Dr. Richard Firshein

CHAPTER 3. MAGNESIUM: Nature's Great Relaxer

It might be hard to believe, but a substance that could help prevent America's No. 1 killer, heart disease, is right on the shelf of your local health food store. This natural mineral is found everywhere in life, from fish to barley to spinach. Magnesium. You've probably heard of it before but never really considered its importance. I believe magnesium is the most significant healing mineral we have.

Magnesium is one of the most essential nutrients in maintaining optimal health. It's a mineral that bathes the cell and seems to stabilize it, calming your body at a metabolic level, a microscopic level. If there is a tendency-whether in the cells of your heart or lungs, your muscles or blood vessels-to over-react, magnesium soothes and relaxes the body.

Research on magnesium's benefits dates back to the early 1930's, and recently we've seen a renaissance in our study of this mineral. It turns out that at the beginning of the century, most Americans got about 1200 milligrams of magnesium a day in their diet, while today the minimum RDA is about 400 milligrams. And not all of us get even that. We don't eat enough whole grains, fruits and vegetables to fulfill our needs for this crucial mineral. A recent Gallup survey revealed that 72 percent of adult Americans are falling short of the recommended dietary allowance for magnesium. It also found that an astounding 55 percent of adults consume 75 percent or less of the recommended daily allowance, while 30 percent are eating less than half the required amount.

Modern chemical farming and food processing is partly to blame for our magnesium deficiency. Worse yet, we lose almost 40 percent of the magnesium content in our food when it is cooked. And our bodies need magnesium more than ever, since our polluted air and water can interfere with the mineral's function in the body.

The elderly are even more at risk than the young. The Gallup survey showed that magnesium consumption decreases with age. Seventy-nine percent of adults 55 and over eat well below the RDA for magnesium, and 66 percent receive less than three-quarters of their allowance from food.

A dietary deficiency of magnesium can be a major factor in the development of life-threatening illnesses like heart disease and diabetes, as well as in chronic fatigue syndrome, asthma, muscle cramps and migraine headaches. It is even implicated in osteoporosis. Study after study clearly shows that magnesium is the missing link between these ailments and good health. In fact, I take it every day myself, to prevent asthma attacks.

How can such a common mineral be so significant-and overlooked?

The Secret of Magnesium

Magnesium might be called life's lubricant. It's like an hour of intercellular meditation which relaxes and expands blood vessels, stops muscles from cramping, prevents inflammation, and allows energy to be used more efficiently. How does it do this? One simple way is this: magnesium blocks the influx of calcium into the cells.

Magnesium and calcium compete and cooperate, one flowing into the cell while the other flows out, and it is the balance of both that is supremely important. They allow the cell to excrete what it does not need or want, and to absorb necessary nutrients. Calcium both elevates your blood pressure when necessary (say, during exercise) and contracts your muscles. However, while calcium is essential for contraction, excess availability of calcium can lead to serious problems-a state of sustained contraction that can show up in many different illnesses. Even in rigor mortis, a stiffening of the body that occurs after we die, calcium remains in the cell, while magnesium drains out.

When magnesium levels are low, the body releases stress hormones and substances that constrict blood vessels, and cause the blood to clot more easily. In turn, stress of any kind, whether physical or emotional, increases the need for magnesium. Take the stress of marathon running: magnesium supplements improve endurance and reduce cramps and fatigue in athletes. And in these runners, magnesium is commonly depleted. In fact, one study of five marathon runners found that the four runners who did not receive any magnesium supplements experienced a steady fall in blood levels of magnesium during the race (monitored by blood samples drawn at six different times).

STOP HEART ATTACKS AND STROKES

Despite the incredible advances modern medicine has made in the last twenty years, heart attacks are still the nation's single leading cause of death. Even though we understand the importance of a diet low in saturated fats, and the preventive impact of exercise, most of us know little about magnesium, the one mineral that can do the most to help us.

Many researchers now believe that magnesium deficiency can be linked to hardening of the arteries and hypertension. They've discovered that many heart attack victims have low magnesium levels in their blood and heart muscles. Researchers even consider magnesium deficiency a contributing factor in atherosclerosis, the accumulation of fats within the arterial walls.

Research into magnesium and heart disease is so encouraging that I don't know why every cardiologist doesn't prescribe this mineral as a matter of course. This mineral can treat mild to moderate hypertension as well as some drugs. For instance, a recent study in the British Medical Journal of 100 middle aged and elderly men and women found that magnesium supplements lowered blood pressure by almost 8 points. Another study of 30,000 male health professionals found that the combination of dietary fiber, potassium and magnesium lowered the risk of high blood pressure. A 1996 study of German men found that magnesium was beneficial in treating heart attacks - helping to minimize damage. And a 1995 study of early deaths resulting from strokes found that magnesium supplementation was a significant protector.

HOW DOES IT WORK?

How does magnesium heal the heart and blood vessels? Like a symphony conductor, magnesium orchestrates the complex process that keeps the heart beating with regularity and precision. In its function as a cellular lubricator, magnesium is critical to the continued health of our hearts. A severe lack of magnesium can cause muscle spasms, and without enough magnesium present in the blood to play the role of the body's great relaxer, a coronary artery supplying the heart muscle with oxygen can suddenly clamp shut without warning.

Amazingly enough, 25 percent of all heart attacks occur in people with clean coronary arteries that are otherwise free of the junk-food-created garbage usually associated with heart disease. So, what's killing these healthy people? Numerous studies suggest that people who die suddenly from ischemic heart disease, an oxygen-starved heart, often have tissues severely depleted of magnesium. And research shows that treatment with intravenous magnesium improves the survival of patients who have just suffered a heart attack.

In a recent study at John Hopkins, 18 subjects admitted for cardiac surgery were discovered to have extremely low levels of intracellular magnesium, and intravenous magnesium corrected these levels.

When we lack magnesium, calcium deposits can accumulate in our soft tissues. The risk of a spasm in the muscular tissue surrounding a coronary artery-the source of all blood and oxygen for the heart-is greater. Since most women taking calcium to prevent bone loss are post-menopausal (and at greater risk for heart disease), magnesium should be a staple of their diet as well.

Many individuals with coronary artery disease are usually placed on drugs called "calcium channel blockers" which function to increase magnesium in the cell; their side effects include dizziness, fatigue, and disorientation.

The American Heart Journal, in an editorial written by leading heart disease researchers, described magnesium as "Nature's channel blocker." Magnesium is critical in maintaining the natural balance of calcium both in and outside of cells. Without it, the calcium scale tips too far in one direction, leading to a variety of conditions which can affect the heart and blood vessels. These include problems such as hypertension and heart disease.

WHAT'S HIDING IN YOUR RED BLOOD CELLS?

I use a special test to measure how well your red blood cells are able to carry magnesium. Often a regular blood panel will show adequate levels of magnesium, which can mask a true, underlying deficiency. Magnesium may be floating in the blood itself, but cells may not absorb it. However, if magnesium cannot actually get into the cell, it cannot work. Since magnesium is carried to cells all over the body through the blood, and the proper functioning of red blood cells is greatly dependent on magnesium, a test for red blood cell (RBC) magnesium levels is important. Many patients with asthma, heart disease, and diabetes have low levels.

THIS MINERAL MAY BANISH FATIGUE FOR GOOD

"I'm so tired." I hear that statement from many of my patients. No matter what the illness-whether it's as serious as diabetes or heart disease, or as mild as allergies and malaise-fatigue is often a cardinal symptom. Clearly, it's an immensely important signal that something has gone awry. Patients who are fatigued are frightened as well-they wonder if they're ever going to feel energetic again. And because it is so commonplace, even among those of us who are healthy, I am addressing it first.

Sometimes I think that, just as the Eskimos have dozens of words for "snow"-words that describe whether the snow is soft, fresh, days old, turning to ice-we ought to have different words for different kinds of "fatigue." The fatigue that hits when you've just gone for an hour's bike ride or a mile long swim. The fatigue that fells you when you get a bad flu. Every bit of your body seems to hurt. The fatigue that follows a sleepless night.

I've had patients tell me that their fatigue is so persistent it seems to have penetrated to the very core of their being. Those suffering from fibromyalgia, an increasingly common muscle disorder, experience deep, and painful muscle fatigue. The approach I take to fatigue is a good example and template of my nutritional approach to all kinds of illness.

What, then, is fatigue?

It's a good question, and a hard one to answer. Fatigue is both the most common and the most elusive condition I see. It's the problem few doctors take seriously, and yet it's the foundation of a wide range of illnesses. Yet how do you actually describe fatigue? You can't measure it in the blood or urine. There is no test to prove that somebody is exhausted. Fatigue is unlike other conditions. You can see the changes in an arthritic joint, you can measure blood sugar elevation in diabetes, you can perform pulmonary function tests in asthma, and you can run an EKG in heart disease. You can even measure high levels of viral antibodies in the blood of patients suffering from chronic fatigue immune dysfunction syndrome (CFIDS)-an immune disorder in which fatigue is a major symptom.

But if you are simply tired-just plain old exhausted--the only proof is that you say so. How is a doctor going to treat that?

As noted before, magnesium allows our muscles to relax. If our bodies become calcium deficient, we can borrow from the large reserves contained in our bones, but when our bodies become magnesium deficient, we must borrow from the already low supply in our muscles. But as our muscles lose magnesium, calcium charges in to replace it, and as a result, our muscles grow tense and cramped. This can result in debilitating problems, especially in the case of chronic fatigue syndrome.

Magnesium has had a profound impact in the treatment of this disease.

Chronic fatigue syndrome, according to the Centers for Disease Control, is a diagnosis of exclusion, meaning that certain conditions must be ruled out before a true diagnosis can be made. There are specific major and minor criteria that must be fulfilled for at least a six month period. Some of the conditions that are ruled out include hypothyroidism, lyme disease or other chronic illnesses such as diabetes, hypoglycemia or multiple allergies.

A recent article in Health Watch, a publication of the CFS Research Foundation, showed magnesium to be the single most critical supplement for patients with chronic fatigue syndrome (CFS). It is known that intracellular magnesium deficiencies exist in patients with this disorder.

A lack of magnesium in the cells would disrupt the flow of energy that causes muscle relaxation and a regular heartbeat. Some pioneering doctors have started treating CFS patients with magnesium injections, and found them helpful.

As part of the treatment for CFS, I also take a comprehensive look at the patient's condition and check for any allergies the patient might have, since 80 percent of chronic fatigue patients suffer from them. I also check for nutritional and hormonal deficiencies.

A MINERAL MEANT FOR WOMEN?

Women might be pleased to learn that by adjusting their diet slightly and adding daily magnesium supplements, they could banish the more unpleasant symptoms of PMS. It's been discovered that women suffering from headaches, intense muscle cramps and fatigue had extremely low levels of RBC magnesium, leading many researchers to conclude that such painful problems, usually treated with aspirin or Tylenol, could be caused by magnesium deficiency.

In a recent study reported in Family Practice News, women were given doses of oral magnesium three times a day for two weeks prior to the onset of menstruation. This managed to reduce the severity of PMS and the duration and intensity of PMS-related migraines. A 1991 study, in the journal Headache, found that women suffering from migraines triggered by their menstrual cycle had lower levels of magnesium.

I've been impressed by magnesium's ability to alleviate PMS symptoms. Even when migraines are not pre-menstrual, magnesium can help. A 1996 study in a journal devoted to studying only headaches evaluated 81 patients between the ages of 18 to 65. One group was given 600 milligrams of magnesium daily, while the other group took a placebo. After 12 weeks, there were 41% fewer headaches in the magnesium group, and only 15% fewer headaches in the placebo group.

There is also a tremendous need for magnesium in the early stages of pregnancy, and researchers estimate that pregnant women only get 50 to 60 percent of the RDA of magnesium in their diet. Studies have shown that magnesium helps prevent migraine headaches, especially in pregnant women.

For sudden and excruciating headaches and migraines, I sometimes use an IV solution containing magnesium, along with other vitamins and minerals. This natural approach almost entirely eradicates the pain, in about twenty to thirty minutes. Often this is all that's necessary to break a migraine, and no drugs are needed. For many patients who endure frequent migraines, the severity and duration of the headaches are greatly reduced, and in a few cases, the headaches have not returned at all.

BRITTLE BONES: DON'T RELY ON CALCIUM ALONE

Calcium builds healthy bones, right? Yes and no. Though calcium has been hailed as an osteoporosis preventive, it is not the only answer. Magnesium is just as important.

Milk mustaches on celebrities, bottles of calcium stacked on shelves in pharmacies, drugstores, supermarkets, and health food stores, and countless articles on calcium's benefits have obscured the importance of its sister mineral, magnesium. Magnesium can combat osteoporosis, too. Magnesium can help prevent fractures and increase bone density. It appears to have a direct effect on the parathyroid hormone, which is associated with low calcium levels. Many elderly patients have problems with malabsorption of minerals, and they may using diuretics for blood pressure problems. In both cases, magnesium is excreted, and low levels of the mineral contribute to porous, brittle bones.

Many women are advised to take estrogen and calcium together, but that can also worsen magnesium deficiency. Estrogen has been shown to increase blood clotting, which may raise the risk for circulatory and heart problems. Magnesium can help combat this problem. In a study of 31 women, bone density increased by as much as 8% after two years of magnesium supplementation. In an untreated group of women monitored over the same two years, bone density decreased significantly.

I advise supplementation with both calcium and magnesium as a preventive measure for all my patients who are going through menopause, or have passed through menopause already.

BREATHE EASY AT LAST

Asthma is epidemic in our time. Fifteen million Americans now suffer from this devastating condition, and it is the primary cause of hospitalization in children. We spend $6 billion a year on asthma treatment, and our solution so far has been the use of potent and sometimes harmful drugs, along with minimal exposure to allergens when possible.

Many studies show that magnesium is a key mineral in treating asthma. A 1996 European study found that magnesium diminishes the "bursting" of inflammatory white blood cells that often occurs in asthma, and which begins a cascade of reactions that result in wheezing and rawness. A study of asthmatic children treated with IV magnesium showed that this mineral alone improved lung function, and another study of IV magnesium in adults, in 1995, found that the mineral dramatically reduced hospitalizations.

Is it really possible that something as simple and abundant as magnesium might arrest devastating asthma symptoms? I take it myself for my own asthma, and it has helped tremendously. I've also seen it work in my practice again and again. Magnesium, along with fish oils and other herbs and nutrients, is a mainstay of my natural approach to reversing asthma. Every asthmatic patient of mine takes oral magnesium, and many receive the mineral in IV form until their asthma is stabilized.

How does it work? Magnesium relaxes the bronchial muscles and prevents them from overreacting to allergic stimuli. It also seems to quench or calm the allergic response. In a sense, magnesium's effect is not that different than bronchodilators and steroids, but instead of causing side effects like dry mouth and nervousness, magnesium leaves the patient in a calm state of well-being. That's because it also helps relax the entire body, calming the central nervous system.

Whether magnesium is given to children or adults suffering from asthma, it is one of the most effective and natural aids available.

CAN MAGNESIUM KEEP DIABETES UNDER CONTROL?

A Gallup survey of five hundred adults with diabetes reported that 83 percent consumed insufficient magnesium from foods. Both Type I and Type II diabetics are susceptible to magnesium depletion, but type II patients are at a greater risk. Magnesium depletion is a common but sometimes unnoticed problem in diabetic patients, damaging their heart function and glucose control.

Magnesium deficiency is the most common disturbance in mineral metabolism observed in insulin-dependent diabetics. The body needs magnesium to create insulin naturally, and studies have shown that insulin resistance is definitely connected with magnesium depletion. A Viennese study in 1992 found that low magnesium actually contributes to insulin resistance, and there was a marked improvement in the control of diabetes when magnesium was added to the diet.

Research indicates that raising the low magnesium levels in diabetic patients improves cardiovascular function and glucose control. Although magnesium cannot "eliminate" diabetes, it can help enhance insulin function, thereby preventing or warding off many of the serious complications associated with this illness, such as blood vessel damage.

MAGNESIUM AND YOU

Magnesium is one of the most important and healing minerals in the body. It can help prevent some of the most serious ailments we face: heart disease, asthma and diabetes. It can also treat less serious but nonetheless frustrating, chronic conditions, such as fatigue, mitral valve prolapse, muscle aches and spasms.

Now that you know that magnesium is just as important as vitamin C or vitamin E, you can add it to your diet, through foods and supplements.

Magnesium-rich foods are available at your local health food store and even at the corner grocery. Rich food sources of magnesium include wheat germ, wheat bran, nuts, soybeans, whole grain oats and barley, corn, fish and various green, leafy vegetables. Bottled mineral waters also contain magnesium. And for those of us who need extra magnesium in addition to our diet-perhaps because of an inherited risk for heart disease or diabetes-magnesium supplements are easily available in your health food store. I recommend magnesium aspartate, which is easily absorbed, or citrate, which is the least expensive type of magnesium available. For the average individual, I would supplement between 300-500 mg daily. For serious conditions like heart disease or diabetes, higher doses may be recommended; however, magnesium can trigger diarrhea. Higher doses should be monitored by a knowledgeable physician.

Even after all my experience with magnesium's healing powers and the many patients I've seen it help, I sometimes find myself amazed to think that such a simple mineral could help in such a wide range of health problems. Sometimes the simplest cures are the best.

HOW MUCH SHOULD I TAKE?

For General Health
100-25- milligrams a day
Special Conditions
Leg cramps 300-400 mg/day
Fatigue 400-600 mg/day
Heart attack 400-600 mg/day
Hypertension 400-700 mg/day
Palpitations 300-500mg/day
Asthma 200-600 mg/day
Fibromyalgia 400-600 mg/day
PMS 400-600 mg/day
Migraines 400-600 mg/day
Mitral valve prolapse 300-500 mg/day

Note: Consult with your physician before making any changes to your current medication schedule or health program.

by Dr. Richard Firshein