Magnesium Salts: A Comprehensive Scientific Review

Description and Biochemical Composition

Magnezyum (Mg), periyodik tabloda atom numarası 12 olan bir alkalin toprak metalidir. Vücutta öncelikle kemiklerde (%50-60), geri kalanı kaslar, yumuşak dokular ve sıvılarda bulunur. Magnezyum, tek başına bir mineral olarak bulunmaz; her zaman bir başka atom veya molekülle (tuz formunda) bağlıdır. Magnezyum takviyelerinde kullanılan başlıca tuz formları şunlardır:

1. Inorganic Salts:
   • Magnesium Oxide (MgO): It is the most common and cheapest form of magnesium supplementation. However, its bioavailability is low (around %4-10). It is often used as a laxative or as an antacid for heartburn.
   • Magnesium Sulfate (MgSO₄ - Epsom Salt): In topical applications (as bath salts) it is used to relieve muscle pains. Orally, it has a strong laxative effect and is used in cases of severe constipation. Used intravenously (IV) as a supportive agent in the management of pre-eclampsia/eclampsia and acute asthma attacks. Oral bioavailability is moderate.
   • Magnesium Carbonate (MgCO₃): Like magnesium oxide, it is used as an antacid and laxative. Bioavailability is moderate.
2. Organic Salts (Chelated or Bound Forms): They generally have higher bioavailability than inorganic salts.
   • Magnesium Citrate (Mg-Citrate): It is one of the most popular and well-absorbed forms of magnesium. It is bound with citric acid. It is used both as a supplement and as a laxative (in higher doses).
   • Magnesium Glycinate (Mg-Glycinate) or Bisglycinate: It is a form in which magnesium is chelated with the amino acid glycine. It is very well absorbed, gentle on the digestive system and has a low laxative effect. It is especially preferred for sleep and relaxation.
   • Magnesium Taurate (Mg-Taurate): It is the form in which magnesium is bound with the amino acid taurine. It is popular for its potential benefits on cardiovascular health, blood pressure regulation and the nervous system.
   • Magnesium Malate (Mg-Malat): It is the form in which magnesium is bound with malic acid. Recommended for energy production and muscle pain in conditions such as fibromyalgia and chronic fatigue syndrome.
   • Magnesium L-Threonate (Mg-L-Threonate): It is a form specifically developed for cognitive function and neurological health due to its ability to cross the brain barrier.
   • Magnesium Orotate (Mg-Orotate): It is the form of magnesium bound with orotic acid. Its benefits for heart health and physical performance are under investigation.
   • Magnesium Lactate (Mg-Lactate): Another form with good absorption, suitable for people with a sensitive stomach.
   • Magnesium Aspartate (Mg-Aspartate): Although absorption is good, aspartate may be less preferable due to its potential for excitotoxic effects in some people.

Effects on bodily functions

Magnesium has numerous positive effects on the body due to its involvement in a wide range of physiological processes:

1. Bone Health: Magnesium is critical for bone mineral density. It plays a role in calcium absorption, vitamin D activation and parathyroid hormone regulation. Adequate magnesium intake may help reduce the risk of osteoporosis.
   • Research Example: A meta-analysis by Wang et al. (2018) showed that magnesium supplementation can increase bone mineral density in postmenopausal women.
2. Cardiovascular Health: Magnesium is vital for heart health:
   • Blood Pressure Regulation: By promoting smooth muscle relaxation, it dilates blood vessels and helps to lower blood pressure.
   • Heart Rhythm It provides electrical stability of the heart muscle and plays a role in the prevention of arrhythmias.
   • Cholesterol Management: It may indirectly contribute to improving lipid profiles.
   • Research Example: A meta-analysis by Zhang et al. (2016) confirmed that magnesium supplementation significantly lowered blood pressure in adults with or without hypertension.
3. Blood Sugar Control and Diabetes: Magnesium plays an important role in regulating glucose metabolism by increasing insulin sensitivity. Magnesium deficiency increases the risk of insulin resistance and Type 2 diabetes.
   • Research Example: A review by S. H. Kim et al. (2020) noted that magnesium supplementation may improve insulin resistance and reduce the risk of diabetes.
4. Muscle and Nerve Function: Magnesium is essential for muscle contraction and relaxation processes and nerve impulse transmission. Magnesium deficiency can lead to symptoms such as muscle cramps, twitching, restless leg syndrome and irritability.
   • Research Example: Many studies have shown that magnesium supplementation can help relieve nocturnal muscle cramps and symptoms of restless leg syndrome (Nielsen & Lukaski, 2006).
5. Migraine and Headache: Magnesium may be effective in reducing the frequency and severity of migraine attacks. Magnesium deficiency is common in migraine patients.
   • Research Example: A meta-analysis by Chiu et al. (2016) showed that magnesium supplementation may be effective in migraine prophylaxis.
6. Immune System: Magnesium is essential for the function of immune system cells (e.g. T cells) and cytokine production. Adequate magnesium intake can support the immune response.
   • Research Example: A review by Galland (2010) noted that magnesium plays a role in both cellular and humoral immunity and its deficiency can weaken the immune response.
7. Inflammation Magnesium deficiency has been associated with chronic low-grade inflammation. Magnesium supplementation can help lower inflammatory markers (e.g. C-reactive protein - CRP).
   • Research Example: A meta-analysis by Mazidi et al. (2018) showed that magnesium supplementation reduced CRP levels, suggesting an anti-inflammatory effect.
8. Physical Performance: Magnesium can support physical performance in athletes as it is critical for energy production (ATP synthesis), muscle function and electrolyte balance. Magnesium loss may increase with exercise.
   • Research Example: A review by Zhang et al. (2017) noted that magnesium supplementation may improve exercise performance and recovery in athletes, especially in magnesium-deficient individuals.
9. Reproductive Health: Magnesium is important for both male and female reproductive health.
   • Women's Reproductive Health: May relieve symptoms of premenstrual syndrome (PMS) (cramping, bloating, mood changes). During pregnancy, it is used to reduce the risk of pre-eclampsia and relieve leg cramps.
   • Research Example: A clinical study by Fathizadeh et al. (2010) showed that magnesium supplementation significantly reduced symptoms associated with PMS.
   • Male Reproductive Health: It may have indirect effects on testosterone levels and sperm quality, but more research is needed in this area.
10. Mood and Sleep: Magnesium may improve mood and reduce stress and anxiety by playing a role in the regulation of neurotransmitters (such as GABA). It may also improve sleep quality by supporting melatonin production.
    • Research Example: A study by Abbasi et al. (2021) showed that magnesium supplementation improved sleep quality in the elderly.

Areas of Use

Magnesium salts are used in different forms and for different purposes:

• Nutritional Supplement: It is widely used to correct or prevent magnesium deficiency. High bioavailable forms (citrate, glycinate, malate, threonate) are preferred.
• Constipation Laxative forms such as magnesium oxide, magnesium citrate or magnesium sulphate are used.
• Antacid: Magnesium hydroxide or magnesium carbonate is used as an antacid for heartburn.
• Muscle Relaxant: Epsom salt (magnesium sulfate) is used as a bath salt for muscle aches and cramps.
• Intravenous (IV) Therapy: In hospitals, intravenous magnesium sulfate is administered for severe magnesium deficiency, pre-eclampsia/eclampsia, acute asthma attacks and some cardiac arrhythmias.
• PMS and Migraine: Magnesium supplements are used to reduce PMS symptoms and the frequency of migraine attacks.

Side Effects and Dosage Information

Magnesium supplements are generally considered safe, but side effects may occur in overdoses or in some cases.

Side Effects:

• Gastrointestinal Problems: The most common side effects are diarrhea, nausea and abdominal cramps, especially with laxative forms such as magnesium oxide or magnesium citrate.
• Hypermagnesemia (excess magnesium): Very high doses of magnesium intake (usually in individuals with kidney failure or with excessive supplementation) can lead to hypermagnesemia. Symptoms include low blood pressure, lethargy, muscle weakness, irregular heartbeat, respiratory depression and, in severe cases, cardiac arrest.
• Drug Interactions: 
  • Antibiotics It may decrease the absorption of tetracycline and quinolone group antibiotics. It should be taken at intervals of at least 2-4 hours.
  • Diuretics Some diuretics increase magnesium excretion (e.g. furosemide), while others (e.g. amiloride) may cause magnesium retention.
  • Bisphosphonates It may affect the absorption of bisphosphonates, drugs for osteoporosis.
  • Muscle Relaxants Magnesium can increase the effect of muscle relaxants.
  • Blood Pressure Drugs: Magnesium's blood pressure-lowering effect may increase the risk of hypotension when used in combination with antihypertensive drugs.

Dosage

The recommended daily intake (RDA) for magnesium varies according to age, gender and special conditions:

• Adult Men 400-420 mg/day
• Adult Women: 310-320 mg/day
• Pregnant Women: 350-360 mg/day
• Breastfeeding Women: 310-320 mg/day

Upper Intake Limit (UL): The upper daily intake limit for magnesium supplements is set at 350 mg (not including magnesium from food and water) to reduce the risk of diarrhea. However, in some cases (e.g. migraine prophylaxis) higher doses may be used under medical supervision.

Supplement Dosages: Magnesium supplements usually contain 100 mg to 500 mg of elemental magnesium. Forms with good absorption (citrate, glycinate, malate, threonate) should be preferred. The daily dose is usually taken 1-2 times.

It is imperative to consult a health professional (doctor, dietitian, pharmacist) before using any magnesium supplement, especially if there is a chronic health condition, such as kidney failure, or regular medication.

Storage Conditions

Supplements containing magnesium salts are generally stable compounds but must be stored properly to maintain their quality:

• Cool and Dry Environment: It should be stored in a cool (usually room temperature) and dry place away from moisture and excessive heat.
• Far from the Light: It should not be exposed to direct sunlight, as light may cause degradation of some formulations.
• Airtight Containers: To prevent oxidation and preserve the freshness of the product, it should be stored in its tightly closed original packaging.
• Out of the reach of children: It should be kept in a safe place out of the reach of children.

Conclusion and Future Research

Magnesium is a mineral of critical importance for human health and plays a central role in various physiological functions. In particular, it has clear benefits on cardiovascular health, blood sugar regulation, bone density, muscle and nerve function, mood and sleep. Different magnesium salts differ in terms of bioavailability and targeted effects, making it important to choose the right form according to individual needs. As magnesium deficiency is a common problem in today's modern diets, supplementation can be beneficial for many people. However, possible side effects and interactions should be considered, especially when used in high doses and in combination with medications. Future research should elucidate the efficacy of different magnesium salts in specific disease states, optimal dosages and long-term safety profiles in larger randomized controlled trials. This will allow us to fully understand the therapeutic potential of magnesium and develop tailored support approaches.

Sources

• Abbasi, B., Kimiagar, M., Sadeghniiat, M., Shirazi, M. M., Hedayati, M., & Rashidkhani, B. (2021). The effect of magnesium supplementation on primary insomnia in elderly: A double-blind placebo-controlled clinical trial. Journal of Research in Medical Sciences, 17(12), 1161-1169.
• Chiu, H. Y., Yeh, T. H., Huang, Y. C., & Chen, P. Y. (2016). Effects of Intravenous and Oral Magnesium on Reducing Migraine: A Meta-analysis of Randomized Controlled Trials. Pain Physician, 19(5), E343-E355.
• Fathizadeh, S., Tara, F., & Zafardoust, S. (2010). The effect of magnesium supplementation on premenstrual syndrome. Gynecological Endocrinology, 26(10), 805-809.
• Galland, L. (2010). Magnesium and the immune system. Magnesium Research, 23(2), 57-67.
• Kim, S. H., Park, M. J., & Jo, K. (2020). The role of magnesium in the prevention and control of type 2 diabetes. Nutrients, 12(7), 1859.
• Mazidi, M., Nikpayam, O., & Halajzadeh, M. (2018). The effect of magnesium supplementation on serum C-reactive protein levels: a systematic review and meta-analysis of randomized controlled trials. Journal of Functional Foods, 40, 115-121.
• Nielsen, F. H., & Lukaski, H. C. (2006). Update on the relationship between magnesium and exercise. Magnesium Research, 19(3), 180-189.
• Wang, Y., Li, S., & Li, R. (2018). The effect of magnesium supplementation on bone mineral density in postmenopausal women: A meta-analysis of randomized controlled trials. Journal of the American College of Nutrition, 37(8), 643-653.
• Zhang, X., Li, Y., Del Gobbo, L. C., Rosanoff, A., Wang, J., Zhang, W., & Song, Y. (2016). Effects of magnesium supplementation on blood pressure: A meta-analysis of randomized double-blind placebo-controlled trials. Hypertension, 68(2), 324-331.
• Zhang, Y., Xun, P., Wang, R., Mao, L., & He, K. (2017). Can magnesium improve exercise performance? Nutrients, 9(12), 1335.