Magnesium is essential, which means it must be obtained through food and cannot be produced by the body itself. An adult's body contains approximately 24 to 28 g of magnesium. Of this, 50-70% is stored in the bones (bound to hydroxyapatite; partially mobilizable in cases of magnesium deficiency) and 25-30% in the muscles and soft tissues (intracellularly).

Relative proportions of magnesium to the total magnesium in our body:

serum Erythrocytes connective tissue muscle Bone Plasma concentration: Ionized Mg: Erythrocyte Mg:

0.3% 0.5% 19.3% 27% 52.9% 0.85 mmol/l 0.5–0.65 mmol/l 1.65–2.73 mmol/l

Magnesium intake:

20-30% of the magnesium ingested from food is absorbed by the body. This occurs through both active transport (via the TRPM6 ion channel) and passive diffusion. The absorption rate is affected. v.a...due to the type of magnesium compound. For example, magnesium bisglycinate, citrate, or lactate are more bioavailable than, for example, magnesium oxide or magnesium sulfate.

Studies show that the best absorption with single doses of &<200 mg elemental magnesium This has been done.

Magnesium elimination:

Magnesium is excreted v.a...via the kidneys, but also via sweat. Thus, the renal magnesium elimination at approximately 100 mg/day. Excretion is increased by alcohol and large amounts of protein.

Effects of magnesium:

Magnesium is involved in almost all metabolic processes:

• Energy metabolism (z.B(ATP is bound intracellularly to magnesium) à Figure below
• Neuromuscular signal transmission (reduces excitability)
• Muscle function
• Protein, DNA and RNA synthesis
• At the cellular level, it contributes to cell membrane permeability and stability via the cross-linking of phospholipids.
• It is of central importance for the control of glucose metabolism.
• Regulation of many cardiac functions (z.BContraction (negative inotropic effect), myocardial metabolism, cardiac output, stabilization of cardiac rhythm
• Biological calcium antagonist

Importance of magnesium in energy metabolism:

Cofactor in over 300 enzyme systems (2), z.B.

• Acetyl-CoA synthetase
• 5'-Nucleotidase
• Phosphoryl kinase
• Phosphoribosylpyrophosphate transferase
• Phosphoglucomutase
• Na+-K+-ATP-ase (activity of the Na+-K pump!)
• Ca++ transport ATPase of the sarcoplasmic reticulum
• H+-ATP-ases of the mitochondrial membrane (seethere)
• Adenylate cyclase
• Myosin-ATPase
• Hexokinase
• Phosphofructokinase
• Phosphoglycerate kinase
• Enolase
• Pyruvate kinase

Glucose metabolism (central importance):

• reduces diabetes incidence
• Improves insulin sensitivity
• stimulates insulin receptors
• increases pyruvate kinase activity,
• Cofactor in glucose transport and glycogen synthesis

Biological calcium antagonist:

• Prevention of excessive calcium influx (protection of heart muscle cells)
• Modulation of intracellular calcium action
• Activation of calcium-ATPase (stabilizes the excitation potential of heart/skeletal muscle cells)
• Influence on potassium channels or Na/K-ATPase (muscle, heart muscle, nerve cells)
  • Mg closes K channels in the cell and increases intracellular K
  • Reduction of muscle contractions and vascular tone
  • But also: Calcium-like effects (synergism)

Involvement in cardiac functions, such as z.B.:

• Regulation of contractile proteins
• Transport of Ca++ (via sarcoplasmic reticulum)
• Co-factor of ATPase activities
• Influence on Ca++ binding and Ca transport in membranes and intracellular organelles
• Metabolic regulation of energy-dependent cytoplasmic and mitochondrial metabolic pathways
• Influence on the contractility of cardiac muscle fibers (negative inotropic effect)
• Influence on hormone-receptor interactions
• Regulation of electrolyte transport and content
• Influence on resting and action potentials
• Change in electromechanical coupling
• Inhibition of calcium-induced NTM release at presynaptic membranes (reduction of stress hormones and excitability -> cf. heart)
• Reduction of cardiac O² consumption
• Improvement of myocardial metabolism, cardiac output, vascular tone
• Protection against cardiac arrhythmias (inhibits excitation conduction at the AV node, improves recovery time at the sinus node)

Magnesium indications:

• Urolithiasis
• Diabetes mellitus
• Heart disease (z.BTachycardia, hypertension)
• Cor pulmonale
• asthma
• Pregnancy eclampsia
• cramps
• stress

Magnesium deficiency &and possible causes:

Magnesium deficiency is linked to a large number of chronic diseases, such as Alzheimer's, type 2 diabetes, high blood pressure, cardiovascular disease, migraines, and ADHD. In the USA, it is estimated that 50% of the population is deficient in magnesium. According to a 2001 study in Germany, nearly 34% of the population has suboptimal magnesium levels in their blood.

Possible causes of magnesium deficiency include::

• Reduced intake (diet, alcoholism, malabsorption)
• Pregnancy and breastfeeding
• Intense sport
• stress
• Increased excretion (in kidney disease, diabetes, alcohol consumption, hyperaldosteronism, diuretics, digitalis, aminoglycosides, etc.).)
• Inhibition of magnesium absorption by tetracyclines and antacids

Magnesium deficiency symptoms (Source: Congress of Internal Medicine 2008, Wiesbaden):

• Neuromuscular hyperexcitability (muscle cramps up to tetany, headache)
• Elevated lactate levels (see sports)
• Confusion, depression
• Insomnia, difficulty concentrating, fatigue
• Mineral imbalances
• Gastrointestinal hyperexcitability
• Cardiac hyperexcitability (arrhythmia, angina pectoris, hypertension)
• Immune disorders
  
  

Magnesium deposits:

• In almost all foods
• But usually only low concentrations.
• Low magnesium content in staple foods
• Found primarily in whole grain products

• People with an average diet consume approximately 200 mg of magnesium per day through their food.

Magnesium-rich foods

• Wheat bran: 600mg magnesium per 100g
• Sunflower seeds: 420mg per 100g
• Soy flour: 245mg per 100g
• Wheat germ: 120-130mg in 50g
• Barley, rice (unpolished): 160mg per 100g
• Walnuts, almonds, peanuts, hazelnuts: 65-90mg per 50g
• Whole wheat bread: 90mg per 100g
• Lentils: 75mg in 100g
• Oat flakes: 70mg in 50g
• Mineral waters rich in magnesium: 80-120mg in 0.2 l
• Spinach: 60mg per 100g

Magnesium interactions with other micronutrients

Calcium

• Magnesium is a calcium antagonist, but also a synergist (z.B. in case of tetany: Ca or Mg are effective!):
• Magnesium is important for calcium metabolism:
  • Magnesium deficiency (decreased PTH) leads to hypocalcemia.
    (in case of Ca ↓, administer Ca + Mg together in a ratio of 2:1 – 3:1)
  • Magnesium competes with calcium for the oxalate anion and lowers oxalate ion concentration (in the blood). urine: Reduction of the risk of calcium oxalate stones)

potassium

• Magnesium deficiency (decreased PTH) leads to potassium deficiency.
• Magnesium influences the transmembrane movement of potassium
• Potassium improves magnesium absorption in the intestine

Interactions of magnesium with medications

Several medications can affect magnesium levels. Here are some examples (see Magnesium Fact Sheet for Health Professionals, National Institutes of Health):

• Diuretics, which are prescribed, for example, to lower blood pressure, often lead to increased magnesium excretion in the urine and thus to a deficiency if magnesium is not taken via a dietary supplement.
• Proton pump inhibitors (PPIs; also known as "acid blockers" or "stomach protectors"), such as omeprazole or lansoprazole, can lead to magnesium deficiency with long-term use. In 25% of affected individuals, even magnesium supplementation failed to raise magnesium levels while continuing to take PPIs. Only discontinuing the medication was able to restore magnesium levels.
• Conversely, magnesium can also influence the absorption and effect of some medications – it can affect the absorption of, for example,Since bisphosphonates used to treat osteoporosis inhibit the absorption of magnesium, magnesium supplementation should always be discussed with the treating physician. Often, taking the magnesium at least two hours apart from the medication is sufficient.
• Magnesium can also form insoluble complexes with some antibiotics, such as tetracyclines (Declomycin®), doxycycline (Vibramycin®), and fluoroquinolone antibiotics (ciprofloxacin (Cipro®) and levofloxacin (Levaquin®)). Therefore, these antibiotics should be taken at least 2 hours before or 4-6 hours after magnesium supplementation.

Current research on the therapeutic use of magnesium

Magnesium in insulin resistance && Type 2 Diabetes

Insulin resistance is a precursor to type 2 diabetes. In this condition, muscle and liver cells no longer fully absorb blood glucose, leading to increased conversion and storage of glucose as fat. Magnesium may help prevent this process (see Rosanoff A, et al, Suboptimal magnesium status in the United States: are the health consequences underestimated? Nutrition Reviews, 2012 Mar;70(3):153-64; Schimatschek HF and Rempis R, Prevalence of hypomagnesemia in an unselected German population of 16,000 individuals, Magnesium Research, 2001 Dec;14).

Additionally, the increased insulin levels associated with insulin resistance lead to increased magnesium loss through urine, further reducing magnesium levels. Magnesium supplementation can improve this condition (see Wang J, et al, Dietary magnesium intake improves insulin resistance among non-diabetic individuals with metabolic syndrome participating in a dietary trial, Nutrients, 2013 Sep 27;5(10):3910-9; Mooren FC, et al, Oral magnesium supplementation reduces insulin resistance in non-diabetic subjects - a double-blind, placebo-controlled, randomized trial, Diabetes, Obesity). &&amp; Metabolism, 2011 Mar;13(3):281-4.; Guerrero-Romero F, et al, Oral magnesium supplementation improves insulin sensitivity in non-diabetic subjects with insulin resistance. A double-blind placebo-controlled randomized trial, diabetes &&amp; Metabolism, 2004 Jun;30(3):253-8).

In a 2003 study, magnesium supplementation led to reduced insulin resistance and also to a decrease in blood sugar levels (see Rodríguez-Morán M and Guerrero-Romero F, Oral magnesium supplementation improves insulin sensitivity and metabolic control in type 2 diabetic subjects: a randomized double-blind controlled trial, Diabetes Care, 2003 Apr;26(4):1147-52.).

A meta-study from 2011 shows how a magnesium deficiency increases the risk of diabetes (see Dong JY, et al, Magnesium intake and risk of type 2 diabetes: meta-analysis of prospective cohort studies, Diabetes Care, 2011 Sep;34(9):2116-22.; Hruby A, et al, Higher magnesium intake reduces risk of impaired glucose and insulin metabolism and progression from prediabetes to diabetes in middle-aged americans, Diabetes Care, 2014 Feb;37(2):419-27).

Furthermore, a 2010 study of more than 4,000 people over 20 years shows that those with the highest magnesium intake had a 47% lower risk of diabetes (see Kim DJ, et al, Magnesium intake in relation to systemic inflammation, insulin resistance, and the incidence of diabetes, Diabetes Care, 2010 Dec;33(12):2604-10).

In a randomized, double-blind study, participants who had low magnesium levels and type 2 diabetes received 50 ml of a magnesium chloride solution daily for 4 months.Apart from the fact that the magnesium level recovered, insulin sensitivity, blood sugar levels and long-term blood sugar (HbA1c) also improved (see Rodríguez-Morán M and Guerrero-Romero F, Oral magnesium supplementation improves insulin sensitivity and metabolic control in type 2 diabetic subjects: a randomized double-blind controlled trial, Diabetes Care, 2003 Apr;26(4):1147-52).

Magnesium in cardiovascular diseases

Low magnesium levels promote the development of high blood pressure and lipid metabolism disorders (high cholesterol and triglyceride levels). According to a 2017 meta-study, high blood pressure can be positively influenced by magnesium supplementation. The administered magnesium dose was 365-450 mg/day of pure magnesium and led to a reduction in both systolic (by 4.18 mmHg) and diastolic (by 2.27 mmHg) blood pressure (see Dibaba DT, et al, The effect of magnesium supplementation on blood pressure in individuals with insulin resistance, prediabetes, or noncommunicable chronic diseases: a meta-analysis of randomized controlled trials, The American Journal of Clinical 2017 Sep;106(3):921-929).

The lower the magnesium level, the higher the risk of peripheral artery disease (PAD), also known as intermittent claudication or "window shopper's disease." According to a 2009 study, magnesium supplementation improves vascular health (see Hatzistavri LS, et al, Oral magnesium supplementation reduces ambulatory blood pressure in patients with mild hypertension, American Journal of Hypertension, 2009 Oct;22(10):1070-5; Kawano Y, et al, Effects of magnesium supplementation in hypertensive patients: assessment by office, home, and ambulatory blood pressures, Hypertension, 1998 Aug;32(2):260-5; Kass LS, et al, A pilot study on the effects of magnesium supplementation with high and low habitual dietary magnesium intake on resting and recovery from aerobic and resistance exercise and systolic blood pressure, Journal of Sports Science). &&amp; Medicine, 2013 Mar 1;12(1):144-50.; Guerrero-Romero F and Rodríguez-Morán M, The effect of lowering blood pressure by magnesium supplementation in diabetic hypertensive adults with low serum magnesium levels: a randomized, double-blind, placebo-controlled clinical trial, Journal of Human Hypertension, 2009 Apr;23(4):245-51.).

In normal doses, magnesium only lowers excessively high blood pressure, whereas healthy blood pressure is not lowered further (cf. Lee S, et al, Effects of oral magnesium supplementation on insulin sensitivity and blood pressure in normo-magnesemic nondiabetic overweight Korean adults, Nutrition, Metabolism, and Cardiovascular Diseases, 2009 Dec;19(11):781-8.).

Magnesium activates vitamin D

A review published in February 2018 in The Journal of the American Osteopathic Association confirmed that vitamin D cannot be metabolized if sufficient magnesium is not simultaneously available. If there is a magnesium deficiency, the vitamin D is stored but remains inactive.

Magnesium influences vitamin D metabolism in three ways:

• Magnesium is involved in the activation of vitamin D; d.hOnly with magnesium can those enzymes that convert vitamin D into its active form become active.
• Vitamin D requires certain transport molecules that would remain inactive without magnesium.
• Parathyroid hormone, a hormone produced by the parathyroid glands, is involved in regulating vitamin D metabolism. Parathyroid hormone levels, in turn, are strongly dependent on magnesium levels.

Magnesium in autoimmune diseases

Magnesium can also be helpful in autoimmune diseases, such as Hashimoto's thyroiditis. A 2018 study found that low magnesium levels are associated with an increased risk of Hashimoto's thyroiditis and hypothyroidism (see Wang K, et al. Severely low serum magnesium is associated with increased risks of positive anti-thyroglobulin antibody and hypothyroidism: A cross-sectional study, Scientific Reports, 2018 Jul 2;8(1):9904).

Magnesium has anti-inflammatory properties.

Chronic inflammatory processes are considered a cause of many chronic diseases (see Nielsen FH, Effects of magnesium depletion on inflammation in chronic disease, Current Opinion in Clinical Nutrition and Metabolic Care., 2014 Nov;17(6):525-30.; Barbagallo M and Dominguez LJ, Magnesium and aging, Current Pharmaceutical Design, 2010;16(7):832-9.; Nielsen FH, Magnesium, inflammation, and obesity in chronic disease, Nutrition Reviews, 2010 Jun;68(6):333-40.).

Even in children, low magnesium levels have been shown to be associated with elevated inflammation markers (sensitive CRP). At the same time, these children had higher blood sugar, insulin, and blood lipid levels. (cf. Rodríguez-Morán M and Guerrero-Romero M, Serum magnesium and C-reactive protein levels, Archives of Disease in Childhood, 2008 Aug;93(8):676-80.).

Magnesium supplementation can lower inflammatory markers – both in older and overweight individuals, as well as in people with prediabetes (see Nielsen FH, et al, Magnesium supplementation improves indicators of low magnesium status and inflammatory stress in adults older than 51 years with poor quality sleep, Magnesium Research, 2010 Dec;23(4):158-68; Chacko SA, et al, Magnesium supplementation, metabolic and inflammatory markers, and global genomic and proteomic profiling: a randomized, double-blind, controlled, crossover trial in overweight individuals, The American Journal of Clinical Nutrition, 2011 Feb;93(2):463-73; Simental-Mendía LE, et al, Oral magnesium supplementation decreases C-reactive protein levels in subjects with prediabetes and hypomagnesemia: a clinical randomized double-blind placebo-controlled trial, Archives of Medical Research, 2014). May;45(4):32530.).

Magnesium prevents migraines

Many migraine patients suffer from a magnesium deficiency (see Mauskop A and Varughese J, Why all migraine patients should be treated with magnesium, Journal of Neural Transmission, 2012 May;119(5):575-9.).

Migraine can be treated with magnesium – not only preventively, but also in cases of already manifest migraine (see Wang F, et al, Oral magnesium oxide prophylaxis of frequent migrainous headache in children: a randomized, double-blind, placebo-controlled trial, Headache, 2003 Jun;43(6):601-10.; Köseoglu E, The effects of magnesium prophylaxis in migraine without aura, Magnesium Research, 2008 Jun;21(2):101-8.).

In a 2015 study, patients with an acute migraine attack were given 1 g of magnesium sulfate, while the control group received standard medication consisting of metoclopramide (for nausea/vomiting) and dexamethasone (cortisone). The results showed that the magnesium was more effective at alleviating the attack than the migraine medications (see Shahrami A, et al, Comparison of therapeutic effects of magnesium sulfate vs. dexamethasone/metoclopramide on alleviating acute migraine headache, The Journal of Emergency Medicine, 2015 Jan;48(1):69-76).

However, a change in diet with increased consumption of magnesium-rich foods can also help to reduce migraine symptoms in the long term. (cf.)Teigen L and Boes CJ, An evidence-based review of oral magnesium supplementation in the preventive treatment of migraine, Cephalalgia, 2015 Sep;35(10):912-22).

Magnesium in premenstrual syndrome

Magnesium, in doses of 200 mg daily, can also be helpful for PMS. In a corresponding study, no improvement was observed in the first cycle of supplementation, but symptoms improved from the second cycle onwards (see Facchinetti F, et al, Oral magnesium successfully relieves premenstrual mood changes, Obstetrics and Gynecology, 1991 Aug;78(2):177-81.; Walker AF, et al, Magnesium supplementation alleviates premenstrual symptoms of fluid retention, Journal of Women's Health, 1998 Nov;7(9):1157-65).

Magnesium for depression

Magnesium also plays an important role in brain metabolism. Low magnesium levels are associated with an increased risk of depression (see Serefko A, et al, Magnesium in depression, Pharmacological Reports, 2013;65(3):547-54.; Tarleton EK and Littenberg B, Magnesium intake and depression in adults, Journal of the American Board of Family Medicine, Mar-Apr 2015;28(2):249-56.).

A 2015 study of 8,800 people showed that those with the lowest magnesium levels had a 22% higher risk of depression. Experts suspect that the low magnesium content of today's diet is a major contributing factor to depression and other mental health disorders (see Eby G and Eby K, Rapid recovery from major depression using magnesium treatment, Medical Hypotheses, 2006;67(2):362-70).

In one study, for example, depressed adults received 450 mg of magnesium daily. The effect was just as good as that of an antidepressant (see Barragán-Rodríguez L, et al, Efficacy and safety of oral magnesium supplementation in the treatment of depression in the elderly with type 2 diabetes: a randomized, equivalent trial, Magnesium Research, 2008 Dec;21(4):218-23.).

Magnesium in sports

Since magnesium is involved in cellular energy production in the mitochondria and in the transport of blood glucose to the muscles, an adequate magnesium supply leads to improved athletic performance. At the same time, magnesium requirements increase by 10-20% during exercise compared to rest (see Chen HY, et al, Magnesium enhances exercise performance via increasing glucose availability in the blood, muscle, and brain during exercise, PLoS One, 2014 Jan 20;9(1)).

According to studies from 2006, 2012, and 2014, magnesium supplementation improves physical performance in older adults and people with chronic illnesses (see Amaral AF, et al, The effect of acute magnesium loading on the maximal exercise performance of stable chronic obstructive pulmonary disease patients, Clinics, 2012;67(6):615-22.; Pokan R, et al, Oral magnesium therapy, exercise heart rate, exercise tolerance, and myocardial function in coronary artery disease patients, British Journal of Sports Medicine, 2006 Sep;40(9):773-8.; Veronese N, et al, Effect of oral magnesium supplementation on physical performance in healthy elderly women involved in a weekly exercise program: a randomized controlled trial, The American Journal of Clinical Nutrition, 2014 Sep;100(3):974-81).

Based on a 2015 study, magnesium is considered to enhance performance in athletes even if there was no prior magnesium deficiency (see Mirela Vasilescu, Magnesium supplementation in top athletes - effects and recommendations, March 2015, Medicina Sportiva. Journal of the Romanian Sports Medicine Society).

It was previously thought that magnesium supplementation was only effective in cases of magnesium deficiency. However, this was first disproven in a 1998 study: volleyball players in the study took 250 mg of magnesium per day, which u.a...their jumping ability and arm movements improved. In another study from the same year, triathletes took magnesium for four weeks and subsequently had better swimming, cycling, and running times. Furthermore, their insulin and stress hormone levels decreased (see Golf SW, et al, On the significance of magnesium in extreme physical stress, Cardiovascular Drugs and Therapy, 1998 Sep;12 Suppl 2:197-202).