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JULY 2022 TABLEHOPPING ARTICLE

Magnesium is the stuff of life. I guess you can say that about all the elements really because without them it would be a different universe but Magnesium in particular holds a special place in the heart of modern nutritionists and health care providers because of its protean effects on the body human. Magnesium deficiency is serious but underdiagnosed because the most severe consequences…ie death, are rarely blamed on an electrolyte abnormality.

The same researchers that say magnesium deficiency is rarely apparent clinically will also admit that 75% of Americans are not getting enough from their diet. It would be great to get all the Magnesium you need from your diet but studies have shown this is unlikely .America’s foremost expert on magnesium if not the world expert on magnesium is Dr Thomas Levy who’s also been extensively on vitamin C and on Calcium the former being beneficial and the latter not so much.

Magnesium is easy to measure in the blood but unfortunately the vast majority of magnesium is not in the blood it’s in the cells and in the mitochondria. You can have a normal serum magnesium level and still have magnesium depletion. Experts say you really should check the red blood cell magnesium level to get a more accurate number but even that doesn’t reflect the true magnesium level. There is only one place to get a cellular magnesium level tested in America and unfortunately New York state does not allow that testing. For reasons that continue to baffle me, New York state does not allow a lot of major laboratories to do business in New York. These companies are attempting to provide Health insights that are not available from companies currently practicing in New York state. I have written repeatedly to the Department of Health questioning the policy and asking them to remove these hindrances and allow me to order tests from certified Labs that are important to my patients but so far the Silence has been deafening. I guess they are busy with other issues but you would think at least a bug off letter and response would be appropriate.

Many patients are on diuretics for their blood pressure and many others are on proton pump inhibitors for indigestion and many patients are on both. These medications are chief causes of hypomagnesemia. Low magnesium can have protean manifestations including weakness, poor sleep, numbness, nausea, muscle twitching or cramps, and even personality changes. Eventually when the magnesium level gets low enough you get irregular heartbeats and finally cardiac arrest.

Why is this element so important? Magnesium is the second most abundant cation, that is, positively charged ions, inside the cells of the body after potassium. It’s an essential cofactor for hundreds of critical enzymes and is known to be involved in roughly 80% of all known metabolic functions in the body. Not impressed yet ? It has been found to be critical for the metabolism of ADP which is one of the energy generating systems in each cell. It’s also required for protein DNA and RNA synthesis as well as for the synthesis of fatty acids and the conversion of vitamin D into its active form in the body. Magnesium may also play a critical role in the production of glutathione, the most important and most concentrated antioxidant inside the cells. inside the cell magnesium works to keep sodium and calcium levels lower and potassium levels higher. At the cellular level calcium is dangerous…when cells die they usually due so because they are flooded with calcium. Excess calcium intake has been associated with higher all-cause mortality. Magnesium is an intracellular calcium channel blocker and you recognize the term because so many blood pressure meds are calcium channel blockers. So magnesium , a natural substance, does the same thing those prescription drugs do.

Studies have shown that deaths from all causes jump 40% in subjects with the serum magnesium below 0.73 millimoles per liter which is found in about 25% of the population. As Dr Levy points out, randomized double-blind clinical trials have shown that magnesium supplementation is an effective treatment for metabolic syndrome. Furthermore, higher dietary intake of magnesium was associated with reduced cardiovascular mortality in a large Japanese study and a similar result was seen in the Hawaiian study with a 30-year follow-up. A study was able to demonstrate that increasing dietary magnesium intake was significantly associated with reduced risk of heart failure and stroke diabetes and all-cause mortality.

Likewise magnesium plays an important role in both increasing and sustaining higher free plasma testosterone levels. Testosterone also increases cortisol levels and Vitamin D also appears to have an independent linear linear association with free testosterone.

Now there are many different forms of magnesium supplements. The only one I don’t recommend is Magnesium Oxide because it’s so poorly absorbed. Liposomal magnesium probably has the best absorption but you have other options including magnesium citrate which also helps with insomnia and constipation. Magnesium sulfate also called epsom salts is great for baths and you can absorb magnesium through your

skin that way. Magnesium taurate is easier on the bowels and the taurine is important for eye health. Magnesium gluconate is also very well absorbed and also has properties that chelates heavy metals like calcium iron and copper. Magnesium chloride has anti infective properties. Magnesium glycinate is well absorbed and the glycine is a component of glutathione which is also used in synthesis of collagen and creatine. Magnesium threonate is best at crossing the blood brain barrier. If you are trying to use magnesium to lower your blood pressure your best bet is the liposomal magnesium. Liposomal means the magnesium is inside a fat globule which greatly increases its absorption.

Obviously I think Magnesium is very important but, of course, you should do nothing without checking with your healthcare provider. Unless your level is high (which, I can tell you from reviewing thousands of samples, is very rare) you should consider trying some supplement and see how you feel and how it affects your health. This is especially important if you are taking a water pill (diuretic) for your blood pressure which many people do and if you are one of those people who treat your indigestion with drugs like prilosec, aciphex, protonix etc. Many people whom I have recommended Magnesium supplementation to have reported feeling better in many different ways. Why not give it a try and see for yourself. There’s that N of 1 experiment I keep referring to. Until next month…..get well and stay well

JT BARRY MD