A quick search on Google Scholar reveals more studies confirming this: [1] [2] [3]. It might be worth trying out, since it seems to be pretty hard to overdose on magnesium unless you have kidney failure. [4]
1 is behind a paywall, so you can't see how many patients were in the study or what the effect size was. 2 and 3 were in mice.
Mice are useful model organisms for many things, but it is very important to remember they are not humans. For one, they have wildly different inflammation responses, (http://blogs.sciencemag.org/pipeline/archives/2013/02/13/mou... ) and inflammation is yet another thing that seems to influence mental illness.
From Journal of Immunology with impact factor 4.92
Note the following quotes are take from an article that's "aim is to sound a word of caution" about the use of mice as a substitute for human studies. Even they note how well mice have served and will continue to serve as a model for human biology.
"Mice are the mainstay of in vivo immunological experimentation and in many respects they mirror human biology remarkably well."
"In this review our aim is not to suggest that the mouse is an invalid model system for human biology. Clearly, with so many paradigms that translate well between the species, and with the relative ease with which mice can now be genetically manipulated, mouse models will continue to provide important information for many years to come. "
Yes, and that is indeed the journal of immunology, which is speaking of mice in a primarily immunological context. One might easily guess that mice are less useful model organisms in neurology.
I think getting the news out about this research could be very important as many people could seek more heavy handed treatment for tiredness, depression and anxiety, not knowing the cause was a simple mineral deficiency.
I used to feel tired all the time, with permanent pain in the neck and the retinas, even though I slept 7 hours a night. After I started taking magnesium, I felt 15 years younger. I could finally get a good night's sleep and my energy recovered. There were also other effects: my sex drive increased, dandruff almost disappeared and my bowel movements have improved.
Another useful mineral for me was Calcium. I got rid of a nagging back pain that affected me for the last 10 years. Other treatments such as massage and exercise had no effect.
It feels like doctors had no idea to check for these two minerals in my case. Even though I visited various specialists and went to a sleep lab to test my brain waves, they had no useful recommendations. Could it be true that doctors have no idea about magnesium and calcium?
Regarding your question at the end - I firmly believe that doctors and day-to-day medical professionals traditionally despise discussions regarding supplementation. This his extremely anecdotal of course, but there seems to be some kind of 'wall' - probably on purpose - where medical professionals believe that only the knowledge on the inside of the wall has merit. This can be seen in the marketing/'re-evaluation' of opiates like Oxycontin, where once the establishment type leadership said it was okay, a lot of doctors started writing up scripts with this encouragement, and now the US is in the grips of a horrible addiction crisis.
It's not that medical professionals don't appreciate healthy living - it's that I frankly don't believe they're trained to promote healthy living. Rather, they treat symptoms. Some things are easier to figure out than others, and anything outside of the 'wall' is more often than not viewed in a negative light.
I don't think it's half as bad as you seem to think. My wife's an NP, so I have an inside view of Syracuse, NY's medical situation. There's two issues at hand:
1. The quality of evidence for most supplements ranges somewhere between Bigfoot and Flat-Earth society. That's not to say it's all bad, but it's generally unstudied and unproven.
That being said: it's standard practice to strongly recommend vitamin D supplements for us northerners. That's reasonably new, high quality supplement data and it's not ignored. There's no bias for these types of medical practitioners, the data's just not there.
2. A lot of older docs are untrained when it comes to new studies about various things: pain meds (don't use them), alternative pain management (can be useful), H. Pylori (a proven explanation for stomach ulcers). These docs don't keep up to date. They're otherwise excellent doctors. Most of them care deeply about their patients and are fiercely defensive of them and their care (exceptions abound, but giving people the benefit of the doubt is a good way to live life a lot happier).
There's tons that's wrong with our medical system, try not to generalize it too far.
Also tell your doctor about ALL supplements you take. Some can react terribly with other medications and supplements.
1. Elsewhere I definitely agree that advertising and claims in the supplement world are a real bothersome issue. However the exact same criticism can be levied at the official medical community which has a habit of prescribing lots of different drugs for things such as "restless leg syndrome" or in the case of Lyrica, advertising it for all sorts of different applications until one finally gets market traction. Selling quick fixes is a long, glamorous and shady business.
Also, in my experience, a good deal of the actual, effective supplements that have been on the market are now illegal for suspect reasons. As in, because it actually works we're going to ban it.
2. A lot of older docs are pretty much what I was getting at, re: the 'wall' of knowledge. They've got long, strong careers in medicine doing things the way they've always done them, occasionally updating their knowledge but not really putting in a lot of effort. That breeds 'know it all syndrome' which, again anecdotally, tends to be a little bit more prevalent in that professional field.
Do you have any examples of where actual, effective supplements have been taken off the market? And if you do, can you say why the removal was suspect?
Sure, the easiest is 4-Androstenedione. It worked as intended. Maybe a little hard on the liver but that's pretty common for the type of compound it was. I say the removal is suspect because the claims of its dangers outwardly appear politically motivated.
Keep in mind this was what Mark McGwire claimed he was taking legally during the height of the steroid era in baseball (which he may have been - but if Canseco is to be believed he was using "real" AAS as well).
Another would be ephedra, in that it did what it claimed, but irresponsible people (apparently) thought eating handfuls of the pills would be a great idea. Several high-profile heat stroke cases as well. I'm not saying it's 100% side-effect free or safe or whatever, but it did what it stated, got a bad rap, and is now banned/illegal.
I'd love to see a comparison between the number of 4-AD and Ephedra related deaths vs. acetaminophen poisoning, which the CDC notes is about 33,000 cases per year (25% unintentional).
It's really just that most nutritional supplements have either low-quality supporting data or contradictory data. The hype surrounding the field of nutrition is not matched by its benefits.
This is not to say that there is no future for it. Rather, it is to say that there is a huge future for it, because at present the field has little to offer backed by strong evidence.
In agreement with you - I'm not trying to really put down the medical establishment outright (they do a lot to resist quackery for sure!) but kind of deal with the lay of the land. I don't think going 'hippie' or all-in with supplementation in nutrition is really going to be a trend within the medical community, but I do think a lot of doctors tend to just, well, use the tools they have. Risk of bad outcomes is real, no doubt, and the US is quite lawsuit happy when it comes to medical cases.
I would definitely like to see more strong evidence regarding supplementation - actually, with a lot of different substances. In a perfect world the DEA wouldn't have the slightest bit of sway in dictating which substances can be researched in traditionally "proper" settings.
When we talk about pharmaceuticals, we talk about financial toxicity. Americans spend over $10 billion on nutritional supplements annually [1], most of which have very poor supporting evidence. Should people be able to spend their money how they see fit? Sure. Are they getting utility from it? Not the utility they're hoping for.
When we talk about healthcare, we talk about financial toxicity. Americans spent $3 trillion on healthcare in 2014 [1], much of which had very poor outcomes. Should the healthcare system get a defacto blank check to charge insurance companies as much as they want? Sure. Are the patients getting utility from it? Not the utility they're hoping for.
I'm not denying there's a lot of unsubstantiated or over-inflated advertising within the supplement market, not at all. It takes hours and lots of digging into personal reviews and other sources to begin to find things that are both 1) effective and 2) legal. It's not a quick fix, which is what most advertising claims to provide.
If we're talking about wasting money and health though, then I think it's equally important to point out that homeopathy is apparently a multi-billion dollar industry as well in the US ($6B in 2012 [1]) and if we're going to rank things on effectiveness, I'm pretty sure homeopathy is just about on par with drinking water from a clean toilet.
In addition, there is some strong evidence linking medium-term St. John's Wort use with cataracts due to photosensitivity. This makes it risky to combine with light therapy, which of course a lot of people do anyway.
Part of me agrees with the monetary aspect, but history and current events have shown that the medical community still doesn't even have solid footing for a lot of 'simple' type issues. Nutrition seems to be a relatively new area of study, as evidenced by the seemingly routine changes in 'official' dietary recommendations. I do think the medical profession is working to incorporate nutrition into their concepts of treatment, but it's going to take a lot of time.
> This can be seen in the marketing/'re-evaluation' of opiates like Oxycontin, where once the establishment type leadership said it was okay, a lot of doctors started writing up scripts with this encouragement, and now the US is in the grips of a horrible addiction crisis.
To be fair with doctors when someone goes along and says "I have crippling back pain" and gets told "You need to lose weight and exercise" they bad mouth that doctor online and then they go to a different doctor.
Well, sure, but the patient doesn't write the script so they're not the one with the power, and if it was 'medically approved' to tell patients how to change their diet, what types of exercise would help, then the patient would simply waste their time going from doctor to doctor getting the same response. Thus the medical community is complicit in taking 'the easy way' in this instance. I'm not a fan of for-profit medicine, which could be somewhat responsible for the patient entitlement complex fueled by commercials which say 'Ask your doctor' but probably mean more along the lines of 'tell your doctor to give it to you' in practical terms.
I take the daily recommended dosage which is marked on the container of the meds, which comes about 400mg/day. It is important to select the right type of magnesium, as they come in many forms (oxide, citrate, taurate, malate etc). I used magnesium citrate. Magnesium oxide is very common but has less efficiency. If you take too much it could cause diarrhea.
You can make your own magnesium bicarbonate solution by adding 90 mL milk of magnesia (Mg(OH)2 aq. susp.) to 2 L carbonated water. This has a taste to it. Some people find it unpleasant, but I think it is tolerable.
I have also used magnesium diascorbate.
The anion does affect the absorption of the magnesium, so 1g of Mg in MgO is not going to have the same effectiveness as 1g of Mg in magnesium citrate. Also, zinc supplementation interferes with magnesium absorption. Generally speaking, the aqueous solubility of the compound predicts absorption rate by the body.
MgO and MgSO4 (epsom salt) are cheap, but poorly absorbed. They will have a laxative effect.
Your entire body has about 25 g of Mg in it, and your kidneys drop about 120 mg of it per day into your urine if you are not deficient. Low magnesium cannot be detected by a blood test unless you are abysmally deficient; the best way is probably a urinary clearance test.
After doing some research, I found that magnesium lactate is the cheapest, most bioavailable, and the supplement with fewer side effects. For example, orotate, taurate, malate, glycinate, and others can give you extra amino acids and you can overdose or break the balance.
> "Dietary deficiencies of magnesium, coupled with excess calcium and stress may..."
Looks like Calcium may be part of the problem, not the solution. Although it is perfectly possible that in your case you had a Calcium deficiency and benefited from extra Calcium. If nothing else, this highlights the fact that people are different!
Calcium and magnesium work together, calcium is necessary for the activity of the nervous system and magnesium for regulating the calcium. I felt no ill effects when taking both, their positive effects seem to add up. Perhaps I had a deficit for both of them. You can test if you have deficit by taking a supplement for a week and if yo feel better, then it means you had a deficiency, but otherwise if you run a blood test it could come out inconclusive (I am not a doctor).
Calcium and magnesium may work together, but they also compete for being absorbed in our bowels, so it's better not to take them at the same time. I'm sure that many people don't know this, but they know that "calcium is good" and "magnesium is good", so they eat a lot of both, not experiencing the positive effects they hope for. Btw. the same is true for zinc and calcium.
I recall the big splash that came with the marketing of ZMA as a supplement[1] for testosterone production quite a while ago. It was something OTC that I tried on several occasions and found to have limited merit. Unlike some other products, I didn't feel the ZMA effects in muscles per se, but noticed significantly deeper (better?) sleep and recovery. If ZMA was assisting in recovery and sleep more than anything, then I could definitely buy into the notion magnesium has quite a few physical and mental upsides as a supplement (with further research!).
What is the recommended procedure to be tested for vitamin/mineral/whatever (vitamin D = steroid?) deficiencies... is it best to head to a random doctor to get blood drawn?
It seems like a good idea to get levels checked regularly - like an annual physical! If there's reliable, low-cost way of getting everything or at least everything important checked I would love to hear about it.
That's part of my yearly(ish) physical. They always tell me I have a vitamin D deficiency, so I take supplements for a few months, forget about it, and I'm deficient again by the next physical.
"If you live north of Atlanta (ahem, Boston), it’s impossible to produce vitamin D from the sun in the winter, because the sun ray’s never get high enough in the sky for the ultraviolet B rays (UVB) to penetrate the atmosphere. This can be a problem for most of us that aren’t lucky enough to have winter homes near the Equator."
That depends on your latitude, altitude, and the season. The type of UV that most effectively produces vitamin D (UVB @ 296 nm) cannot penetrate the amount of atmosphere between you and the sun if it is too low in the sky.
And natural synthesis reaches an equilibrium after about 15 minutes of exposure.
So for many, the most efficient way is swallowing a 10000 IU capsule 1 to 7 times per week.
FWIW I've been doing in the 8-10k range for a bit after reading some other stuff online since my vit. d levels were pretty low, but doctor suggested I tack it back to around 4,000 IU / day max. Still helping, and less risks of (relatively rare), but random side effects.
The fat-soluble vitamins are the ones to watch out for: hypervitaminosis A, D, E. Vitamin D can be frustrating because there's a long delay between when you take supplements and when your levels rise.
Anecdotal Experience follows:
The combination of coffee and exercise was leaving me truly exhausted. I was drinking water but still had signs of dehydration(foggy, listless etc).
Started using rehydration packets EMERGEN-C ELECTRO MIX and instantly(15 min) felt distinctly better than after a liter of straight water. Given the rest of my diet, magnesium was the main probable culprit. I switched to SLOW-MAG and it reduced earlier symptoms. (in theory this was controlling for other electrolytes). My recommendation is to try the Packets first as they effect is within 15 min, although it might take two if you're really dehydrated.
2. I noted that in the first line that this was anecdotal. The implication being that other the comments should be considered just as highly and I offer nothing beyond what is commonly accessible on the web in terms of research, with N=1 additional observations.
3. Despite not being a double blind study(with blood work to corroborate with ground truth, what could in fact be a psychosomatic condition), I varied my choice of supplements considerably and noted those lacking in magnesium provided little benefit.
4. My experience fits what is known in the literature. To quote Carl Sagan,'Extraordinary claims require extraordinary evidence.' but in our case, its effectively an application of occam's razor.
5. Finally, I present what I think is the best way for other people to test if my effect was a placebo effect. The slow absorption isn't nearly as dramatic as the instant with a litter of water. Try it yourself if you think its the case, (not that that will remove the placebo possibility).
From Neuropharmacology, which has an impact factor of 5.1.
"Furthermore, a causal relationship between Mg2+ and anxiety is suggested in mice with low plasma Mg2+ levels which display increased anxiety- and/or depression-related behaviour..."
The hilariously small sample size of this article and the lack of peer review aside, if you want to try this just for the hell of it, be sure to not buy a bunch of magnesium oxide (the cheap stuff), as the bio-availability is terrible (~4%).
In this study, N=small, but nevertheless, I think it is a very interesting article. Because the effects are so rapid, and magnesium supplementation is in general harmless, it is imho definitely a good idea to see if a magnesium deficiency is the cause of the disorder. Please take note that not all magnesium supplements are equal.
From some admittedly not very scientific research into this, it seems that different forms of magnesium are absorbed differently by the body. It is claimed that magnesium oxide is poorly absorbed by the body and can lead to more side effects than other forms of magnesium. Magnesium citrate is supposed to be better, but the best forms are supposed to be chelated magnesium compounds. Chelated magnesium is supposed to be most easily absorbed by the body and best tolerated in terms of side effects.
From personal experience, I will say that I feel better after taking chelated magnesium vs magnesium citrate. The specific chelated magnesium compound I take is magnesium glycinate/lysinate. It has helped ease symptoms of anxiety. I had previously taken magnesium citrate, which ended up making me feel nauseous.
A lot of the sites that come up in google are alternative health sites (Mercola, etc.). Here are two links that may be more reliable:
Also, here is a PDF of a class action lawsuit filed against a manufacturer accused of putting magnesium oxide in their chelated magnesium to cut costs. Has a lot of information on the purported benefits of magnesium and on how the magnesium industry is run:
Very interesting. Can you recommend a specific brand?
By the way, I have noticed that flaxseed oil (1-2 tablespoons/day on some bread) also helps ease anxiety in my case. I have no clue about the mechanism behind it, but I just wanted to mention it.
Flaxseed oil is a good source of an omega 3 essential fatty acid, ALA. Generally most people don't get nearly enough omega 3 - the other source is oily fish. Our nervous system is particularly dependent on it.
Not all forms of magnesium are absorbed equally by the body. The forms mentioned in the article are absorbed well. Other forms, such as "magnesium citrate" are absorbed well.
Some forms of magnesium are better avoided. You can easily find more information by using google.
Here is a diverging opinion, stating that the studies that "proved" this were conducted incorrectly, and the one that had sufficient validity found no difference between chelate, citrate and oxide: http://www.pharmazeutische-zeitung.de/index.php?id=29065
Its in german but Google translate should work well.
BACKGROUND:
To determine in open trials the therapeutic benefit of a nutritional supplement for bipolar disorder.
METHOD:
The sample consisted of 11 patients with DSM-IV-diagnosed bipolar disorder aged 19 to 46 years, who were taking a mean of 2.7 psychotropic medications each at study entry. Three additional patients dropped out prematurely. The intervention is a broad-based nutritional supplement of dietary nutrients, primarily chelated trace minerals and vitamins, administered in high doses. At study entry and periodically thereafter, patients were assessed with the Hamilton Rating Scale for Depression (HAM-D), the Brief Psychiatric Rating Scale (BPRS), and the Young Mania Rating Scale (YMRS).
RESULTS:
For those who completed the minimum 6-month open trial, symptom reduction ranged from 55% to 66% on the outcome measures; need for psychotropic medications decreased by more than 50%. Paired t tests revealed treatment benefit on all measures for patients completing the trial: HAM-D mean score at entry = 19.0, mean score at last visit = 5.4, t = 5.59, df = 9, p < 01; BPRS mean score at entry = 35.3, mean score at last visit = 7.4, t = 2.57, df = 9, p <.05; YMRS mean score at entry = 15.1, mean score at last visit = 6.0, t = 4.11, df = 9, p < .01. The effect size for the intervention was large (> .80) for each measure. The number of psychotropic medications decreased significantly to a mean +/- SD of 1.0+/-1.1 (t = 3.54, df = 10, p < .01). In some cases, the supplement replaced psychotropic medications and the patients remained well. The only reported side effect (i.e., nausea) was infrequent, minor, and transitory.
CONCLUSION:
Some cases of bipolar illness may be ameliorated by nutritional supplementation. A randomized, placebo-controlled trial in adults with bipolar I disorder is currently underway, as well as open trials in children.
NIH points out that "Early signs of magnesium deficiency include loss of appetite, nausea, vomiting, fatigue, and weakness."
And "An analysis of data from the National Health and Nutrition Examination Survey (NHANES) of 2005–2006 found that a majority of Americans of all ages ingest less magnesium from food than their respective EARs"
If Cedars-Sinai's list of magnesium levels in foods[1] is accurate, it seems to me that it'd be kind of hard not to be deficient a majority of days (sources I'm seeing say you need between 300-400mg/day). Add in trying to get enough of all the other things you're supposed to get such-and-such mg/day of and trying to save time/money by not having to cook with 100 different ingredients every week[2] and you're really in trouble if you want to consistently get enough of all this stuff solely from food sources.
[2] It seems that comprehensively nutritious eating is firmly at odds with the typical Internet advice: "you guys are so wrong about how much it costs and how much time it takes to cook at home, just do what I do and make a big pot of rice & beans on Sunday then eat leftovers all week, takes an hour and costs me like $2/day"
It bums me out that HN readers just read and respond to the headline without analyzing the actual content.
My immediate reaction to medical headlines is always to wonder "why should I believe this"? In this particular case the paper tests four people, one of whom is described as only "moderately depressed" and who lost his "craving for smoking, dipping, cocaine and alcohol" with the treatment. I am very skeptical of this magical cure.
(From there, I might also add that the publishing info itself is pretty sketchy (author appears to be some random dude self-publishing, paper cites his own website a lot), but it's a bit ad hominem to rely on this. It's also entirely possible that this hypothesis is correct but I don't think this paper is a good first step on proving that.)
This is exactly right. A quick search for the journal reveals that anything published in it should be taken with a HUGE grain of salt as "The journal's policy placed full responsibility for the integrity, precision and accuracy of publications on the authors, rather than peer reviewers or the editor" [1]
The possibility that magnesium deficiency is the cause of
most major depression and related mental health problems
including IQ loss and addiction is enormously important
to public health and is recommended for immediate further study.
This guy concluded that all depression is caused by lack of magnesium from a sample size of 4 people?
As it is a snow day, I can't get the other articles as well or do a good search (Fallout4 for me, oh shucks).
That said, just because there are only 4 people in a study does not mean that it is a bad article. I agree that the guy is maybe a quack, but that can be said of a lot of scientists too. Truth has a different metric than the opinions of people. That there is only 4 subjects is not all that off in biology, especially in humans. For instance, in the hearing pathway, there is a single layer of neurons that helps mediate the location of low frequency noises in mammals. The Nature Letter that revealed this was done on 4 cells total. The difficulty of the experiment was extreme. Sectioning brains at essentially random, probing neurons perfectly from the input and output neurons to those special neurons, all at body temperature, and in mature animals, it took that team 10 years for 4 neurons. ALL of them now are bakers in Germany; they quit science.
So, though the guy may be a quack, and though this experiment may not be as hard, it does not mean he is necessarily wrong.
Extraordinary claims require extraordinary evidence. Any depression study with only 4 people is not extraordinary considering the pervasiveness of the issue in society.
I have encoutered this argument a lot, and this is why I think it's harmful:
The problem with this is that unsubstantiated cures, even really cheap ones apparently harmless ones, have an opportunity cost in time and effort, and the number of them that exist is almost unbounded. I have heard similar arguments about a hundred fad diets, a hundred nutritional supplements, going vegan/paleo/gluten-free/etc, meditation, homeopathy, accupunture, changing religions, "spacing out vacinations", and so on. Some of this stuff may actually be cheap and effective, but how do you choose?
There are only so many hours in the day and every minute we spend chasing the next dubious fad cure is a minute we can't use to cook and eat healthy food, sleep enough, excercise, take care of our teeth, or go to a doctor.
Furthermore, some of these things have negative side effects, even if those may only be apparent in aggregate (e.g. delaying vacinations).
[1] http://ijp.sagepub.com/content/19/1/57.short
[2] https://www.researchgate.net/profile/Betina_Elfving/publicat...
[3] https://www.researchgate.net/profile/Claudia_Schmuckermair/p...
[4] https://en.wikipedia.org/wiki/Hypermagnesemia