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Supplement

Magnesium

A mineral involved in more than 300 reactions (energy, muscle, blood pressure, blood sugar, sleep). Deficiency is common.
Category
Scientific evidence
Moderate
Number of findings
6
Sources
Our own summaries · Cited studies
Recommended dose and how to use
250–400 mg/day of elemental magnesium, preferably with dinner. Well-tolerated forms: glycinate, citrate, malate (oxide is absorbed less well).

How to take it

250–400 mg/day of elemental magnesium, preferably with dinner. Well-tolerated forms: glycinate, citrate, malate (oxide is absorbed less well).

Safety

Very safe; excess can cause diarrhea (reduce the dose). Caution in kidney disease.

Interactions

Reduces the absorption of levothyroxine and some antibiotics (quinolones, tetracyclines): take them 2–4 h apart.

Effect by goal · level of evidence

Migraine (frequency)

reduces Very high summary of trials (A)
Moderate reduction (G:A)

3 trials · 180 participants: moderate reduction in migraine frequency. Severity: small effect. The subtype with aura is not broken out in meta-analyses.

See the study (Grade A) →

Migraine prevention

improves Moderate RCT (AA)
Fewer migraine days

Among the supplements with the best evidence for preventing migraine: fewer attack days per month.

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Blood sugar / insulin sensitivity

improves Moderate systematic review (AAA)
Slight glycemic improvement

Improves glycemic control, especially when there is deficiency or insulin resistance.

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Blood pressure

reduces (modest) Moderate meta-analysis (AAA)
−2 to −4 mmHg

Slightly lowers blood pressure, more so in people with deficiency or hypertension.

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Vitamin D

improves Moderate RCT (AA)
Cofactor

It is a cofactor: it helps activate and make use of vitamin D.

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Sleep

improves Low-moderate small RCTs (A)
Small effect

May improve sleep quality, especially when there is a deficiency.

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Migraine with aura

reduces Low-moderate extrapolation (A)
Same profile

It is not specifically distinguished from the subtype without aura in meta-analyses; the prophylactic effect applies to migraine in general.

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Anxiety and stress

improves (modest) Low-moderate systematic review (AAA)
Small-to-moderate effect

2017 meta-analysis (18 studies): favorable effect on subjective anxiety and self-reported stress, greater in people with deficiency or low intake. Glycinate is the form with the best tolerability profile for anxiolytic use.

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Fibromyalgia

improves (modest) Low summary of trials (A)
Small improvement (G:C, 1 study)

1 trial · 75 participants: small improvement in pain and fibromyalgia symptoms. Quality of life and sleep without significant changes.

See the study (Grade C) →

Chronic stress and HPA

improves (modest) Low RCT (AA)
↓ Perceived stress

300 mg/day of glycinate for 8 weeks: reduction in perceived stress (DASS) and reactive cortisol in stressed workers. Greater effect combined with B6.

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Generalized anxiety disorder (GAD)

improves (modest) Low pilot RCT (A)
Useful adjunct

Pilot trial in GAD: reduction in HAM-A with glycinate 400 mg/day as an adjunct to psychotherapy. Small effect but an excellent safety profile.

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In depth

⏱ 3 min read

Magnesium is an essential mineral that acts as a cofactor for more than 300 enzymes in the human body and maintains the integrity of cellular structures and DNA; despite its fundamental role in processes as critical as protein synthesis, muscle and nerve function, blood glucose control, DNA repair, and the synthesis of vitamin D, more than half of the population of the United States does not consume the recommended amounts, and the available evidence suggests that this widespread deficiency contributes significantly to the risk of multiple chronic diseases.

One of the lesser-known reasons for the magnitude of the problem is that the magnesium content of vegetables grown in the United States and the United Kingdom is 80 to 90 percent lower than it was a century ago, because of soil depletion from modern agricultural practices based on phosphorus fertilizers, and that federal nutrition databases have not been updated to reflect these changes, which means that people who believe they are getting enough magnesium based on food composition tables may be systematically underestimating their real deficit.

Magnesium and the brain

An observational study of more than 6,000 people aged 40 to 73 found that a high dietary magnesium intake, approximately 550 milligrams daily, was correlated with greater gray matter and hippocampal volumes compared with the average intake of about 350 milligrams daily, with a difference equivalent to roughly one year less of brain aging, especially in women; although observational correlations have limitations, the fact that lower magnesium levels are consistently linked to the development and progression of multiple age-related brain disorders adds credibility to the relationship.

In a study that followed more than 1,000 middle-aged adults for 17 years, those who consumed more magnesium daily, at least 196 milligrams, were 37 percent less likely to develop dementia in later life compared with those who consumed less than 174 milligrams, and in a study of adults over 60 without dementia, a higher magnesium intake, at least 434 milligrams daily, reduced the risk of developing mild cognitive impairment by 7 percent; a person with adequate magnesium intake is not immune to brain aging, but does appear to age with a measurable advantage.

Magnesium and stress: a vicious circle

Chronic stress depletes magnesium stores through multiple mechanisms: cortisol signals the kidneys to increase magnesium excretion, and other stress mediators promote lower intestinal absorption and greater renal excretion of the mineral; what makes this relationship especially pernicious is that many symptoms of magnesium deficiency, such as fatigue, irritability, and mild anxiety, are indistinguishable from the symptoms of stress itself, creating a vicious cycle in which stress produces deficiency and deficiency amplifies the stress response; correcting the deficit lowers cortisol levels, finally closing that cycle in the right direction.

Magnesium and athletic performance

Magnesium can improve athletic performance through its roles in energy production, muscle function, and electrolyte balance: male athletes who took 390 milligrams of magnesium daily for 25 days experienced an improvement in maximal oxygen uptake and in total work output, and adolescents who took 8 milligrams of magnesium per kilogram of body weight daily saw increases in endurance and reductions in oxygen consumption during submaximal exercise; sauna and intense exercise, two of the most powerful tools for health, are precisely the activities that deplete magnesium the most, which makes supplementation especially relevant for those who practice them regularly.

Forms of supplementation and what matters

Not all magnesium supplements are equivalent: magnesium glycinate and citrate have high bioavailability and are well tolerated, with glycinate especially recommended for improving sleep and reducing anxiety because of its weaker laxative effect; magnesium threonate has generated interest for its supposed ability to cross the blood-brain barrier and improve cognitive function, although human clinical studies are scarce, mostly industry-funded, and had results that were significant only in pooled analyses of multiple tests, not in individual tests; magnesium sulfate in Epsom salt baths, despite its popularity, lacks solid scientific evidence supporting its transdermal absorption in clinically relevant amounts.

References

  1. Gröber, U. et al. (2015). Magnesium in Prevention and Therapy. Nutrients 7, 9.
  2. Fawcett, W.J. et al. (1999). Magnesium: physiology and pharmacology. Br J Anaesth 83, 2.
  3. Volpe, S.L. (2013). Magnesium in disease prevention and overall health. Adv Nutr 4, 3.
  4. Schwalfenberg, G.K.; Genuis, S.J. (2017). The Importance of Magnesium in Clinical Healthcare. Scientifica 2017.
  5. Maier, J.A.M. (2012). Endothelial cells and magnesium. Magnes Res 25, 2.
  6. DiNicolantonio, J.J. et al. (2018). Magnesium for the prevention and treatment of cardiovascular disease. Open Heart 5, 2.
  7. Held, K. et al. (2002). Oral Mg(2+) supplementation reverses age-related neuroendocrine and sleep EEG changes. Pharmacopsychiatry 35, 4.
  8. Abbasi, B. et al. (2012). The effect of magnesium supplementation on primary insomnia in elderly. J Res Med Sci 17, 12.
  9. Tarleton, E.K. et al. (2017). Role of magnesium supplementation in the treatment of depression. PLoS One 12, 6.
  10. Schurgers, L.J. et al. (2015). Vitamin K-dependent carboxylation of matrix Gla-protein: A crucial switch to control ectopic mineralization. Thromb Haemost 113, 6.
  11. Barbagallo, M.; Dominguez, L.J. (2010). Magnesium and aging. Curr Pharm Des 16, 7.
  12. Rondón, L.J. et al. (2014). Possible link between hyperglycemia and magnesium deficiency. Magnes Res 27, 2.

Information, not medical advice. Scientific evidence reflects the quality of the studies.

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