A previous clinical study found that parenteral magnesium treatment without vitamin D replacement in 23 magnesium-deficient patients led to a normalizing of VDBP. In a study in teenaged girls, magnesium balance was negative with calcium intakes of 1800 mg/d; however, compared with positive magnesium balance results with 800 mg calcium/d, the differences in magnesium absorption, excretion, and balance were not significant in this small crossover trial (n = 5) (102). COPD 2007;4:41-7. The largest data source for serum magnesium reference ranges is derived from a 19711974 US study in 15,820 presumably healthy individuals aged 1-74 y (83), a population who may not have been fully magnesium replete (75). [Frequency of magnesium deficit in the normal subjects and in various steopathies]. 2012 Sep;15(3):80-4. doi: 10.5770/cgj.15.39. 3) Calcium somewhat blocks Magnesium and Risco F, Traba ML. Both bone and soft tissue intracellular magnesium concentrations may be depleted (or depleting) while serum/plasma magnesium concentrations remain in the “healthy” range (75). Best Pract Res Clin Endocrinol Metab 2011;25: 633-46. Magnesium intake and risk of type 2 diabetes: meta-analysis of prospective cohort studies. Available from: Rosanoff A, Weaver CM, Rude RK. Dietary magnesium intake and risk of cancer: a meta-analysis of epidemiologic studies. Not getting enough magnesium can lead to … Lancet 1974;1:963-5. Essential Nutrient Interactions: Does Low or Suboptimal Magnesium Status Interact with Vitamin D and/or Calcium Status? Guasch-Ferre M, Bullo M, Estruch R, Corella D, Martinez-Gonzalez MA, Ros E, Covas M, Aros F, Gomez-Gracia E, Fiol M, et al. Chu HI, Liu SH, Hsu HC, Choa HC, Cheu SH. What we eat in America, NHANES 2009-2010, individuals 2 years and over (excluding pregnant and/or lactating females and breast-fed children), day 1 food and supplement intake data, weighted. Ryzen E, Elbaum N, Singer FR, Rude RK. J Pediatr 1991;118:220-5. Normal vitamin D metabolism requires Mg2+ for its synthesis and metabolism of parathyroid hormone and vitamin D (see above). These basic cellular calcium-magnesium interactions are at work in human cells (94, 95), in which the imbalance of these 2 essential minerals can give rise to cellular phenotypes manifesting the physiologic symptoms of modern chronic diseases (96). The most important of these co-factors is the mineral magnesium. Are we really low in magnesium? Available from: USDA Agricultural Research Service. Atherosclerosis Risk in Communities Study. Nutr Cancer 2014;66:915-23. Taken together, these findings suggest that a possible interaction between magnesium and vitamin D influences vitamin D status (150), but these findings should be tested in a large clinical trial. Thus, these findings showed no effect for a high dose of vitamin D alone or magnesium infusion alone; however, there was a substantial increase in serum 25(OH)D due to vitamin D supplementation with magnesium infusion. The Shanghai Women’s Health Study and the Shanghai Men’s Health Study are 2 population-based cohorts with >130,000 participants. Oral vitamin D is widely recommended in US age-sex groups with low dietary magnesium. Nutr Metab Cardiovasc Dis 2013;23:169-76. Table 1. Lancet 1973;1:803-4. Amiot D, Hioco D, Durlach J. Frequence du deficit magnesique chez le sujet normal et dans diverses osteopathies. Does the calcium to magnesium ratio affect this activation? Available from: USDA Agricultural Research Service. Lowenstein FW, Stanton MF. Studies are needed to address whether there are physiologic changes to bone or soft tissue that are associated with low magnesium intakes but normal serum magnesium concentrations. Chambers EC, Heshka S, Gallagher D, Wang J, Pi-Sunyer FX, Pierson RN Jr. Serum magnesium and type-2 diabetes in African Americans and Hispanics: a New York cohort. Serum magnesium is an independent predictor of frequent readmissions due to acute exacerbation of chronic obstructive pulmonary disease. Magnes Res 2011;24:225-7. This explanation is supported by 2 case studies reported by Reddy and Sivakumar (146), in which magnesium supplementation substantially reversed the resistance to vitamin D treatment in magnesium-deficient patients. The patients were given magnesium because of low levels, and, as a result, the calcium levels quickly returned to normal. Intravenous magnesium for prevention of atrial fibrillation after coronary artery bypass surgery: a systematic review and meta-analysis. http://www.ars.usda.gov/SP2UserFiles/Place/12355000/pdf/0506/usual_nutrient_intake_vitD_ca_phos_mg_2005-06.pdf. Magnesium intake and risk of colorectal cancer: a meta-analysis of prospective studies. Hopping BN, Erber E, Grandinetti A, Verheus M, Kolonel LN, Maskarinec G. Dietary fiber, magnesium, and glycemic load alter risk of type 2 diabetes in a multiethnic cohort in Hawaii. I ran out of magnesium, was taking 250 mg a day and 6000 IU of Vitamin D. I do think they can help a little bit, but make sure to address the source of the anxiety as much as you can too. Note that the current adult DRIs for magnesium are based on intakes of 4.3 mg • kg" 1 • d"1 to maintain balance in healthy adults (60), and human studies found this factor to be 2.36 mg • kg"1 • d"1 (95% CI: 1.58, 3.38 mg • kg"1 • d"1) (99). Resnick LM. Magnesium is a cofactor for vitamin D biosynthesis, transport, and activation. Low magnesium intake is associated with chronic diseases of global concern [e.g., cardiovascular disease (CVD), type 2 diabetes, metabolic syndrome, and skeletal disorders], as is low vitamin D status. Interactions between magnesium intake and serum vitamin D contributing to the risk of CVD and colorectal cancer were recently indicated. Clin Endocrinol (Oxf) 1989;31:31-8. Guerrero-Romero F, Rodriguez-Moran M. Low serum magnesium levels and metabolic syndrome. Resnick LM. Calcium intakes as high as 2-2.5 g/d caused lower magnesium absorption in 2 small, earlier studies (100, 101). Sales CH, Pedrosa LF, Lima JG, Lemos TM, Colli C. Influence of magnesium status and magnesium intake on the blood glucose control in patients with type 2 diabetes. Oral vitamin D has recently been recommended and is widely available. This is in contrast with US studies undertaken with a high background calcium to magnesium ratio ($3.0), which showed decreased mortality when magnesium intakes were increased by 200-375 mg/d (7, 13, 115, 116). A study by Joosten et al. Evidence clearly shows that magnesium and vitamin D [1 alpha, 25-dihydroxyvitamin D3; 1,25(OH)2D3] independently affect numerous aspects of the immune system. Get the latest public health information from CDC: https://www.coronavirus.gov. Despite these changes in intakes, research on the interactions between these 3 essential nutrients has been sparse. Circulation 2013;127:33-8. Wong ET, Rude RK, Singer FR, Shaw ST Jr. A high prevalence of hypomagnesemia and hypermagnesemia in hospitalized patients. Yang CY, Chiu HF, Cheng MF, Tsai SS, Hung CF, Tseng YT. Dietary phosphorus interacts with each of the 3 above- described nutrients (magnesium, calcium, and vitamin D) and dietary intakes of phosphorus in US adults are well above the RDA of 700 mg/d. Ishimura E, Okuno S, Yamakawa T, Inaba M, Nishizawa Y. Serum magnesium concentration is a significant predictor of mortality in maintenance hemodialysis patients. Ann Clin Lab Sci 2005;35:423-7. COVID-19 is an emerging, rapidly evolving situation. NIH (33) that used data from the Women’s Health Initiative, a lower magnesium intake was associated with lower BMD of the hip and whole body, as expected; however, this did not translate into an increased risk of hip or total fractures. Hauppauge (NY): Nova Science Publishers; 2008. p. 271-84. J Am Geriatr Soc 2005;53:1875-80. This lack of data is in contrast with the extensive literature on interactions of vitamin D with calcium. 1985 [cited 2012 Jul 10]. New York: Avery, Penguin; 2003. p. 211-8. Future studies are warranted to replicate the findings of Deng et al. Dietary and plasma magnesium and risk of coronary heart disease among women. Seelig MS. 85-1. Diabetes Care 2012;35:565-73. Does low magnesium status affect this activation? Vittel: SGEMV, 1971:11-38 (in French). The 2011 report on Dietary Reference Intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. Chiuve SE, Sun Q, Curhan GC, Taylor EN, Spiegelman D, Willett WC, Manson JE, Rexrode KM, Albert CM. Effect of magnesium supplementation on the fractional intestinal absorption of 45CaCl2 in women with a low erythrocyte magnesium concentration. J Am Geriatr Soc 2012;60:1515-20. Calcium to magnesium ratios <1.7 and >2.8 can be detrimental, and optimal ratios may be ~2.0. For example, individuals in the serum magnesium range from 0.6 or 0.7 up to 0.84 mmol/L are labeled “normomagnesemic” and are thus assumed to be non-magnesium depleted when, in fact, a large portion of these persons might more accurately be designated as magnesium depleted. Association of macrovascular complications of type 2 diabetes mellitus with serum magnesium levels. Individuals with the 14821le allele and calcium to magnesium ratios >2.8 had a 60% greater risk of colorectal adenoma and an 85% increased risk of hyperplastic polyps than those without the 14821le allele in the TRPM7 gene (71). Available from: USDA Human Nutrition Information Service. Medalle R, Waterhouse C, Hahn TJ. In a study by Orchard et al. Associations of dietary magnesium intake with mortality from cardiovascular disease: the JACC study. any of the products or services that are advertised on the web site. Qu X, Jin F, Hao Y, Zhu Z, Li H, Tang T, Dai K. Nonlinear association between magnesium intake and the risk of colorectal cancer. Despite food fortification and dietary supplementation, low vitamin D status (<20 mg/L or <50 nmol/L; Table 3) is still relatively common in the United States (143). Between 1977 and 2012, . Mitri J, Muraru MD, Pittas AG. Ionic basis of hypertension, insulin resistance, vascular disease, and related disorders: the mechanism of “syndrome X”. Kieboom BC, Kiefte-de Jong JC, Eijgelsheim M, Franco OH, Kuipers EJ, Hofman A, Zietse R, Stricker BH, Hoorn EJ. Ruljancic N, Popovic-Grle S, Rumenjak V, Sokolic B, Malic A, Mihanovic M, Cepelak I. COPD: magnesium in the plasma and polymorphonuclear cells of patients during a stable phase. 2007 [cited 2012 Feb 29]. Wark PA, Lau R, Norat T, Kampman E. Magnesium intake and colorectal tumor risk: a case-control study and meta-analysis. High magnesium intakes may increase the availability of 1,25(OH)2D by activating the synthesis of 25(OH)D and 1,25(OH)2D and increasing the transfer to target tissues by elevating VDBP. Serum magnesium and CLMD. Am J Clin Nutr 2012;96:622-31. Resurrection of vitamin D deficiency and rickets. (117) found that lower serum magnesium coupled with high serum calcium and phosphorus was a risk factor for heart failure. High calcium intakes can exacerbate the onset of low magnesium status and vice versa. Barragan-Rodriguez L, Rodriguez-Moran M, Guerrero-Romero F. Depressive symptoms and hypomagnesemia in older diabetic subjects. Am J Clin Nutr 1964;14:242-90. There has been a recent surge of positive studies for several human health issues with vitamin D in the peer-reviewed literature, giving rise to medical prescriptions for and over-the-counter sales of high doses of vitamin D to increase serum vitamin D concentrations. Nutrients don't work alone, and when it comes to taking vitamin D, it's important that you take magnesium and vitamin D together and not JUST vitamin d alone in large doses as this can lead to what people BELIEVE are vitamin d side effects, but are really just magn… At this time, serum magnesium values can be considered a useful, but not an absolutely reliable, indicator of whole-body magnesium status when interpreting human magnesium research. Serum magnesium may not be a reliable marker of magnesium status in clinical settings or research studies partly because the accepted “normal range” in North America is not evidence based. http://www.ars.usda.gov/SP2UserFiles/Place/80400530/pdf/0708/Table_1_NIN_GEN_07.pdf. Am J Clin Nutr 1976;29:854-8. 2020 It would have been interesting to see whether calcium intakes and calcium to magnesium ratios might have further explained this detrimental outcome of higher magnesium intakes (33).