S05E106 Magnesium: Magic Mineral or Overhyped Supplement?

Magnesium has become the one of the most popular supplements in the world, but does it deserve the hype? As both a physician with nearly three decades of experience and someone who's relied on magnesium to combat debilitating muscle cramps, host Sam Rhee looks at the science behind this popular mineral and his personal journey with the supplement.

Beginning with his experience during surgical internship and years later starting magnesium supplements himself, Sam takes a deep dive into magnesium's benefits and its possible effectiveness for muscle cramps, sleep, mood, exercise performance, heart health, and even blood sugar regulation.

Practical tips on dosage, types, and potential side effects are discussed, emphasizing the importance of consulting healthcare providers before starting any new supplement.

What's your experience with magnesium? Have you noticed benefits from supplementation? Share your thoughts and let us know which supplement you'd like me to deep dive into next by DMing me on Instagram or commenting on our YouTube channel.

#MagnesiumSupplements #HealthAndWellness #SupplementStack #FitnessJourney #HealthyLiving #MuscleCramps #SleepBetter #HealthTips #NutritionalSupplements #BotoxAndBurpees #podcast

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S05E106 Magnesium: Magic Mineral or Overhyped Supplement?

TRANSCRIPT

[00:00:00]

Sam Rhee: Hello and welcome to Botox and Burpees. Today's episode I cover the popular supplement magnesium and decide whether it's worth taking.

My own supplement stack is over large. I take over 10, maybe closer to 20 pills a day.

I started with a single multivitamin many years ago. But then I added more and more as I kept hearing or reading about other supplements.

And recently I realized I have accumulated a lot, maybe too many daily supplements at this point.

So I've decided to go through and see if they all actually have real health value. So I'm gonna start a deep dive one by one into my supplements, do the research and share with you my thoughts and findings. So let's start the first one, magnesium.

First of all, remember, although I am a physician, this podcast represents my own anecdotal experience.

Only the show is for informational purposes only. [00:01:00] Don't do anything you hear on this podcast without first seeking the advice of your own qualified health provider with any questions you may have regarding your own medical care. So thank you.

So to start, I first learned about the magic of magnesium supplements as a newly minted doctor who just graduated from medical school. This was almost 30 years ago. On one of my first rotations as an intern, I was part of a general surgery team, and one of our intern jobs was to check patient lab values after surgery and make sure they were normal.

I remember having a patient whose potassium levels were very low. Normally potassium ranges from 3.5 to five, but this patient was very low, maybe, uh, under 2.5, and the patient had just had abdominal surgery and so we couldn't give him anything to eat.

So for two days, I ordered intravenous potassium for the patient, which is tedious because it has to be given slowly over hours, and you can't give very much at a time or you'll kill the patient. So I ordered a dose of 20 milli [00:02:00] equivalents for the first day, then another 20 milli equivalents on a second day.

But his potassium levels didn't budge. So on the third day, we were rounding on our patients one afternoon, and I told my senior resident about the patient with hypokalemia, meaning low potassium, who wasn't responding to the IV boluses,

looking at me like the idiot intern I was. She asked if I had given any magnesium sulfate to the patient and I looked at her stupidly and I said no.

So she rolled her eyes side and moved on to the next patient.

So after rounds, I talked to one of the more experienced nurses on the floor who suggested a typical IV magnesium sulfate dose, which I ordered. And then of course, boom, the patient's potassium popped up to normal on his labs the next morning, and problem solved.

Early magnesium light bulb moment.

So the second time magnesium popped into my life in a meaningful way, was much later, about 20 years after I was an intern. I just started doing CrossFit and I was drinking the Kool-Aid and working out [00:03:00] almost every day. Unfortunately, I was debilitated by severe cramps at least once or twice a week, usually at night.

If the barbell had a lot of heavy barbell, my hamstrings or adductors would just cramp up, or if there was a lot of jump rope that day, it would be my calfs.

Whatever muscles the workout really hammered. I would suddenly wake up in the middle of the night, groan in excruciating pain, and slide down on the floor trying to pound on the muscle and get it to stop cramping,

trying to not make too much noise to wake others up and about after five or 10 minutes, I could get it to relax and I would get back into bed, making sure to hold my leg in the right position so it wouldn't start cramping again.

It would feel terrible the next morning. So people gave me all sorts of advice, like stretching more before and after workouts, massages, and of course taking more potassium. So I drank more coconut water, ate bananas, cantaloupe, not so much the spinach and bok choy, but hey, there are limits to what I would do [00:04:00] food wise.

But the cramps still kept happening for months until someone, and I can't remember who, read that magnesium could help with muscle cramps boom, light bulb moment from my intern year. And I thought to myself, but wait a second. I don't need more magnesium. I take a multivitamin every day. And sure enough, I checked and the label said magnesium oxide.

Then when I Googled magnesium oxide, I found out that while it was inexpensive, it didn't dissolve in water and only about 4% of the magnesium oxide was being absorbed by the body. So I then started taking a different kind of magnesium and the cramps really seemed to get better.

I very rarely get cramps at this point.

Uh, but I didn't actually check to see if the magnesium was medically legit, or maybe it was just a placebo effect. So now finally, 10 years later, after I started taking magnesium, I'm actually checking to see what does the medical literature say about people like me taking magnesium supplements.

It may [00:05:00] be the most popular mineral supplement in the world right now.

And on social media, magnesium is often tied as a miracle mineral for muscle sleep, mood, you name it.

Now, normally we absorb magnesium from foods like leafy greens, not seeds, whole grains and beans.

But many people still don't get enough. And one survey found that almost half of all Americans consume less magnesium in their diet than the recommended daily amount.

So with so many of us running low on magnesium, it's no wonder that the magnesium supplement business is booming.

So why is there so much hype about magnesium? A lot of people do take it for muscle cramps or to improve exercise recovery, but a lot of others now take it to help with sleep relaxation

or even blood pressure and migraine control and more.

So let's take a deeper dive into the evidence to start. What is the evidence for athletes regarding magnesium for muscle cramps and athletic performance?

Let's start with [00:06:00] a gym scenario like me using magnesium to prevent muscle cramps or aid recovery.

There are physiologic mechanisms as I've mentioned, where magnesium seems like it would help reduce cramping.

So as I learned as an intern, magnesium can help the overall absorption of other electrolytes.

It can also act as a natural calcium blocker, helping muscles relax after contracting.

And this relaxation can help prevent or Aleve muscle cramps. But scientifically, the results have been mixed for routine muscle cramps, like those that stroke.

For routine muscle cramps, like those that strike older adults at night, magnesium supplements often don't show much benefit.

A recent rigorous review concluded that magnesium is unlikely to provide meaningful cramp relief for older adults with frequent for older adults with frequent cramps. And in these studies, people taking magnesium had about the same number of cramps as those taking placebo.

So for typical leg cramps, unrelated to a clear deficiency, popping a [00:07:00] magnesium pill might not make a big difference.

But what about athletes and exercise performance?

here, the research suggests that magnesium will help if you are deficient. But again, if you have enough magnesium in your system, more might not boost your performance.

If you are a well nourished athlete, the study suggests that you won't find more strength or aerobic performance from higher dose magnesium supplementation.

However, intense exercise might deplete your magnesium sufficiently, which you lose in sweat and urine, and in some athletes such as me back in the day who never hydrate properly, probably got insufficient electrolytes,

will probably run low on magnesium, and in those cases, supplementation would help prevent deficiency that would otherwise hurt performance.

There are also a few small studies suggesting magnesium might reduce post-exercise, muscle soreness or markers of muscle damage, but this evidence wasn't very strong or consistent.

So magnesium's not a magic bullet for recovery.

Just [00:08:00] making sure you have enough magnesium would probably be sufficient.

But if you are someone who does a lot of intense exercise supplementation probably wouldn't hurt.

What about magnesium for general health and heart health?

Magnesium's benefits have been purported to extend beyond the gym. There's a lot of observational research linking good magnesium levels to various health benefits. For example, people who eat magnesium rich diets tend to have a lower risk of high blood pressure and heart disease.

In fact, the FDA even recently allowed a qualified health claim on magnesium saying consuming diets with adequate magnesium may reduce the risk of high blood pressure, but the evidence is inconsistent and inconclusive. End quote. So that sums it up. Magnesium might actually help keep blood pressure in check, but scientists aren't a hundred percent sure.

There are some studies in hypertensive patients, which do show a small reduction in blood pressure with magnesium, especially at higher [00:09:00] doses, around 300 to 500 milligrams a day. But that reduction in blood pressure is not a huge effect.

So more robust clinical trials are needed to know how much taking magnesium can truly prevent heart attacks or strokes by blood pressure reduction.

One review did note that while higher magnesium intake is associated with lower heart disease risk, it's hard to tease out that cause and effect.

So until we get larger, better, well controlled studies, we'll have to wait for definitive answers.

of course, magnesium is crucial for heart function. I learned as a newbie intern that we use IV magnesium for certain arrhythmias as well as severe asthma attacks

because it can stabilize excitable cell membranes and low magnesium can definitely cause problems such as heart rhythm disturbances.

So maintaining adequate magnesium is part of overall heart health, but again, won't replace your blood pressure meds, undo a heavy cheeseburger diet, but might play a supporting role.

[00:10:00] In terms of diabetes, magnesium has been suggested to play a role in blood sugar re in terms of diabetes. Magnesium might also play a role in blood sugar regulation and reduction of diabetes risk. Higher magnesium diets have been tied to lower risk of type two diabetes and observational studies,

and in people with diabetes, magnesium deficiency can worsen their insulin resistance. So some trials suggest supplementation can improve insulin sensitivity.

so for those who are borderline diabetic or who do have type two diabetes, especially if you have low magnesium levels, supplementation might be helpful.

So what about magnesium for brain health, including mood and sleep?

One of the reasons why magnesium is one of the hottest supplements right now is because it's termed the relaxation mineral with its possible effects on the nervous system.

There has been newer evidence that magnesium might have mild benefits for mood and sleep. A 2023 review [00:11:00] found an association between magnesium supplementation and improved depression symptoms

and a review from last year concluded that magnesium supplements might actually help people with mild anxiety and insomnia, helping them feel calmer and sleep better.

Now, I certainly have as much anxiety as anyone else out there. The literature does make sense since magnesium is involved in neurotransmitter regulation and stress responses, so I might up my magnesium dose, which I'll talk about in a little bit.

Many people also anecdotally report better sleep quality when they take their magnesium at night.

The science isn't complete, but it is relatively low risk to try magnesium if you have occasional sleeplessness, as long as you don't overdo it.

Magnesium is also sometimes recommended for migraine headache prevention.

some clinical guidelines suggest magnesium usually around 400 milligrams a day as a preventative for migraines based on studies showing it might reduce headache frequency for some sufferers.[00:12:00]

It's not effective for everyone,

but again, given it's low risk, migraine specialists often consider it worth a try.

So in summary, maintaining adequate magnesium levels is clearly important for overall health.

It can affect your muscles, heart, metabolic, and nervous system function.

But if you have a decent diet with sufficient magnesium, taking extra supplements might only help you in specific ways, possibly better sleep or fewer migraines.

It probably won't overwhelm you with results, but there are definitely situations where evidence does support magnesium use.

So if you do choose to supplement with magnesium, here are a few guidelines to do it smartly. For adults, around 200 to 400 milligrams of magnesium a day is a common supplemental dose, and the recommended daily allowance in total is 400 milligrams for men, about 320 for women. That includes the magnesium that you consume in your diet. More magnesium is not [00:13:00] necessarily better.

In fact, if you take more than about 350 milligrams at once, it might cause diarrhea because magnesium does draw water into the intestines, and high doses of magnesium are used in laxatives or for colonoscopy prep.

So make sure you start on the lower end of the dose and then first, see how you feel.

Choose the well absorbed forms. Forms that dissolve well in liquid, which tend to be absorbed better in your gut. Magnesium citrate, glycinate, chloride are examples that are more bioavailable. In contrast, magnesium oxide, which is found in many cheaper supplements or multivitamins, is less absorbed and is more likely to cause GI upset.

Read the label for the form. And I personally use magnesium glycinate capsules, which seem to work for me.

In terms of timing, magnesium can be taken in the evening if it helps you relax or sleep. If you take it for workout recovery, you might take it, uh, after exercise or before bed as well.

there's no strict rule and do what fits your [00:14:00] routine.

Some people will split the dose morning and night to avoid any stomach issues. For me personally, I currently take about 120 milligrams of magnesium glycinate a day,

usually every morning as soon as I wake up.

I won't count my daily multivitamin, which has a hundred milligrams of magnesium oxide because of the terrible absorption rate.

But anyway, I must be used to taking it in the morning because I don't feel drowsy in the morning. Or maybe I'm already drowsy enough, so I don't notice the effect.

I've been taking it for years, so I'm very used to it. But as I mentioned, I am now considering adding another 120 milligrams at night before I go to bed to help me sleep based on this research. But since right now I'm doing a couple other things to try to help my sleep routine, I'll probably wait and see how those maneuvers work first before I start on more magnesium.

In terms of quality and purity, look for reputable brands and third party testing. Since supplements aren't tightly regulated, it's better to choose products that have been verified by an independent group. For example, A USP verified or [00:15:00] NSF certified indicates that the product has been tested for quality and is free from contaminants.

You can check if the company uses third party labs to check their magnesium for heavy metals or impurities. I personally take the pure encapsulations magnesium glycinate, which is a third party tested.

probably the most rigorously tested product I've seen out there is thorn's Magnesium biglycinate, which is NSF certified for sport, which means the product undergoes rigorous independent testing and is certified free from 200 banned substances for sport competition.

But since I'm not going to the CrossFit games anytime soon, I'm okay with the formulation I'm taking right now. Also know when to consult your medical specialist. If you have kidney issues, you should be careful with magnesium. Since kidney's clear excess magnesium and magnesium can interact with certain medications like antibiotics or blood pressure medications.

So when in doubt, ask your medical provider or pharmacist,

especially if you plan on taking higher doses.

So in conclusion, is magnesium worth taking? Yes, but it does depend [00:16:00] on your individual needs and expectations.

for someone like me who probably has low magnesium levels to start having, taking it for muscle cramps can be helpful.

If you have

migraines, anxiety or poor sleep, it might also be helpful.

for those with high blood pressure or type two diabetes, this might be something to discuss with your medical provider about as well.

Fortunately, magnesium is low risk and low cost.

I plan on continuing my magnesium might increase my dose at night.

Most of these studies showed that a magnesium rich diet was the most helpful in terms of the beneficial effects, so supplements may or may not have those same effects that a magnesium rich diet has.

But if your blood work shows low magnesium, then starting with a supplement might be beneficial.

Remember to talk to your healthcare provider if you have conditions or take other medications before you start any of these new supplements.

If you are considering [00:17:00] magnesium, what is the reason why you're planning on taking it? I'd be interested in knowing.

If you're already taking magnesium, what has been your experience with these supplements

and what other supplements would you want me to deep dive on next, please DM me on Instagram @BotoxAndBurpeesPodcast, or leave a comment on our YouTube channel, www.youtube.com/@Botoxandburpees. If you already hit the like and subscribe buttons, I really appreciate it and as always, thank you for listening.