Research & Education

A Condition-Specific Approach to Magnesium Supplementation

More than 50% of Americans are magnesium deficient, and nearly 60% of U.S. adults do not consume the estimated average requirement for magnesium. A deficiency in magnesium is a serious and common health problem as this vital mineral is involved in virtually every metabolic process essential for health. It is a cofactor in more than 350 enzyme systems that regulate biochemical reactions including energy production, protein synthesis, muscle and nerve function, oxidative phosphorylation, blood glucose control, and blood pressure regulation. Every organ in the body, especially the heart, kidney, and muscles, requires magnesium in order to function properly. It contributes significantly to the structural development of bones, is required for the synthesis of DNA, RNA, and glutathione, and supports active transport of calcium and potassium, which is critical for nerve impulse conduction, muscle contraction, and normal heart rhythm. 


Certain conditions and states contribute to magnesium deficiency including gastrointestinal diseases, hypertension and cardiovascular disease (CVD), type 2 diabetes, alcohol misuse/dependence, various forms of chronic stress, as well as the natural aging process. Conversely, insufficient magnesium intake is associated with metabolic syndrome, type 2 diabetes, CVD, Alzheimer’s disease, asthma, migraines, ADHD, osteoporosis, depression, and possibly some cancers according to research. Furthermore, every form of stress accelerates magnesium loss including but not limited to emotional stressors (e.g., chronic worrying, anxiety, depression), physical stressors (e.g., heavy exercise, sports performance, inadequate sleep, pregnancy), environmental stressors (e.g., toxins, pollution, GMOs, heavy metal exposure, cigarette or drug use) and dietary stressors (e.g., processed foods, pesticides, coffee, alcohol, sugar, sodas). Thus, patients under chronic stress may greatly benefit from an increased intake of magnesium. 


There are several forms of supplemental magnesium that play specific roles and impart specific functions in the body depending on a condition or need. As mentioned in a previous article, magnesium L-threonate (MgT) promotes mental health and cognitive function. This form of magnesium is chelated to threonic acid (a metabolite of vitamin C) which drives the transport of magnesium ions across lipid membranes, including those of brain cells; thus it is superior to other forms at passing through the blood-brain barrier and is effective at increasing magnesium levels in the cerebrospinal fluid. MgT may benefit patients suffering from mood disorders, migraines, and neurodegenerative diseases.


Magnesium bisglycinate chelate is one of the most well-absorbed forms of magnesium, where magnesium is bound between two glycine amino acids, forming a very stable chelate. This chelated form results in excellent bowel tolerance, eliminating the traditional loose stool or upset stomach that may be experienced with other forms of magnesium. This “sandwiching” process between the glycine molecules protects it from being bound by dietary compounds, further enhancing bioavailability and best for multiple applications including support for bone health, digestion and elimination, cardiovascular health, relaxation and sleep, blood sugar control, and kidney health.


Magnesium malate is a highly bioavailable form of magnesium bound to malic acid, a compound found naturally in fruits and vegetables. Malic acid is an intermediary of the citric acid cycle, a complex process that generates cellular energy from glucose, fats, and ketones; thus, magnesium malate may be especially beneficial for individuals who experience low energy and fatigue, such as those with fibromyalgia and chronic fatigue syndrome.  


Magnesium citrate is beneficial for helping promote regularity and bowel relaxation by drawing water into the intestine and softening the stool. Because magnesium is a natural muscle relaxant, it may calm the nervous system and promote a restful night’s sleep. The citrate form of magnesium exhibits greater bioavailability than inorganic and insoluble forms of the mineral. Magnesium citrate may be helpful for patients with occasional or chronic constipation and those who have trouble falling or staying sleeping. This form is often found in powder form, making it a convenient delivery method that doesn’t require swallowing pills, which is helpful for older adults. 


Regardless of the form, magnesium repletion is necessary for optimizing health. Thus, supplementation may be critical for many patients considering the statistics on magnesium deficiency and insufficiency and the rates of non-communicable diseases of the modern Western world due to nutrient-poor diets and modern farming practices. Patients may also consider consuming more magnesium-rich foods like dark leafy green vegetables, nuts and seeds, and whole grains.


By Caitlin Higgins, MS, CNS, LDN