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Magnesium is a less discussed mineral element, but epidemiological studies in recent years have shown that low levels of magnesium are associated with a variety of chronic diseases, such as Alzheimer’s disease, metabolic syndrome, attention deficit ADHD, Type 2 Diabetes, Cardiovascular Disease, Migraine, Osteoporosis…etc
What are the benefits of magnesium in evidence-based medicine? Are there any side effects or contraindications? See in-text analysis
What is Magnesium?
Magnesium is one of the macrominerals, which means that the demand is much greater than that of trace minerals, and it is the fourth most common mineral in the human body (after sodium, potassium, and calcium).
About 99% of magnesium in the human body is stored in bones, muscles and non-muscle soft tissues (such as nerves, blood vessels and internal organs). Its main function is to act as a catalytic assistant for more than 300 important biochemical reactions, and it plays an important role in many physiological functions. , such as: ATP metabolism, blood pressure regulation, muscle contraction (including cardiac contraction), nervous system function, neurotransmitter release, insulin metabolism, glycolysis, synthesis of DNA/RNA and protein are all related to magnesium.
According to a number of dietary surveys abroad, it is found that Western-style diets are often deficient in magnesium, so the total intake of magnesium is often insufficient, only reaching 30% to 50% of the recommended dietary allowance (RDA).
What Are The Proven Benefits of Magnesium?
1. Magnesium Benefits Insomnia
Insomnia is a common sleep disorder that reduces quality of life, increases utilization of medical services, reduces work productivity, and leads to absenteeism.
Nearly 50% of severe insomnia turns into chronic insomnia, which lasts for more than 10 years. Benzodiazepines are commonly used drugs for the treatment of insomnia and are recommended by clinical guidelines.
However, long-term use of benzodiazepines may have adverse effects, including: dependence, rebound insomnia, low sleep quality, negative effects on cognitive function, and decreased effectiveness, so it is imperative to find safe alternatives.
A systematic literature review and meta-analysis (Meta-Analysis, consisting of 3 randomized controlled trials in 151 adults diagnosed with insomnia) found that magnesium supplementation resulted in a reduction in sleep latency compared with placebo. 17.36 minutes, while total sleep time improved by 16.06 minutes, but not statistically significant (by sleep parameters and questionnaires). Note 1
＊Conclusion: The effect of magnesium supplementation on insomnia symptoms is between positive and ineffective, and is limited by the low quality of evidence and high risk of bias of the included studies, and more studies are needed for further verification.
2. Magnesium Benefits Migraine
Migraine is a chronic neurological disease with periodic attacks. Up to 25% of migraine sufferers may have brief neurological local symptoms before headache, usually lasting 4 minutes to 1 hour, which is defined as migraine aura.
The most common aura symptoms are visual disturbances (flickering blind spots), sensory disturbances (unilateral paresthesias affecting the face and extremities, numbness), or speech disturbances (dysarthria, aphasia). Less common aura phenomena include weakness, ataxia, dizziness, or loss of consciousness.
Triggers of migraine headaches include dietary factors (such as hunger, alcohol, and chocolate), hormonal changes (menstruation), environmental factors (such as bright lights, smell, and altitude), physical activity (sex, exercise), and psychological and biological clock changes (stress, Sudden anxiety or happiness, sleeping too much or too little, changes in routine).
A meta-analysis of the literature (21 randomized controlled trials involving 1737 patients with migraine) found that intravenous magnesium significantly relieved acute migraine headaches at 15-45 minutes, 120 minutes and 24 hours, while oral magnesium Significantly reduces the frequency and intensity of migraine attacks. Note 1
＊Conclusion: Intravenous magnesium and oral magnesium should be used as adjuvant therapy for acute migraine and migraine prevention, respectively, but more well-designed studies are needed to confirm.
3. Magnesium Benefits Weight Management
Obesity is becoming one of the most prevalent health problems in all populations worldwide, leading to significant increases in mortality and morbidity associated with coronary heart disease, type 2 diabetes, metabolic syndrome, stroke and cancer.
Lifestyle and pharmacotherapy interventions are seen as the main modes of obesity treatment.
A systematic literature review and meta-analysis (including 22 randomized controlled trials with a total of 2551 participants) pointed out that magnesium supplementation can help reduce the body mass index (Body Mass Index), but body weight, body weight, Waist Circumference, Body Fat percentage and Waist to Hip Ratio did not change significantly. Note 2
In addition, Subgroup analyses showed that changes in body weight and waist circumference were significant in subgroups of insulin resistance-related disorders, hypertension, obesity, baseline magnesium deficiency, and women.
*Conclusion: Magnesium supplementation may have positive effects on weight management, especially for patients with metabolic syndrome and magnesium deficiency, but limited by the heterogeneity between studies, further validation is needed
4. Magnesium Improves Muscle Health
Muscle fitness is a multidimensional construct that includes the combined functions of muscular strength, muscular endurance, and muscular strength.
Muscle health is an important marker of quality of life, metabolic syndrome, cancer, cardiovascular disease, fracture risk, cognitive function, and all-cause mortality, and these associations are more pronounced in men than in women.
A systematic review of the literature and a meta-analysis (including 14 randomized clinical trials) found that magnesium supplementation had a significant effect on muscle health (related to magnesium deficiency) in the elderly and alcoholics, but not for magnesium Not evident in higher level athletes and physically active individuals. Note 3
In addition, magnesium supplementation has no significant effect on muscle health-related measures, such as prolonged isokinetic peak torque, muscle strength, and muscle strength.
*Conclusion: For improving muscle health, magnesium supplementation only has positive benefits for magnesium-deficient groups, and has no significant benefit for most athletes with high magnesium levels and physically active people.
5. Magnesium Helps With Nighttime Leg Cramps
Nocturnal Leg Cramps is a musculoskeletal disorder characterized by sudden episodes of persistent pain and involuntary contractions of the calf, hamstring, or foot muscles during the night.
Up to 33% of people over the age of 50 have had the disorder, with 20% of cramps occurring during daytime rest.
There is currently no consensus on the etiology of nighttime leg cramps, but it is thought that shortened muscle length due to physical inactivity in the elderly is a risk factor, while other pathological factors are: chronic liver and kidney failure (hemodialysis), vascular disease, magnesium or Calcium deficiency, dehydration and varicose veins.
A systematic literature review and meta-analysis (7 randomized controlled trials involving 361 patients with nocturnal leg cramps) indicated that magnesium therapy (whether oral or intravenous) did not improve symptoms in the general population Obvious effect, but may have a slight positive effect on pregnant women. Note 4
＊Conclusion: For nocturnal leg cramps, the use of magnesium therapy did not bring significant benefits, but limited by the low quality of the existing evidence, more research is needed to further verify.
6. Magnesium Benefits Blood Lipid Regulation
Lipids are important substances in blood vessels. For example, cholesterol is necessary for the formation of cell membranes, hormonal precursors and the formation of bile acids, while triglycerides play an important role in energy supply.
However, any molecule in excess will pose a threat to the human body, and hyperlipidemia is an important driver of atherosclerosis and cardiovascular disease. It is estimated that the prevalence of dyslipidemia in adult males is about 41.9%, which is much higher than that in females.
A meta-analysis of the literature (18 studies with 1192 participants) indicated that oral magnesium had no significant effect on improving hyperlipidemia (including total cholesterol, low or high-density lipoprotein cholesterol and triglycerides). Note 5
*Conclusion: Magnesium supplementation did not produce statistically significant improvements in dyslipidemia subjects.
7. Magnesium Reduces Inflammation Markers: C-Reactive Protein
C-reactive protein (CRP) is an acute-phase plasma protein produced by systemic inflammatory symptoms and is highly recognizable for nonspecific inflammation.
In the average person, CRP levels are usually low, and elevated high-sensitivity C-reactive protein is often associated with many diseases, including infectious diseases, cardiovascular disease, diabetes, inflammatory bowel disease, autoimmune disease, arthritis and various cancers.
A systematic literature review and meta-analysis (including 11 randomized controlled trials) indicated that magnesium supplementation was effective in reducing C-reactive protein levels (especially in subjects with CRP > 3 mg/dL). Note 6
*Conclusion: Magnesium supplementation reduces inflammatory markers: C-reactive protein, with additional help in managing low-grade inflammation.
8. Magnesium Benefits Diabetes
Diabetes Mellitus is a disease in which the body metabolizes blood sugar abnormally. It is mainly caused by insulin resistance or insufficiency, resulting in the inability of blood sugar to enter cells and the high sugar concentration in the blood.
Type 2 diabetes is currently the most common. It is estimated that in China alone, 9.7% of the population over the age of 20 is affected (about 90 million people). The result of long-term hyperglycemia is multiple organ lesions, including loss of Vision, renal failure, peripheral neuropathy, cardiovascular disease, sexual dysfunction, etc.
A meta-analysis of 25 randomized controlled trials with 1677 participants found that magnesium supplementation reduced fasting blood glucose in people with type 2 diabetes compared with placebo . Note 1
In addition, magnesium supplementation not only significantly reduced blood glucose values in 2-hour oral glucose tolerance test (2h OGTT), but also reduced fasting blood glucose and insulin resistance (HOMA-IR) in high-risk groups of diabetes.
＊Conclusion: Magnesium intake may have a positive effect on diabetes blood sugar control, but more research is needed to further verify
9. Magnesium Benefits Blood Pressure Regulation
High blood pressure is the most common chronic disease in adults, with one in three adults in the United States having high blood pressure, affecting approximately 70 million people.
Long-term high blood pressure can easily damage the walls of blood vessels, and even various tissues and organs, causing dangerous diseases such as heart disease, stroke, and aneurysm
Most patients with high blood pressure often have no obvious symptoms. When the following conditions occur, high blood pressure may have existed for a long time or the value has suddenly increased, please seek medical examination immediately (such as frequent dizziness, headache, nosebleeds, sudden blurred vision for no reason).
A meta-analysis of the literature (22 studies with 1,173 participants) found that oral magnesium (median duration 11.3 months, mean dose 410 mg daily) was associated with a reduction of 2 to 3 mm Hg Systolic blood pressure of 3 to 4 mm Hg and diastolic blood pressure of 3 to 4 mm Hg, although small, are clinically significant. Note 7
＊Conclusion: Magnesium intake may have positive effects on blood pressure regulation, which is worthy of further verification by more large-scale experiments.
10. Magnesium Benefits Mineral Bone Disease Associated With Chronic Kidney Disease
Chronic kidney disease is a worldwide health problem affecting 5% to 10% of the population. As the glomerular filtration rate (glomerular filtration rate) declines, the risk of bone and mineral metabolism disorders in patients increases .
This is known as chronic kidney disease-associated mineral bone disease and is characterized by abnormalities in calcium, phosphorus, parathyroid hormone, or vitamin D metabolism, abnormalities in bone turnover, mineralization, linear growth in volume, or strength, vascularity, or extraskeletal soft tissue Calcification. Patient presents with bone pain, muscle and tendon rupture, pruritus, high incidence of fractures, cardiovascular calcification.
A systematic literature review and meta-analysis (Meta-Analysis, including 8 randomized controlled trials, with 309 hemodialysis patients) pointed out that magnesium supplementation can reduce the risk of hemodialysis patients by regulating serum calcium and parathyroid hormone metabolism . Carotid intima-media thickness (CIMT), thereby improving chronic kidney disease-related mineral bone disease (Chronic Kidney Disease-Mineral and Bone Disorder). Note 2
*Conclusion: For chronic kidney disease-related mineral bone disease, magnesium may be able to bring positive help, but limited by the small number of samples, more research is still needed for further verification.
Are there any side effects of magnesium?
Magnesium is safe for most adults up to 350 mg per day (the maximum tolerated intake established by the Food and Nutrition Board/FNB), but possible side effects include gastrointestinal upset, nausea, and vomiting , diarrhea, etc.
In addition, high blood magnesium concentration may lead to hypermagnesemia (hypermagnesemia), symptoms such as: low blood pressure, muscle weakness, irregular heartbeat, difficulty breathing, arrhythmia, cardiac arrest, drowsiness, coma, worsening kidney function and other serious symptoms.
What AreThe Contraindications and Safety Precautions For The Use of Magnesium?
1. Do not use it in patients with heart block (Heart block), there may be unknown risks.
2. Intravenous magnesium should not be administered to patients with myasthenia gravis, as it may aggravate weakness and cause difficulty breathing.
3. Do not use for intestinal diseases (intestinal obstruction) (due to unknown safety)
4. Do not use in patients with poor liver and kidney function (due to unknown safety)
5. May slow down the coagulation time, so please be careful if you have abnormal coagulation function or take anticoagulants
6. Magnesium may interact with various drugs, affecting the action or absorption of drugs, and may cause adverse effects in severe cases (related drugs such as: heart drugs (digoxin), anti-malarial drugs, tranquilizers (chlorpromazine), antibiotics, drugs for the treatment of osteoporosis (Bisphosphonates) ), penicillamine, calcium ion blockers, levothyroxine, etc. Therefore, if you take any western medicine, please discuss it with your medical staff before using it)
7. Long-term use of proton-pump inhibitors (a type of stomach acid control drug) may increase the risk of hypomagnesemia
8. Because magnesium may increase the effect of muscle relaxant drugs, please inform medical personnel if taking any magnesium or magnesium-containing antacids and laxatives before any surgical procedure.
9. Hormone replacement therapy will slow down the loss of minerals, so please pay attention to this therapy
10. Do not use it in combination with aminoglycoside antibiotics, which may cause muscle problems. The related drug names are: Amikacin, gentamicin, kanamycin, streptomycin, tobramycin
11. Do not use in combination with Quinolone antibiotics and Tetracycline antibiotics, which may affect the efficacy of the drug. The related drug names are: Ciprofloxacin, enoxacin, norfloxacin, sparfloxacin, trovafloxacin, grepafloxacin, Demeclocycline, minocycline, tetracycline
12. Do not use in combination with bisphosphonates for the treatment of osteoporosis, which may affect the efficacy of the drug. sedronate), tiludronate
13. Do not use it in combination with high blood pressure drugs, which may lead to low blood pressure. The related drug names are: Nifedipine, verapamil, diltiazem, isradipine, felodipine (non- lodipine), amlodipine
14. Do not use it in combination with muscle relaxants, as it may increase the side effects of drugs. The related drug names are: Carisoprodol (isopropyl methylbutycarbamide), pipecuronium (guacuronium bromide), orphenadrine (o-tolyl seamin), cyclobenzaprine (benzaprine), gallamine, atracurium, pancuronium (diafenthiam), succinylcholine
15. Do not use it in combination with potassium-sparing diuretics, which may lead to excessive magnesium in the body. The related drug names are: Amiloride, spironolactone, triamterene
Note 1: https://pubmed.ncbi.nlm.nih.gov/33865376/
Note 2: https://pubmed.ncbi.nlm.nih.gov/32654500/
Note 3: https://pubmed.ncbi.nlm.nih.gov/29637897/
Note 4: https://pubmed.ncbi.nlm.nih.gov/24280947/
Note 5: https://www.ncbi.nlm.nih.gov/pubmed/28180945
Note 6: https://www.ncbi.nlm.nih.gov/pubmed/28545353
Note 7: https://www.ncbi.nlm.nih.gov/pubmed/22318649