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Most people don’t consume enough magnesium in their diets. Many nutritionally oriented doctors recommend 250–350 mg per day of supplemental magnesium for adults.
Nuts and grains are good sources of magnesium. Beans, dark green vegetables, fish, and meat also contain significant amounts.
Magnesium deficiency is common in people taking “potassium-depleting” prescription diuretics. Taking too many laxatives can also lead to deficiency. Alcoholism, severe burns, diabetes, and heart failure are other potential causes of deficiency. In a study of urban African-American people (predominantly female), the overall prevalence of magnesium deficiency was 20%. People with a history of alcoholism were six times more likely to have magnesium deficiency than were people without such a history.200 The low magnesium status seen in alcoholics with liver cirrhosis contributes to the development of hypertension in these people.201
Almost two-thirds of people in intensive care hospital units have been found to be magnesium deficient.202 Deficiency may also occur in people with chronic diarrhea, pancreatitis, and other conditions associated with malabsorption.
Fatigue, abnormal heart rhythms, muscle weakness and spasm, depression, loss of appetite, listlessness, and potassium depletion can all result from a magnesium deficiency. People with these symptoms should be evaluated by a doctor before taking magnesium supplements.
As previously mentioned, magnesium levels have been found to be low in people with chronic fatigue syndrome.
Deficiencies of magnesium that are serious enough to cause symptoms should be treated by medical doctors, as they might require intravenous administration of magnesium.203
Most forms of magnesium—including magnesium oxide, magnesium glycinate, magnesium aspartate, magnesium citrate, magnesium lactate, magnesium amino acid chelate, and magnesium hydroxide—are acceptable for supplementation. However, there are a few relevant considerations. Magnesium glycinate may reduce the risk of diarrhea as a side effect of magnesium supplementation. The aspartate in potassium magnesium aspartate (which delivers both potassium aspartate and magnesium aspartate) may increase uptake of magnesium. Yet, care needs to be taken not to consume excessive amounts of aspartate. To avoid consuming too much aspartate, one recommendation is to limit potassium magnesium aspartate to 3.35 g/day (equivalent to around 2.7 g of aspartate and 280 mg of magnesium), and to get additional magnesium from other forms. Enteric-coated magnesium chloride may reduce absorption of magnesium. For people taking thiazide or loop diuretics (which deplete magnesium, potassium, and chloride), it is recommended that they take magnesium chloride and/or potassium chloride. Magnesium sulfate is not to be preferred since the sulfate molecule may interfere with the correction of associated potassium deficiencies.204
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