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What Are the Symptoms of Magnesium Deficiency and How Is It Treated?

Signs, causes, and natural treatments for magnesium deficiency

Mar 25, 2022




What Are the Symptoms of Magnesium Deficiency and How Is It Treated?

Magnesium Deficiency and Muscle Cramps

Muscle cramps, especially in athletes, are often linked to magnesium deficiency. Despite its importance, magnesium is frequently overlooked as a crucial electrolyte that needs to be replenished after stress, sweating, and poor nutrition. Unlike sodium or potassium, magnesium deficiency is difficult to detect through routine blood tests, which adds to the challenge of recognizing and treating it effectively. Nevertheless, countless athletes and healthcare professionals observe firsthand the positive effects of magnesium supplementation.

Treatment of Muscle Cramps

If you have ever experienced muscle cramps, you’ve probably been told that they will resolve on their own. You may also have been advised to stop your activity and gently stretch or massage the affected muscle. While this advice can help in many cases, it is not sufficient for athletes who experience cramps during competition.

For athletes, muscle cramps can be serious and even lead to muscle fiber tears, potentially sidelining them for an entire season. Stretching and warm-up exercises do not restore the body’s magnesium levels, which are crucial in preventing cramps.

Why Magnesium Is Important

During intense physical activity, especially in hot environments, magnesium is lost in significant amounts through sweat. This loss disrupts the body's electrolyte balance. Magnesium plays a vital role in muscle relaxation while calcium triggers muscle contraction. When magnesium levels drop, calcium becomes dominant, causing muscles to contract uncontrollably, leading to cramps.

Effects of Heat and Sweating

High temperatures amplify the risk of muscle cramps due to increased sweating. Magnesium, being water-soluble, is lost more rapidly in sweat than calcium. This imbalance raises the calcium-to-magnesium ratio, which can cause involuntary muscle contractions.

In extreme conditions, such as intense training or military operations in hot climates, athletes and soldiers can lose one to two liters of fluid per hour. The mineral loss can be so severe that salt and mineral residues form visible crusts on clothing.

Limitations of Sports Drinks

Most sports drinks focus on replenishing water, sodium, and sugar but do not adequately replace magnesium and potassium. This means that while hydration is maintained, the critical minerals needed to prevent cramps and support muscle function are not fully restored.

Understanding Heat Stress

Heat-related problems such as muscle cramps and sunstroke are often misunderstood. They are not caused solely by external temperature and humidity but primarily by a deficiency in minerals and electrolytes. These elements are essential for transporting heat out of cells. When mineral and water levels are sufficient, cells can regulate heat effectively, preventing overheating regardless of the external temperature.

Magnesium Deficiency and Stress

Stress is one of the leading reasons people seek medical help today. In the early 1980s, Time magazine called stress the “epidemic of the ’80s,” and since then, the problem has only intensified. Modern life forces us to juggle multiple jobs, constant use of electronic devices, broken families, economic challenges, unhealthy diets, and exposure to alarming news about global and environmental threats. These pressures make it difficult for our bodies to adapt and cope.

The American Institute of Stress (AIS), founded by the renowned stress researcher Dr. Hans Selye, estimates that 75 to 90 percent of all visits to general practitioners are related to stress.

How Stress Affects the Body (According to AIS):

  • Increased Heartbeat and Blood Pressure: Blood flow to the brain rises sharply to improve decision-making.
  • Elevated Blood Sugar: Stress hormones cause the breakdown of glycogen, fat, and protein to increase blood sugar for energy.
  • Blood Redistribution: Blood is diverted from the digestive system to the large muscles in the arms and legs to prepare for “fight or flight.”
  • Faster Blood Clotting: To reduce the risk of excessive blood loss from injuries during emergencies.

The Role of Magnesium in Stress Responses

  • Blood Vessel Function: Rising blood pressure causes smooth muscles in blood vessel walls to contract. Without enough magnesium, these muscles can cramp, potentially leading to chronic high blood pressure.
  • Blood Sugar Regulation: Magnesium is essential for insulin to open cell membranes and allow glucose to enter cells. Magnesium deficiency disrupts this process, causing blood sugar levels to remain high while cells starve for energy.
  • Muscle Health: Low magnesium in large muscles can trigger spasms, irritability, and conditions like restless legs syndrome due to increased blood flow during stress.
  • Blood Clotting: Magnesium deficiency can increase blood clotting, raising the risk of dangerous clots forming in the legs, lungs, and brain.

Magnesium Deficiency and Panic Attacks

Panic attacks are often treated symptomatically, primarily with medications such as SSRIs, antidepressants, or even antipsychotics when symptoms escalate. However, panic attacks themselves are symptoms, not standalone diseases.

One potential underlying cause for panic attacks is magnesium deficiency — a critical mineral for many bodily functions:

  • Muscle relaxation: Magnesium counterbalances calcium, preventing muscle stiffness and tension. Deficiency can lead to tight, painful muscles, which can contribute to physical discomfort and stress.
  • Nervous system regulation: Magnesium helps calm the nervous system, reducing excitability and overreaction, which are often present during panic episodes.
  • Adrenal function: Magnesium supports healthy adrenal glands, which modulate stress hormones like adrenaline. Without sufficient magnesium, stress responses can be exaggerated.
  • Serotonin production: Serotonin plays a key role in mood regulation; magnesium deficiency can disrupt serotonin synthesis, contributing to anxiety and panic symptoms.

The Role of Stress and Blood Sugar

  • Stress and Type A personalities: Chronic stress depletes magnesium, creating a vicious cycle of increased irritability, muscle spasms, rapid heartbeat, and anxiety.
  • Blood sugar fluctuations: Low blood sugar triggers adrenaline release to keep the brain fueled, but this adrenaline surge can mimic or trigger panic attacks.

Why Not Start with Magnesium Before Medication?

Many treatments jump straight to medication, sometimes without investigating or correcting nutritional deficiencies. Since magnesium is a natural nutrient essential to many systems involved in panic and anxiety, it is logical to:

  • Assess magnesium status.
  • Supplement if deficient.
  • Address diet and lifestyle to stabilize blood sugar and reduce stress.

Medication Concerns

  • Medications like SSRIs and antidepressants may only be effective in about 40% of cases.
  • Side effects and long-term dependency risks exist.
  • Overmedication (“polypragmasia”) can complicate treatment and increase side effects.

Practical Takeaways

  • If panic attacks or anxiety symptoms arise, consider magnesium supplementation as a low-risk, potentially high-benefit intervention.
  • Support overall nutrition, focusing on balanced blood sugar through regular meals with protein, fiber, and healthy fats.
  • Manage stress through lifestyle adjustments like mindfulness, exercise, and sleep hygiene.
  • Consult healthcare professionals who are open to exploring nutritional and holistic approaches rather than solely relying on medication.

Magnesium Deficiency and Headaches

Headaches are often a clear sign of stress. Tension builds up as your shoulders slump and your neck muscles tighten, spreading discomfort to the muscles around your skull. Magnesium plays a crucial role in reducing this muscle tension by helping your muscles relax.

While magnesium deficiency is not the only cause of tension headaches, it can significantly affect migraines, PMS-related headaches, and post-traumatic headaches.

How Magnesium Can Help Alleviate Migraines and Headaches

  • Blood Vessel Relaxation: Magnesium helps relax blood vessels, allowing them to dilate and reducing cramps and constrictions that contribute to migraines.
  • Neurotransmitter Regulation: It balances neurotransmitters and inflammatory substances in the brain, which, when out of sync, can trigger migraines.
  • Platelet Function: Magnesium inhibits excessive platelet aggregation, preventing tiny clots that might block blood vessels and cause pain.
  • Muscle Relaxation and Lactic Acid Prevention: It relaxes muscles and prevents the build-up of lactic acid, which, alongside muscle tension, can worsen headaches.

Magnesium Deficiency and PMS

Many women who take magnesium regularly report significant relief from their PMS symptoms. Premenstrual Syndrome (PMS) typically occurs 2 to 14 days before menstrual bleeding begins, and its exact cause remains uncertain. Symptoms like bloating, water retention, muscle tension, and mood swings can appear and disappear cyclically.

Increasing magnesium intake often helps alleviate severe PMS symptoms. Magnesium acts as a mild diuretic, helping reduce water retention, relaxes muscles, and boosts serotonin levels, the neurotransmitter linked to mood regulation and feelings of well-being.

How to Include Magnesium for PMS Relief

  • Dietary Sources: Incorporate magnesium-rich foods such as leafy green vegetables (spinach, kale), nuts and seeds (almonds, pumpkin seeds), whole grains (brown rice, quinoa), legumes (black beans, lentils), and dark chocolate.
  • Supplements: Magnesium supplements can be useful, especially during the premenstrual phase. Forms such as magnesium glycinate, magnesium citrate, and magnesium malate are often better absorbed and gentler on the stomach.
  • Dosage: Typical supplemental doses range from 200 to 400 mg daily, but it’s best to consult with a healthcare provider before starting any supplement, especially if you have underlying health conditions or take other medications.

By maintaining adequate magnesium levels, many women experience fewer PMS symptoms and improved overall mood and comfort during their cycle.

Magnesium Deficiency and Pregnant Women

Magnesium plays a crucial role in ensuring a healthy pregnancy and childbirth. Adequate magnesium intake during pregnancy not only supports the mother’s well-being but also positively impacts the baby's health from the very beginning.

Why Magnesium is Important During Pregnancy

Magnesium is essential for many physiological processes, including muscle function, nerve transmission, and bone development. During pregnancy, the body's demand for magnesium increases significantly to support the growth and development of the fetus.

Preventing Complications

Research shows that sufficient magnesium levels can help prevent premature labor and reduce the risk of eclampsia, a serious condition characterized by high blood pressure and seizures in pregnant women. Additionally, magnesium supplementation has been linked to a decreased risk of cerebral palsy and sudden infant death syndrome (SIDS) in newborns.

Given these benefits, magnesium supplementation, much like folic acid, should be considered an important part of prenatal nutrition.

Symptoms of Magnesium Deficiency in Pregnancy

Many common discomforts experienced during pregnancy may be signs of magnesium deficiency. These include:

  • Constipation
  • Leg cramps
  • Back pain
  • Water retention
  • Irritability
  • Insomnia

Addressing magnesium deficiency can alleviate these symptoms and improve overall pregnancy comfort.

Magnesium and Fertility

Beyond pregnancy, magnesium also supports women trying to conceive. It helps relax spasms in the fallopian tubes, which can otherwise prevent the fertilized egg from successfully implanting in the uterus.

Magnesium Deficiency and Children

Magnesium deficiency affects not only adults but children as well. Unfortunately, many symptoms related to low magnesium levels in children are often misattributed to other causes, which can delay proper diagnosis and treatment.

It’s remarkable to observe how physical and behavioral changes in children with conditions like ADHD and autism can improve simply through magnesium supplementation. For instance, parents have noted significant positive effects after giving their children warm baths enriched with magnesium salts. These changes often include:

  • Relief from constipation
  • Improved skin complexion
  • Enhanced mood and reduced irritability
  • Better social interaction and engagement

Of course, adequate nutrition is essential to maintain healthy magnesium levels, but such simple interventions can make a significant difference.

In summary, magnesium is vital from the very beginning of life, starting at conception, and remains crucial throughout our entire lifespan.

Magnesium Deficiency and Heart Health

Magnesium deficiency is common in people with heart disease. It is associated with a range of cardiovascular symptoms, including:

  • Angina (chest pain)
  • Palpitations
  • Arrhythmias (irregular heartbeats)
  • High blood pressure
  • Blood clots
  • Poor circulation

In some hospitals, magnesium is administered immediately during acute heart attacks and cardiac arrhythmias. Magnesium helps the heart muscle stay flexible and relaxed, similar to other muscles in the body. Based on these effects, it appears logical to consider magnesium for managing heart-related symptoms. However, there is ongoing debate in the medical community about the routine use of magnesium in treating heart disease.

Magnesium Deficiency and High Blood Pressure

High blood pressure (hypertension) is one of the most common medical conditions worldwide, especially among older adults. The standard treatment often includes diuretics, which help the body eliminate excess water and salt. However, there’s an important downside: diuretics also cause the body to lose magnesium, a vital mineral with many physiological functions, including the regulation of blood pressure.

Case Example: Irene's Medical Journey

Irene, a 58-year-old woman, went to her doctor for a routine check-up. Her blood pressure was slightly elevated. However, her doctor did not ask about her recent life circumstances. Irene had just lost her mother and was under significant emotional stress, a factor that can reduce magnesium levels in the body.

Assuming that age alone caused the hypertension, Irene’s doctor prescribed a diuretic, without considering her stress or checking her magnesium status.

One Month Later: Worsening Blood Pressure

After a month, Irene’s blood pressure had increased further. The doctor was puzzled and decided to add a second anti-hypertensive medication. The underlying issue with low magnesium, worsened by the diuretic, was not addressed or even suspected.

Two Months Later: Rising Cholesterol

At her next follow-up, Irene’s cholesterol levels had spiked. Again, the doctor didn’t connect this to magnesium deficiency, although studies show a relationship between low magnesium and lipid metabolism. Instead of exploring nutritional or lifestyle factors, he prescribed a statin to lower her cholesterol.

Three Months Later: Elevated Blood Sugar

Soon afterward, routine blood tests showed elevated blood sugar levels. Magnesium plays a key role in insulin sensitivity, and low magnesium is a known risk factor for type 2 diabetes. Nevertheless, the doctor prescribed an anti-diabetic medication, still unaware of the potential root cause.

The Downward Spiral

Irene was now taking four prescription medications:

  • A diuretic for blood pressure (which lowers magnesium)
  • A second anti-hypertensive
  • A statin for cholesterol
  • An anti-diabetic drug for high blood sugar

All of these medications can either deplete magnesium or worsen its deficiency.

Overlooked Magnesium Testing

At no point during these six months was Irene’s magnesium level tested. Even if a test had been done, it might have been misleading. That’s because only about 1% of the body’s magnesium is found in the blood, and serum levels can appear normal even when tissue levels are dangerously low.

Key Takeaways

  • Stress, aging, and certain medications can significantly reduce magnesium levels.
  • Magnesium deficiency can contribute to high blood pressure, high cholesterol, and insulin resistance.
  • Diuretics, commonly prescribed for hypertension, can worsen magnesium depletion.
  • A standard serum magnesium test may not detect deficiency reliably. Intracellular magnesium or magnesium retention tests may be more informative.
  • Always consider lifestyle factors, stress, and nutritional deficiencies before beginning long-term pharmacological therapy.

Magnesium Deficiency and Cholesterol

Magnesium plays a crucial role in maintaining healthy cholesterol levels and overall heart health.

Magnesium-Dependent Enzymes and Cholesterol Regulation

Magnesium is essential for the activity of several enzymes involved in cholesterol metabolism:

  • LDL-related enzyme: Magnesium is required for an enzyme that helps lower LDL cholesterol (“bad” cholesterol). This enzyme also reduces triglycerides and increases HDL cholesterol (“good” cholesterol).
  • Fatty acid conversion: Another magnesium-dependent enzyme converts essential fatty acids, omega-3 and omega-6, into prostaglandins. Prostaglandins are hormone-like substances vital for heart health and general well-being.

Magnesium vs. Statins: Natural Regulation vs. Drug Intervention

Magnesium acts as the body’s natural regulator of cholesterol levels. When cholesterol rises, magnesium helps control its production and function. In contrast, statin medications work by blocking the entire cholesterol production pathway.

The majority of cholesterol in the body is produced by the liver, not directly from dietary sources. This production depends on an enzyme called HMG-CoA reductase.

  • When cholesterol levels are sufficient, magnesium slows down HMG-CoA reductase, reducing cholesterol synthesis.
  • When the body needs more cholesterol, for hormone production or to maintain cell membranes, magnesium helps accelerate this enzyme.

Thus, magnesium helps balance cholesterol production according to the body’s needs.

Scientific Evidence Supporting Magnesium’s Role

At least 18 human studies have demonstrated the beneficial effects of magnesium supplementation on blood lipids:

  • Total cholesterol was reduced by 6% to 23%
  • LDL (bad) cholesterol decreased by 10% to 18%
  • Triglycerides dropped by 10% to 42%
  • HDL (good) cholesterol increased by 4% to 11%

These studies also found that low magnesium levels are associated with higher LDL cholesterol, while high magnesium levels correlate with increased HDL cholesterol.

Why Magnesium Matters

Unlike statins, which completely inhibit HMG-CoA reductase and can cause significant side effects, magnesium supports the body’s natural cholesterol regulation without disrupting vital cholesterol-dependent functions. Cholesterol is essential for hormone synthesis, cell membrane integrity, and many other physiological processes.

Magnesium Deficiency and Blood Sugar Regulation

Magnesium deficiency is recognized as a risk factor for diabetes in medical guidelines, yet many doctors overlook its importance in treatment. Magnesium plays a vital role in:

  • Increasing insulin production
  • Facilitating insulin’s ability to transport glucose into cells

Good nutrition and adequate magnesium intake should be foundational steps in managing blood sugar levels, often before resorting to anti-diabetic medications.

Magnesium Deficiency in Sports and Muscle Health

Athletes are particularly vulnerable to magnesium deficiency because:

  • Magnesium is primarily lost through sweat during exercise.
  • Magnesium helps relax muscles, while calcium causes muscle contraction.
  • It regulates the balance by controlling calcium entry into cells and removing excess calcium.

When magnesium levels are low, muscle cramps, twitches, and painful spasms often occur, making exercise difficult or even impossible. Cramps in athletes can lead to injuries and missed competitions.

Managing muscle cramps with magnesium:
  • Using magnesium salts in baths or taking magnesium citrate supplements can relieve muscle tightness.
  • Animal studies show magnesium deficiency reduces exercise capacity, which improves with magnesium supplementation.
  • Magnesium helps neutralize lactic acid buildup, speeding up recovery.

Despite its importance, many doctors and trainers are unaware of magnesium’s critical role because it rarely appears as abnormal in standard blood tests. The best approach is to recognize deficiency triggers and supplement magnesium if symptoms improve.

Magnesium’s Role in Mental Health for Athletes

Former athletes often experience anxiety and panic attacks after their careers, linked to bodily tension and irritability caused by magnesium deficiency. Instead of addressing the root mineral deficiency, these symptoms are often treated with psychiatric medications.

Magnesium in Agriculture and Diet

Modern agricultural practices have significantly depleted magnesium in the soil because:

  • Magnesium is no longer included in many fertilizers.
  • Once soil magnesium is depleted, crops grown on this soil contain far less magnesium.

This means the magnesium content listed in nutrient databases (based on ideal growing conditions) may overestimate the actual magnesium in modern produce.

A report from the National Academy of Sciences highlights that 80% of American men and 70% of American women do not meet the recommended daily allowance (RDA) for magnesium.

Given that the RDA might already be set too low, and considering the loss of magnesium in food processing and cooking, it’s clear why magnesium deficiency is widespread.

Challenges of Magnesium Testing

Only about 1% of total body magnesium is found in the blood, and the body tightly regulates this level to protect essential functions like heart muscle contraction.

  • When blood magnesium drops, the body draws magnesium from bones and tissues.
  • When it rises, excess magnesium is excreted through urine and feces.

Because of this tight regulation, serum magnesium tests usually appear normal even when deficiency exists. For this reason, magnesium testing is often excluded from routine blood panels.

More accurate testing options:

  • Red blood cell magnesium test: Measures magnesium at the cellular level but reflects only about 40% of total body magnesium.
  • ExaTest: A non-invasive test involving scraping tissue from under the tongue and microscopic examination, typically performed by naturopaths or chiropractors.
  • Ionized magnesium blood test: The most precise test measuring free, biologically active magnesium in the blood. Unfortunately, it is rarely available.

Increased awareness and use of better testing methods could help diagnose magnesium deficiency more reliably and improve patient outcomes.


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