Magnesium deficiency is known to be associated with Type 2 diabetes, high blood pressure, cardiovascular disease, stroke, migraine headaches, anxiety, depression, Alzheimer’s disease and muscle pains, to name a few. 1
What is Magnesium?
Magnesium is a mineral that plays an important role in maintaining our health. In particular, it supports healthy glucose metabolism, blood pressure, heart rate, brain function, nerve conduction, muscle relaxation and immune system health. Magnesium is involved in more than 300 metabolic reactions in our body. That’s why it has such as wide range of effects on our health.
Magnesium Deficiency, Insulin Resistance and Type 2 Diabetes
There is an interesting relationship between Magnesium deficiency and Type 2 diabetes.
Several studies show that low Magnesium may contribute to the development – and worsening – of Type 2 diabetes.
When diabetes is uncontrolled, there is excess loss of Magnesium in the urine which causes further depletion of magnesium in the body. Then, low Magnesium worsens insulin resistance – the root cause of Type 2 diabetes. Consequently, there is a further rise in blood sugar levels and diabetes gets more out of control. In this way, a vicious cycle sets in: Magnesium deficiency causing uncontrolled diabetes which causes further depletion of Magnesium which leads to further elevation in blood glucose levels.
How does Low Magnesium cause High Blood Sugar and Type 2 Diabetes?
Magnesium plays an important role in carbohydrate metabolism, in particular insulin sensitivity. Therefore, Magnesium deficiency can lead to a decrease in insulin sensitivity. In other words, an increase in insulin resistance. 2 In most cases, insulin resistance is the root cause of elevated blood glucose, Prediabetes and Type 2 diabetes. This is how low Magnesium can increase your blood sugar and contribute to the development of Prediabetes and Type 2 diabetes.
Evidence that Low Magnesium may Increase the Risk of Type 2 Diabetes
A number of studies show a relationship between low Magnesium level and a high risk of developing Type 2 diabetes. One such study comes from Harvard University and was published in Diabetes Care, official journal of the American Diabetes Association. In this long-term, prospective study, researchers followed 85,060 women and 42,872 men who had no history of diabetes, cardiovascular disease, or cancer at baseline. A total of 4,085 women and 1,333 men developed Type 2 diabetes. According to the researchers, there was a significant inverse association between Magnesium intake and diabetes risk. In other words, the lower the Magnesium intake, the higher the risk of developing Type 2 diabetes.3
Can Magnesium Supplement Help Type 2 Diabetes?
Researchers have been curious to find out if magnesium supplements can help diabetes. Researchers from Mexico carried out a study which included a total of 63 Type 2 diabetics with low Magnesium levels in the blood. These diabetic patients received either 50 ml of Magnesium Chloride solution (containing 2.5 g of Magnesium Chloride) or a placebo for a period of 16 weeks. The researchers found that Magnesium supplementation, as compared to a placebo, showed a significant decrease in fasting blood glucose levels from 185 (10.3 mmol/l) to 144 mg/dl (8.0 mmol/l). Hemoglobin A1c also decreased from 10.1% to 8.0%. In addition, Magnesium supplementation decreased insulin resistance in these diabetics. This study was published in Diabetes Care in 2003. 4
Can Magnesium Deficiency Cause Hypertension and How?
Magnesium plays an important role in the relaxation of the blood vessel wall – a process called vasodilatation – which gets impaired if you have low Magnesium. Then, blood vessels get constricted – a process called vasoconstriction – which leads to hypertension – high blood pressure.
At the cellular level, there are two important pumps: Sodium-Potassium pump and Calcium-Magnesium pump. These pumps – when working optimally – keep most of the Potassium and Magnesium inside the cell and most of the Sodium and Calcium outside the cell – in the blood. In this way, there is a balance between vasodilatation and vasoconstriction and you have a normal blood pressure.
But when you are low in Magnesium – or Potassium – these pumps do not function right. Consequently, there is an accumulation of Calcium and Sodium inside the cell which causes the blood vessels to constrict. Consequently, your blood pressure gets elevated. 5
Can Magnesium Supplements Lower high Blood Pressure?
A number of studies have investigated the effect of Magnesium supplements to lower blood pressure, but the results are conflicting – mainly due to inconsistency in the study designs. Therefore, researchers from Stanford University – in collaboration with their peers in China and Japan – analyzed 34 trials involving 2028 participants. They concluded, “Our findings indicate a causal effect of Mg supplementation on lowering BPs in adults. Mg supplementation with a dose of 300 mg per day for a duration of 1 month is sufficient to elevate serum Mg and reduce BP.” 6
This critical scientific analysis clearly demonstrate that Magnesium supplements may lower blood pressure in a period of one month.
Can Low Magnesium Cause Migraine Headaches?
Migraine headache is usually associated with low level of Magnesium in the brain, cerebrospinal fluid (CSF) to be more specific. Migraine sufferers seem to be low in magnesium due to genetic as well as environmental factors.7
Symptoms of migraine include pain on one side of the head, nausea, vomiting, intolerance of light and sound, and sometimes visual changes.
Migraine headache is basically a form of a seizure-like neurological disorder with secondary changes in the blood vessels. That’s why the anti-seizure drug, Topiramate, is an effective treatment for migraine headaches.
Can Magnesium Supplements Prevent and Treat Migraine Headaches?
Magnesium has a calming effect on the brain. Therefore, it makes sense to use Magnesium supplements in the prevention and treatment of migraine headaches. In fact, Magnesium supplements has been used extensively in the prophylaxis and treatment of migraine headaches.7
According to researchers from New York Headache Center, all migraine sufferers should be given a trial with oral Magnesium supplement because Magnesium deficiency may be present in up to half of migraine patients. 8
Magnesium Deficiency and Alzheimer’s Disease
A link between Magnesium deficiency and Alzheimer’s disease has been a topic of intense research for more than 30 years. Researchers from the University of Padova, Italy critically analyzed all of the studies on Magnesium deficiency and Alzheimer’s disease in 2016. Their research included 559 patients with Alzheimer’s disease and a comparable number of controls. They discovered that patients with Alzheimer’s disease had significantly lower Magnesium in the CSF (cerebrospinal fluid) and in the hair. 9
Can Magnesium Supplements Improve Cognitive Impairment?
Alzheimer’s disease has a multitude of symptoms: memory loss, impairment of cognition and behavioral changes being the most common ones. While there aren’t any credible studies on the benefits of Magnesium supplement on Alzheimer’s disease per se, there are studies which show beneficial effects of dietary Magnesium on cognition. One such study comes from Australia, in which researchers found higher Magnesium intake in diet was associated with a reduced risk of developing mild cognitive impairment.10
Magnesium Deficiency is Linked to Anxiety and Depression
Low magnesium is one of the dietary factors that can increase your risk of anxiety as well as depression, according to several studies. One such study comes from Iran. A total of 3172 adults were included in the study. Researchers investigated the dietary intake of Magnesium and symptoms of anxiety and depression. They found a 39% risk reduction for anxiety and 55% lower risk for depression in individuals with the highest dietary intake of Magnesium. In addition, participants who were low in Magnesium had about 80% increased risk of developing anxiety. 11
Is there evidence to show that Magnesium deficiency is not merely an association but can actually cause anxiety? The answer is yes. Researchers from Austria – in 2012 – clearly demonstrated that low Magnesium can cause anxiety in an animal model. They demonstrated that low Magnesium state caused an activation of the stress hormone – CRH (Corticotropin Releasing Hormone) from the hypothalamus, the brain center of the stress hormones, and gave rise to the classical symptoms of anxiety. 12
Can Magnesium Supplements Help to Relieve Anxiety?
As Magnesium deficiency is linked to anxiety, researchers have been curious to see if Magnesium supplements may relieve anxiety symptoms. A randomized, double-blind, placebo-controlled study from the UK, enrolled Forty-four women with an average age of 32 years. Participants were given 200 mg of Magnesium and 50 mg of vitamin B6 for one cycle for the relief of mild anxiety-related premenstrual symptoms. Researchers noted a significant reduction in the anxiety-related premenstrual symptoms (nervous tension, mood swings, irritability, or anxiety.) 13
Low Magnesium can Cause Muscle Cramps
Low Magnesium is a known risk factor for muscle spasms. Researchers from Newfoundland, Canada, described two dramatic cases of Magnesium deficiency. First was a 17- year old soldier who presented with severe generalized muscle pain and weakness to the point that he could not even walk. He was found to have low Magnesium level in the blood and was given intravenous Magnesium sulfate. He was completely pain free in four days. The other case was an 81- year old woman who presented with some pains in her legs, but severe pain in her abdomen. She was also found to be low in Magnesium and was treated with intravenous Magnesium sulfate. She was completely pain free by the third day. 14
Magnesium, Immune System and COVID-19
Magnesium helps to regulate our immune system. Scientists have discovered a gene called MAGT1, that leads to the production of Magnesium transporters. These transporters help to move Magnesium into special immune cells called CD8+ T cells. 15
Specialized T-cells specifically attack the invading viruses such as Epstein-Barr virus (EBV) and Coronavirus which is responsible for COVID-19. In this way, Magnesium plays an important role in boosting our immune system against viruses.
In addition, Magnesium is required for the activation of Vitamin D, which has been shown to regulate our immunity against COVID-19
Evidence that Magnesium Supplement may Help COVID-19 Patients
Is there a role of Magnesium supplement in COVID-19?
In a recently published study, researchers from Singapore carried out a placebo-controlled study in COVID-19 patients who were more than 50 years of age and required hospitalization. They administered a vitamin cocktail of 1000 IU/day of oral Vitamin D3, 150 mg/day of oral Magnesium, and 500 mcg/day of oral Vitamin B12 upon admission if patients did not require oxygen therapy. They followed these patients to see how many deteriorated to the point of requiring oxygen and/or admission to an intensive care unit.
The authors observed an overwhelming 83% risk reduction for oxygen therapy – and 80% reduction for admission to an intensive care unit- in patients who received Magnesium, Vitamin D and Vitamin B12. 16 This is an impressive scientific study to show the role of Magnesium supplement in COVID-19 – in addition to Vitamin D and Vitamin B12.
Symptoms of Magnesium Deficiency
Common symptoms of low Magnesium include:
- Muscle spasms and cramps
- Fibromyalgia
- Irritability
- Anxiety
- Insomnia
- Migraine headaches
- Seizures
- Irregular heart beat/heart arrhythmias/Atrial fibrillation
- High blood pressure
- Chest pain to spasm of coronary arteries
- Chronic fatigue
- Menstrual cramping
- Menopausal symptoms
- Tics
- Lack of appetite
- Nausea/vomiting
- Lack of balance
- Vertigo
- ADD/ADHD
- Dementia
- Constipation
The Pandemic of Magnesium Deficiency
We are facing an epidemic of Magnesium deficiency. This is probably one of the factors for such an increase in the number of Type 2 diabetes, high blood pressure, anxiety, depression and migraine headaches in the U.S as well as around the world.
Here are some of the reasons for this pandemic.
What Causes Magnesium Deficiency?
- Stress, both physical as well as psychological, causes a continuous release of adrenaline, which causes constriction of blood vessels, a rise in heart rate and an increased demand on the heart muscle. The body uses Magnesium to counteract all of these negative effects of excess adrenalin. Consequently, less magnesium is available for the rest of the body.
- The typical western diet is low in food items that contain Magnesium. According to USDA (United States Department of Agriculture), only 1 out of 3 Americans consumes the recommended amounts of Magnesium in their diet.17 Unfortunately, western diet has now become the global diet.
- Phosphates in sodas, processed meats and other foods combine with Magnesium to produce Magnesium phosphate, which is an insoluble compound and cannot be absorbed.
- Old age is also associated with low Magnesium due to a decrease in the absorption of dietary Magnesium and use of a number of medications – outlined below.
- There are a number of medical conditions and drugs that can lower your Magnesium level.
Medical Conditions that can Cause Magnesium Deficiency
The following medical conditions can cause Magnesium depletion.
- Uncontrolled diabetes causes an increased loss of Magnesium in the urine.
- Alcoholism causes a decrease in the absorption of Magnesium.
- Chronic malabsorption diseases such as Crohn’s disease, ulcerative colitis, Irritable Bowel Syndrome and Celiac sprue cause a decrease in the absorption of Magnesium.
- Stomach or intestinal bypass surgery cause a decrease in the absorption of Magnesium.
- Chronic pancreatic insufficiency causes a decrease in the absorption of Magnesium.
Drugs that can cause Magnesium Deficiency
Diuretics:
Lasix (Furosemide) and Hydrochlorothiazide, which are so commonly used in diabetics for their high blood pressure and weak heart. These drugs cause an excessive wasting of Magnesium in the urine.
Heartburn and anti-ulcer medications:
Prolonged use of heartburn and anti-ulcer medications (more than one year.)
These drugs include Prilosec (omeprazole), Prevacid (lansoprazole), Nexium (esomeprazole), Protonix (pantoprazole), Aciphex (rabeprazole), Dexilant (dexlansoprazole). Magnesium in diet as well in Magnesium supplements need to be broken down by Hydrochloric acid in the stomach before it can be absorbed. The above-mentioned medicines drastically reduce the amount of Hydrochloric acid in the stomach. That’s how they interfere with the absorption of Magnesium.
Steroids:
Steroids such as Hydrocortisone, Prednisone and Dexamethasone cause an increased loss of Magnesium in the urine.
Estrogen:
Estrogen in birth control pills and hormone replacement therapy causes an increased loss of Magnesium in the urine.
Asthma medications:
Drugs to treat asthma such as epinephrine, isoproterenol and aminophylline cause more consumption of Magnesium in the cells of the blood vessels to counteract the effects of adrenaline, which creates a relative deficiency of Magnesium for the rest of the body.
Antibiotics:
Some antibiotics such as Garamycin (gentamycin), Nebcin (tobramycin), carbenicillin, ticarcillin, and tetracyclines cause an excessive loss of Magnesium in the urine.
Anti-fungal drugs:
Amphotericin B and Pentamidine cause huge losses of Magnesium in the urine.
It’s no surprise that we are facing a pandemic of Magnesium deficiency.
What is the Test for Magnesium Deficiency?
There is a blood test available for Magnesium level in the blood. However, this test diagnoses only severe cases of Magnesium deficiency, because 99% of Magnesium is inside the cells and only about 1% is present in the blood. Even when you have mild Magnesium deficiency, blood level of Magnesium is kept within the normal range due to import of Magnesium from the bones which store most of the Magnesium in the body.
The best way to diagnose Magnesium deficiency is through your symptoms, your eating habits, presence of medical diseases and use of medicine, as mentioned above. If you suspect you have Magnesium deficiency, increase your consumption of foods rich in Magnesium and/or take Magnesium supplements, and see what happens to your symptoms. The good news is that in general, Magnesium supplements are safe in individuals without any kidney disease. However, toxicity can develop in patients with advanced kidney disease. Many Magnesium supplements can also causes loose stools.
Foods high in Magnesium
The best way to get Magnesium is through foods that are high in Magnesium. Good dietary sources of Magnesium are seeds, nuts, dark leafy green vegetables and fish. These foods are also important for your overall health.
Other foods that contain some quantities of Magnesium include beans, lentils, whole grains and figs.
Seeds and Nuts:
Seeds and nuts are some of the best dietary sources of Magnesium. These include pumpkin seeds, squash seeds, sesame seeds, Brazil nuts, almonds, cashews, pine nuts, pecans and walnuts.
Seeds and nuts are highly beneficial for your overall health as well. For example, almonds are loaded with good fats (monounsaturated fatty acids), and can help to increase your HDL (good) cholesterol. Almonds are a good source of Biotin, fiber and Vitamin E. Almonds and other nuts also slow down the emptying of the stomach and consequently, slow down the rise in blood sugar after a meal. Therefore, a handful of nuts after a meal is much better for your health than traditional desserts.
Pumpkin seeds are important for your prostate health. Brazil nuts are a great source of Selenium, which is important for the normal functioning of your thyroid, immune cells and prostate gland. However, too much Selenium can cause toxicity. About 1 or 2 Brazil nuts a day provide enough selenium for your body.
Note: Raw nuts are better than roasted nuts, as roasting decreases the amount of available Magnesium.
Dark Leafy Green Vegetables:
Spinach, mustard greens, Swiss chard, and kale.
Fish:
Mackerel, Halibut, Pollock, tuna, and most other fish.
Beans and Lentils:
White beans, French beans, black-eyed peas, kidney beans, chickpeas (garbanzo), soybeans, and lentils.
Whole Grains
Quinoa, millet, wheat, brown rice. However, diabetics should consume whole grains in small quantities, as these foods are rich in carbohydrates and can significantly raise your blood sugars.
Magnesium Supplements
If you cannot increase the ingestion of foods that are high in Magnesium, then the alternative is a Magnesium supplement. The daily recommended dose of Magnesium is about 400 mg. In general, Magnesium supplements are safe in individuals without any advanced kidney disease, but toxicity can develop in patients if you have kidney failure. Oral supplements can sometimes cause loose stools, indicating a need to reduce dosage or change the type of Magnesium supplement.
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- Lopez-Ridaura R1, Willett WC, Rimm EB, Liu S, Stampfer MJ, Manson JE, Hu FB. Magnesium intake and risk of type 2 diabetes in men and women. Diabetes Care. 2004 Jan;27(1):134-40.
- Rodríguez-Morán M1, Guerrero-Romero F. Oral magnesium supplementation improves insulin sensitivity and metabolic control in type 2 diabetic subjects: a randomized double-blind controlled trial. Diabetes Care. 2003 Apr;26(4):1147-52.
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