September 2017
Gerry K. Schwalfenberg and Stephen J. Genuis
Abstract
The scientific literature provides extensive evidence of widespread magnesium deficiency and the potential need for magnesium repletion in diverse medical conditions. Magnesium is an essential element required as a cofactor for over 300 enzymatic reactions and is thus necessary for the biochemical functioning of numerous metabolic pathways. Inadequate magnesium status may impair biochemical processes dependent on sufficiency of this element.
Emerging evidence confirms that nearly two-thirds of the population in the western world is not achieving the recommended daily allowance for magnesium, a deficiency problem contributing to various health conditions. This review assesses available medical and scientific literature on health issues related to magnesium.
A traditional integrated review format was utilized for this study. Level I evidence supports the use of magnesium in the prevention and treatment of many common health conditions including migraine headache, metabolic syndrome, diabetes, hyperlipidemia, asthma, premenstrual syndrome, preeclampsia, and various cardiac arrhythmias.
Magnesium may also be considered for prevention of renal calculi and cataract formation, as an adjunct or treatment for depression, and as a therapeutic intervention for many other health-related disorders. In clinical practice, optimizing magnesium status through diet and supplementation appears to be a safe, useful, and well-documented therapy for several medical conditions.
Conclusion
The concept of chronic latent Mg depletion is relatively new, yet deficiency of this required biochemical element has been shown to be an often unrecognized and widespread reality in the modern world. Furthermore, insufficient Mg has been linked to a spectrum of clinical afflictions, a not surprising finding considering the required role of the electrolyte in hundreds of essential biochemical reactions. Mg supplementation in appropriate clinical situations appears to be immensely useful in the management of a number of potentially serious and chronic medical conditions.
With the Institute of Medicine (IOM) setting an upper tolerable limit for supplementation without side effects at the considerable dosage of 350 mg/day, there is a substantial margin of safety; intoxication with Mg is rare. Higher levels can be used when indicated and excess Mg will usually result in bowel intolerance such as diarrhea as the first sign of excess. As the half-life of Mg is 42 days, ongoing correction of this deficiency may require long-term supplementation for those not able to secure sufficiency from diet.
There is good evidence for the use of supplemental Mg in preeclampsia/eclampsia, various cardiac arrhythmias, migraine headache, metabolic syndrome, diabetes and diabetic complications, premenstrual syndrome, hyperlipidemia, and asthma. Magnesium should also be considered as an adjunct for depression, attention deficit disorder, prevention of renal calculi, prevention of cataracts, smoking cessation, and a number of other conditions as outlined above.
With the alarming increase in diabetes in the general population, it would be prudent to optimize Mg intake for prevention and also for use as an adjuvant agent in the management of this common disorder.
It is evident from the scientific and medical literature that repletion and maintenance of Mg sufficiency can have a profound impact on many common clinical conditions routinely seen and managed by health practitioners. The lack of practical training in clinical nutritional biochemistry within medical education [5] remains an ongoing issue of enormous importance and perhaps represents a significant determinant of the widespread problem of Mg insufficiency.
Applied education on the assessment and practical management of nutrient compromise, including Mg deficiency, needs to be provided in medical education in order to overcome and diminish the risk of acquiring chronic disease states associated with biochemical inadequacy.
