The Dance of Calcium and Magnesium
by Allen S. Josephs, M.D.
Magnesium is a core nutrient of which most Americans probably do not
get enough. Its status as an important nutrient with incredible benefits
has long been recognized by myself and the other doctors associated with
the Nutraceutical Sciences Institute (NSI), even though it has been understated
or ignored by many medical doctors. Magnesium is an essential mineral
in your body. It is needed for your bone, protein and fatty acid formation.
Magnesium is crucial in creating new cells, activating your B vitamins,
relaxing your muscles, clotting your blood and forming your adenosine
triphosphate (ATP-the energy on which our bodies run). The secretion and
action of insulin also require magnesium.
It is this association between magnesium and insulin that caught my
attention again this week. The trigger was a recent study on childhood
obesity, diabetes and magnesium's role concerning insulin. And since
it happens to center on our children and grandchildren's welfare,
it makes it particularly poignant for so many of us.
As most of us are painfully aware, childhood obesity in the United States
is at epidemic proportions. Several months ago, a report was published
indicating that the United States had the greatest percentage of obese
adolescents in the world. What a dubious distinction! Along with exploding
rates of childhood obesity, there is also the problem of an alarming rise
of pediatric diabetes mellitus. In general, obesity-be it in childhood
or adulthood-can lead to an increased risk of diabetes mellitus because
of the problem of insulin resistance. Although the insulin remains present
in your body, it does not seem to be as effective in the obese individual
as compared to a leaner person.
A study just published in the prestigious journal Diabetes Care appears
to shed some light on the issue of insulin resistance. Researchers primarily
out of the University of Virginia studied 24 obese, non-diabetic children
between the ages of eight to seventeen, comparing them to 24 similarly-matched
lean children. It was found that serum magnesium concentrations were significantly
lower in obese children, compared to the lean children. In studying dietary
patterns, it appeared that the obese children had a lower dietary magnesium
intake compared with the lean children. Further, it was found that serum
magnesium and dietary magnesium levels were inversely associated with
insulin resistance. While the findings were not clear on the mechanism
by which magnesium deficiency may lead to insulin resistance, we do know
that magnesium is an important cofactor for enzymes involved in the metabolism
of carbohydrates. Also, magnesium deficiency is associated with increased
intracellular calcium levels, which may be a factor leading to insulin
resistance.
In a previous survey of food intake by individuals, it was found that
one-third of our school-age children did not meet the estimated average
requirement for magnesium. Adding to the risk factor, it was also found
that obese children consumed a higher percentage of total calories from
fat and a lower percentage of calories from carbohydrates. The fiber intake
was lower in the obese group, as well. Subsequently, it is speculated
that obese children could suffer a double-whammy of magnesium deficiency
that puts them at particular risk for diabetes mellitus. First, they bear
the general magnesium deficiencies that many children experience. Second,
their higher fat, lower fiber intake can cause problems with absorption
of the magnesium they do get in their diets. Additionally, low fiber intake
alone was also clearly correlated with insulin sensitivity. The authors
of the article indicated that this study provides the first evidence showing
that magnesium deficiency is associated with insulin resistance in children.
Of course, this article got me thinking about the other important benefits
of magnesium, not only for children but for adults as well. As it turns
out, in the current edition of the Journal of Cardiac Surgery, intravenous
magnesium was analyzed as a preventative for certain heart arrhythmias
after coronary bypass surgery. Atrial fibrillation is an extremely common
arrhythmia and one of the most common complications you can encounter
after coronary bypass surgery. In a meta-analysis of eight randomized,
controlled trials, it was found that intravenous magnesium was associated
with a statistically significant reduction in the incident of atrial fibrillation
after coronary bypass surgery.
In another study published in the current journal Heart, a group of
researchers analyzed 20 randomized trials utilizing magnesium after cardiac
surgery. The study involved almost 2,500 patients. The conclusion was,
again, magnesium administration was an effective prophylactic measure
for the prevention of post-operative atrial fibrillation. As a practicing
neurologist, I frequently see patients who have suffered strokes as a
result of atrial fibrillation. It can be devastating, and therefore is
an important condition to keep under control.
Magnesium has many other valuable uses as well. It is considered the
treatment of choice in preventing eclampsia during and after delivery.
It has become increasingly valuable in the emergency room in treating
patients with acute asthmatic attacks. In a study published in the Archives
of Disease of Children in January of this year, a meta-analysis involving
five randomized placebo-controlled trials indicated that intravenous magnesium
sulfate probably provides additional benefits in moderate to severe acute
asthmatic attacks in children treated with bronchodilators and steroids.
Magnesium appears to be even more effective for asthma in an inhaled form.
Oral magnesium may have some modest benefit in possibly reducing the frequency
of asthma attacks.
You should also know that magnesium can be an extremely effective nutrient
in the treatment of migraines. There have been multiple studies in the
medical literature indicating that migraine sufferers have a relative
deficiency of total body magnesium. Intravenous magnesium has been used
successfully to abort acute migraine attacks. It can also be very beneficial
taken orally on a chronic basis to reduce the frequency of attacks, much
the same as asthma.
On the flip side, magnesium deficiency commonly occurs in critically-ill
patients, and generally correlates with a higher mortality and overall
worse clinical outcome. In an article published earlier this year in the
Journal of Intensive Care Medicine, Dr. Tong out of UCLA indicated that
magnesium may play a role in acute coronary syndromes, acute cerebral
ischemia and asthma. There is also a clear body of literature indicating
that decreased magnesium intake leads to an increased risk of osteoporosis.
The challenge is to truly diagnose the deficiency in the first place.
Since magnesium is lost primarily through the gastrointestinal system
(and through the kidneys), making a diagnosis of true magnesium deficiency
can be difficult because of limitations in measuring serum magnesium.
Finally, there is ongoing research about the potential of magnesium
as a neuro-protective agent. In a German journal published this month,
rats that were pretreated with intravenous magnesium and then subjected
to 90 minutes of occlusion of a major blood vessel in the brain, significantly
reduced the area of brain damage by 32% to 42%, as compared to controls.
Again, as a neurologist, I take particular interest in this matter.
It is generally recommended that adults consume about 300 mg or 400
mg of magnesium daily. You should know that the average healthy adult
in the United States typically consumes less than 200 mg a day of this
important nutrient. For those with diabetes mellitus or a history of heart
disease, 400 mg to 500 mg is recommended. I also usually recommend 400
mg to 500 mg of magnesium daily to my migraine sufferers whom I see in
my practice. A child over five years old should consume at least 100 mg
a day of magnesium, and by early teens, at least 200 mg a day. Magnesium
is usually well tolerated, although it can cause loose bowel movements
at higher doses. Individuals suffering with kidney disease should not
take magnesium without consulting their doctor.
As I stated earlier, Nutraceutical Sciences Institute (NSI) has for
many years realized the incredible benefits of magnesium. Many of our
Synergy line of multivitamins contain excellent doses of this critical
nutrient. We also offer many different magnesium products, including several
combinations of magnesium and calcium, a magnesium, calcium citrate malate
and Vitamin D formula, along with several popular stand-alone magnesium
products. Regarding the latter, we have a specially-formulated Magnesium
Ultra formula that blends various chelated forms of magnesium, including
amino acid chelate, malate and taurinate.
As you can see from our selection, we are very serious about you getting
the proper levels of magnesium. And of course, the monetary value and
savings from these products are second to none.
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