Faculty Member - Istanbul Kent University, Faculty of Pharmacy, Department of Pharmacology

"Magnesium and its derivatives have effects on the gastrointestinal, cardiovascular, reproductive, musculoskeletal, respiratory, and neurological systems."

THE ROLE OF MAGNESIUM AND ITS DERIVATIVES IN THE BODY

Title:

| What is Magnesium? | The Role of Magnesium in the Body | Role of Magnesium in Metabolic and Cardiovascular Functions | Neuromuscular and Tocolytic Effects of Magnesium | Role of Magnesium in the Endocrine and Respiratory System | The Role and Effectiveness of Magnesium in Migraine Treatment | Hypomagnesaemia: Causes, Symptoms and Treatment Methods | Hypermagnesaemia: Causes, Symptoms and Management | Magnesium Intake and the Role of Mineral Waters in Daily Magnesium Intake | Magnesium Derivatives, Intended Use, and Time of Use

What is Magnesium?

Magnesium is one of the essential minerals needed for the body to stay healthy. It is found in many natural foods such as milk, yoghurt, wholemeal foods, green leafy vegetables, legumes, but can also be added to some fortified foods such as breakfast cereals. Magnesium preparations can be divided into two categories: Food and Drug Administration (FDA) approved and non-FDA approved. However, magnesium is also widely used as an over the counter (OTC) product. When it is intended to be given as a multivitamin-mineral supplement, there are various salt forms including magnesium aspartate, magnesium citrate, magnesium lactate, magnesium oxide, magnesium sulphate, magnesium hydroxide, magnesium gluconate, and magnesium chloride, which are more easily absorbed by the body.

Magnesium is the fourth most common cation in the body. About 50% is found in bone, 25% in muscle and the remainder in soft tissue, serum and red blood cells. Like other electrolytes, it can be found in the body in ionised, protein-bound or anion-bound forms. The most active of these forms is ionised magnesium. The balance of magnesium in the body is provided by the intestine, bone and kidney. Similar to calcium, magnesium is absorbed through the intestine, stored in the bone and excreted through the kidneys. If the magnesium level in the body decreases, more magnesium will be absorbed from the intestines to compensate for this deficiency.

The Role of Magnesium in the Body

As with other electrolytes, the role of magnesium in the body is varied and complex. Magnesium's mechanism of action depends on which organ system it is involved in. It is mostly intracellular and is the second most common intracellular cation after potassium. It has effects on gastrointestinal, cardiovascular, reproductive, musculoskeletal, respiratory, and neurological systems in the body.

Role of Magnesium in Metabolic and Cardiovascular Functions

It plays a vital role in more than 300 reactions involving metabolism. Magnesium is involved in hormone-receptor binding, muscle contraction, neural activity, neurotransmitter release, vasomotor tone, and cardiac excitability. It is necessary for the active transport of potassium and calcium across the cell membrane. The proper functioning of ATP, the energy source of our body, depends on magnesium. It facilitates defecation by providing osmotic retention of fluids as a result of oral use. It is also used in over-the-counter antacids. Magnesium, which acts as a natural calcium channel blocker, is a cofactor of Na-K-ATPase pump. It also helps to control atrioventricular node conduction. Therefore, hypomagnesaemia can cause myocardial excitability resulting in ventricular tachycardia and arrhythmias.

Neuromuscular and Tocolytic Effects of Magnesium

Magnesium depresses the central nervous system while producing anticonvulsant effects. It blocks peripheral neuromuscular transmission by inhibiting acetylcholine release at neuromuscular junctions. It stimulates calcium reuptake by the sarcoplasmic reticulum, causing muscle relaxation and vasodilatation, reduces calcium in uterine muscle and is thus used as a tocolytic in preterm labour.

Role of Magnesium in the Endocrine and Respiratory System

Magnesium is a cofactor of parathyroid hormone synthesis. Therefore, if hypomagnesaemia occurs in the body, hypoparathyroidism will also occur. Hypoparathyroidism can lead to calcium depletion and eventually osteopenia or osteoporosis. The effect of magnesium on the respiratory system is relaxation of bronchial smooth muscle. The cause of smooth muscle relaxation is unclear. Magnesium is thought to exert this effect by inhibiting the release of calcium, histamine or acetylcholine.

The Role and Effectiveness of Magnesium in Migraine Treatment

Analyses in migraine patients usually show hypomagnesaemia. Although the use of magnesium in these patients is currently limited, treatment of the disease with additional magnesium intake is considered to be both a cheap and simple option for patients. However, hypermagnesaemia may be seen in patients since the dose required for treatment is above the daily requirement. For this reason, the American Academy of Neurology and the American Headache Society have stated that magnesium therapy is ‘probably effective’ in preventing migraine.

Hypomagnesaemia: Causes, Symptoms and Treatment Methods

Magnesium administration to individuals can occur in a variety of ways. Dietary intake is the main source of magnesium for a healthy individual. Although the recommended daily intake varies according to gender and age, a normal serum magnesium level of 1.8 to 2.2 mg/dL is accepted. If the serum magnesium concentration is below 1.8 mg/dL (hypomagnesaemia), oral magnesium salts, intravenous (IV) or intramuscular (IM) magnesium sulphate may be given in treatment. Hypomagnesaemia may result from inadequate magnesium consumption or decreased renal or gastrointestinal absorption. However, chronic diarrhoea, proton pump inhibitor therapy, excessive alcohol consumption and diuretic use may also trigger hypomagnesaemia. Low levels of other electrolytes, such as hypokalaemia or hypocalcaemia, may also cause hypomagnesaemia. Therefore, symptoms of hypomagnesaemia include hyperreflexia, tremor and muscle fasciculations. Patients may also experience symptoms such as nausea, vomiting, drowsiness and weakness. In severe hypomagnesaemia below 1.25 mg/dL, generalised tonic clonic seizures may occur.

Hypermagnesaemia: Causes, Symptoms and Management

A serum magnesium concentration above 2.6 mg/dL is called hypermagnesaemia. Symptoms include vasodilatation causing skin rashes, hypotension, hyporeflexia and respiratory depression. Magnesium concentrations above 6 mg/dL may include electrocardiographic (ECG) changes, PR prolongation, QRS widening and peak T waves. When levels are above 15 mg/dL, cardiac arrest occurs. Hypermagnesaemia is less common than hypomagnesaemia. The major cause of hypermagnesaemia is renal failure, which causes increased magnesium retention. It can also occur with excessive use of magnesium-containing laxatives and antacids. Treatment includes calcium gluconate, diuresis or dialysis. For those with severe hypermagnesaemia, it is important to maintain circulatory and respiratory support. IV furosemide is the diuretic of choice as it increases magnesium excretion.

Magnesium Intake and the Role of Mineral Waters in Daily Magnesium Intake

The Food and Nutrition Board (FNB) of The Institute of Medicine of the National Academies has determined the daily intake of magnesium for men and women aged 31-50 years as 320 mg and 420 mg. Kızılay Afyonkarahisar natural mineral water (200 mL) contains 16.57 mg/L magnesium. Thus, when this mineral water is drunk, 1% of the daily magnesium intake for women and 0.8% for men will be met. Kızılay Erzincan natural mineral water (200 mL) contains 317.45 mg/L magnesium. After the consumption of this mineral water, 20% of the magnesium required to be taken daily in women and 15% in men will be met.

With the vital role it plays on many systems in the body, magnesium has an important role in all our lives. For this reason, attention should be paid to dietary intake, attention should be paid to changes in serum levels and a doctor should be consulted in any symptoms seen due to a decrease or increase in serum concentrations.

Magnesium Derivatives, Intended Use, and Time of Use

Below are magnesium derivatives, their intended use, and times of use.

Magnesium Compounds, Purpose, When to Use?

-Magnesium Citrate

Used for general magnesium deficiency, constipation treatment, digestive issues, muscle cramps, and energy production.

For digestive issues, take in the morning; for muscle cramps, take in the evening, either on an empty stomach or after a meal.

-Magnesium Malate

Used for chronic fatigue syndrome, fibromyalgia, laxative effects, and energy production.

It is recommended to take on an empty stomach or after a meal, in the morning or at noon.

-Magnesium Bisglycinate

Ideal for anxiety, stress, sleep disorders, migraines, and nervous system health.

Take at night before bed, either on an empty stomach or after a meal.

-Magnesium Oxide

Used for constipation, indigestion, and regulating stomach acid. It may also help prevent migraines and lower blood pressure and blood sugar.

For digestive issues, take as an antacid either on an empty stomach or after a meal; for constipation, take before bed.

-Magnesium Taurate

Effective for stress, anxiety, migraines, memory problems, blood pressure regulation, and blood sugar balance.

Take in the morning or evening, either on an empty stomach or after a meal.

-Magnesium L-Threonate

Used for treating stress, anxiety, improving sleep quality, enhancing brain health, and boosting cognitive functions and memory.

For cognitive function, take on an empty stomach or after a meal; for sleep, take before bed.

-Magnesium Sulfate

Used for relieving stress and muscle pain.

It is recommended to take orally in the morning on an empty stomach or to add to bath water for external use.

-Magnesium Chloride

Regulates stomach acid, helps relieve constipation, and eases heartburn.

Take during mealtime.

-Magnesium Carbonate

Regulates stomach acid, helps relieve stomach issues.

Can be taken before meals or when experiencing stomach discomfort.

-Magnesium Phosphate

Used to relax muscles and prevent muscle cramps.

Can be taken 2 hours after meals.

-Magnesium Lactate

Preferred for digestive system issues.

Can be taken 2 hours after meals.

-Magnesium Orotate

Helps with cellular regeneration and supports bone, heart, and brain function improvement.

Take with meals.

-Magnesium Aspartate

Used to address magnesium deficiency.

Take with meals.

-Magnesium Picolinate

Used to address magnesium deficiency.

Take with meals.

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