Magnesium

[Hutan]

(We have a members only thread on magnesium deficiency here)

I know a lot of members take magnesium, and there does look to be good evidence for magnesium deficiency being fairly common, and credible support for orally administered magnesium being useful for things like muscle spasms, and possibly high blood pressure and migraine.

But I remember when I looked into transdermal magnesium some years ago that the evidence for magnesium absorption through unbroken skin was weak and contradictory.

There's a 2017 study title 'Myth or Reality - Transdermal Magnesium' which is a bit oddly written, but cites a lot of studies. It concluded that magnesium supplementation can be important in addressing health conditions, but transdermal magnesium is a 'scientifically not yet proven form of magnesium application'. It found that there was a bit more evidence for magnesium in creams and that there should be more research on creams with higher concentration of magnesium administered for longer durations. The evidence for magnesium chloride solutions being useful seems to be very weak indeed.

A problem is that entities with conflicts of interest have been involved in studies.

There's a mention of one of the first studies of transdermal magnesium absorption. published in 2000 by the founder of the Americas Holistic Medical Association, an early advocate for the benefits of transdermal applications of magnesium. But, only an abstract for a conference without data was published to support the claimed improvement in magnesium deficiency from transdermal application.

There's mention of another study supporting Epsom salt baths - but it was reported only published on website of an Epsom salt council, and not in a peer-reviewed journal.

The Israeli Army made a skin cream that they hoped would prevent the absorption of chemical warfare agents. The cream was described as 'magnesium-rich'; it had magnesium sulphate. 34 health volunteers applied the cream 3 times a day for 3 days. This regime didn't affect blood magnesium levels.

A study with magnesium chloride solution (often called 'magnesium oil') found that absorption of magnesium was no different than when just the potassium chloride buffer was used. But better results were found for a magnesium chloride cream (maybe a patented product?).

One study found:

After the Mg2+ cream intervention there was a clinically relevant increase in serum magnesium (0.82 to 0.89 mmol/L, p = 0.29) that was not seen in the placebo group (n = 10) (0.77 to 0.79 mmol/L), but this difference was only statistically significant (p = 0.02)) in a subgroup of non-athletes (n = 20).

That's not sounding very impressive. There is a possibility that people with a magnesium deficiency might have higher increases in blood magnesium, as any excess over healthy levels will be excreted.

I haven't gone to the source documents to check those papers. But, I have tried googling. There's an enormous amount of marketing pitches, but very little evidence that transdermal delivery mechanisms are useful.

It's quite remarkable, the extreme difference between multiple marketing claims and the study evidence.


The NIH Magnesium Fact Sheet for Health Professionals (updated in March 2022) looks good. But it only talks about oral administration. Transdermal administration isn't even mentioned.

Magnesium Deficiency
Symptomatic magnesium deficiency due to low dietary intake in otherwise-healthy people is uncommon because the kidneys limit urinary excretion of this mineral [3]. However, habitually low intakes or excessive losses of magnesium due to certain health conditions, chronic alcoholism, and/or the use of certain medications can lead to magnesium deficiency.

Early signs of magnesium deficiency include loss of appetite, nausea, vomiting, fatigue, and weakness. As magnesium deficiency worsens, numbness, tingling, muscle contractions and cramps, seizures, personality changes, abnormal heart rhythms, and coronary spasms can occur [1,2]. Severe magnesium deficiency can result in hypocalcemia or hypokalemia (low serum calcium or potassium levels, respectively) because mineral homeostasis is disrupted [2].

Groups at Risk of Magnesium Inadequacy
Magnesium inadequacy can occur when intakes fall below the RDA but are above the amount required to prevent overt deficiency. The following groups are more likely than others to be at risk of magnesium inadequacy because they typically consume insufficient amounts or they have medical conditions (or take medications) that reduce magnesium absorption from the gut or increase losses from the body.
People with gastrointestinal diseases
People with Type 2 diabetes
People with alcohol dependence
Older adults

Have you found good evidence for transdermal magnesium making a difference to magnesium levels in the body or symptoms?

 

[Midnattsol]

We've been taught that transdermal magnesium is an alternative to oral, but I don't know what evidence is behind this. As we know health care can also but into hype

One thing that transdermal magnesium is said to be good at is delivering magnesium at the spot where it's needed, ie if you have muscle twitching you can apply it at the site and it can quickly be absorbed by those cells and not enter circulation. If that's the case you wouldn't expect a large increase in blood magnesium levels. Likewise if someone has adequate magnesium status already, too much magnesium in the blood is most likely due to the kidneys not functioning well, as they can regulate what is kept in the body vs excreted in urine.

 

[Jonathan Edwards]

I know a lot of members take magnesium, and there does look to be good evidence for magnesium deficiency being fairly common,

But is that right?

As far as I am aware clinical magnesium deficiency is largely limited to specific conditions where it will be expected - like severe renal disease or malabsorption. I don't see any reason to think PWME are likely to need to take magnesium.

One thing that transdermal magnesium is said to be good at is delivering magnesium at the spot where it's needed, ie if you have muscle twitching you can apply it at the site and it can quickly be absorbed by those cells and not enter circulation.

That looks highly implausible. The paper Hutan quotes confirms the as a highly hydrated ion magnesium in solution is not going to cross the epidermis much. And if it does it will first reach dermis and dermal circulation and be cleared. It is pretty well impossible for it to have a therapeutic effect on a muscle deeper down without spreading everywhere else.

It always shocked me that topical non-steroidal drugs like diclofenac were allowed when the evidence for them being able to target the painful site specifically was zero and transdermal absorption was so unpredictable that it would be expected to be far more toxic than oral use. People used to rub on enough cream that, if it were absorbed into the bloodstream they would have much higher levels than what was allowed by oral dosing. And it was known that things like GI haemorrhage were at least partly die to systemic levels.

 

[Hutan]

But is that right?

As far as I am aware clinical magnesium deficiency is largely limited to specific conditions where it will be expected - like severe renal disease or malabsorption. I don't see any reason to think PWME are likely to need to take magnesium.

I haven't looked at the evidence for oral magnesium supplementation. The NIH fact sheet that I quoted above says that overt deficiency is rare, but that magnesium inadequacy is fairly common due to some health conditions and some drugs. Maybe a restricted diet and/or diarrhoea might be reasons for someone with ME/CFS to be lowish in magnesium? I guess it could be worth having a look at the evidence.

But, as far as I can see, the transdermal solutions are almost certainly just a waste of money.

 

[livinglighter]

A few years back, I was advised to take magnesium by a fatigue clinic practitioner. I never did as I wasn't told why I should or pointed to any evidence that explained the reasoning.

I've recently had some blood tests back, which demonstrate very high elevated creatine kinase and lactate, which could result from several things, including neuromuscular. I'm now wondering if the magnesium recommendations could be linked?

 

[Midnattsol]

That looks highly implausible. The paper Hutan quotes confirms the as a highly hydrated ion magnesium in solution is not going to cross the epidermis much. And if it does it will first reach dermis and dermal circulation and be cleared. It is pretty well impossible for it to have a therapeutic effect on a muscle deeper down without spreading everywhere else.

As I said, repeating what I've been taught. The evidence behind it is not presented alongside the lectures

It's the same in Norway as the NIH fact sheet states, overt deficiency is rare, but inadequacy is common for a number of reasons. In some groups more so than others.

 

[Amw66]

Magnesium is one of the few supplements which makes a difference for us .

The type may be important.

My aunt did magnesium injections and these made a difference in terms of energy but also they appeared to reduce heart palpitations at night. ( Stopped and restarted to check this whilst maintaining the same diet for 4 weeks) . I know quite a few who inject and tell me this is the only way they feel benefit. Cheney found this I think .

We can't do magnesium transdermally . My daughter described it as like 3rd degree burns. Seemingly this means you are deficient.

We used citrate and malate and have used a buffered version too but swallowing and gut issues mean that we are using liquid and Epsom salts.We have also cut supplements down to a minimum.
For us it does make a difference.

We did the Myhill ATP test early on. Whilst now discredited , I found it interesting in that the " energy score" results corresponded accurately to the Bell disability scale.
The Magnesium aspect of this test found very low levels of magnesium.

My understanding is that like calcium , magnesium blood levels are fairly constant ( perhaps related to maintaining cardiac function ) and it can be pulled from tissues to maintain a datum in blood. This may be wrong - I picked it up from somewhere early on and it has kind of stuck in my memory.

Tissues may be a different matter.

ETA - if calcium channels are affected then this might provide an explanation for magnesium
ETA ,changed vitd to calcium per @Midnattsol comment

 

[Midnattsol]

My understanding is that like vitD , magnesium blood levels are fairly constant ( perhaps related to maintaining cardiac function ) and it can be pulled from tissues to maintain a datum in blood. This may be wrong - I picked it up from somewhere early on and it has kind of stuck in my memory.

Are you perhaps thinking of calcium not vitamin D? Vitamin D levels would not be described as "farly constant", although with calcium it takes a lot for them to get out of range. I've heard magensium can be sequestered from bone like calcium is to maintain serum levels, but I've tried looking for the source and can't say I've had any luck.

 

[Amw66]

Are you perhaps thinking of calcium not vitamin D? Vitamin D levels would not be described as "farly constant", although with calcium it takes a lot for them to get out of range. I've heard magensium can be sequestered from bone like calcium is to maintain serum levels, but I've tried looking for the source and can't say I've had any luck.

Yes thanks @Midnattsol. Now having my morning coffee to kick-start my brain

 

[Mij]

I took injections back in early 2000 for a couple of years to bring up my mg stores.

We've been taught that transdermal magnesium is an alternative to oral, but I don't know what evidence is behind this. As we know health care can also but into hype

This is the 'evidence' I based my usage on. I use mg chloride transdermal aloe gel twice a week for the last 12 years.

I trust the results from ExaTest who have no financial interest.

https://www.ancient-minerals.com/transdermal-magnesium/

Upon being introduced to the potential of liquid soaks for magnesium and natural DHEA stimulation, Dr. Shealy, a trained neuroscientist and medical researcher who studied at Duke University, performed experiments to test the ability of the skin to absorb magnesium.

Sixteen individuals with low intracellular magnesium levels were enlisted in his study. Participants were instructed to perform a 20 minute foot-soak daily with transdermal magnesium chloride bath flakes, in additional to spraying their entire body once daily with magnesium oil. Intracellular magnesium levels were assessed on all participants after 4 weeks, utilizing a diagnostic called ExaTest. The results – 12 of the 16 participants in the study showed marked improvements in their intracellular magnesium levels.

Averaged diagnostic results after 4 weeks of daily body spraying and foot soaks:

Electrolyte Name: Before: After: Reference Range:

 

[Mij]

I agree with JE that there is no reason to assume that pwME in particular have low mg stores, malabsorption issues are not uncommon for pw chronic illnesses. I had/have many other deficiencies, not just mg.

An interesting thing I observed back in the late 90s and early 2000s is that my Mg stores dropped quickly when I started running again. My health was improving but I started experiencing PEM. I didn't understand what PEM was back then so I continued to run after I 'recovered'.

@Jonathan Edwards is there a possibility that aerobic exercise uses up more Mg for pwME to fuel ATP? I spoke to a biochemist during a consultation and he advised me to stop aerobic exercise based on my OAT, but he said to absolutely continue mg/taurine shots for a while longer.

 

[Wonko]

I use a capsule called 'ZMA' - which is a mix of magnesium (citrate I think), zinc and B6.

It improves my sleep, in general.

I've gone from sleeping 2-4 hours most nights to sleeping 5-6, sometimes longer (one night recently was 13 hours in bed as well as about 3 hours on the sofa). As well as duration sleep quality also feels better.

I also tend to get to sleep much faster, generally within an hour, if it's going to happen, where it used to commonly be several hours before I could fall asleep.

The only other supplement I am currently taking is D3, but I am also taking prescribed meds as well, a statin, blood pressure meds (calcium channel something and something else), a diabetes med with a weird and unrememberable name, but the thing I am led to believe may impact on magnesium is co-codamol.

My diet 'should' give me enough magnesium, but it's possible, according to probably woo woo science, that the co-codamol is sucking it out of me

Regardless...it seems to help, with sleep anyway.

 

[FMMM1]

I happened to be looking up TPPP gene, i.e. since it turned up in a recent (small) GWAS study in ME/CFS*, and I noticed that magnesium got a mention:

"Entrez Gene Summary for TPPP Gene

• Enables several functions, including GTPase activity; magnesium ion binding activity; and protein homodimerization activity. Involved in several processes, including microtubule cytoskeleton organization; negative regulation of tubulin deacetylation; and positive regulation of protein polymerization. Located in several cellular components, including mitochondrion; mitotic spindle; and perinuclear region of cytoplasm. Colocalizes with microtubule and microtubule bundle. [provided by Alliance of Genome Resources, Nov 2021]"
  https://www.genecards.org/cgi-bin/carddisp.pl?gene=TPPP

*thread here:
https://www.s4me.info/threads/genet...ential-risk-loci-2022-hajdarevic-et-al.25070/

 

[TigerLilea]

I've gone from sleeping 2-4 hours most nights to sleeping 5-6, sometimes longer (one night recently was 13 hours in bed as well as about 3 hours on the sofa). As well as duration sleep quality also feels better.

I also tend to get to sleep much faster, generally within an hour, if it's going to happen, where it used to commonly be several hours before I could fall asleep.

I also sleep really well when I'm taking magnesium supplements. I get to sleep within about 15 minutes and if I wake up during the night I get back to sleep within 10 minutes. The only problem is that after a few weeks of taking magnesium every night I can't stay awake during the day. I can't think. I can't function. Therefore, I can't take magnesium supplements on a daily basis. Now I take them once or twice per week. I know someone else who has the same problem and her Nephrologist told her that some people have that problem with supplemental minerals.

 

[Hutan]

This is the 'evidence' I based my usage on. I use mg chloride transdermal aloe gel twice a week for the last 12 years.

I trust the results from ExaTest who have no financial interest.

https://www.ancient-minerals.com/transdermal-magnesium/

Mij, that study is the one I mentioned first in my post above. Dr Shealy is the founder of the Americas Holistic Medical Association. According to the paper I quoted, his study was only published as an abstract at a conference. It wasn't published in a journal with peer review. And it's quoted on a website that sells transdermal magnesium.

There's a mention of one of the first studies of transdermal magnesium absorption was published in 2000 by the founder of the Americas Holistic Medical Association, an early advocate for the benefits of transdermal applications of magnesium. But, only an abstract for a conference without data was published to support the claimed improvement in magnesium deficiency from transdermal application.

 

[Mij]

@Hutan thanks. I missed that. I don't absorb supplements so will continue with the transdermal application.

It's possible that it does absorb somewhat? The abstract that was posted does show lower calcium and potassium status after 6 weeks from applying mg chloride. This is exactly what happened to me when I took mg shots for almost 2 years.

I bought a liter of mg chloride around 10 years ago and only half way through, so it's not costing me much.

 

[Wonko]

Something is being absorbed, or leached, at least in my case.

Using mg salts in a bath causes me to be edgy, anxious, whatever the word is.

Not using them, in the same bath, that doesn't happen.

So something is being transfered one way or the other.

 

[Mij]

My heart started racing really fast when I added 2 cups of epsom salts to my bath water. At first I thought it was the warm water, but that racing didn't occur with water on it's own. I'm not sure what that was all about so I stopped taking epsom salt baths and just use the transdermal.

 

[Hutan]

Dr Shealy has a website selling magnesium solutions, among other things. He looks pretty dodgy, although I guess that doesn't mean products he has promoted necessarily are useless.

Welcome to the Shealy-Sorin Wellness Store! Here you will find a curated collection of our proprietary health & wellness products & brands we trust! All products here are specifically recommended by us at the Shealy-Sorin Wellness Institute. We never recommend a solution without definitive scientific proof & that we use ourselves and our own family!

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It's possible that it does absorb somewhat?

I don't know, maybe? It's just that I can't find convincing studies to show that it does. It's weird that so many brands of magnesium solution are promoted and sold, and yet the evidence for the product is so sparse.

The Israeli army magnesium-rich cream that was applied 3 times a day for 3 days made no difference to magnesium levels in the blood. But it sounds as though the body keeps magnesium levels in the blood quite constant - so maybe serum levels don't say much about levels in the tissue?

There was this study -

Also in a study on isolated human cadaver skin, no significant difference could be found for the skin penetration of magnesium from solutions containing magnesium chloride (MgCl2).

But given magnesium doesn't passively infuse through a cell membrane and has to be actively transported, the cells in cadaver skin maybe weren't doing much actively.

 

[Mij]

From his website. The all caps and exclamations marks

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1. We NEVER promote solutions without DEFINITIVE Clinical Proof!

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