, S. (2017). Serum Magnesium Concentrations in the Canadian Population and Associations with Diabetes, Glycemic Regulation, and Insulin Resistance. Nutrients, 9(3), p.296.

[3] Pham, P., Pham, P., Pham, S., Miller, J. and Pham, P. (2007). Hypomagnesemia in Patients with Type 2 Diabetes. Clinical Journal of the American Society of Nephrology, 2(2), pp.366-373.

[4] Toh, J., Ong, E. and Wilson, R. (2014). Hypomagnesaemia associated with long-term use of proton pump inhibitors. Gastroenterology Report, 3(3), pp.243-253.

[5] Guo, W., Nazim, H., Liang, Z. and Yang, D. (2016). Magnesium deficiency in plants: An urgent problem. The Crop Journal, 4(2), pp.83-91.

[6] Turkulov, V. (2014). Multivitamin mineral supplementation in patients with chronic fatigue syndrome. Medical Science Monitor, 20, pp.47-53.

[7] Abraham, G. and Flechas, J. (1992). Management of Fibromyalgia: Rationale for the Use of Magnesium and Malic Acid. Journal of Nutritional Medicine, 3(1), pp.49-59.

[8] Mühlbauer, B., Schwenk, M., Coram, W., Antonin, K., Etienne, P., Bieck, P. and Douglas, F. (1991). Magnesium-L-aspartate-HCl and magnesium-oxide: bioavailability in healthy volunteers. Eur J Clin Pharmacol., 40(4), pp.437-8.

[9] Nagle FJ, Balke B, Ganslen RV, Davis AW. (1963). The mitigation of physical fatigue with "Spartase". FAA Office of Aviation Medicine Reports. Rep Civ Aeromed Res Inst US. 26:1-10.

[10] Witteman, J., Grobbee, D., Derkx, F., Bouillon, R., de Bruijn, A. and Hofman, A. (1994). Reduction of blood pressure with oral magnesium supplementation in women with mild to moderate hypertension. The American Journal of Clinical Nutrition, 60(1), pp.129-135.

[11] McCarty, M. (1996). Complementary vascular-protective actions of magnesium and taurine: a rationale for magnesium taurate. Med Hypotheses, 46(2), pp.89-100.