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How magnesium supports metabolic and musculoskeletal health

Magnesium serves as a cofactor for more than 300 enzymes and is essential for the functioning of every organ in the human body.[1],[2],[3],[4] It is the fourth most abundant mineral in the body, following calcium, phosphorus, and potassium. However, it remains one of the least understood and appreciated elements in human nutrition.[5]

Although magnesium is essential for good health, nearly two-thirds of adults are not achieving the recommended dietary allowance (RDA) for this mineral.[6] The use of medications that deplete magnesium, strenuous exercise, indigestion, and stress all further contribute to magnesium insufficiency.[5],[7],[8],[9] Unfortunately, most cases of magnesium deficiency go undiagnosed.[4],[10]

Magnesium insufficiency has been associated with a plethora of diseases, including Alzheimer’s disease, diabetes, fibromyalgia, heart disease, migraine, muscle weakness, osteoporosis, premenstrual syndrome, Raynaud’s syndrome, stroke, and many other ailments. In today’s article we’ll focus on the role of magnesium in the support of musculoskeletal and metabolic health.

Magnesium for energy production

Inadequate magnesium levels disrupt ATP production, which explains why fatigue can be an early sign of magnesium deficiency.

Magnesium forms active complexes with adenosine triphosphate (ATP), the primary energy source for the cell.[11],[12],[13] Inadequate magnesium levels disrupt ATP production, which explains why fatigue can be an early sign of magnesium deficiency.[14],[15],[16]

One enzyme that uses massive amounts of ATP is the sodium-potassium pump (Na-K pump).[17] It pumps sodium out of the cell and potassium in, and maintains the critical electrical gradient that is needed for cellular activity. A shortfall of magnesium can disrupt the Na-K pump, and thus interfere with the day-to-day activities of the brain, muscles, heart, lungs, kidneys, and other organs.[18] It’s easy to see why magnesium deficiency has widespread consequences throughout the body.

Magnesium for your bones

Approximately 60% of the body’s total magnesium is stored in the bones.

Many people reach for calcium and vitamin D supplements to support bone health, but research has shown that magnesium is equally important.[19] In fact, approximately 60% of the body’s total magnesium is stored in the bones.[20] Magnesium is required for calcium absorption in the small intestine, and for the deposition of calcium and other minerals in the bone matrix.[21] Magnesium also assists in the activation of vitamin D, which helps regulate calcium and phosphate homeostasis to influence bone formation.[22] It’s not surprising, then, that adequate magnesium helps reduce the risk of osteoporosis and fractures.[21] In a study of 3,765 individuals, those with the highest intakes of magnesium had a 50% to 60% lower risk for bone fractures, compared with those with the lowest level of intake.[23]

Magnesium for your muscles

Magnesium intakes were found to be directly associated with handgrip strength.

Magnesium status has an impact on muscle strength and performance.[24],[25] For example, magnesium intakes were found to be directly associated with hand grip strength and jumping performance in basketball and volleyball players.[26] Higher magnesium intakes are also associated with lower oxygen needs during aerobic exercise.[27] Magnesium supplementation may help facilitate muscle recovery from intense exercise.[28]

Magnesium may also help preserve muscle strength as we age.[29],[30],[31] In a study of middle-aged men and women, magnesium intake was positively associated with hand grip strength and skeletal muscle mass, as well as bone mineral density.[29] The authors conclude that magnesium has relevance for the prevention of sarcopenia (age-related muscle loss) as well as osteoporosis and fractures.

Magnesium for your heart and circulation

Higher magnesium intakes may be associated with a 20-40% reduction in coronary heart disease mortality and stroke.

Magnesium deficiency has been shown to contribute to hypertension (high blood pressure), coronary artery disease, cardiac arrhythmias, heart attack, and stroke.[4],[32],[33],[34] Dr. Andrea Rosanoff, a leading researcher in the field, has proposed that low magnesium levels may contribute more to heart disease than cholesterol or even saturated fat.[35]

Magnesium deficiency causes excessive contractions in the smooth muscle surrounding arteries, thereby contributing to hypertension.[36],[37] Oral magnesium supplements, however, have been shown to reduce blood pressure in individuals already taking anti-hypertensive medicines,[38],[39] as well as in those with insulin resistance and other chronic non-communicable diseases.[40] In the general population, studies suggest that higher magnesium intakes may be associated with a 20-40% reduction in coronary heart disease mortality and stroke.[34],[41],[42] In adults with type 2 diabetes mellitus (T2DM, commonly known simply as “diabetes”), higher magnesium intakes were associated with a 60% lower risk of heart disease.[43]

Insufficient magnesium levels may also contribute to circulatory problems in other parts of the body, such in Raynaud’s syndrome, where the extremities become very cold due to vasoconstriction of the peripheral blood vessels.[44] The study’s authors found that during the winter months, women with Raynaud’s syndrome had significantly lower red blood cell magnesium concentrations than healthy individuals.

Magnesium for blood sugar control

Even a 100 mg per day increase in magnesium intake may significantly reduce the risk of developing diabetes.

Magnesium plays a crucial role in blood sugar balance through its role in enzymes regulating insulin secretion and insulin sensitivity.[45],[46] In a study of 8,555 individuals without diabetes followed for a median period of six years, a decreasing serum magnesium level was associated with increased risk for developing prediabetes (mildly elevated blood glucose levels) and diabetes.[47]

In a placebo-controlled trial of subjects with prediabetes who already had low magnesium levels, magnesium supplementation (382 mg daily) significantly reduced blood glucose levels after four months.[48] The evidence further suggests that even a 100 mg per day increase in magnesium intake – by either diet or supplementation – may significantly reduce the risk of developing diabetes.[49]

Further studies have shown that 88.6% of individuals with T2DM had magnesium intakes below the RDA,[50] and that serum HbA1c (hemoglobin A1c, an indicator of blood glucose control) was significantly higher in T2DM patients with low magnesium levels, suggesting poorer glucose control.[51] Low serum magnesium levels also were associated with peripheral neuropathy in patients with T2DM.[52],[53] In other words: the lower a person’s magnesium levels, the greater their risk of developing diabetes and diabetes-related complications.

In closing

Adequate magnesium levels are essential for good health, but two-thirds of adults are not getting enough of this nutrient. Major dietary sources of magnesium include whole grains, nuts, and green leafy vegetables, but many scientists advise supplementing with magnesium to ensure adequate cellular stores. Organic forms of magnesium, such as magnesium citrate, are more bioavailable than magnesium oxide, and may thus be more effective.[54] The RDA for magnesium for adults is 310-420 mg per day, depending on age and gender.[55]

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