“Lower Mg intake was associated with worse pain and function in knee OA, especially among individuals with low fiber intake” (Shmagel et al 2018).

“Mg is effective for mild-to-moderate depression in adults” (Tarleton et al 2017)

“…4 weeks of oral Mg supplementation can reduce pain intensity and improve lumbar spine mobility…in patients with refractory chronic LBP with a neuropathic component” (Yousef et al 2013).


I have had numerous patient success stories after my recommendation of taking this safe and easily available supplement. Despite limited evidence, I will try to explain why and when to recommend Mg supplements & Mg rich foods to your patients.


When serum Mg levels drop, this essential mineral is rapidly harvested from bone and muscle cells, in order to normalize serum levels.  Therefore, doctors do not routinely test serum Mg because results usually come back normal whilst actual Mg level in tissues can be low. So how can low tissue Mg then be identified?

The only option is to identify if a patient has a combination of symptoms after an MD has ruled out other medical conditions (e.g. thyroid issues, diabetes, low iron, etc.).

Here are the top 10 signs that a patient may be Magnesium (Mg) deficient, meaning they may have potentially low Mg in their tissues:

  • Headaches
  • Muscle aches and cramps (e.g. calf, low back)
  • Muscle fasciculation (e.g. eyes/biceps twitching)
  • Poor sleep/difficulty falling asleep
  • Frequent urination (especially at night)
  • Constipation
  • Heart palpitations
  • High stress, low mood, decreased concentration
  • Craving for dark chocolate (especially after period)
  • Severe PMS symptoms

5 things to do for potentially low tissue Mg

  1. Request the patient to consult a pharmacist and go on a two-month trial of 400mg of Mg citrate supplementation and note any changes in symptoms.

Note: Mg supplements can interact with antibiotics, cardiac, blood pressure, diabetes and osteoporosis medications.

Mg citrate (e.g. CALM brand) derives from the Mg salt of citric acid and the body easily absorbs it (Note: I have no financial ties to any brand).

  1. Take an Epsom salt bath as the salt contains Mg sulphate, which may give temporary relief from general muscle aches.
  1. Try topical Mg chloride gels and oils over painful muscles.
  1. Reduce the intake of alcohol, caffeine and carbonated sodas.
  1. Eat Mg rich foods such as almonds, pumpkin seeds, navy beans, spinach, broccoli, avocado brown rice, …just Google it!

References: Yousef AA1, Al-deeb AE. A double-blinded randomised controlled study of the value of sequential intravenous and oral magnesium therapy in patients with chronic low back pain with a neuropathic component. Anaesthesia. 2013 Mar;68(3):260-6.

Tarleton et al Role of magnesium supplementation in the treatment of depression: A randomized clinical trial. PLoS One. 2017 Jun 27;12(6):e0180067.

Shmagel A et al Low magnesium intake is associated with increased knee pain in subjects with radiographic knee osteoarthritis: data from the Osteoarthritis Initiative. Osteoarthritis Cartilage. 2018 Feb 15.


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