Why magnesium for the chiropractic patient?

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Back in 1992, Elin referred to mag-nesium as the fifth, but forgotten, electrolyte.1  This is not surprising, as magnesium’s importance is rarely mentioned, perhaps due to our culture’s obsession with calcium.   One would never know that magnesium plays a crucial role in bone metabolism, for it is never mentioned.  Even certain researchers do not consider magnesium when studying osteoporosis.  Alexandersen, et al., state that, “It is not a general practice to include a magnesium supplement in osteoporosis studies.”2  Such sentiments are inconsistent with well-known facts about calcium and magnesium metabolism.  A basic endocrinology book explains that magnesium deficiency creates a deficiency in calcium that cannot be corrected until magnesium levels are restored.3  In fact, magnesium supplementation has been used in the research setting in the treatment of osteoporosis. 
In a group of postmenopausal women in Israel suffering from osteoporosis who received magnesium supplements in the range of 250-750 mg/day for 24 months, in 87% of the cases, either trabecular bone density increased up to 8% or bone loss was arrested; in some cases, both an increase in bone density and arrested bone loss occurred.  Untreated controls, on the other hand, lost bone density at an average of 1% a year.4   In another study, postmenopausal osteoporotic women in Czechoslovakia received magnesium at levels ranging from 1500-3000 mg of magnesium lactate per day for two years.  Nearly 65% were classified totally free of pain and with no further deformity of vertebrae, with the condition in the remainder either arrested or slightly improved.4
Magnesium is not limited to improving bone health.  There are some three hundred bodily enzymes that require magnesium, which suggests that magnesium is vital for most cells and tissues of the body.  Deficiency in magnesium can have far reaching effects on many different tissues, to the point that a leading magnesium researcher wrote an article entitled, “Magnesium deficiency:  A cause of heterogeneous disease in humans”.5  Numerous conditions and symptoms can be promoted by magnesium deficiency, including osteoporosis, muscle dysfunction, depression, apathy, cardiac arrythmias, hypertension, atherosclerosis, and even stress and aging.5,6  
Literally no bodily system can escape without being insulted by magnesium deficiency, even the human genome.  In fact, magnesium is thought to promote genomic stability, such that DNA synthesis and repair depends on magnesium.7
Consider how the muscular component of subluxation may by driven by magnesium deficiency.  In particular, magnesium is required for ATP synthesis, which is needed for normal patterns of muscle contraction and relaxation.  Consider that ATP is needed to pump calcium back into the sarcoplasmic reticulum after muscle contraction.  Inadequate magnesium intake is likely to promote increased muscle tension.  Indeed, Rude explains this relationship quite concisely:  “The mechanism by which Mg affects the neuromuscular system relates to the fact that Mg stabilizes the nerve axon, as well as influences the release of neurotransmitters at the myoneural junction….  In Mg deficiency, there is a lower threshold for axonal stimulation and increased nerve conduction velocity, as well as increased quantity of neurotransmitter released.  Mg is also involved in calcium handling by the muscle cell.  With low intracellular Mg, calcium is more readily released from the sarcoplasmic reticulum and is reaccumulated more slowly….  This results in a muscle that is more readily contractible to a given stimulus and is less able to recover from contraction, i.e., tetany prone.”
With the above in mind, one can only hope that he is getting adequate magnesium in his diet.  Regretfully, this is not the case.  Marginal magnesium deficiencies are very common.  At the turn of the century (1900), magnesium intake was estimated to be 475-500 mg per day,8 which is substantially higher than today’s RDA’s.  The current US RDA for magnesium is 320 mg for women and 420 mg for men.  Intakes below the RDA are common, if not the norm, for the people of many countries, including the United States.7,8  While we cannot attribute this lowered intake to be the cause of the conditions and diseases mentioned above, it certainly makes sense to increase magnesium ingestion to at least the RDA. 
Researchers suggest that for every 2.2 pounds of body weight, which is equivalent to 1 kilogram (kg), we should be ingesting six mg of magnesium.  Accordingly, a 150-pound man (70 kg) would require 420 mg/day, while a 200-pound man (90 kg) requires 540 mg/day. 
As most in the US are deficient, it is suggested that we supplement five mg per kg of body weight to replenish what has been lost.6  Researchers have observed that between 950-1020 mg of magnesium per day is required to create a positive magnesium balance.7
For those taking calcium supplements, it is very important to add a magnesium supplement to the regimen.  The current accepted balance of calcium/magnesium intake is 2:1.  At present, the average intake of calcium in the US is thought to be about 1000 mg/day or greater (which includes supplements and fortified foods) and only about 250-350 mg of magnesium.  This imbalance, i.e., about a 4:1 ratio of calcium/magnesium, is thought to reduce magnesium absorption and further enhance magnesium deficiency.4
I suggest we give patients a nutritional adjustment by supplementing with magnesium.  Take magnesium about thirty minutes before eating a meal.  Divide your magnesium supplementation throughout the day if you are taking more than 300 mg, which will help to avoid the only side-effect to taking magnesium, that being loose stools. TAC

  1. Elin R. Magnesm: the fifth but forgotten electrolyte. Am J Clin Path 1994; 102:616-22
  2. Alexandersen P, Riis B. Ipriflavone and osteoporosis. JAMA. 2001; 286(15):1836-7
  3. Besser GM et al. Clinical Endocrinology. 2nd ed. London: Times Mirror; 1994: p. 18.10
  4. Dreosti IE. Magnesium status and health. Nutr Rev 1995; 53(9):S23-S27
  5. Rude RE. Magnesium deficiency: a cause of heterogeneous disease in humans. J Bone Mineral Res  1998; 13:74-958
  6. Durlach J, Bac P, Durlach V, Rayssiguier Y, Bara M, Guiet-Bara A. Magnesium status and ageing: an update. Mag Res 1997; 11:25-42
  7. Hartwig A. Role of magnesium in genomic stability. Mutation Res 2001; 475:113-21
  8. Saris NL, Mervaala E, Karppanen   H, Khawaja JA, Lewenstam A. Magnesium: an update on physiological, clinical and analytical concepts. Clin Chim Acta 2000; 294:1-26

Dr. Seaman is the Clinical Chiropractic Consultant for Anabolic Laboratories, one of the first supplement manufacturers to service the chiropractic profession.  He is on the postgraduate faculties of several chiropractic colleges, providing nutrition seminars that focus on the needs of the chiropractic patient.   Dr. Seaman can be reached by e-mail at [email protected].