Why magnesium is so important for your health and well-being

1. How important is magnesium, and what role does it play in maintaining our overall health?

Dr Ludwig Spätling: Magnesium is a vital mineral that is central to our bodily needs. For example, without magnesium, we would be unable to produce and utilise adenosine triphosphate (ATP), the universal “energy carrier” within our body cells. The human body needs magnesium for many aspects of the metabolic cycle, including normal muscle and nerve function, bone health and much more.

2. What signs indicate our body may be lacking magnesium?

Dr Ludwig Spätling: Because our essential metabolic processes are so dependent on magnesium, a deficiency can manifest itself via an enormous range of symptoms and complaints. So, the typical muscle cramps are really just the tip of the iceberg.

Just a limited snapshot would include general hypersensitivity, nervousness, sleep disorders, lower stress tolerance, headaches, psychological changes (e.g. depression), impaired breakdown of blood sugar and – last but not least, an important topic in my own field – premature contractions during pregnancy. This list also helps us understand why a magnesium deficiency is now associated with an increased risk of serious illness.

3. What foods are good natural sources of magnesium, and how should you adjust your diet to meet your needs?

Dr Ludwig Spätling: A good dietary supply of magnesium is best achieved by eating plenty of natural foods while limiting your intake of processed foods as much as possible. For example, by consuming whole-grain foods rather than white-flour products because 70% or more of the original magnesium is lost as a direct result of processes such as polishing rice and grinding flour.

As well as whole-grain products and brown rice, legumes, nuts and seeds are excellent sources of magnesium, as are products such as dark chocolate, which contains lots of magnesium due to its high cocoa content.

Drinking water tends to be low in magnesium, averaging around 10 mg per litre. However, certain mineral waters, which have a magnesium content of around 100 mg magnesium per litre or more, can make a meaningful contribution to your needs.

When a magnesium deficiency occurs and needs to be remedied, adjusting your diet alone won’t usually be enough. Such cases generally require an appropriate treatment.

4. What are the benefits of taking magnesium supplements, and when are they particularly useful?

Dr Ludwig Spätling: Numerous studies show just how difficult it can be to obtain a sufficient amount of magnesium from conventional foods and also demonstrate that magnesium levels in blood serum are too low for a large sector of the general population. Magnesium supplements offer a simple and reliable way to improve the magnesium supply you acquire through your diet.

This is particularly true with an unbalanced diet, i.e., a diet primarily consisting of a high proportion of highly processed foods (in other words, “fast food”), as well as weight-loss diets. A poor magnesium supply can also occur with certain illnesses (e.g. diabetes and bowel conditions) and when taking certain medications (e.g. diuretics and proton pump inhibitors). Other contexts in which an increased magnesium supply may be recommended include heavy physical activity, high alcohol consumption, chronic stress, during older age, as well as during pregnancy and breastfeeding.

Taking magnesium supplements at the usual recommended dosage carries virtually no health risks. Nevertheless, if you have severe kidney disease, such supplements should only be taken after consulting the doctor responsible for your treatment. Too high a dosage here means your stools may occasionally become soft, or diarrhoea may occur. However, this still carries no risk to your health and can be quickly remedied by reducing the daily dosage.

5. What different forms of magnesium supplements are available, and how do they differ? Do you have any specific recommendations for choosing the right format?

Dr Ludwig Spätling: Magnesium preparations offer various different ways to take the recommended dosage. However, from a medical perspective, it doesn't really matter whether magnesium is taken in the form of sugar-coated pills, tablets, capsules, granular powder or chewable tablets. The most important consideration is that the format should be acceptable to the user because many cases may require a long-term or even permanent intake of magnesium. So you should really choose the option that suits you best.

However, the choice of any specific magnesium compound is very relevant from a medical perspective. The reason for this is that certain organic compounds, such as magnesium citrate or magnesium aspartate, have a higher bioavailability, i.e., they are easier for your body to access than inorganic magnesium oxide or magnesium carbonate.

In addition, commercially available magnesium preparations differ significantly in their dosage: low-dose preparations have the advantage that they can be taken several times a day, thereby achieving particularly good bioavailability. Users who cannot always guarantee to take a dose several times a day, will find high-dose preparations (e.g. 300-400 mg of magnesium per dose) taken once a day are an adequate alternative.

6. Are there any potential interactions between magnesium and other medications or supplements that would-be users should be aware of?

Dr Ludwig Spätling: Magnesium can be easily combined with most preparations – whether these are medicines or other dietary supplements. Greater caution should be exercised with certain antibiotics (tetracyclines) and fluoride preparations, and here, your intake should be offset by 2-3 hours. In addition, just to be on the safe side, products containing inorganic magnesium compounds (magnesium oxide, magnesium carbonate) should not be taken alongside iron supplements.

Contrary to popular belief, magnesium and calcium can be taken together in the usual dosages because this will not inhibit the absorption of either substance.

However, the opposite is true in certain other contexts: Some drugs can cause a magnesium deficiency – either by increasing magnesium losses through the urine (e.g. diuretics and certain chemotherapy drugs) or by hindering intestinal magnesium absorption, as in the case of proton pump inhibitors.

7. How much magnesium should you take daily, and are there any circumstances in which a higher dose could be recommended?

Dr Ludwig Spätling: The recommended daily dose of magnesium depends entirely upon the individual context: Is this a therapeutic response designed to resolve a magnesium deficiency? Or is the aim to improve the daily magnesium supply via a nutritional supplement? In the first instance, i.e., for the therapeutic treatment of magnesium deficiency, a daily dose of 240-480 mg would usually be advised, though a doctor may prescribe a higher dose in individual cases. Sensible amounts for use as a nutritional supplement would be lower – perhaps 150-300 mg per day. Given the safety of magnesium taken as a dietary supplement, certain lifestyles and/or life events creating increased magnesium demands may also justify a higher dose (e.g. 400 mg per day).

8. Do you have any tips for people who want to start taking magnesium supplements to ensure optimal absorption and tolerability?

Dr Ludwig Spätling: As I have explained above, for the best possible absorption and tolerability, I would recommend the use of organic magnesium compounds such as magnesium citrate or magnesium aspartate in low-dose preparations taken several times a day.

Taking supplements away from meal times is also beneficial for bioavailability – for example, an hour before eating. However, if you should forget to take it just before eating, it’s then best to take magnesium along with your food.

If magnesium supplements are to be effective, what is crucial is that they should be taken regularly, in adequate doses, and over suitably longer periods of time. It may be necessary to take magnesium over several months to correct a magnesium deficiency, and many cases involving chronic illness and/or regular medication may require long-term use.