Magnesium

I've briefly read DR. Carolyn Dean, MD ND's book at Border's once (took about 20min); it's short and easy-peasy. We apparently deplete out Mag a VARIETY of ways:

--breathing
--moving
--living
--generating ATP those little packets of energy produced by mitochondria in every cell (even sperm)
-- remember the Ca-Mg-ATPase enzymes from bio?
--high cortisol, chronically elevated cortisol (eg, insomnia, stress, physical/mental stress, injections for joints or orally for tx of autoimmune d/o or allergic reactions, etc)
--chronic pain syndromes (see above)
--autoimmune diseases (Grave's, Hashimoto's, RA, psoriasis, T1DM, etc)
--high elevated blood glucoses (due to high urination)
--sweating
--exercise (esp endurance types)
--alcohol
--caffeine
--diuretics: HCTZ, furosemide/LASIX, bumetanide, metolazone, chlorthalidone, etc
--diarrhea
--growth (pregnancy, lactation, weight gain, etc)
--acute syndromes (preeclampsia, V-tach, DKA, acidosis, etc)
--high phytic acid and high whole grain intake (binds iron, minerals including Magnesium)
--consumption of nuts/seeds/fruits/veggies grown on depleted soils
--consumption of livestock and fowl raised on grain/depleted-soils


Also, with high calcium supplementation (eg, pregnant/lactating women, post-menopausal women, osteopenic/-porotic individuals) and/or consumption of highly processed food/beverages that are 'calcium-fortified', the minerals Ca++ and Mg++ compete for the same carriers for uptake from the stomach and intestines which prevents uptake of magnesium. Of course, we require Calcium, approximately 300-500 mg daily however minimal dietary calcium is absorbed if blood levels of vitamin D are low (eg, 25OHD less than 20-30 ng/ml).


When initiate vitamin D therapy is initiated, a baseline Mag level and a repeat 1-2mos out should be checked. Unless someone is supplementing Mag, the blood levels typically drop... and I would assume the more accurate assessment, the RBC Magnesium, does critically decrease as well.

Not good.

Initially with vitamin D therapy, Mag will appear 'high' or normal. This is deceptive. Often PTH is also mildly suboptimal (eg, greater than 20-30 pg/ml) though within 'normal standard range' or clinically elevated (eg, greater than 65 pg/ml) which indicates bone resorption and breakdown. The serum Mag is being 'sourced' from degradation of the bone matrix until minerals/hormones are re-balanced.


Many conditions are highly associated with low serum Magnesium:
--atrial fibrillation
--irregular heart beats (PVCs, PACs)
--osteoporosis
--muscle spasms/cramping/Charley horses
--impaired insulin secretion, insulin resistance
--chronic pain, fibromyalgia, back pain, body aches
--headaches, migraines
--hypothyroidism
--hyperthyroidism
--hypertension
--low HDL, high Triglycerides
--high blood glucoses
--dysmenorrhea, PMS, peri-menopausal symptoms
--impaired clotting
--rapid-cycling bipolar


Magnesium (like thyroid hormone) is required by every cell and tissue for every second of our lives to produce ATP and the function of a variety of other vital celllular processes (according to Dr. Dean ~375 but I bet there are more than this now). Maintaining the high end of 'normal' serum levels for Magnesium (2.2-2.5 mg/dl) is extremely prudent if you lack access to RBC Mag measurements. Go by symptoms too -- take enough to eliminate muscle cramps/Charley horses, migraines/headaches, and other overt signs, etc.


Taking warm baths with Epsom salts helps Magnesium status and is very soothing prior to bedtime. (thank you Ted H. for the link)
Bathing in a magnesium-rich Dead Sea salt solution improves skin barrier function, enhances skin hydration, and reduces inflammation in atopic dry skin. Proksch E, et al. Int J Dermatol. 2005 Feb;44(2):151-7.


What form to take?

(a) FOOD -- whole, organic, from farmers and ranchers who rotate crops, compost, pasture-raise livestock/chickens, etc

(b) Safe well water (why your tap water sucks)

(c) Mineral water (variety of brands)

(d) Supplementation:
--Magnesium Aspartate (ZMA w/Zinc used by body builders and X-fitters)
--Chelated Magnesium (Citrate, Amino Acid, etc)
--Magnesium Glycinate ($$$$)
--Magnesium Malate (preferred by many cardiac patients, esp GI-intolerant)
--Magnesium Taurate (Cardiovascular Research brand is raved about)
--Magnesium Orotate (very popular too)
--Magnesium Citrate (CALM makes a liquid kids like)
--Magnesium Ascorbate
--Magnesium Gluconate (weak potency)
--et cetera




Magnesium oxide is the least favorite of members for its poor GI tolerability (more laxative effects, think Mg...'must go') and poor absorption compared with other salt forms.



I started thinking about Magnesium after I came across this provocative article about how potentially statins 'work' to increase HDLs 2-5% initially (not at high dose Zocor/simvastatin and Lipitor/atorvastatin which LOWERS HDLs 2-5% over time by 12 to 24wks) like Magnesium.
Comparison of mechanism and functional effects of magnesium and statin pharmaceuticals. Rosanoff A, Seelig MS. J Am Coll Nutr. 2004 Oct;23(5):501S-505S. Review. PDF here.


Several Magnesium-dependent enzymes exert control on inflammation:
--Mg-ATP complex controls HMG-CoA Reductase, the rate limiting step in cholesterol formation. The authors report "When cellular Mg is low, this ratio tilts towards the active form, and when such a state occurs, more cholesterol, more mevalonate and more of the pathway’s other intermediates will be produced."
--Lecithin cholesterol acyl transferase (LCAT) which lowers LDL and triglyceride levels and raises HDL-cholesterol levels
--Desaturase and other vital enzymes involved in lipid metabolism and balance. "Desaturase catalyzes the first step in the conversion of essential fatty acids (omega-3 and omega-6s) into prostaglandins, which, like the prenylated proteins, have a cascade of stimulating and inhibiting cellular effects important in cardiovascular and overall health."