Magnesium is an essential mineral and acts as a cofactor in over three hundred biochemical processes. (1) Human bodies contain about 25 grams of magnesium, on average, and approximately 50 percent of it is housed in our bones, with the remainder distributed throughout our soft tissues, such as our musculature. (2) Magnesium also preponderates in our extracellular fluid (ECF) as well as our cerebrospinal fluid (CSF). (3)

Because our food supply no longer contains the required levels of magnesium due to top soil erosion and deficiency, estimated average requirements (EAR) for healthy individual groups often are globally not met. (4) The richest sources of magnesium include nuts, legumes, whole grains, and fruit, but there are also significant amounts in coffee and cocoa, as well as dairy, meats, and fish. Harder water, that is, water which is high in dissolved minerals, can also be a rich source of magnesium. (5)

Types of Magnesium

There are up to eleven various forms of magnesium. (6) Various forms and their known applications include the following: 

• Magnesium chloride (which can help replete overall magnesium)
• Magnesium citrate (which can improve constipation, sleep, anxiety, and depression)
• Magnesium glycinate (which can improve sleep and stress, as well as anxiety and depression)
• Magnesium lactate (which is known for lowering stress and anxiety)
• Magnesium malate (which can improve fibromyalgia, fatigue, and muscle weakness)
• Magnesium orotate (which can improve heart health)
• Magnesium oxide (which can improve digestion and constipation)
• Magnesium sulfate (which can soothe muscles and relieve stress)
• Magnesium taurate (which can improve blood sugar dysregulation and heart health)
• Magnesium L-threonate (which can improve brain health) 

How magnesium may impact your health

This article will briefly discuss seven reasons that magnesium may be the most underrated nutrient.

1. Malabsorption Can Cause Magnesium Deficiency: Magnesium is mainly absorbed in the distal small intestine, that is, in the distal jejunum and ilium, but some is also absorbed in the large intestine (7). 
   
   For this reason, surgeries such as small bowel resection or conditions such as small intestinal bacterial overgrowth (SIBO), could significantly impact the body’s ability to absorb magnesium and even cause malabsorption. (8)
   
   According to a review study, about half of the US population may be magnesium deficient. (9)

2. Chronic Stress Can Cause Magnesium Deficiency: Pre-clinical and clinical studies have demonstrated that chronic stress depletes magnesium stores. (10)
   
   When the body is exposed to a stressful environment, magnesium levels temporarily rise in the extracellular fluid (ECM), that is, the fluid not contained in the cells but rather in the blood and lymph. 
   
   The kidneys are responsible for filtering the ECM, so then they filter out the magnesium levels and the body becomes depleted. When this happens frequently over time, a person becomes more at risk of severe magnesium deficiency.
   
   In other words, part of the problem is that under stress magnesium moves from the intracellular fluid, that is, the compartments of the cells, to the ECM, that is, the blood and the lymph, and then is excreted by the kidneys. (11)

3. Blood Levels of Magnesium Can Be Inaccurate: Serum or blood levels of magnesium are the most common tests relied upon to test magnesium but they are often not accurate. (12)
   
   The reason is that the body will draw upon magnesium from the bone stores when magnesium is low, offsetting any deficiency which may show up on blood work. 
   
   For this reason, magnesium deficiency is a vastly underdiagnosed condition and often not identified in the blood when it is likely present and producing symptoms in the body. (13)

4. Allostatic Overload Can Cause Magnesium Deficiency: Stress impact can be cumulative and a detriment to health outcomes, explained by the concept of allostasis. (14)
   
   Basically, daily situations such as exercising or hunger, can signal constant changes to the organism that help it to achieve and maintain normal functions, thus reflecting an adaptive response. 
   
   However, over time the continual maintenance of normal function while adapting to these constant changes or new normal, which costs the body energy and resources, may cause functional and structural damage due to “wear and tear” on the body, or allostatic overload. (15)
   
   With acute or chronic stress, our allostatic load becomes heavier, and this can deplete our magnesium stores.
   
   What may add insult to injury is that magnesium deficiency can further exacerbate chronic stress, and vice versa, a process which has been referred to as the vicious cycle in the magnesium literature. (16)

5. Our Brain Depends on Magnesium: As previously mentioned, magnesium also runs aplenty in our cerebrospinal fluid (CSF), transported there by the choroidal plexus of the ventricular system. Interestingly, magnesium is less likely to fall at a rapid rate in the brain as opposed to the ECM, when the system is under stress. (17)
   
   Brain-derived neurotrophic factor (BDNF) is a neuroprotective protein, which steps in during allostatic overload to protect our brain by promoting neuronal survival and plasticity. 
   
   However, stressful can decrease our BDNF signaling. When stress stimuli are high oxidative stress also ramps up in the brain. 
   
   Magnesium serves an inhibitory function in the regulation of our stress response. In other words, magnesium deficiency can indirectly impact neurotransmission and neuroprotection. Studies have shown that magnesium appears to positively impact BDNF expression. (18)

6. Depression Is Linked to Magnesium Deficiency: Did you know that magnesium is the main cofactor in our brain for the enzyme, tryptophan hydroxylase, that synthesizes serotonin (5-HT)? (19) 
   
   Serotonin plays a profound role in memory, learning, attention, and most notably, happiness, so it implies that magnesium deficiency could directly lead to symptoms of depression, brain fog, attention and cognitive deficit, as well as learning disorders. (20)
   
   Not only is magnesium required to make 5-HT but it also plays an important role in the sensitivity of our serotonin receptors to receive neurotransmission. (21)

7. Vitamin D Deficiency and Calcium Deficiency Can Be Caused by Magnesium Deficiency: Studies show that inadequate blood magnesium levels directly lead to low calcium levels as well as resistance to some of the effects of Vitamin D. But most importantly magnesium is a cofactor in the production and synthesis of Vitamin D in the liver and kidneys, as well as in the absorption of D2 and D3 in the diet. (22)

Obviously, magnesium is pretty incredible. And slightly underrated, dare I say? My favorite form of magnesium in terms of therapy is floating in a sensory deprivation float tank rich in magnesium sulfate or epsom salts. Though studies are limited, one session of sensory deprivation is enough to significantly raise magnesium levels in the blood. (23) The skin actually absorbs magnesium (transdermal magnesium) better than the gut does. If you have not tried this therapy, please do, and let me know what you think?

What are your favorite forms of magnesium, whether it be from diet, supplements, or therapies such as epsom salt baths or sensory deprivation therapy?

Resources:

1. Magnesium. Linus Pauling Institute. (2022, January 3). Retrieved December 19, 2022, from https://lpi.oregonstate.edu/mic/minerals/magnesium
2. Pickering, G., Mazur, A., Trousselard, M., Bienkowski, P., Yaltsewa, N., Amessou, M., Noah, L., & Pouteau, E. (2020). Magnesium Status and Stress: The Vicious Circle Concept Revisited. Nutrients, 12(12), 3672. https://doi.org/10.3390/nu12123672
3. Morris M. E. (1992). Brain and CSF magnesium concentrations during magnesium deficit in animals and humans: neurological symptoms. Magnesium research, 5(4), 303–313. https://pubmed.ncbi.nlm.nih.gov/1296767/
4. Cazzola, R., Della Porta, M., Manoni, M., Iotti, S., Pinotti, L., & Maier, J. A. (2020). Going to the roots of reduced magnesium dietary intake: A tradeoff between climate changes and sources. Heliyon, 6(11), e05390. https://doi.org/10.1016/j.heliyon.2020.e05390
5. Healthdirect Australia. (n.d.). Foods high in magnesium. healthdirect. Retrieved December 19, 2022, from https://www.healthdirect.gov.au/foods-high-in-magnesium
6. U.S. Department of Health and Human Services. (n.d.). Office of dietary supplements - magnesium. NIH Office of Dietary Supplements. Retrieved December 19, 2022, from https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/
7. Schuchardt, J. P., & Hahn, A. (2017). Intestinal Absorption and Factors Influencing Bioavailability of Magnesium-An Update. Current nutrition and food science, 13(4), 260–278. https://doi.org/10.2174/1573401313666170427162740
8. Miranda, S. C., Ribeiro, M. L., Ferriolli, E., & Marchini, J. S. (2000). Hypomagnesemia in short bowel syndrome patients. Sao Paulo medical journal = Revista paulista de medicina, 118(6), 169–172. https://doi.org/10.1590/s1516-31802000000600004
9. DiNicolantonio, J. J., O'Keefe, J. H., & Wilson, W. (2018). Subclinical magnesium deficiency: a principal driver of cardiovascular disease and a public health crisis. Open heart, 5(1), e000668. https://doi.org/10.1136/openhrt-2017-000668
10. Pickering, G., Mazur, A., Trousselard, M., Bienkowski, P., Yaltsewa, N., Amessou, M., Noah, L., & Pouteau, E. (2020). Magnesium Status and Stress: The Vicious Circle Concept Revisited. Nutrients, 12(12), 3672. https://doi.org/10.3390/nu12123672
11. Pickering, G., Mazur, A., Trousselard, M., Bienkowski, P., Yaltsewa, N., Amessou, M., Noah, L., & Pouteau, E. (2020). Magnesium Status and Stress: The Vicious Circle Concept Revisited. Nutrients, 12(12), 3672. https://doi.org/10.3390/nu12123672
12. Workinger, J. L., Doyle, R. P., & Bortz, J. (2018). Challenges in the Diagnosis of Magnesium Status. Nutrients, 10(9), 1202. https://doi.org/10.3390/nu10091202
13. Ismail, A. A. A., Ismail, Y., & Ismail, A. A. (2018). Chronic magnesium deficiency and human disease; time for reappraisal?. QJM : monthly journal of the Association of Physicians, 111(11), 759–763. https://doi.org/10.1093/qjmed/hcx186
14. Zhang, Y., Yang, Z., Yang, H., Li, X., Liu, Z., Bai, Y., Qian, G., Wu, H., Li, J., Guo, Y., Yang, S., Chen, L., Yang, J., Han, J., Ma, S., Yang, J., Yu, L., Shui, R., Jin, X., Wang, H., … Tao, S. (2022). A multi-center study on the association between serum magnesium levels and allostatic load in hemodialysis patients. Frontiers in physiology, 13, 963914. https://doi.org/10.3389/fphys.2022.963914
15. Rodriquez, E. J., Kim, E. N., Sumner, A. E., Nápoles, A. M., & Pérez-Stable, E. J. (2019). Allostatic Load: Importance, Markers, and Score Determination in Minority and Disparity Populations. Journal of urban health : bulletin of the New York Academy of Medicine, 96(Suppl 1), 3–11. https://doi.org/10.1007/s11524-019-00345-5
16. Pickering, G., Mazur, A., Trousselard, M., Bienkowski, P., Yaltsewa, N., Amessou, M., Noah, L., & Pouteau, E. (2020). Magnesium Status and Stress: The Vicious Circle Concept Revisited. Nutrients, 12(12), 3672. https://doi.org/10.3390/nu12123672
17. Morris M. E. (1992). Brain and CSF magnesium concentrations during magnesium deficit in animals and humans: neurological symptoms. Magnesium research, 5(4), 303–313. https://pubmed.ncbi.nlm.nih.gov/1296767/
18. Afsharfar, M., Shahraki, M., Shakiba, M., Asbaghi, O., & Dashipour, A. (2021). The effects of magnesium supplementation on serum level of brain derived neurotrophic factor (BDNF) and depression status in patients with depression. Clinical nutrition ESPEN, 42, 381–386. https://doi.org/10.1016/j.clnesp.2020.12.022
19. Maffei M. E. (2020). 5-Hydroxytryptophan (5-HTP): Natural Occurrence, Analysis, Biosynthesis, Biotechnology, Physiology and Toxicology. International journal of molecular sciences, 22(1), 181. https://doi.org/10.3390/ijms22010181
20. Dfarhud, D., Malmir, M., & Khanahmadi, M. (2014). Happiness & Health: The Biological Factors- Systematic Review Article. Iranian journal of public health, 43(11), 1468–1477. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4449495/
21. Botturi, A., Ciappolino, V., Delvecchio, G., Boscutti, A., Viscardi, B., & Brambilla, P. (2020). The Role and the Effect of Magnesium in Mental Disorders: A Systematic Review. Nutrients, 12(6), 1661. https://doi.org/10.3390/nu12061661
22. McVay, I. (2021, June 25). The tremendous trio: Magnesium, vitamin D, and calcium. IPA Physio. Retrieved December 19, 2022, from https://ipa.physio/the-tremendous-trio-magnesium-vitamin-d-and-calcium/#:~:text=Magnesium%20is%20involved%20in%20over,calcium%20for%20total%20body%20homeostasis.
23. Gröber, U., Werner, T., Vormann, J., & Kisters, K. (2017). Myth or Reality-Transdermal Magnesium?. Nutrients, 9(8), 813. https://doi.org/10.3390/nu9080813