Council | Should I be taking a magnesium supplement? Here’s what science says.

Q: I’ve heard that magnesium can be related to fatigue and mood symptoms. Should I start taking supplements?

ABOUT: The data on magnesium supplementation is overwhelming for some of the purported benefits that have been popularized on social media, including taking magnesium for fatigue and mood symptoms. There are several clear circumstances in which magnesium supplementation is warranted, but it is difficult for a doctor like me to give magnesium supplementation an unconditional approval.

Here is alternative I be able to are happy to support: Eat more magnesium-rich foods. That way, you’ll get a boost of magnesium as well as the other natural benefits of this food.

What does magnesium do for the body?

Magnesium is an essential ion found in every cell of our body. We rely on magnesium for many important cellular functions, including metabolism, transport across cell membranes, and binding hormones.

Can I take a daily magnesium supplement if I’m healthy?

It becomes difficult when relatively healthy people start taking magnesium supplements. Although too much magnesium can be toxic to your body, taking low levels of less than 350 mg per day is unlikely to cause any harm unless you have kidney disease. But that may not bring any good either.

It is important to discuss starting magnesium supplementation with your doctor. People with kidney disease may have a harder time getting rid of excess magnesium taken as a supplement. Signs of magnesium overdose include hypotension, weak reflexes, and changes in heart rhythm.

What are magnesium supplements good for?

Here are some areas where we know magnesium supplementation can be helpful and some areas where there may be some benefit, but the evidence is not as strong:

Mild constipation: A known side effect of these supplements is diarrhea, which is why I confidently recommend certain magnesium formulations for my mildly constipated patients.

Preeclampsia and other serious conditions in the hospital: When magnesium is given intravenously to patients with preeclampsia, it more than halves the risk of developing eclampsia. However, in these scenarios, magnesium would be given by your healthcare team at the hospital. Similarly, there are certain critical cardiac arrhythmias, such as torsades de pointes, where your healthcare team may administer intravenous magnesium.

migraines: Randomized trials of oral magnesium supplements here are mixed, but the trend is positive, although the overall data are quite limited. If you still want to try magnesium, increasing the amount of magnesium-rich foods in your daily diet is probably a better way to go.

Mood disorders: A 2016 study found that people with mild to moderate depression who took magnesium supplements for six weeks reported improved mood compared to those who did not. However, this study was not blinded or placebo-controlled, and we do not have high-quality trials showing a benefit of magnesium for anxiety symptoms. My advice? Discuss your symptoms with your provider, as psychotherapy and medication are still the options with the strongest evidence to help.

High blood sugar: Increased consumption of magnesium-rich foods is associated with a lower risk of type II diabetes, however, according to the American Diabetes Association, there is insufficient evidence that magnesium supplements help lower blood sugar in people with diabetes.

High blood pressure: Multiple studies have confirmed that magnesium supplementation will lower blood pressure, but the magnitude of the effect is not profound (on average, a 2.2 mmHg reduction in diastolic blood pressure). It’s worth talking to your doctor about more effective strategies for lowering blood pressure, bearing in mind that increased levels of magnesium in the diet are associated with a lower risk of cardiovascular disease.

Other areas where there is even less evidence for magnesium supplements are insomnia, leg cramps and dementia.

Which food has the most magnesium?

Data from the National Health and Nutrition Examination Survey found that about half of Americans do not meet their estimated dietary needs for magnesium. Adult men should aim for 400-420 mg per day and women 310-320 mg per day.

Magnesium is often found in fiber-rich foods such as leafy greens, seeds and nuts. Try saving those fall pumpkins and roasting the seeds, one cup contains 168 mg of magnesium. These foods tend to have many well-established health benefits, abundant in the Mediterranean diet, that would outweigh taking magnesium pills. Here is a list of common foods that are high in magnesium.

  • Leafy greens like spinach and kale
  • Seeds and nuts
  • Dark chocolate
  • Avocado
  • Fatty fish
  • Legumes
  • Whole grains

What are the signs that I am low on magnesium?

Critically low levels of magnesium in the blood are associated with serious complications such as abnormal heart rhythms and sudden cardiac death. But poor dietary intake of magnesium does not necessarily lead to dire blood levels. Our kidneys do a fantastic job of collecting and storing the minerals we need and excreting the ones we don’t.

A few examples of conditions or medications that we know are associated with magnesium deficiency and for which supplementation might actually be recommended are:

  • Celiac disease
  • Crohn’s disease
  • Chronic alcohol use
  • Insulin resistance or type II diabetes
  • Certain diuretic drugs, including furosemide and hydrochlorothiazide
  • Proton pump inhibitors, such as pantoprazole, if taken long-term

What I want my patients to know

I get it: who wouldn’t rather take a pill than change the way they eat? That’s why I recommend starting with small changes that don’t take away from your enjoyment of food. Mix some spinach into your next pasta dish, or reach for a serving of almonds or cashews when you need a snack.

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