From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history

Magnesium (chemical or element symbol Mg) is an essential mineral in the human body. It plays a key role in DNA and RNA synthesis and in the production of ATP. It is a cofactor in more than 300 enzyme systems.[1] Muscle and bone comprise 90% of the body's magnesium content. A serum value of 75–95 mmol/L is considered normal but some research would indicate that serum levels less than 85 mmol/l should be considered deficient. An individual may be profoundly deficient in total body or intracellular Mg, yet have a serum value within normal range.[2]

Role in the body[edit | edit source]

Deficiency[edit | edit source]

Symptoms of magnesium deficiency include loss of appetite, nausea, vomiting, fatigue, and weakness. As magnesium deficiency worsens, numbness, tingling, muscle contractions and cramps, seizures, personality changes, abnormal heart rhythms, and coronary spasms can occur. Severe magnesium deficiency can result in hypocalcemia or hypokalemia (low serum calcium or potassium levels, respectively) because mineral homeostasis is disrupted.[1]

Magnesium deficiency disrupts the HPA axis and increases susceptibility to physiological damage produced by stress. Deficiency can promote activation of the N-methyl-D-aspartic acid (NMDA) receptor which triggers inflammatory pathways and cortisol release.[3]

People with gastrointestinal[1] disorders and chronic fatigue syndrome are at higher risk of magnesium deficiency.

Deficiency increases the risk of osteoporosis. Magnesium supplementation may help prevent migraine.[1]

Forms of administration[edit | edit source]

Magnesium may be taken as an oral supplement but may not be well absorbed. Magnesium oxide and citrate are poorly absorbed forms compared to glycinate and orotate.[2] Magnesium malate is another popular form. Other forms of magnesium administration include transdermal magnesium and intramuscular magnesium sulphate injections.

Magnesium is hypotonic. Administration can cause water to flow into cells in the local area where it is applied, which can cause a temporary stinging sensation.

In human disease[edit | edit source]

Chronic fatigue syndrome[edit | edit source]

In 1991, Cox et al., performed a randomized, double-blind, placebo-controlled trial of 20 United Kingdom chronic fatigue syndrome (CFS) patients finding that the subjects with CFS had lower red blood cell magnesium than healthy controls. Patients treated with intramuscular magnesium sulphate for six weeks had higher self-reported energy levels, better emotional state and less pain on the Nottingham health profile when compared to placebo.[4]

In contrast, three subsequent case‐report studies, two in the UK (Clague et al., 1992[5] and Hinds et al., 1994[6]), and one in the Netherlands (Swanink et al., 1995[7]), did not find magnesium deficiency in CFS trial subjects.

X-MEN[edit | edit source]

A 2014 study found magnesium transporter issues were linked to chronic Epstein-Barr virus infection, decreased Natural killer cell function, and neoplasia (sometimes-cancerous growths).[8] This disorder, termed 'X-MEN' (for X-linked, EBV, and neoplasia) was identified as a recessive, X-linked disorder that would therefore be many times more common in men. Due to magnesium's role as a 'second messenger', this magnesium transporter disorder also would result in a primary immunodeficiency that would worsen with age.[8] Patients also have impaired T-cell activation and decreased natural killer (NK) cell function due to a decreased expression of "the NK stimulatory receptor 'natural-killer group 2, member D' (NKG2D)."[9] Although T-cells are affected, there is no direct evidence of B-cell effects in X-MEN disease.[9]

Since chronic Epstein-Barr virus infection has been associated with chronic fatigue syndrome, this error in magnesium transport may be worth considering in male patients, especially with slow onset and history of childhood infection.[8]

Mast cell activation disorder[edit | edit source]

Magnesium is a cofactor in the production of diamine oxidase. It is an enzyme that breaks down histamine, which is released by mast cells.

Migraine[edit | edit source]

Magnesium has been shown to be effective for headaches and for migraine prevention.[10][11][12][13]

Notable studies[edit | edit source]

  • 1991, Red blood cell magnesium and chronic fatigue syndrome[4] - (Abstract)
  • 1994, Normal red cell magnesium concentrations and magnesium loading tests in patients with chronic fatigue syndrome[14] - (Abstract)
  • 1997, Magnesium deficit in a sample of the Belgian population presenting with chronic fatigue[15] - (Abstract)
  • 2006, Increase of free Mg2+ in the skeletal muscle of chronic fatigue syndrome patients[16] - (Full text)

See also[edit | edit source]

Learn more[edit | edit source]

References[edit | edit source]

  1. 1.0 1.1 1.2 1.3 Magnesium: Fact sheet for health professionals, National Institutes of Health: Office of Dietary Supplements, March 2, 2018, retrieved May 22, 2018
  2. 2.0 2.1 Schwalfenberg, Gerry K.; Genuis, Stephen J. (2017). "The Importance of Magnesium in Clinical Healthcare". Scientifica. doi:10.1155/2017/4179326. ISSN 2090-908X. PMC 5637834. PMID 29093983.
  3. Rayssiguier, Yves; Libako, Patrycja; Nowacki, Wojciech; Rock, Edmond (June 2010). "Magnesium deficiency and metabolic syndrome: stress and inflammation may reflect calcium activation". Magnesium Research. 23 (2): 73–80. doi:10.1684/mrh.2010.0208. ISSN 1952-4021. PMID 20513641.
  4. 4.0 4.1 Cox, I.M.; Campbell, M.J.; Dowson, D. (March 30, 1991). "Red blood cell magnesium and chronic fatigue syndrome". Lancet (London, England). 337 (8744): 757–760. ISSN 0140-6736. PMID 1672392.
  5. Clague JE, Edwards RH, Jackson MJ (1992). Intravenous magnesium loading in chronic fatigue syndrome. Lancet 340: 124–125. PMID:1352002
  6. Hinds G, Bell NP, McMaster D, McCluskey DR (1994). Normal red cell magnesium concentrations and magnesium loading tests in patients with chronic fatigue syndrome. Ann Clin Biochem 31 (Pt 5): 459–461. DOI:10.1177/000456329403100506
  7. Swanink, C.M.; Vercoulen, J. H.; Bleijenberg, G.; Fennis, J.F.; Galama, J.M.; van der Meer, J.W. (May 1995). "Chronic fatigue syndrome: a clinical and laboratory study with a well matched control group". Journal of Internal Medicine. 237 (5): 499–506. ISSN 0954-6820. PMID 7738491.
  8. 8.0 8.1 8.2 Li, F.-Y.; Chaigne-Delalande, B; Su, H; Matthews, H; Lenardo, M.J. (2014), "XMEN disease: a new primary immunodeficiency affecting Mg2+ regulation of immunity against Epstein-Barr virus.", Blood, doi:10.1182/blood-2013-11-538686
  9. 9.0 9.1 Ravell, J; Chaigne-Delalande, B; Lenardo, M (2014), "XMEN disease: a combined immune deficiency with magnesium defect.", Current Opinion in Pediatrics, doi:10.1097/MOP.0000000000000156
  10. "Dietary Supplements for Headaches: What the Science Says". National Center for Complementary and Integrative Health. Retrieved October 13, 2021.
  11. Sun-Edelstein, Christina; Mauskop, Alexander (March 2011). "Alternative Headache Treatments: Nutraceuticals, Behavioral and Physical Treatments: March 2011". Headache: The Journal of Head and Face Pain. 51 (3): 469–483. doi:10.1111/j.1526-4610.2011.01846.x.
  12. Barmherzig, Rebecca; Rajapakse, Thilinie (May 10, 2021). "Nutraceuticals and Behavioral Therapy for Headache". Current Neurology and Neuroscience Reports. 21 (7): 33. doi:10.1007/s11910-021-01120-3. ISSN 1534-6293.
  13. Sun-Edelstein, Christina; Mauskop, Alexander (June 2009). "Foods and Supplements in the Management of Migraine Headaches". The Clinical Journal of Pain. 25 (5): 446–452. doi:10.1097/AJP.0b013e31819a6f65. ISSN 0749-8047.
  14. Hinds, G.; Bell, N.P.; McMaster, D.; McCluskey, D.R. (September 1994). "Normal red cell magnesium concentrations and magnesium loading tests in patients with chronic fatigue syndrome". Annals of Clinical Biochemistry. 31 (Pt 5): 459–461. doi:10.1177/000456329403100506. ISSN 0004-5632. PMID 7832571.
  15. Moorkens, G.; Manuel y Keenoy, B.; Vertommen, J.; Meludu, S.; Noe, M.; De Leeuw, I. (December 1997). "Magnesium deficit in a sample of the Belgian population presenting with chronic fatigue". Magnesium Research. 10 (4): 329–337. ISSN 0953-1424. PMID 9513929.
  16. McCully, Kevin K; Malucelli, Emil; Iotti, Stefano (January 11, 2006). "Increase of free Mg2+ in the skeletal muscle of chronic fatigue syndrome patients". Dynamic Medicine. 5: 1. doi:10.1186/1476-5918-5-1. ISSN 1476-5918. PMC 1360067. PMID 16405724.