Magnesium Supplement Review

Two weeks ago I published an overview of magnesium – that you can read here.

Towards the end of the article I promised a review of the different forms of magnesium supplement and its taken me this long to get through all the material. There are more forms of magnesium than I ever imagined and so the process has taken longer.

But first lets do a quick review of what will be covered in this post so if you don’t see it you can look elsewhere, or ask me the question and I’ll attempt to answer it.

1. Why does magnesium deficiency occur and what’s the difference between that and insufficiency?
2. Who is likely to need magnesium supplementation?
3. What forms of magnesium supplement are there?
4. How do you decide which is the best form for you?
5. Are there risks of taking too much and how do you know?

Deficient vs Insufficient?

Regular readers will be aware of my focus on ensuring sufficiency rather than just avoiding deficiency.

What’s the difference?

Nutritional deficiency is the state where the supply of a nutrient is at such a low level that the body’s normal function is reduced and clinical signs of disease show. As an example scurvy occurs when vitamin C is deficient. Rickets occurs when vitamin D is deficient. How quickly the evidence of deficiency appears depends largely on the nutrient and the size of your body’s reserve if any.

Nutritional insufficiency occurs when your body’s demand for the nutrient is bigger than it’s supply. This is the space where chronic disease plays.

Nutrient insufficiency causes so many chronic problems because it can be difficult to diagnose. How much one person needs can be quite different from another. It depends on their age, race, sex, activity level, genetic make up, diet and many other factors, so understanding exactly what one person needs may just not apply to another person.

In my view insufficiency is far more common and worse than deficiency because it leaves you in an unhealthy state putting up with compromised health and goes undiagnosed and untreated, sometimes for years and even decades. Deficiency is the extreme end of insufficiency but all my discussions here refer to insufficiency.

Simply put – not enough.

Remember, as mentioned in other posts, your bodies only have so many ways they can  respond and similar symptoms can be caused by totally different events, so make sure you check with your health professional.

How Do You Become Magnesium Insufficient?

Only in three ways.

1. Not getting enough in your diet. Recent NHANES surveys in the US indicated that many Americans do not get enough magnesium in their diets (75-85% of diets only deliver 50-60% of Recommended Daily Allowance or RDA). Some activities such as alcoholism reduce food intake and subsequently drive a secondary deficiency. 30-60 % of alcoholics have this problem.

2. Not absorbing enough through your intestinal tract. Diseases such as Crohns disease, prolonged diarrhoea or vomiting, gluten intolerance or intestinal cancer will reduce your ability to absorb magnesium.

3. Losing too much through your kidneys. Healthy kidneys help reclaim magnesium that would otherwise be lost in your urine. So any medication, disease, or event that increases urine production can negatively affect your magnesium balance.

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Who Is Most Likely To Need Magnesium Supplementation?

The magnesium RDA for men over 31 is 420mg/day and women is 320mg/day and 360mg/day if pregnant. Finding out just how much is in your food is not that easy as most packaging does not tell you, so here are two free handy references that you can use giving you the amount of magnesium in mg in each described serving of food. They are long running to about 26 pages each but the information will save you alot of time:

Magnesium List by Alphabetical Food Order (36)

Magnesium List by Volume (41)

Pharmaceuticals can lower your body magnesium:

• Diuretics: Bumex, Edecrin, Lasix and hydrochlorothiazide family
• Antibiotics: Amphotericin and Gentamicin
• Anti-neoplastic drugs: Cisplatin

Diabetes can cause magnesium loss when poorly managed due to the effect of hyperglycemia.

Alcoholism and malabsorption diseases as mentioned above reduce intake and or absorption as mentioned above.

When other mineral deficiencies are present, particularly potassium and calcium may appear in people with magnesium insufficiency. However excess supplementation with potassium can also trigger reduction in the effectiveness of magnesium absorption from the intestinal tract highlighting the complexity of ensuring sufficiency.

There is an age relationship that parallels magnesium deficiency, however this is not due to a physiological failure of magnesium transport but simply as people age their diet changes and they are more likely to be impacted by one of the categories above. So magnesium awareness is increasingly important as people age.

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What Forms of Magnesium Supplement Are There?

As mentioned above there alot and there are probably some I’ve missed but here goes.

Once you’ve calculated how much magnesium you’re getting in your diet on an average day and you’ve confirmed you are not getting your daily requirement AND in the absense of any of the contributing factors such as other disease, medication or regular magnesium containing antacids how do you choose which supplement is best for you?

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How Do You Decide Which Form is Best For You?

There are a number of considerations including size of capsules, cost, personal preference and personal tolerance. In many cases it may come down to your personal reasons or the particular body system you are trying to support.

Of all the supplements magnesium oxide has the highest concentration of magnesium at 60% but it has the lowest level of absorption from your intestinal tract meaning you have to take much more. High levels of supplementation can also cause diarrhoea in fact magnesium sulphate (or epsom salt) was an old remedy for constipation due to its known effect to draw water into the bowel.

The picture is further confused with much discussion about both the amount of elemental magnesium present in a supplement and its bio-availability. Both factors must be considered. Since these are not hugely expensive supplements and research is sparse, manufacturers guidelines should be followed, however ultimately let your body tell you.

If you are trying supplements out – look for retailers that provide you with a money back satisfaction guarantee.

Here are my rules of thumb. Avoid all aspartate and stearate containing supplements. Less in volume is simpler and providing expense is reasonable look for additional benefits from other constituents, which typically comes with the chelated products such as malate, glycinate and orotate.

Magnesium malate is reported to have aluminium binding function from the malate component.

Magnesium glycinate is very gentle on the bowel with five times the absorbability of magnesium oxide.

Magnesium orotate is reported to provide significantly higher bio-availability levels. Strong evidence from double blind placebo controlled research showed reduced symptoms and increased survival rate in patients with severe congestive heart failure. ^[1]

Magnesium orotate also showed improved glucose mobilisation with a reduced stress response under extreme physical demand in a placebo controlled study in Germany, however this study did not evaluate this form against others.^[2]

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Are There Risks Of Taking Too Much And How Do You Know?

There is no risk of excess magnesium intake from food, however whenever using supplements including drugs and antacids or anti-constipation treatments it always pays to know what you are taking in total. Although the symptoms of excess magnesium intake are generally very mild being diarrhoea and intestinal cramps, with higher levels of intake signs of toxicity can occur.

Interestingly these present similar signs to magnesium deficiency being changes in mental status, nausea, diarrhoea, loss of appetite, muscle weakness, difficulty breathing, very low blood pressure and irregular heartbeat.

N.B. Always seek the advice of your health care professional.

References:

[1] “Magnesium orotate in severe congestive heart failure (MACH)”, PMID 18281113 (2008 Feb 15):

[2] Cardiovasc Drugs Ther. 1998 Sep;12 Suppl 2:197-202.
On the significance of magnesium in extreme physical stress.
Golf SW, Bender S, Grüttner J.
Institute of Clinical Chemistry and Pathobiochemistry, University Medical School, Justus-Liebig-University, Giessen, Germany.