Magnesium: forgotten mineral in the spotlight Varied diet with nuts and vegetables prevents magnesium deficiency

6 June 2024

In recent years, magnesium has been increasingly recognized both socially and scientifically. The importance of magnesium for various processes in our body is becoming clearer. However, more understanding of how the human body precisely absorbs magnesium remains a challenge, as this opens the door to better treatments. This is stated by scientists from Radboud university medical center in the New England Journal of Medicine.

Magnesium is essential for our health, and two organs work together to maintain stable magnesium levels: the intestines regulate absorption, and the kidneys manage excretion through urine. A magnesium deficiency is generally preventable with a varied diet rich in green vegetables and nuts. A very small portion of the population, about 1 to 2 percent, has a magnesium deficiency that cannot be resolved through a varied diet.

Professor of Molecular Renal Physiology Joost Hoenderop researches the causes of magnesium deficiency. In a review, now published in the scientific journal New England Journal of Medicine, he, along with fellow researcher Jeroen de Baaij, describes the current state of knowledge on magnesium deficiency.

They look, among other things, at patients who, due to a rare disease, do not absorb or retain magnesium. Hoenderop says, ‘Even if there are only five patients with a particular condition in the Netherlands, research into this is very important. Because insights into rare diseases help us better understand what goes wrong, enabling us to help many more people.’

This is crucial because commonly used medications, such as strong antacids and diuretics, increase the risk of magnesium deficiency, as do certain types of chemotherapy and immunosuppressive drugs. Long-term use can lower magnesium levels in the blood. Additionally, type 2 diabetes patients are more likely to have a magnesium deficiency than the general population. Magnesium deficiency causes various symptoms, with muscle cramps being the most well-known. However, nonspecific symptoms such as lethargy and cardiac arrhythmias also occur.

Research in Nijmegen

Over the past twenty years, researchers of Radboud university medical center in Nijmegen have mapped several proteins that regulate magnesium absorption in the kidney, including a specific magnesium channel. ‘We are increasingly understanding how the kidney retains magnesium; our picture is becoming more complete. We also better understand disruptions,’ says Hoenderop.

In a previous study, he and De Baaij examined patients with severe symptoms, such as tingling fingers, tremors, and a restless feeling. These patients received inulin, a type of compound that improves magnesium absorption in the intestine. This research yielded positive results and prevented the aforementioned symptoms. Hoenderop states, ‘We still know little about magnesium absorption in the intestine. To me, this is a significant area of inquiry.’

Deficiency in Hospitals

There are more challenges, according to Hoenderop. Hospital patients often have a noticeable magnesium deficiency. In the intensive care unit, this percentage ranges from 10 to 60 percent. ‘We don’t yet know exactly why, but low magnesium levels lead to slower recovery,’ says Hoenderop.

A new measurement method should provide more insight. This method measures the ionized magnesium levels in the blood, Hoenderop explains: ‘We have long looked at the total amount of magnesium in the blood, but this can underestimate it. Ionized magnesium levels reflect the biologically available magnesium, and the introduction of these measurements of ionized magnesium is a significant step forward.’
He and De Baaij are now starting a study with the Jeroen Bosch Hospital, using this measurement method to detect deficiencies more quickly in people using antacids. Hoenderop says, ‘We want to investigate how we can quickly identify high-risk patients and then develop a system that promptly signals abnormal magnesium levels and potential consequences.’

Hype

Magnesium has also been increasingly in the social spotlight in recent years. In a previous article, De Baaij explained who exactly benefits from magnesium and in what way. Hoenderop states, ‘Healthy people who eat a varied diet generally do not have a magnesium deficiency. A deficiency occurs in only a small part of the Dutch population, about one to two percent. These are often people who use antacids or have type 2 diabetes. We therefore expect the problem to grow, due to the rising number of type 2 diabetes patients.’

 

For them, as well, pills from the drugstore are not the solution. Although overdosing is rare, frequent use can cause unpleasant side effects like diarrhea. Hoenderop advises, ‘If you have symptoms, see a doctor who will look into what is going on with you. We must prevent people from taking supplements prophylactically. Only one group benefits from this, and that’s the people selling them.’

About the Publication

This review is published in the New England Journal of Medicine: Magnesium Disorders – Rhian M. Touyz, Jeroen H.F. de Baaij, and Joost G.J. Hoenderop. DOI: 10.1056/NEJMra1510603. 

Previously on this website, an article about the pros and cons of magnesium was published.

In this picture: Joost Hoenderop (left) and Jeroen de Baaij. 

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