@Dr. harinder grewal So true, Dr. Grewal, and yet millions of American women are being pumped full of calcium and, when still turning up with “osteopenia,” are given the likes of Fosamax, with all of its side effects. All because their physicians do not understand basic biochemistry.
does rbc magnesium reflect intracellular stores. Is it worth testing?
perfect, succinct summary. Every resident physician should read and understand this one. It’s a no- brainer except it’s too easy, no MRI required!
very interesting information and useful.
So in puerchasing an OTC form of Mag, which one have the most bioavailability?
You have listed 8 forms of magnesium citrate , amino acid chelate, chloride, glycinate, malate, taurte, carbonate, and others. Have used Magnesium OXIDE 500 mg. Bad diarrhea!! Have very painful muscle spasms at night . Very painful, every night. I eat all of the food items you have listed. I eat leafy green , bananas, nuts, dark chocolate and beans some or all, virtually every day. What form do you suggest I try first. What form do you use? Thank you for a response.
Curiously, I’m on topirimate and because it significantly alters citrate levels in the urine I developed a renal stone. Obviously, not desiring a repeat episode I began citrate supplementation and because I am also on a PPI I used Magnesium Citrate. Great combo and subjectively I’ve never had another stone in 4 years and do feel much better overall. J. Tucker Neilson, MD, FACP
Excellent article. Magnesium both slow IV and IM are rapidly effective in many illnesses.
@Dr. George Lundberg @Dr. Higinio Fuentes Age related iron accumulation is a fascinating subject. I’ve pulled my ferritin down from well over 100 (well in the normal range of most labs) to around 50 and have noticed remarkably better health. My fountain of youth! http://www.healtheiron.com/iron-reduction-therapy
As a Naturopath in Australia I have been prescribing magnesium to my patients for 25 years… Drs are a little slow on the uptake, but glad you are catching on ! great read, thank you
good advise i will try to do the prescription and recommendation of magnesium with my patients; Dr;Huaman Juan from France
Ever since I added a 500mg magnesium daily supplement, my migraines have decreased in intensity and frequency. I have two friends who also have added a magnesium supplement and they also have fewer and less intense migraines. But for one friend it did not help. Is it time for a study?
Vitamin D, zinc and magnesium are consistently at the top of these lists. Low levels of all three are correlated with a number of prevalent neurodevelopmental symptomologies (ADHD, autism, etc). I wish more doctors utilized these very basic interventions with their patients. Instead, most jump towards pharma first. I also wish there were good studies to show which over-the-counter supplements are considered the best (ie actually contain what they say they contain, have good absorption by the body, etc).
I LOVE the flair and language of your article. You make a major point. Our diet is in the toilet and our health has NEVER been worse except perhaps during the PLAGUE. We who live in a developed country have no excuse as we have such an array of foods to choose from and the wherewithal to purchase as least a few bits. Thank GOD for MOLASSES!!!!
@Dr. Justin Baldwin It is also supposed to have beneficial effects in Alzheimers.
Actually, it is fairly hard to become magnesium toxic. The classic known methods are for one to fall asleep in a bathtub full of magnesium solution or for one to have an intestinal obstruction such that the magnesium tablets are piling up inside. Generally I advise patients to begin with one tablet (of any kind of magnesium) per day for one week, then move to twice a day for one week, then to 3 times per day, etc — with the limiting factor being loose bowels. Usually the “correct” dose is the one that is just shy of producing loose bowels — which dose generally correlating with a serum magnesium level of about 2.2-2.4 (assuming that both serum albumin and serum sodium are mid-range — as each of these can pull up or pull down the serum magnesium level).
Eniva has a liquid Mg that achieves close to 100% absorption and is in the cells working as soon as 5 minutes. When I have my pre-atrial contractions ( I wrestled in College and that high intensity workouts can lead to this problem – free radical production.) an ounce of Eniva’s Mg and within 5 minutes my heart is beating normally . Before Eniva the only thing that would stop them was to rest and take a nap.This is something I had to do after almost every 5k and 10k race I ran after college.
Thank you, your article is a wisdom gift, that all doctors need to keep in mind,
@Dr. Mukund Gnanadesikan As an OB nurse we give Magnesium IV almost daily for pre-eclampsia and preterm labor. We monitor reflexes, urine output and responsiveness. There is always Calcium IVP in the room. I have seen unresponsive people with zero reflexes respond within minutes of this treatment. Lab draws of Mag levels are done every 4 or 6 hours, lab always calls us when they are over 4, but with responsive person we just monitor. At levels of 7 to 8 they begin to show symptoms and we call in the OB doc to give the calcium IVP.
I tried everything for my hot flashes, except hormone replacement therapy, and nothing worked. I read something about magnesium and thought, at that point, anything was worth a try. As long as I take magnesium, no hot flashes. If I stop, a week or two later, hot flashes start. Anecdotal evidence, I know, but as long as it works, I’m using it.
Thank you Dr. Lundburg I also supplement magnesium and I find I sleep more soundly. I use “Calm”.
@Dr. Herbert Kleinman I disagree doctor. Take a look at the collective date for Vitamin D.
This is a very interesting and valuable information
@Janice Dougherty , Big Pharm won’t because of the lack of profit.
Very informative article . Very few people and medicos are aware of this topic
@Richard Sherwill Natural medicines do not yield a profit or are not patentable. That is the main reason natural ingredients are not tested. There’s little to no funding for it. Even if the test results were to turn out positive, and beneficial along with little to no side effects, no one company could patent and exclusively sell it to the public. Therefore, no pharma company wishes to invest in funding the tests/approval process for it. Now if magnesium were to become popular, THEN big pharma would test it BUT in a way to disprove what is being discovered through anecdotes experiences of other people. .
@Dr. Robert Powell One of my optometrist friend once told me that his wife was under the care of Psychiatrist for depression and was on two medications. I had read somewhere along the line that some of these patients do well with Mg ++ supplement. She started taking it twice daily. Lo and behold, she felt better and stopped taking her anti depressant medications. This was almost two years ago. To this day, she is feeling fine and going about her work without any sign of depression. Several patients who came to ER in a small western town where I practiced for many years with “heart attack” had cardiac arrhythmia. In some of these cases we found that their Mg level was low. Once they received it IV, not only the arrhythmia stopped , but these patients felt much improved almost immediately.
My wife (age 91 and I (age 95) have been taking Magnesium for two years now. We have not seen any change in our health or well being or “feeling Terrific.”
Hello? Is there anyone out there who has heard of evidence-based medicine? Anyone?
Do we really have to wait for big pharma to solve this, considering the awful state of the average diet?
@Dr. Chagai Dubrawsky Actually, inflammation is the mother of all disease. I figured that out the first year of med school.
thank u for this excellent topic
Well, some food for thought.
I’m a NP who use to suffer from leg cramps. I also suffer from migraines and through trial and error I have been able to find my migraine triggers, although there are some I’m still exploring. I started taking daily magnesium about 6-9 mo ago and my leg cramps are few and far between, almost non-existant except for my running days, but that’s nothing compared to what I use to have. What I didn’t know, was that the supplemental magnesium had a positive affect on my migraines. I now get 1-2/month which is a 50% reduction from my monthly average. I’m also trying to get pregnant so this is a bonus as magnesium is safe for pregnancy and the reduction in the frequency… awesome! I have always had a well-rounded diet, but since adding the extra magnesium daily I feel much better. I have more energy, my BMs (sorry if TMI) are more regular, I ache less, and my migraines have reduced in frequency. I would love to see a study looking at the effects of supplemental magnesium on other ailments such as fibromyalgia, DM, HTN, migraines, etc.
Eating whole natural foods twice or thrice a day– will keep that tribe of surgeons and doctors at bay!
@Dr. Higinio Fuentes Hello, Here is my position on Vitamin K2. http://www.medscape.com/viewarticle/834763 I have not yet written about Iron supplements.
Worth trying for non specific symptoms
I am consultant in drug and alcohol and many of my patient especially those who have malnutrition complaining of cramps and tiredness. I agree some these may have Kg def.
Agree. As a former critical care nurse, I saw that patients needed supplemental Mg at admission and started taking a supplement. I too feel terrific, and no further “Carlie horses”.
George, You raise an important issue that has unfortunately not received its due. No pharma budget to promote it either. The effect on the heart and other muscles are huge. I lectured on this topic for decades but not sure the audience really absorbed it. ARE
If one looks at the doses given in preeclampsia and eclampsia 4-6 GM to load and then 1 Gm per hour IV then amount in supplements pales. Unless the patient has kidney failure no problem. If diarrhea decrease the dose. It is excellent for leg cramps, decreases cardiac arrhythmias and may be helpful in asthma. Patients on long term PPI’s waste huge amounts of Mg in their urine. It may not be reversible. Another reason to try to get pt’s off PPI’s which is very difficult. But they need to have Mg supplements at the least.
I agree with you because until I supplemented myself with magnesium, I was sore in the muscles after a workout and usually couldn’t sleep because the muscles would not relax. Then last of all. Constipation. Magnesium? Works wonders on the smooth muscles of the intestinal tract. Before magnesium, I had both these ailments, soreness and constipation and of course irritability. After magnesium, all gone!
Very succinct and interesting presentation.
Dear George, I was delighted to read your comments on magnesium. It is a forgotten electrolyte. I have some interesting insights on magnesium to share with you. Please send me your e-mail address and phone number. I am still at “firstname.lastname@example.org”. Ray Gambino
Many mag supplements can be taken without GI issues. Perhaps you are thinking of Milk of Magnesia? That’s entirely different from the mag supplements. Some people do best with mag citrate, but there is also malate, aspartate, etc. Liquid magnesium chloride is thought by some to be the best absorbed. The main thing is to “start low, titrate slow.”
choride 30 mgrs in 1,500 cc of water, twice al day morning-nigth 30c.c. enough, also cure intestinal constipation, and decrease ostheoporosis
I like it!
Great personality coming through article!
Dr, Lunberg, I totally praise the benefit of magnesium to cellular health. I’ve heard that magnesium maleate is the most absorbable. Which formulation do you take?
I predict that fully 40% of patients will respond, at least initially!
Great article, we need to get this word out there more than anything. I suggest it to all of my patients everyday, why, because it works and people are clueless about it.
George, any thought on measuring RBC magnesium level as we do RBC folate???
so much we don’t know. Magnesium is certainly important but what about other micronutrients and their interactions. While it probably will not cause harm to start supplements, I prefer improving the diet and address the root of the problem.
About 25 years ago, I undertook a study where I found out that hypomagnesimia significantly affected the evoked twitching properties particularly in skeletal muscles. That affected the contractile power in them. However the riddle in the real magnesium level in the body remains as a very large proportion of magnesium is intracellular and it is difficult to measure excepting in specialized laboratories.
Let’s not forget that there is such a thing as magnesium toxicity, and that when we can’t really measure how much is enough, we have no idea how much is too much.
I suffer some of those mentioned symptoms. Will follow DR advice and see what happens. Jen Car Registered Nurse
Dr. Lundberg: My focus has been on the role of magnesium deficiency in anxiety, negativity, irritability, and insomnia. I have collected a fair amount of patient data and have assembled from PubMed the world medical literature in abstract regarding these issues. I would like to share this information with you and/ or with interested colleagues. Robert Charles Powell, MD, PhD rcpowellpowell at excite.com
@Carol Lanier Hi Carol, I highly recommend Solgar’s Magnesium Citrate from Amazon.com
Excellent review and great speaker !!!
@Becky Lehr One of the more reliable manufacturers of supplements is http://www.lef.org. Check them out and see what you think.
Ionic Magnesium is the best way, at 100% absorption, pills are wasting money. Magnesium oil is the second best way at over 90% absorption by rubbing it through the skin.
I was having terrible leg cramps at night that have stopped since my doctor recommend a magnesium supplement.
@bob okhikian…agreed. Has anyone pondered the prevalence of CKD in the population and that magnesium is a stressor to the kidneys and effect Mg supplementation might have on CKD, especially since measuring Mg levels is difficult? I’m not a doctor but I believe that excess Mg intake can also adversely affect calcium metabolism ?? Mg is readily available in many foods and a well-balanced diet should supply enough. Nuts and nut milks (almond milk), avocados and green leafy vegetables are very high in Mg. Why not supplement with more of these foods to increase Mg levels instead of taking inorganic supplements that can contain other unwanted substances, and playing a guessing game with how much you really need?
Thanks DR George Lundberg. great talk
@Dr. Chris Foley Kudos!! I noticed the same with the Mayo Clinic, on their page about magnesium. Very disappointing. But I’ve never held that clinic in the esteem it used to enjoy among the public.
Could Dr. Lundberg address the previously mentioned question regarding measuring RBC magnesium levels and is there also data that cooking, for example, of greens increases the release of magnesium? Thank you
Thank you Dr. Lindbergh! Finally! An article clearly written and understandable with excellent content we can all put into practice.
I suggest eat well and you don’t need supplements.
@Judy Taylor Another god way of getting Mg into the body is through Epsom Salt baths. I Cup of Epsom Salts in the bath water. It is absorbed through the skin thus bypassing the gut and diarrhea. Magnesium chloride is better than the sulfate but you will have to order that. The sulfate, which is the form in Epsom Salts on the other hand, is available in every grocery shop. Richard Crabbe MD
Agree with you , my experiance is with taking homeopathic pellet which is nothing but Mg for cramps in calf muscles , releived so much & many others finding the same ,conclusion is our body needs Mg !
In a 1990’s study of celiacs with low bone densityy Robert Rude, MD, an endocrinologist at the University of Southern California School of Medicine, found Mg+ serum levels were within a normal range, but intracellular levels wrere low. Supplementation with Magnesium, in addition to Vit D and Calcium, was successful in increasing bone density in a year as compared to controls without magnesium supplementation. An uninteded benefit, was to also treat the constipation often associated with celiac disease, but it made finding study controls when the word regarding the latter benefit was shared by subjects, P. S. It must have been published prior to Pub Med in the 90’s….I have read it, but could not locate it now online.
There is always a place for an honest sharing of experiences without waiting for Big Pharma to tell us what is good for us with false evidence and statistical magic
People read this—-
51 years ago I at UTMB Galveston I picked as a topic Magnesium metabolism.. The big problem then was an accurate way to measure it.Not manypeople have ever seen myoclonus multiplex but you see it in burn patients and in a lot of DTs. In general mg parallels K except in burn patients. There you pray for good kidneys. If you just hit a muscle wit th apercussion hammer you can see the muscle contract and you can see it contract. I many articles even theou don’t think I foundgh my night job was working in the Library. I take K,mg Ca,zn to supplement my iintake onixf Lasix and protonix.afYou can see it in Toxemia pregnancy. I don’t even know whether the pathologist developed a good method of assay of
Thank you for your wonderful articles!
Hi, thanks for your talk. It seems to me more or less like vitamin D deficiency, causing a wide variety of symptoms like a rainbow!..
I see a great deal of case-level support for these claims in my practice. Like thyroid function, however, standard methods of diagnosis are limited in usefulness. Since the downside risks are few and since the likelihood that few pts. are close to optimal levels, a “try it and see how you feel” approach is not as unscientific as it might seem at first. Colleagues: Mg. L-threonate is assimilated better than most forms and demonstrates negligible laxative effect.
@Dr. harinder grewal Magnesium is used in obstetrics to treat two conditions, Preterm labor ( a tocolytic) that relaxes the smooth muscle of the uterus and for Preeclampsia to prevent seizures. While it has a transient effect on lowering BP it is NOT used as an antihypertensive in obstetrics – but, it is a great mineral used in OB since the 1800’s!
wonderfully informative article and very well written.. Thank you!
@Becky Lehr I second LEF. Good intelligence at this level.
Dr. Lundberg, This is very enlightening information on magnesium deficiencies in view of the potential health issues where magnesium levels are below the desired level. As a lay person, I appreciate your taking the time to address this issue.
Lack of ANY essential nutrient leads to lack of health in the body. Welcome to the primary causative factor for why our population is getting sicker, younger…. And eating more whole grains aint the fix (actually quite the contrary). Might want to consider liver though (grandma always had it on her menu) – which contains the broadest array of bio-available nutrients, for Homo sapiens, than any other single substance on the planet, magnesium included. 4-6oz of liver a week might truly “help keep the doctor away”! (Apples are way over rated).
When I forget to take my magnesium, I start having “restless leg syndrome” type of leg jerks at night. I also start having “skipped” beats in my heart. I start to take the magnesium and behold, gone. I am sold on this Magnesium parade.
George looks as if he is a mouth breather and has OSA, does not look “terrific”
About time that Magnesium got the recognition it deserves. I totally agree with your commentary and have recommended Manesium supplementation for last 20 years to my patients. Not only Is it a calming mineral, it is the best thing the OB orders for a pre eclampsia patient to reduce the Blood pressure and decrease the risk of seizures. For diabetic patients it deserves a special place in their diet supplement as it helps regulate glucose metabolism. Somewhere I read that if you wanted to DUMB a nation, it was to feed the natives, excessive calcium and lower their magnesium levels. Medical students, pay attention and grab those magnesium rich nuts, especially cashews ad then gulp down some extra supplement to keep that brain sharp and help insulin metabolize the glycogen stores to provide the brain with ready source of much needed energy, the glucose. Seriously, magnesium is extremely important supplement that helps prevent osteoporosis, (equally important, if not more important than calcium), and keep the BP under control. Disclosure: No, I do not get paid by magnesium manufacturers. And thank you Dr. Lundberg !!
Magnesium is a very good adyuvant therapy for neuropathic pain, and in general it doesnt have any adverse effects Very good article!!! than you very much Dr. Ariel Cherro
@Dr. Michael Hunter for 82 years looks pretty darn good and is sharp as a tack, witty, smart and well meaning
Dear Dr. Lubdberg, Greeting! I am very happy to hear that you feel terrific. Your hypothesis is quite intriguing. How are you going to find out, if your well-being is really due to magnesium? Liisa Russell
@Joel Blanchfield “Pre-atrial contractions” …?
Carolyn Dean, MD wrote a very thorough book, The Magnesium Miracle, about the epidemic of magnesium deficiency and exactly how to treat it. It is recommended if there’s a deficiency to stop calcium and supplement with magnesium at 600 mg till symptoms are alleviated and then to continue at 400 mg. Magnesium glycinate will not cause diarrhea, but if constipation is an issue, magnesium citrate or malate can be used. Magnesium taurate is recommended if heart issues like palpitations or arrhythmia are the main symptoms. RBC magnesium is the best way to test. It would be nice if that became part of the yearly labs, similar to the way testing for Vitamin D has become standard. I’d hate to think we have to wait until there’s a high dose magnesium pharmaceutical before such an easy and low cost fix is implemented.
Sounds good enough for me!
@Dr. Chris Foley How do you test for cellular magnesium? As a psychiatric RN and a Certified Health Coach, I have recommended magnesium and seen its benefits for many clients. It is especially helpful in alleviating anxiety. The MD’s at the facility where I work are open, but typically skeptical of “unproven” treatments like this. It would be quite helpful to be able to suggest a test they could use to identify patients with low magnesium levels. Also, as oral supplementation can be quite tricky and unreliable, I find Epsom Salts soaks quite useful. The magnesium is absorbed directly through the skin, and the bath or foot soak itself is calming, thus boosting the anti-anxiety effect of the treatment. Thank you for your very educated comment.
Yes , as we talk about modern research and drugs so much , we ignore the basic vitamins and minerals that are essential co enzymes in so many metabolic reactions . Please let us go back and revisit our basics and see how we can help ourselves and patients overcome several Symptoms and side effects of other frequently used drugs that interfere with absorption .
I absolutely agree. As a hospitalist, I routinely assess Magnesium level in my patients, feeling that 75% or more of the patients had low Magnesium levels (same report %), too often to ignore or forget to evaluate it. When practicing in Europe, Magnesium level was used at that time as another marker for poor nutritional condition
How do we teach this to alot of docs??
Great article. I also have noted that an intake of 400 mg daily of magnesium has made a difference in my well being as well as that if my family members. I have done my own research and agree with your article. Magnesium deficiency may be the root cause of many ills and we as doctors may not even consider this as we were not trained to look for it.
- Effects of magnesium and its mechanism on the incidence of reperfusion arrhythmias following severe ischemia in isolated rat hearts - Abstract: Magnesium sulfate (Mg) has been widely used for the treatment of ventricular arrhythmias (VF) in patients with coronary artery disease. However, the mechanisms of prevention on the incidence of VF have not been defined. The aim of study was to investigate the role of Mg in the prevention of VF and the mechanism of […]
- Magnesium supplementation in the prevention of arrhythmias in pediatric patients undergoing surgery for congenital heart defects - Abstract: BACKGROUND: The efficacy of magnesium in the prevention of arrhythmias in pediatric patients after heart surgery remains unknown. Therefore we prospectively examined the effect of magnesium treatment on the incidence of postoperative arrhythmias in pediatric patients undergoing surgical repair of congenital heart defects. METHODS AND RESULTS: Twenty-eight pediatric patients undergoing heart surgery with cardiopulmonary […]
- Magnesium treatment of ventricular arrhythmias - Abstract: The association between marked hypomagnesemia and arrhythmias, particularly those associated with digitalis intoxication, has long been recognized. More recently, acute intervention with magnesium in patients who are not hypomagnesemic has demonstrated arrhythmia suppression in 3 settings: digitalis intoxication, long QT-related arrhythmias and arrhythmias after acute myocardial infarction. Although the electrophysiologic effects of magnesium are […]
- [Magnesium and arrhythmia] - Abstract: Experimental and clinical studies have shown the antiarrhythmic activity of magnesium salts and the arrhythmogenic effect of hypomagnesemia. Both are observed mainly but not exclusively during treatment with digitalis. The Mg++ plays an essential role in transmembrane K+ exchange in that a deficit of magnesium leads to a loss of intracellular K+ which cannot […]
- Effect of acute magnesium administration on the frequency of ventricular arrhythmia in patients with heart failure - Summary: Giving magnesium to patients with heart failure reduces the frequency of their arrhythmias. Abstract: BACKGROUND: There is a high incidence of ventricular arrhythmia and sudden death in patients with heart failure. Unfortunately, currently available antiarrhythmic agents have only limited efficacy and may result in proarrhythmia and hemodynamic deterioration in these patients. METHODS AND RESULTS: […]
- Magnesium therapy of cardiac arrhythmias in critical-care medicine - Abstract: A common complication of critically ill patients is cardiac tachyarrhythmia. The role played by magnesium is not well appreciated. Well-documented cases indicated that magnesium may be effective in controlling the rhythm when conventional methods fail. The following tachyarrhythmias respond favorably to magnesium: (1) intractable ventricular tachycardia and fibrillation, whether hypo- or normomagnesemic, (2) torsades […]
- [Significance of magnesium in cardiac arrhythmias] - Abstract: Magnesium is of great importance in cardiac arrhythmias. It increases the ventricular threshold for fibrillation. Sinus node refractoriness and conduction in the AV node are both prolonged. Main indications for intravenous application of magnesium are Torsade de pointes tachycardias, digitalis toxicity induced tachyarrhythmias and multifocal atrial tachycardias. Additionally, patients with ventricular arrhythmias due to […]
- Intravenous magnesium for cardiac arrhythmias: jack of all trades - Abstract: Intravenous magnesium has been used to prevent and treat many different types of cardiac arrhythmia. It has diverse electrophysiological actions on the conduction system of the heart; including prolonging sinus node recovery time, and reducing automaticity, atrioventricular nodal conduction, antegrade and retrograde conduction over an accessory pathway, and His-ventricular conduction. Intravenous magnesium can also […]
- Low extracellular magnesium induces epileptiform activity and spreading depression in rat hippocampal slices - Abstract: The effect of low extracellular Mg2+ concentration ([Mg2+]o) on neuronal activity was studied in rat hippocampal slices. After 20-40 min of perfusion with Mg2+-free medium, when [Mg2+]o declined to approximately 0.1-0.4 mM, spontaneous field potentials developed in the CA1 and CA3 regions, but not in the dentate gyrus. In the CA3 pyramidal cell layer, […]
- Effect of magnesium chloride and magnesium L-aspartate on seizure threshold in rats under conditions of dietary magnesium deficiency - Abstract: We studied the effect of Mg-L-aspartate, MgCL2, and their combinations with vitamin B6, magneB6, and MgSO4 on seizure threshold in rats with dietary Mg2+ deficiency. Mg2+ deficiency was followed by a decrease in the threshold dose of corazol (from 79.20 to 49.48 mg/kg), shortening of the latency of the first jerk (by 33.6%, p=0.012), […]