Depression, Anxiety and Magnesium. Does Magnesium play a role in mental health?

Depression, anxiety and magnesium deficiency often co-occur but are regularly overlooked in the mental health field. Magnesium plays a crucial role in more than 350 enzymatic reactions and studies show that a deficiency in magnesium can lead to depression, anxiety and other mental health problems. The purpose of this page is to provide a summary of the importance of magnesium in mental health, some of the signs of magnesium deficiency and ways to correct magnesium deficiency through eating more foods containing magnesium and supplementation.

Magnesium is the fourth most abundant cation (positively charged ion) in the body and, after potassium, is the second most common intracellular cation. A healthy adult human contains about 24 grams of magnesium distributed in various organs and compartments. It is mainly distributed in bones (53%) and intracellular compartments of muscle (27%) and soft tissue (19%). Less than 1% of total body magnesium is found in serum and red blood cells with approximately 0.3% located in serum.

Magnesium plays a role in more than 350 enzymatic reactions involved in energy metabolism and nucleic acid synthesis. It is important for brain function and therefore anxiety and magnesium and depression are crucially interlinked. If you are suffering from magnesium deficiency, you must ensure your magnesium status is increased.

Conditions Associated with Magnesium Deficiency

As magnesium is a critical co-factor in hundreds of enzymatic reactions in the human body, deficiency can affect virtually every organ of the body. Altered magnesium balance has been found in a large range of health conditions. These include diabetes mellitus, chronic renal failure, nephrolithiasis, osteoporosis, aplastic osteopathy, cardiovascular disease (e.g., arthrosclerosis, hypertension, congestive heart failure, arrhythmias, myocardial infarction), obstetric conditions (preeclampsia, eclampsia), neurological disease (stroke, epilepsy), affective disorders, and alcohol withdrawal syndrome. Depression, anxiety and magnesium deficiency are also commonly related.

Food Sources of Magnesium

Primary sources of magnesium in the diet are whole grains (such as brown rice and millet), legumes, seeds, nuts (such as almonds and cashews) and vegetables (particularly dark green, leafy vegetables). Other good sources include soybeans, seafood, figs, dates and garlic^.

Signs of Magnesium Deficiency

Because of magnesium's numerous roles in the body, magnesium deficiency can lead to a large array of symptoms. Below are some of signs of magnesium deficiency:

Skeletal muscle

Backache, neck pain, tension headaches, tightness in the chest, cramps, muscle twitch, jaw joint dysfunction.

Smooth muscle

Constipation, menstrual cramps, urinary spasms, difficulty swallowing, sensitivity to loud noise.

Central nervous system

Hyperactivity, depression, anxiety and magnesium, premenstrual irritability, apprehensiveness, panic attacks, disorientation, confusion, personality changes.

Cardiovascular

Palpitations, angina, high blood pressure arrhythmias, mitral valve prolapse.

Causes of Magnesium Deficiency

With our changing diets and lifestyle, magnesium is often cited as the element most deficient in modern diets. The causes of magnesium deficiency are numerous and are summarised below.

Reduced intake of magnesium-containing foods

Due to increased refining of grain to make processed foods, magnesium intake has steadily declined over the past century. It has been reported that only 3-28% of the original magnesium found in whole wheat remains in refined wheat processed foods.

It is estimated that as a result of our changing diets approximately 68% of US adults consume less than the American recommended daily allowance of magnesium (420mg/day for men, 320mg/day for women), with 19% consuming less than half the RDA. Consumption levels in other countries are unlikely to be much better.

Intake of magnesium-eliminating substances

When consumed in excess or for prolonged periods, many substances increase the renal elimination of magnesium. These include over-the-counter diuretics, coffee, tea, salt, and soft drinks. Medications such as diuretics, chemotherapeutics, immunosuppressive agents and antibiotics have also shown to cause hypomagnesemia due to increased renal loss.

Malabsorption

Malabsorption of magnesium in the ileum results in hypomagnesemia. Situations of decreased absorption include malabsorption syndromes (eg, coeliac sprue, irritable bowel syndrome, Crohn’s disease), radiation injury to the bowel, bowel resection, or small bowel bypass.

Alcoholism

Alcohol acts as a magnesium diuretic causing an increase in the urinary excretion of this element along with that of certain other electrolytes.

Renal disorders

Primary renal disorders cause hypomagnesemia due to decreased tubular reabsorption of magnesium by the damaged kidneys.

Hyperparathyroidism

Parathyroid hormone (PTH) is crucial for magnesium absorption and regulation. Because PTH is necessary for magnesium uptake, severe hypoparathyroidism will lead to magnesium deficiency. A further cycle of deficiency then occurs as magnesium is required for the release of PTH.

Nutrient imbalances

Magnesium requires vitamin D for absorption so deficiencies in vitamin D will adversely affect magnesium levels. The balance between calcium and magnesium is also particularly important as magnesium absorption is inhibited by calcium. Calcium competes with magnesium for the same absorption sites so a high calcium intake needs to be balanced with an increased magnesium intake. Phytates in grains, legumes, and seeds, along with excess fats in the diet can also interfere with magnesium absorption.

Prolonged, excessive stress

Research showed an inverse relationship between, stress, anxiety and magnesium. This means that prolonged, excessive anxiety or stress can lead to magnesium deficiency.

Medical/ health condition

Magnesium excretion is increased during prolonged diarrhoea or vomiting, biliary fistulas, chronic pancreatic insufficiency, acute tubular necrosis, aldosteronism, and diabetic ketoacidosis.

Studies in Magnesium and Mental Health

Research in the area of anxiety and magnesium, depression and magnesium and other mental health problems such as ADHD and bipolar disorder is accumulating. Although further research is required studies to date do show that magnesium deficiency can adversely affect mental health. Below are summaries of just a few studies in this area.

1.       To determine whether there was an association between magnesium intake and depression and anxiety, Jacka and colleagues completed assessments on 5708 individuals aged 46-49 or 70-74 years.  The researchers found that higher depression scores were significantly associated with lower magnesium intake (this was not confounded by age, gender, body habitus, or blood pressure).

2.       Plasma magnesium levels were measured in 15 schizophrenic, 10 depressed and 6 manic and 6 presenile Alzheimer's disease patients and compared with 303 healthy controls. The schizophrenic and depressed patients showed lower levels of plasma magnesium, although the levels were normal in the other two groups of patients.

References

1. Giannini, A (2000) Magnesium oxide augmentation of verapamil maintenance therapy in mania. Psychiatry Research, 93(1): 83-87.

2.  Mousain-Bosc M, Roche M, Polge A, Pradal-Prat D, Rapin J, Bali JP. (2006) Improvement of neurobehavioral disorders in children supplemented with magnesium-vitamin B6. I. Attention deficit hyperactivity disorders. Magnesium Research, 19(1):46-52.

Although further studies in the area of depression, anxiety and magnesium and other mental health problems are required, the research studies reviewed (plus many more) do demonstrate a relationship between magnesium deficiency and mental health conditions such as depression, bipolar disorder, anxiety, ADHD and schizophrenia.

For information about the assessing and treating magnesium deficiency, click here 

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