Magnesium

Magnesium is very important to our body’s function, playing a role in more than 300 biochemical reactions. Magnesium is the 4th most plentiful mineral found in the human body and every cell needs it to function properly.

Our body contains around 25 grams of magnesium, 50 to 60% of which is stored in the bone, and the rest is found in muscle, soft tissues, and bodily fluids. Unfortunately, studies have found that about 50 percent of the US population get less than the recommended daily amount of magnesium.

6 Musculoskeletal Benefits of Magnesium

1. Magnesium Supports Joint Health

Inappropriate calcium mineralization of cartilage is a hallmark of unhealthy joints. Magnesium enhances the production of special calcium binding proteins called Matrix GLA proteins. These proteins capture free calcium, limiting the likelihood of calcium crystals forming and injuring cartilage.

Also, optimal magnesium levels are imperative for cartilage cell proliferation. Magnesium makes it much easier for new cartilage cells to attach to the surrounding support structures. Magnesium boosts the function of a fastener protein called integrin that helps new cartilage cells anchor to the extracellular matrix. This anchoring of new cartilage cells is a crucial step to promote and ensure cartilage sustainability and health.

Additionally, magnesium helps trigger certain critical genes that initiate a series of steps that promote cartilage growth, maturation, and survival.

Low levels of magnesium have been linked to knee osteoarthritis in multiple studies. Researchers in China looked at the dietary magnesium intake of close to 3000 Chinese people. The participants who consumed the most Mg, on average 350 mg/day, were a whopping 75% less likely to develop knee osteoarthritis. (Zeng et al. PLOS ONE I DOI:10.1371/journal.pone.0127666)

British scientists analyzed the differing dietary patterns between identical twins. Interestingly, participants who consumed more magnesium compared to their twin had a lower rate of osteoarthritis. (Hunter DJ, Hart D, Snieder H et al. (2003) “Evidence of altered bone turnover, vitamin D and calcium regulation with knee osteoarthritis in female twins”. Rheumatology (Oxford) 42, 1311–1316.)

2. Magnesium Supports Bone Health

Approximately 60% of total body magnesium is stored in bone, making magnesium a major component of healthy bone. Magnesium boosts the production of hydroxyapatite. Hydroxyapatite is a substance that gives bone rigidity.

Magnesium also enhances the mineralization of bone cells and supports Vitamin D synthesis. Magnesium deficiency has been associated with localized bone inflammation and decreased activity of cells that build bone, called osteoblasts.

The overall consequence of magnesium deficiency is accelerated bone loss, decreased bone formation, and sub optimal bone quality.

Researchers in the UK analyzing a large group of adult subjects demonstrated that dietary magnesium and serum magnesium were positively associated with heel bone density in women and negatively associated with fracture risk in both women and men.(Hayhoe R et al. Dietary magnesium and potassium intakes and circulating magnesium are associated with heel bone ultrasound attenuation and osteoporotic fracture risk in the EPIC-Norfolk cohort study1,2. Am J Clin Nutr. 2015 Aug;102(2):376-84. doi: 10.3945/ajcn.114.102723. Epub 2015 Jul 1.)

3. Magnesium Supports Muscle Health

Healthy magnesium intake is critical for properly functioning ATP. ATP is the main energy molecule in the body. Given the high demands placed on muscle, ATP plays an oversized role in maintaining muscle health. Research suggests magnesium improves muscle glucose utilization and delays the onset of lactic acid build up, a telling sign of muscle fatigue.

Magnesium also assists in normal muscle contraction and relaxation. Some research implies abnormal magnesium levels contribute to muscle cramps by disrupting the normal relationships between nerves and muscle at the neuromuscular junction.

Moreover, magnesium plays a vital role in new protein synthesis.

Danish scientists reviewed over 3000 articles analyzing mineral intake and chronic muscle loss and dysfunction. Optimal magnesium was associated with improved physical performance and decreased likelihood of sarcopenia, a state of advanced muscle wasting. (Van Dronkelaar et al. Minerals and Sarcopenia; The Role of Calcium, Iron, Magnesium, Phosphorus, Potassium, Selenium, Sodium, and Zinc on Muscle Mass, Muscle Strength, and Physical Performance in Older Adults: A Systematic Review. J Am Med Dir Assoc. 2017 Jul 12. pii: S1525­8610(17)30305­5.

 

4. Magnesium Supports Natural Antioxidant Defenses

Even marginal magnesium deficiency catalyzes a cascade of events that results in an increased production of inflammation promoting proteins, called cytokines, and oxidizing free radicals. Invariably, this uptick in inflammation increases the production of enzymes that attack and damage healthy cartilage tissue. Moreover, magnesium is required for the production of glutathione. Glutathione is a formidable natural antioxidant that the body uses to protect against oxidative stress.

5. Magnesium Supports Tendon Health

As previously mentioned, magnesium is a necessary cofactor for integrin. Integrin helps individual tendon fibers align themselves properly to give the tendon the right amount of strength and flexibility.

Additionally, research suggests chronic inflammation contributes to the pre-mature aging and dysfunction of tendons. Unhealthy inflammation leads to damaged tendon tissue and the activation of pain receptors. Healthy tendon tissue is replaced by a lackluster scar that tears easily and is a source of pain. Magnesium helps protect against unhealthy inflammation.

6. Magnesium Supports a Limited Pain Response to Injury

Experts believe magnesium likely inhibits NMDA pain receptor activation. Muscle and joint pain are communicated to the brain through stimulation of NMDA pain receptors. Magnesium may act to stymie NMDA activation by modulating the voltage and current across the NMDA triggering mechanism. This results in decreased activity and decreased pain.

Furthermore, some evidence indicates that magnesium deficiency leads to an increase in Substance P. Substance P is a key neuroprotein that communicates pain information from your joint to your brain. More substance P, means more pain.

Egyptians surgeons injected magnesium sulfate into the knees of patients who underwent an arthroscopic knee procedure. Compared to controls the treatment group experienced a longer period of tolerable pain after their procedure and needed less pain medication. (Radwan et al.Analgesic effect of intra-articular magnesium sulphate compared with bupivacaine after knee arthroscopic menisectomy. Journal of Advanced Research (2013) 4, 355–360)

 

Other Health Benefits

There are other conditions that magnesium may assist, although more research is needed and for some conditions results to date have been mixed. Those include:

  • Promotes Heart Health
  • Supports Healthy Blood Pressure
  • Boosts Healthy Blood Sugar
  • Enhances Nerve Health
  • Improves Energy

 

Rich Sources of Magnesium

Rich sources of magnesium include dark green leafy vegetables, nuts, seeds, and legumes.


 


Recommended Dietary Allowance (RDA)

The Food and Nutrition Board has published recommended dietary allowances (RDAs) for vitamin magnesium, based on age and gender. The values are:

Age Males (mg/day) Females (mg/day)
0 to 6 months 75 (AI) 75 (AI)
1 to 3 years 80 80
4 to 8 years 130 130
9 to 13 years 240 240
14 to 18 years 410 360
14 to 18 years 410 360
9 to 30 years 400 310
31 years and older 420 320
Pregnant women (19 to 30 years)   350
Pregnant women (31 years and older)   360
Breast-feeding (18 years and younger)   360
Breast-feeding (19 to 30 years)   310
Breast-feeding (31 years and older)   320

 

At risk groups for magnesium deficiency

  • Alcoholics: Risk of magnesium deficiency is increased by alcohol abuse.
  • Diabetics: Diabetes increases the risk for magnesium deficiency. Poorly controlled diabetes reduces body’s capability to control how much magnesium it absorbs.
  • Elderly: Decreased magnesium consumption puts older people at risk of magnesium deficiency.

 

Precautions

Magnesium from natural foods is generally well tolerated. RDA amounts can be obtained from a balanced, healthful diet. 

The FNB has published a supplemental upper limit value of 350 mg /day. 

Excessive intake of supplemental magnesium may cause diarrhea and more seriously cardiac abnormalities. 

Magnesium supplements can interact with oral bisphosphonates, a common medication in the treatment of osteoporosis. If using both, separate ingestion by at least two hours.

Any consideration a supplementation should be discussed with a qualified health professional familiar with your unique medical history.

 

References

(2016). Magnesium. The World’s Healthiest Foods. Retrieved from http://www.whfoods.com/genpage.php?tname=nutrient&dbid=75

(2016). Magnesium: Fact sheet for health professionals. National Institutes of Health. Retrieved from https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/

(2017). Magnesium. Micronutrient information center. Retrieved from http://lpi.oregonstate.edu/mic/minerals/magnesium

(2017). Magnesium in biology. Wikipedia. Retrieved from https://en.wikipedia.org/wiki/Magnesium_in_biology

(2017). Magnesium. Wikipedia. Retrieved from https://en.wikipedia.org/wiki/Magnesium

AINA V, LUSVARDI G, ANNAZ B, GIBBON IR, IMRIE FE, MALAVASI G, MENABUE L, CARRATO G, MARTRA G: Magnesium - and stroncium-co-substituted hydroxyapatite: the effects of doped-ions on the structure and chemico-physical properties. J Mater Sci Mater Med 23: 2867-2979, 2012.

Castiglioni, S., Cazzaniga, A., Albisetti, W., & Maier, J. A. M. (2013). Magnesium and osteoporosis: Current state of knowledge and future research directions. Nutrients, 5, 3022-3033. doi:10.3390/nu5083022

Ehrlich, G. E., Miller, S. B., & Zeiders, R. S. (1980). Choline magnesium trisalicylate versus ibuprofen in rheumatoid arthritis. Rheumatol Rehabil, 19(1), 30-41.

Frestedt, J. L., Kuskowski, M. A., & Zenk, J. L. (2009). A natural seaweed derived mineral supplement (Aquamin F) for knee osteoarthritis: A randomised, placebo controlled pilot study. Nutrition Journal, 8(7). doi:10.1186/1475-2891-8-7

Lee, C. H., Wen, Z. H., Chang, Y. C., Huang, S. Y., Tang, C. C., Chen, W. F., & … Jean, Y. H. (2009). Intra-articular magnesium sulfate (MgSO4) reduces experimental osteoarthritis and nociception: Association with attenuation of N-methyl-D-aspartate (NMDA) receptor subunit 1 phosphorylation and apoptosis in rat chondrocytes. Osteoarthritis and Cartilage, 17(11), 1485-1493. doi:10.1016/j.joca.2009.05.006

Li, Y., Yue, J. & Yang, C. (2016). Unraveling the role of Mg++ in osteoarthritis. Life Sciences, 147, 24-29.

Macmanus, J., & Heaton, F. W. (1970). The influence of magnesium on calcium release from bone in vitro. Biochim Biophys Acta, 215(2), 360-7.

Morais, J. B., Severo, J. S., Santos, L. R., De Sousa Melo, S. R., De Oliveira Santos, R., De Oliveira, A. R., & … Do Nascimento Marreiro, D. (2017). Role of magnesium in oxidative stress in individuals with obesity. Biol Trace Elem Res, 176(1), 20-26. doi:10.1007/s12011-016-0793-1

Otten, J. J., Hellwig, J. P., & Meyers, L. D. (Eds.). (2006). Dietary reference intakes: The essential guide to nutrient requirements. Washington D.C.: National Academy of Sciences.

Radwan, Y. A., Alfeky, A. A., & Faramawi, M. F. (2013). Analgesic effect of intra-articular magnesium sulphate compared with bupivacaine after knee arthroscopic menisectomy. Journal of Advanced Research, 4, 355–360.

Rude, R. K., Singer, F. R., & Gruber, H. E. (2009). Skeletal and hormonal effects of magnesium deficiency. Journal of the American College of Nutrition, 28(2), 131-141. doi:10.1080/07315724.2009.10719764

Shimaya, M., Muneta, T., Ichinose, S., Tsuji, K., & Sekiya, I. (2010). Magnesium enhances adherence and cartilage formation of synovial mesenchymal stem cells through integrins. Osteoarthritis and Cartilage, 18(10), 1300-1309. doi.org/10.1016/j.joca.2010.06.005

YOSHIZAWA S, BROWN A, BRCHOWSKY A, SFEIR C: Magnesium ion stimulation of bone marrow stromal cells enhances osteogenic activity, stimulating the effect of magnesium alloy degradation. Acta Biomater 10: 2834-2342, 2014.

Zeng, C., Li, H., Wei, J., Yang, T., Deng, Z., Yang, Y., & ... Lei, G. (2015). Association between Dietary Magnesium Intake and Radiographic Knee Osteoarthritis. Plos ONE, 10(5), 1-9. doi:10.1371/journal.pone.0127666

Zeng, C., Wei, J., Li, H., Yang, T., Zhang, F., Pan, D., & … Lei, G. (2015). Relationship between serum magnesium concentration and radiographic knee osteoarthritis. The Journal of Rheumatology, 42(7), 1231-1236. doi:10.3899/jrheum.141414

ZOFKOVA et al. Trace Elements Have Beneficial, as Well as Detrimental Effects on Bone Homeostasis Physiol Res. 2017 Jul 18;66(3):391-402. Epub 2017 Feb 28

 

 Lucas J. Bader MD

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