I wanted to go into a bit of detail as to why magnesium is recommended as a baseline starting point for a whole host of physical and behavioral issues. As many of you have noticed, regardless of what kinds of problems your child is having, whether it be ADHD, stomach issues, poor behavior, chronic diarrhea, etc, I will usually try to raise the nutritional status of the child by trying to remove unhelpful foods (or non-foods, as the case may be) and introduce helpful substances such as magnesium, probiotics, omega 3 fatty acids, zinc, B complex vitamins, and sometimes more specific recommendations like enzymes and immune enhancement. Each one of these has an extremely broad range of actions in the body and so a deficiency of any one of them will possibly cause a wide range of issues. Once we discuss each, you will have an enhanced understanding as to why they are useful for a wide range of apparently unrelated problems. None are a panacea, but all together can give major benefit. https://www.amazon.com/Magnesium-Miracle-Second-Carolyn-Dean/dp/0399594442/ref=sr_1_1?ie=UTF8&qid=1505761657&sr=8-1&keywords=magnesium+miracle
The first is Magnesium. This is going to be a bit long but is well worth going through. The source of most of this information is from the book “The Magnesium Miracle” by Carolyn Dean, MD and the text “Advanced Nutrition and Human Metabolism” by Gropper and Smith. I am going to rattle off a number of characteristics of magnesium and its actions in the body. We will discuss functions of Mg in the body, sources, daily allowance, forms of Mg, and possible side effects. I will use the symbol “Mg” as this is the chemical symbol for Magnesium. There has been an explosion of Mg research over the past 5-10 years. The research touch on everything from Mg in memory, brain plasticity, life extension, chronic fatigue syndrome, diabetes, colon cancer, to connective tissue disease, stroke, pancreatic enzyme function, neuroprotection in premature infants, prostate cancer, and glaucoma!!! It is used in a wide range of enzyme systems in the body, over 300 (per official texts) and over 700 in another count. It 1) catalyzes most chemical reactions in the body; 2) Active in producing and transporting energy; 3) Synthesizing protein; 4) Transmitting nerve signals; 5) Relaxing muscles. This is the broad paintbrush stroke of the portrait of Mg. We will get into details shortly. Mg is derived by plants from the soil. If the soil is depleted, the food will be also. Over the past 100 years, farming practices have left the soil depleted. According to repeated government statistics and the National Academy of Sciences, 80% of the US population is deficient and does not come up to even the RDA (recommended daily allowance) for Mg intake. Remember that the RDA was set up as the minimum amount that prevents deficiency. It says nothing about optimal levels for optimal physiological functions. This level may be twice or more higher than the RDA. During the early 20th century the average Mg intake was around 500 mg daily. Now it is 200 mg or less.
The following are conditions associated with Mg deficiency (it gives you a feel for why I have recommended Mg for things as disparate as migraines, sleep disorders, muscle spasms, growing pains, stomach reflux, and anxiety):
1. Acid reflux: stomach muscle as well as the lower esophageal sphincter can become spastic and cause reflux.
2. Stress: Adrenalin, noradrenaline, and cortisol which are elevated in stress all deplete Mg. The stress may be physical, mental, emotional stress.
3. Alzheimer disease: Mg blocks the neuroinflammation caused by the inappropriate deposition of calcium and other heavy metals in brain cells. Mg can act as a guard on the ion channels to not allow these metals to enter the brain cells.
4. Angina: The pain of angina is caused by severe muscle spasm in heart muscles which in turn can be caused by Mg deficiency. The ventricles have the highest levels of Mg in the whole body. This is why Mg is so important for the pumping function of the heart.
5. Anxiety and panic attacks: when the adrenals are no longer protected by sufficient Mg, the fight-or-flight hormones called adrenaline and noradrenaline become more easily triggered. They then surge erratically causing rapid pulse, high blood pressure, and heart palpitations. The more Mg deficient you are, the more exaggerated is the adrenaline release. Mg calms the nervous system and relaxes muscle tension, helping reduce anxiety and panic attacks.
6. Arthritis: Pain and inflammation are two major symptoms of arthritis that are amenable to treatment with Mg.
7. Asthma: histamine production and bronchial spasms of the smooth muscle in the bronchial tract increase simply as a result of Mg deficiency.
8. Atherosclerosis: Mg is necessary to help dissolve calcium and keep it soluble in the bloodstream. Mg, along with Vit K2, helps direct calcium to the bones, where it belongs.
9. Blood clots: Mg does not act like blood-thinning drugs but instead helps prevent blood clots by preventing excess calcium from triggering them, and it naturally balances the blood clotting factors in the blood as required by the situation.
10. Bowel disease: Mg deficiency slows down bowel peristalsis, causing constipation, which could lead to toxicity as well as symptoms of colitis, diverticulitis, and Crohn’s disease.
11. Brain dysfunction: Remember, Mg is the nerve “calm-me-downer” while calcium is the nerve tone elevator. Magnesium is the cofactor for C-O-Methyltransferase that metabolizes norepinephrine along with its “flight/fight/fright” response. When Mg is deficient, the brain and nerves are on constant edge.
12. Cholesterol elevation: Mg is responsible for slowing down HMG-CoA reductase activity when cholesterol is present in sufficient quantities. Mg keeps cholesterol levels down in the normal range. Levels rise in the presence of Mg deficiency.
13. Cystitis: Mg deficiency causes bladder spasms which cause daytime urinary frequency.
14. Depression: Serotonin, which elevates mood, is dependent on Mg. A Mg deficient brain is also more susceptible to allergens and foreign substances, which in some instances can cause symptoms similar to mental illness. This is especially true with high levels of histamine in allergic people.
15. Detoxification: Mg is crucial for removal of toxic substances and heavy metals such as mercury, aluminum, and lead from the body. Mg is a cofactor in the production of glutathione and in the function of the P450 enzyme systems in the liver that detoxify the body. When using Mg sulfate baths (Epsom salts) the Mg absorbs and enhances glutathione production and the sulfur serves to create a movement gradient for toxins from body to bath water.
16. Diabetes: Mg enhances insulin secretion, facilitates carbohydrate metabolism, and allows insulin to transfer glucose into cells. With Mg deficiency, glucose and insulin build up in the blood causing various types of tissue damage. Seven of the ten enzymes needed to metabolize glucose are also Mg-dependent. You cannot make or secrete insulin without Mg.
17. Fatigue: Mg-deficient patients commonly experience fatigue because dozens of enzyme systems are not functioning up to par. The most important substance in energy production is ATP (adenosine triphosphate). Mg must be attached to ATP in order to be biologically active. Without Mg, energy in the body goes down.
18. Headaches: The muscle tension and spasm in neck and head muscles can be alleviated with Mg therapy. The spasm of the arterioles during a migraine can also be alleviated with Mg.
19. Heart disease: IV Mg given at the time of a heart attack can prevent extensive damage of the heart muscle. Many cardiac drugs deplete Mg from the body and actually make the heart more vulnerable to damage.
20. Hypertension: With low Mg levels and too much calcium, the muscles in the blood vessels can go into spasm and cause high blood pressure. If cholesterol also rises, due to Mg deficiency, it can bind to calcium in the blood vessels, making the high blood pressure worse.
21. Hypoglycemia: Mg balances the release of insulin so that inappropriately large amounts of that insulin don’t cause the blood sugar to drop suddenly, resulting in symptoms of low blood sugar.
22. Indigestion: The gastric proton pump that acidifies the contents of the stomach is dependent on Mg.
23. Inflammation: calcium is pro-inflammatory and Mg is very anti-inflammatory. Research by William Weglicki and Terry Phillips proved that the entire inflammatory cascade escalates when Mg is deficient. This includes substance P, interleukins, tumor necrosis factor, chemokines, and cytokines. Inflammation is triggered by Mg deficiency and the relative Calcium excess. That is one reason why taking large amounts of calcium is a really bad thing especially in the absence of Mg.
24. Insomnia: Mg prevents muscle tension that can prevent restful sleep. Sleep-regulating melatonin production pathway is disturbed without sufficient Mg.
25. Kidney disease: Mg deficiency contributes to atherosclerotic kidney failure. Mg deficiency creates abnormal lipid levels and worsening blood sugar control.
26. Kidney stones: When associated with Vit B6, Mg can prevent and/or treat stones.
27. Migraines: Serotonin balance is Mg-dependent. Deficiency of serotonin can result in migraine headaches and depression. Mg also keeps the vessels in the brain from spasming.
28. Irritable bowel syndrome: Mg keeps the bowel muscles from spasming. The more laxative forms like Mg citrate can treat the symptoms of constipation in IBS.
29. Musculoskeletal conditions: Low Mg levels and a relative excess of calcium will cause sustained muscle contraction in any muscle of the body. The following muscle dysfunctions are amenable to Mg treatment: cramps, fibrositis, fibromyalgia, intestinal spasms, gallbladder spams, tension headaches, chronic neck and back pain.
30. Nerve problems: Low Mg and the relative excess of calcium will cause sustained nerve excitation in any nerve cells of the body. The following nerve dysfunctions are amenable to Mg treatment: burning sensations, muscle weakness, numbness, paralysis and sensitivity, pins-and-needles sensations, seizures, twitching, vertigo.
31. OB/GYN issues: Mg helps prevent and treat the following: premenstrual syndrome, dysmenorrhea, infertility, premature contractions, preeclampsia. Remember the Mg sulfate that you got if you happened to go into premature labor?
32. Osteoporosis: high dose calcium with or without Vit D used without a balancing amount of Mg triggers a cascade of events leading to bone loss.
33. Parkinson’s disease: Mg blocks the neuroinflammation caused by calcium deposits in the brain.
34. Raynaud’s syndrome: Mg helps relax the spastic blood vessels that cause pain and numbness of the fingers.
35. Sports injuries: Pain, inflammation, muscle spasm, muscle tension, and scarring can all be treated with Mg.
36. Tooth decay: Mg deficiency causes an unhealthy balance of phosphorus and calcium in saliva which damages teeth.
So, can you see why Mg is so important to supplement as a baseline nutrient regardless of the complaint? It is like the lubricating oil in an engine. Without Mg, literally nothing works!!! You can try to chase symptoms but will not get a permanent fix without looking at the underlying cause…Mg deficiency. Testing for Mg deficiency is not usually helpful because the body keeps the blood level at an extremely tight tolerance. If inadequate Mg intake is experienced, the blood will maintain its level at the expense of all other tissues including brain, heart, muscles, and literally every organ system in the body. (BTW, the heart contains the highest concentration of any organ). You can have seriously depleted totally body Mg with a normal blood level. Only 1% of Mg is in the blood. The rest is in other huge reservoirs such as RBC’s, bones, and all other body cells. One way to monitor is the Mg red blood cell test. It can be used to get baseline levels and monitor therapy efficacy. This is why we physicians don’t pay as much attention to Mg as we should; because the blood level is usually normal. We look at the RBC Mg in our functional panel of labs. Mg in food can be found in wheat, rice bran, blackstrap molasses, legumes, beans, nuts, and greens. But, again, our food is generally Mg deficient. The supplemental forms of Mg are as follows:
1. The salts: Mg bicarbonate, Mg carbonate, Mg chloride, Mg oxide, Mg phosphate, and Mg sulfate.
2. The organic acid chelates: malate, adipate, aspartate, citrate, glutamate, glycinate, lysinate, malate, orotate, taurate, threonate.
3. The picometer magnesium
4. Slow release Mg like Jigsaw SRT brand
What is the absorption and use of all these? The Mg oxide is only 4% absorbed, most of which makes its way into the stool loosening it in the process. Mg citrate is widely available due to its cheap cost and palatability. The laxative effect is mild. The amino acid chelates are all well absorbed but are significantly more expensive. You will absolutely want to avoid the glutamate and aspartate chelates as these are neurostimulants like MSG and Nutrasweet that we are trying to avoid. The Magtein (Mg threonate) that I have been recommending as penetrating the nervous system is 7% more absorbed than the others. It is also quite spendy. All of these chelates are somewhere around 50% absorbed or less. The picometer Mg is a mineral liquid form that is much more highly absorbed but the sharp bitter taste will make it more difficult to use in kids.
What are the contraindications to taking Mg? These are not going to be common in the pediatric age group: 1. Kidney failure; 2. Myasthenia gravis; 3. Excessive bradycardia (slow heart rate); 4. Bowel obstruction.
What is the safety of Mg? Diarrhea is a typical safety relief valve for overdoing the dosing. You are going to get diarrhea with most forms well before you will get into toxic range. In fact, in the literature, the main way to toxicity is via IV Mg, usually the Mg sulfate given to moms with pre-eclampsia. This laxative effect is even true of the well absorbed forms like the ReMag.
How does one dose Magnesium? It is not a bad idea to start lower and gradually increase the dose to the tolerance level, which means diarrhea. Once you reach that by increasing every few days, then back off until there is no diarrhea. It is also a good idea to spread out the dose over 2-3 doses daily if you can. You can start around 50 mg daily and work up. You may be able to get up to 400-500 mg daily.
Foods that interfere with or waste Mg: all refined and processed foods (e.g. cookies, cakes, doughnuts, bagels, white bread, luncheon meats, soy protein powder); all refined and processed sugars including fructose, corn syrup, NutraSweet, Splenda; Pasteurized dairy products, especially feed-lot milk; Hydrogenated or partially hydrogenated oils and trans fats; Alcohol; Pasteurized fruit juices and sodas; MSG, hydrolyzed vegetable protein, and chemical preservatives; commercial iodized salt. So not a bad idea to avoid these. We have elsewhere discussed avoidance of these foods for other reasons as well.
What is the RDA or Recommended Daily Allowance for Mg?
Age 1-3 yrs: 80 mg daily
Age 4-8 yrs: 130 mg daily
Age 9-13 yrs: 240 mg daily
Age over 13: 310 – 420 mg daily depending on whether male or female, pregnant , or lactating
Now remember, the body only absorbs 50% of what it takes in so some have pushed for a doubling of these numbers. You will likely get into twice these numbers before you develop diarrhea. This indicates the need to “fill the tank”.
Dosing for the Mg citrate would be 1-3 tsp one to two times daily. Dosing for the ReMag (150 mg elemental Mg per ½ tsp) would generally be ½ tsp twice daily. For the younger kids and if you have diarrhea on this dose, back off to ¼ or even 1/8 tsp once or twice daily and increase every other day until you get to your tolerance level or RDA for age. For the first few weeks to replenish your body’s supply, you may need twice your maintenance dose, then you can back off. Basically let your body let you know the right dosing for maintenance.
For those who will stick with the Magtein, the dosing is 45 mg in AM and 90 mg in evening.
The slow release called Jigsaw is 2 tab twice daily equivalent to 500 mg per day.
What about other nutrients like Vit D3, Calcium, and Vit K2? You cannot benefit from these without the magnesium!!! We have started dosing the Vit D3 to levels from 2000 – 5000 units daily. This tends to deplete the Mg levels so that some of the Mg deficiency symptoms can be actually induced by overdoing the Vit D3. Also, the calcium has been pushed for decades for prevention of osteoporosis. The problem is that in spite of the increased Ca intake, osteoporosis incidence has increased dramatically. The reason is that calcium alone or with Vit D is not adequate to strengthen bones. Magnesium needs to be present in at least the same proportion as calcium and it has been determined that Vit K2 is the “director” that moves the calcium into the bone. Also, calcium tends toward increased muscle and nerve tone without the counterbalance of the magnesium. Calcium is also an inflammatory mineral. Mg is an anti-inflammatory mineral. It needs to be present. I have always recommended it in a ratio of 2:1 Ca:Mg. That was based on recommendations using faulty interpretation of German studies where that was the maximal ratio to not be exceeded. The ideal is actually 1:1. So, since most kids will be getting enough calcium from their diet, I will not be advising added calcium supplementation, only the Mg, Vit D3, and Vit K2. If we can’t find one without the calcium, we will try and limit the calcium to that 1:1 ratio with Mg.