In this blog, I will be discussing all things magnesium — its role in maintaining your health, why your magnesium levels may become low, the symptoms associated with magnesium deficiency, and what you can do to optimize your magnesium levels.
Symptoms of Low Magnesium
The symptoms of low magnesium are often non-specific, which means they can be easy to overlook or to attribute to other causes. Common signs include fatigue, general weakness, muscle spasms, pain, poor appetite, or nausea.[1-3]
Do you experience any of those issues?
Many people with MS experience one or more of these symptoms and assume they’re simply part of the disease. But some of these symptoms may be affected (or caused) by insufficient magnesium levels. [1-3]
If magnesium levels continue to decline, more serious problems can develop. These may include heart palpitations, numbness and tingling, personality changes, and seizures.
Are you at risk for low magnesium? Let’s look at how you might have gotten there.
How Magnesium Insufficiency Develops
There are several way low magnesium levels can develop:
Low stomach acid. We need adequate stomach acid to absorb minerals like magnesium. Unfortunately, stomach acid production begins to decline over the age of 40, making absorption more difficult.
Inadequate dietary intake. Most Americans don’t get enough magnesium through food. Diets high in processed foods and low in leafy greens, nuts, and seeds often fall short.[4]
Excessive alcohol consumption. Drinking more than two alcoholic beverages per day or engaging in binge drinking can deplete magnesium levels.
Chronic diarrhea. Ongoing digestive issues, especially diarrhea, can reduce the body’s ability to absorb and retain magnesium.
Diuretics. These medications, often prescribed for high blood pressure or heart conditions, increase the loss of magnesium through urine.
Type 2 diabetes. People with type 2 diabetes often lose more magnesium in their urine due to higher blood sugar levels, which can contribute to deficiency.
How Magnesium Supports the Brain, Heart and Muscle
We enjoy good health and vitality when the chemistry of life runs smoothly within our cells, and the vitamins and minerals we consume act as vital co-factors for the enzymes that carry out the chemical reactions that make this possible.[1, 2] Magnesium is one of the most important of these minerals; it serves as a co-factor for more than 300 different enzymes and plays a key role in brain, heart, and muscle function. [5, 6]
This helps explain why low magnesium levels can lead to symptoms like fatigue, personality changes, seizures, pain, and other neurological or psychiatric issues. These symptoms are often attributed to an underlying neurological or mental health condition, and magnesium deficiency is overlooked.
But we now know that insufficient magnesium is linked to neuroinflammation, neurodegeneration, and increased leakiness of the blood-brain barrier — all of which can accelerate brain aging and worsen symptoms.[3, 7]
How Magnesium Supports Stronger Teeth and Bones
Magnesium is also essential for healthy teeth and bones. People with multiple sclerosis (MS) face a higher risk of developing osteopenia and osteoporosis — and they’re more likely to fall or stumble, increasing the chance of fractures.
Many people focus on getting enough vitamin D and vitamin K2, and they work on strength training to protect their bones. But magnesium is just as important. Without it, the body can’t properly build or maintain strong teeth and skeletal structure.[1, 2]
Given the increased risk of bone thinning and fractures in MS, it’s critical to pay attention to your magnesium intake, not just vitamin D, K2, or calcium.
How Do We Assess Magnesium Levels?
Standard blood tests often check serum magnesium, but this doesn’t reflect what’s happening inside your cells (where magnesium does most of its work). To get a more accurate picture of your magnesium status, ask for a red blood cell (RBC) magnesium test. This test measures intracellular magnesium, the form that’s active in your brain, muscles, and heart.
Foods That Support Magnesium
Magnesium is the central mineral in chlorophyll, just like iron is the central mineral in hemoglobin. That’s why green leafy vegetables — especially kale, collards, and spinach — are naturally rich in magnesium. If you're concerned about oxalates, opt for low-oxalate greens like kale and mustard greens to boost your intake safely.
However, if your stomach acid is low, it may be harder for you to absorb magnesium from plant sources. Fortunately, the magnesium in meat and other animal products tends to be more easily absorbed than the magnesium in vegetables.
If you’re getting a red blood cell magnesium test, it may also be worth asking your medical team whether assessing your stomach acid levels would be appropriate. Poor absorption could be limiting your ability to benefit from magnesium-rich foods.
Magnesium Supplements That Can Help Support Your Brain, Your Muscles and Your Heart
Magnesium supplements have been used as supportive therapies for a variety of neuroimmune conditions, including multiple sclerosis.[3, 5] Research shows that magnesium may also help ease anxiety and depression,[5, 8] improve attention, [9], and reduce pain.[10]
Among the various forms available, magnesium citrate and magnesium malate are both well absorbed. But magnesium threonate stands out — it’s the only form shown to effectively cross the blood-brain barrier, allowing it to reach the central nervous system.[9, 11]
Personally, I’ve found that taking magnesium threonate at bedtime has helped improve my insomnia, which is something I’ve struggled with for much of my life.
I regularly recommend magnesium supplementation to my patients with MS, mood disorders, or chronic pain. We also assess stomach acid levels and check red blood cell magnesium to guide our strategy and support better outcomes.
Summary
Low magnesium can cause symptoms like fatigue, muscle weakness, pain, personality changes, and heart palpitations. It also contributes to leaky brain. a breakdown in the blood-brain barrier that may raise the risk of relapses and new enhancing lesions in people with MS.
Most Americans don’t get enough magnesium from food, and many have additional risk factors for deficiency. Increasing your intake of green leafy vegetables is a great start.
For additional support, especially in those with neurological or psychiatric concerns, a well-absorbed supplement can make a meaningful difference. I often recommend Better Brain Mag Capsules, which combine magnesium citrate, malate, and threonate — the latter of which crosses into the brain. This combination has helped me personally, particularly with improving sleep quality.
New to The Wahls Protocol® Supplements? Subscribe and save with 5% OFF your first order, and get 10% OFF each order thereafter! Shop Now
Citations
- Bourre, J.M., Effects of nutrients (in food) on the structure and function of the nervous system: update on dietary requirements for brain. Part 1: micronutrients. J Nutr Health Aging, 2006. 10(5): p. 377-85.
- Bourre, J.M., Effects of nutrients (in food) on the structure and function of the nervous system: update on dietary requirements for brain. Part 2 : macronutrients. J Nutr Health Aging, 2006. 10(5): p. 386-99.
- Long, S. and A.M. Romani, Role of Cellular Magnesium in Human Diseases. Austin J Nutr Food Sci, 2014. 2(10).
- Cordain, L., et al., Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr, 2005. 81(2): p. 341-54.
- Nogueira-de-Almeida, C.A., et al., Neuronutrients and Central Nervous System: A Systematic Review. Cent Nerv Syst Agents Med Chem, 2023. 23(1): p. 1-12.
- Vink, R., Magnesium in the CNS: recent advances and developments. Magnes Res, 2016. 29(3): p. 95-101.
- Maier, J.A.M., et al., Magnesium and the Brain: A Focus on Neuroinflammation and Neurodegeneration. Int J Mol Sci, 2022. 24(1).
- Zielinska, M., E. Luszczki, and K. Deren, Dietary Nutrient Deficiencies and Risk of Depression (Review Article 2018-2023). Nutrients, 2023. 15(11).
- Zhang, C., et al., A Magtein((R)), Magnesium L-Threonate, -Based Formula Improves Brain Cognitive Functions in Healthy Chinese Adults. Nutrients, 2022. 14(24).
- Wu, S., et al., Oral application of magnesium-L-threonate enhances analgesia and reduces the dosage of opioids needed in advanced cancer patients-A randomized, double-blind, placebo-controlled trial. Cancer Med, 2023. 12(4): p. 4343-4351.
- Surman, C., et al., L-Threonic Acid Magnesium Salt Supplementation in ADHD: An Open-Label Pilot Study. J Diet Suppl, 2021. 18(2): p. 119-131.
