Dr. Mark Hyman:
Coming up on this week’s episode of the Doctor’s Pharmacy. Basically anything that twitches, spasms, cramps, or is irritable in your body is likely in full or in part related to inadequate magnesium levels.
Welcome to the Doctor’s Pharmacy. I’m Dr. Mark Hyman. That’s pharmacy with an enough place for conversations that matter. And today I want to welcome you to a new podcast series I’m doing called Know Your Numbers. It’s designed to help you understand how your body works, what your own lab and biological data means. A lens of functional medicine, which is the signs of creating health. Now for too long, healthcare has required you to go through your doctor to access your own blood tests and your biology and rely solely on your doctor to guide you. We are now entering an era where each of us can understand our own biological data and become the CEO of our own health. Know your numbers will help you understand the key lab tests that you need to track your health, including critical tests that traditional medicine often ignores. You’re going to learn how to interpret your own lab tests, what the true optimal ranges are, and how important biomarkers connect.
Most importantly, you will learn how to optimize your health based on your own personal medical history and biological data. You’ll also learn when it’s important to see your doctor for further testing or treatment. Now, in a perfect world, I’d have the chance to see millions of patients, but the truth is I’m just one doctor. Over 30 years of seeing millions of biomarkers in tens of thousands of patients, I’ve come to understand that much is being missed by conventional healthcare. We often wait until we have symptoms of diseases, then we get tested. But the transition from wellness to illness often be detected decades before any symptom or diagnosis. I want people to have access to their own health data and the ability to engage in self-care and lifestyle practices that I believe can optimize their health and reverse the trajectory of chronic diseases that now affect six in 10 Americans and accounts for over $4 trillion in healthcare costs.
And that is why I recently co-founded Function Health where I’m the Chief Medical Officer function is a revolutionary way to understand and manage your health through lab testing that you are often not getting through your healthcare system. All the results are delivered in an easy to use dashboard that tracks your numbers over time and gives you actionable insights for every biomarker. Now we’re building function to democratize much of what I do and to give you the keys to your health and put control of your health firmly back in your hands. Now this podcast is separate from my clinical practice to the Ultra Wellness Center from my work at Cleveland Clinic and Function Health. This podcast represents my opinions and my guest opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for general information purposes only. It does not establish a Doctor-patient relationship.
And because everyone has unique life circumstances, the content in this podcast should not be taken as personal medical advice, consult with a qualified healthcare professional with any medical questions or concerns. Now, keeping this podcast free is part of my mission to bring practical ways of improving health to the general public. In keeping with that theme, I’d like to thank those sponsors that made today’s podcast possible. And now let’s get started with Know Your Numbers. Okay, we’re going to talk about one of the most important things that is missed by traditional medicine. It’s so easy to treat that creates so much suffering that most people don’t know about, and that about 45% of Americans are severely deficient in or insufficient. And what am I talking about? I’m talking about magnesium problems, either insufficiency or true deficiency of magnesium. Now, how do you know if you have magnesium deficiency?
Well, I call magnesium the relaxation mineral. Basically, anything that twitches, spasms, cramps, or is irritable in your body is likely in full or in part related to inadequate magnesium levels. Things like heart palpitations, anxiety, depression, insomnia, blood sugar issues, hormone imbalances, irritability, aggressiveness, PMS, menstrual cramps, preterm labor, muscle spasms, tremors, vertigo, ringing in your ears, tinnitus, chronic pain, muscle weakness, kidney stones, angina, high blood pressure, constipation, acid reflux headaches, hearing loss, being sensitive to loud noises, immune dysfunction, seizures, right, which is irritability of your brain, cognitive decline. And all these muscle cramps are related to potentially low magnesium levels. So if you have any of these symptoms, you got to be thinking about magnesium. So why is it a problem? Well, about 20% of the population is living with overt magnesium deficiency. This is full-blown magnesium deficiency and that’s like one in five people. That’s a lot of people subclinical or insufficiency, not true deficiency, which you see on a lab test, but insufficiency can affect up to 80% of the population.
Now why is this important? Well, unlike drugs which work with one pathway and one particular reaction in the body, magnesium and most vitamins and minerals by the way, work on hundreds and hundreds of different pathways, and magnesium is involved in over 600 enzymatic reactions in your body. Now, enzymes help convert one molecule to another critical for everything, and it basically influences every single one of our biological systems, which is why it can cause symptoms all over the place. From your brain to your heart, to your gut and constipation to menstrual issues and cramps and muscles. I mean it’s literally everything in low levels or suboptimal levels impact every air of her health, increase our risk for chronic disease. So it’s not just this annoying symptoms like muscle cramps, it puts you at big risk for serious illnesses. Now, it really probably should be considered a public health crisis, but most physicians don’t test for it.
It’s not on your regular blood panel you get every year. If they do agree to test for it, they’re likely to run. We’ll call a serum magnesium test. That’s what I learned in medical school, but it’s not really the indicator of what’s happening in your body. It’s like this joke I often tell when I’m giving lecture, I say, this guy dropped his keys on the street and his friend comes over and sees him looking under this lamppost and he goes, well, what are you looking for? What are you doing? He says, well, I’m looking for my keys. He said, where’d you drop ’em? He said, well, I dropping ’em down the, but he said, well, why are you looking over here? He says, well, the light’s better here under the lamppost. So that’s how medicine is. It’s easy to test serum magnesium, but it’s not the right way to find out if you’re low or not.
I mean, if it’s low on the sear magnesium, you are really, really low. By the time it gets low, you’re in trouble. So the best test, which is really not practical, is something called a magnesium loading test, which is a 24 hour urine intestine and you basically give people magnesium iv and then you collect their urine for 24 hours and you see what spills out. And if they don’t spill out anything, it means they’re lone magnesium. If they spill out a lot, it means their body’s good and they can get rid of what they don’t need. The next best test and what we do with function health is called the red blood cell magnesium level. Now, this is not as good as the magnesium loading test, but it’s pretty good and it gives you a sense if you’re insufficient or low and people should be over five.
And often we see levels much lower than that. Okay, so what does magnesium do? Why should you care? As I mentioned, I call it the relaxation mineral. I think about Epsom salt, that’s magnesium sulfate. You soak in a hot bath, your muscles get relaxed, you don’t have soreness. It just basically relaxes everything. And again, it controls over 600 different enzyme reactions. It helps in the production of a TP, which is the thing that makes you move and grow and do everything you do. It’s basically the energy of life and it’s really the key to making energy in the body. And often when you see low magnesium, and I’ve had this before, it can be something that’s found in chronic fatigue syndrome, fibromyalgia. Often if you have insulin sensitivity issues, in other words, your insulin resistant and your blood sugars not good, it could be low magnesium, and magnesium is very much involved in blood sugar regulation.
Also, it’s involved in regulation of vitamin D in the body, the activation and transport of vitamin D. It’s important not just for muscle health and contraction and relaxation of muscles, but also bone strength and bone density. It’s also critical of making hormones such as testosterone, progesterone, estrogen is important in the sense this of neurotransmitters in your brain. It’s involved in calming and relaxation and inhibits the release of we call excitatory neurotransmitters. It’s also involved in DNA repair. It’s involved in fluid and electrolyte balance with calcium, sodium, potassium and hydration, which is why it’s so often an electrolyte. So it’s really important for electrolyte replacement. It’s critical for heart. I mean having a healthy heartbeat, blood pressure, high blood pressure is basically tightness of the arteries and the blood vessels, and so magnesium is used in relaxation. We actually, when we have patients with really severe diseases, this is what’s so interesting.
When I trained as a doctor, it was kind of a last resort drug, right? It’s a mineral, but it was a drug that we used when things didn’t work or nothing else worked. For example. So if you’re in every ICU in every cardiac unit, in every emergency room, it’s on the crash cart, which is basically what we use when we resuscitate a person who basically has their heart stop and stop breathing, and when none of the drugs work, the last thing we give to stop a cardiac arrhythmia, which is the rapid beating of the heart that can kill you, we use intravenous magnesium. We use it to treat preterm labor. If someone comes in in early labor, we give them IV magnesium. If someone has high blood pressure in pregnancy, we call preeclampsia and that causes seizures. We give them intravenous magnesium, and we only use it when everything else has failed, but it shouldn’t really be like that.
We also use it for bowel prep. If you’re constipated, it’s basically one of the best treatments. Milk and magnesium heard of that, and it also is used to prep for colonoscopies such as magnesium, magnesium citrate, which makes you really go. So it’s used in everything in the body. We use it in medicine a lot. It’s just one of those things that doctors don’t really think about as a problem for people when they come in with all these symptoms. So the question is why are we deficient, right? Well, 75% of Americans aren’t eating enough magnesium in their diet. Where does it come from? Dark greens, beans, nuts, seeds, seaweed. People don’t eat that. It’s declining soil quality. It’s resulted in almost a 50% dec decline in magnesium, in fruits and vegetables. Over the last 50 years, there’s been a dramatic decline. So I think it’s really concerning.
Also, about 25% of kids are magnesium deficient, which is very concerning to me too because it’s critical for their bodies and to grow. Another thing is ultra processed foods deplete magnesium. So 60% of our diet is ultra processed food. 67% of kids’ diets, food processing reduces magnesium in the food by up to 80%. Also, if we eat a lot of high starch and sugar foods, which is our standard American diet or sad diet, those foods deplete magnesium. So the more sugar you eat, the more starch you eat, the more you lose magnesium and increases the rate of excretion of magnesium, and that’s not good. So you eat sugar and starch pi. Magnesium also, the recommended levels are to prevent deficiency diseases. The RDA, what we call the RDA, it’s about 300 to four 20 milligrams. It’s just too low. It’s set to prevent deficiency, but it’s not really about optimal health and about half the population doesn’t even get the minimum amount you need to prevent deficiency.
And globally it’s a huge problem as well. And a study of healthy university students in Brazil, they consumed an average of about 215 milligrams of magnesium, and 42% have low levels in healthy healthy college students. Also, there’s a number of groups that are higher risk for magnesium efficiencies. So if you’re in one of these groups, you got to pay attention if you’re pre-diabetic or diabetic. If you’re low in magnesium, it increases the risk of various things like eye damage or retinopathy neuropathy, nerve damage, kidney disease, and blood vessel disease. It’s a really critical in regulating our blood sugar For women. It’s involved in estrogen regulation and metabolism. Detoxification and deficiency is present about 80% of pregnant women and 55% of women with hormone related issues. Think about that. I mean, if you’re pregnant and 80% of women are deficient, it’s one of the biggest causes of preterm labor is low magnesium level.
So if you have low preterm labor or you have high blood pressure in pregnancy, like I said before, we treat you with intravenous magnesium, so why not take magnesium? Also, you can get constipated when you’re pregnant too. So it helps with all that. 84% of post-menopausal women with osteoporosis had low magnesium. So this is just a rampant problem. As you get older, you’re not so good at absorbing things. It’s another group that has risk, so you don’t absorb it. You excrete more magnesium if you have certain age-related diseases that cause low magnesium. Certain medications we’ll talk about in a minute, can lower magnesium levels and make you peel magnesium. Often things that’ll use to treat high blood pressure like diuretics. If you look at hospitalized patients, 65% of people who are critically ill who are admitted to the ICU or intensive care unit were magnesium deficient.
And with COVID-19, we saw also those who had the highest magnesium intake had the lowest levels of inflammation and had 70% lower odds of developing severe symptoms. So just taking magnesium can reduce the inflammation. If you get covid and reduce your risk of having severe covid by 70%, that’s amazing. And this is completely safe unless you have kidney failure is an incredibly safe mineral to take. Now, the other thing you should know is most doctors don’t think about it unless you’re in an extreme situation like we talked about, whether you have preterm labor and arrhythmia or having seizures from pregnancy or high blood pressure in pregnancy, we still don’t think about it, but we should, and again, as I mentioned, if it’s tested, it usually is a serum magnesium, which doesn’t reflect whole body. It’s only about 1% of the magnesium in your body. 99% is in your tissues, your bone muscle.
The body has really tight regulation methods for magnesium, and it pulls from the reservoirs in your bone or muscle if you’re needing to keep levels stable. So if your whole body’s depleted, it’s going to be hard to replenish. And normal, normal serum magnesium levels are about 1.8 to 2.3, but I think anything under two is linked to increased health risks and optimal levels should be over two. So if you’re getting a serum magnesium, it should be over two, but I don’t like that. I like the red blood cell magnesium. So functional medicine looks at this a little bit differently. We look at comprehensive testing to look at what’s going on with all their biomarkers, and we look at red blood cell magnesium. It’s a way more accurate reflection of whole body magnesium. It measures intracellular magnesium, which is where often it needs to be to do the job.
It reflects the magnesium content of muscles and bones. It has a longer half-life. It’s less prone to fluctuations from your diet. It correlates with clinical symptoms. So it’s a really good biomarker that is part of the function panel that you’re not getting when you go to your regular doctor. We’re sure it’s not on your annual panel, and it’s probably not on any panel that they do at all if they’re going to measure. The other things you can kind of look at in relation to magnesium that are part of the functional panel include kidney tests like creatinine and BN vitamin D levels because low levels are often associated with low levels of magnesium absorption, just like calcium absorption. Calcium levels are also interacting potassium levels, low levels of potassium or calcium, an indicator of low magnesium if you’re high in sodium. Another clue that you might have a low magnesium, if your blood sugar’s high, your insulin’s high, your A1C, your average blood sugar is high blood control, that’s a sign of low magnesium.
So a lot of things you can look at to kind get a clue that you might be magnesium deficient. Another hormone that’s important you should look at is a parathyroid hormone, and we also think it’s important to look at that and magnesium be involved in the release of parathyroid hormone from the parathyroid gland in the neck, and if your parathyroid levels are low, you’re going to have low magnesium. So it’s important to look at all this stuff. Look at your EKG and look at your heart function. So there’s a lot of ways to look at magnesium, but the key is a red blood cell magnesium to start, what are the root causes of having an abnormal magnesium or low magnesium? Well, our diet, right? Our sad diet, our standard American diet, as I mentioned, salt and sugar make you pee out. Magnesium starch, phosphorus also that’s in soda, right?
Cole is particularly food additives and all these things are used in ultra processed foods, and that caused us to peacefully pee out. Magnesium. Coffee and alcohol also make us lose magnesium, and too much calcium from supplements is not a good idea either. Stress another one. Chronic stress is a big factor because obviously when you have a magnesium, your nervous system is relaxed, your body’s calm. When you are stressed, you actually pee out Magnesium. Those living in Kosovo during the war in one study had higher cortisol levels, which is a stress hormone and lower magnesium levels. Also, if women have heavy periods, it’s another factor that can cause low magnesium malabsorption issues. If you have celiac, inflammatory bowel disease, colitis, Crohn’s, if you have diarrhea, you lose magnesium. If you have diabetes and you’re peeing too much, you lose magnesium, you have kidney damage, you’ll have magnesium issues.
Also, if you sweat a lot like you do saunas exercise, go on a hot climate, you’re going to without electrolyte replacement, get into low magnesium states. Again, over supplementation with calcium. You don’t want to do that. And then a few other things can cause you to have magnesium issues. One is having aluminum from antacids and cookware, food additives, drinking water, deodorant, all that will potentially affect your magnesium drugs. A lot of drugs, as I mentioned, affect magnesium levels. So these are common drugs like diuretics, which are used in high blood pressure, which is often a low magnesium issue, certain antibiotics, steroids, I mentioned the cortisol will make you lose magnesium used for inflammatory disorders. Acid blocking drugs we use for reflux are horrible because they block acid, which you need to absorb minerals such as magnesium. Another deficiencies, nutrients like vitamin B six or vitamin D or selenium often will cause us to have low magnesium.
Alright, so what are the things we talked about? Let’s just kind of go over those. One of the things we should be worried about that can be related to magnesium deficiency. Well, cardiometabolic disease type two diabetes, as I mentioned in one small study, they looked at the intracellular magnesium status of patients with diabetes and it was depleted over 30% of patients. And now this problem affects 93% of the population to some degree or another heart disease. Another big category, if you have a coronary artery disease, and this is the Rotterdam study looked at 10,000 people reported a 36% greater risk of death from heart attacks and a 54% greater risk of sudden cardiac death in those with low serum magnesium levels. So that’s really concerning. So if you have low magnesium, you’re 54% greater to die from a sudden death, 30% greater risk of having a heart attack.
That’s bad. If you have high blood pressure, often a clue that you might be low magnesium because magnesium relaxes blood vessels and improves flexibility if you have palpitations or rapid heartbeat. Again, magnesium could be the cure, heart attack, strokes, and a blockage in your arteries. Again, studies show that this was a cross-sectional study published in nutrition, metabolism, and cardiovascular disease showed that otherwise healthy Koreans with the lowest serum magnesium had two times the risk of having calcium buildup in their heart, which is a huge clue that there’s atherosclerosis or plaque development. And also it could involve calcium metabolism. There’s too much calcium, non magnesium, it’s a problem. You’ve had a stroke. Those with highest versus lowest magnesium intake had a 40% reduction in all cause mortality versus the lowest intake. So basically you had high intake of magnesium and ended up with a stroke. You’re going to have a 40% reduction in your risk of death after.
That’s pretty good. It’s low magnesium been linked to cataracts, it’s been linked to headaches obviously. In fact, American Academy neurology gives magnesium a level B rating as probably effective for the prevention of treatment of migraine. So often when someone comes in with a migraine to the emergency room, I would give them intravenous magnesium because it relaxes all the spasming blood vessels in their head and helps them relax. Osteoporosis. Often we see it low in osteoporosis, as we mentioned, we see a problem with chronic fatigue and fibromyalgia, mood disorders, anxiety, depression, A DHD. Autism often is very low in these problems. Sleep issues, if you have insomnia and you can’t sleep or other problems that may be magnesium. It’s one of the best sleep aids out there. People don’t realize that if you take magnesium at night, you’ll sleep well. And Epsom salt bass do the same thing you get through your skin.
If you have hormone issues like PMS, often a low magnesium issue or PCOS, fibromyalgia, as I mentioned, asthma, witchy airways, chronic kidney disease, seizures, all these things can be a clue that they may be low magnesium. Now what about high magnesium? Well, this is very rare, but there are certain things that can cause it. If you have chronic kidney failure, adrenal issues, maybe different kinds of tumors or prompts to your adrenals, overtaking anac acids with magnesium in them, severe dehydration because it changes your electrolyte balance and you lose a lot of potassium and sodium and the symptoms of it having high magnesium or nausea, vomiting, fatigue, low blood pressure, trouble breathing, and even respiratory problems and heart attack because it slows everything down. So basically when we give B magnesium to women who are in preterm labor, we watch the respirations because it slows down your respirations, it slows down your breathing, it slows down your heart, it relaxes everything.
So the idea if you tube, you have too much, it kind of relaxes things too much and that’s not good. Okay, so how do you address this? How do you address and treat magnesium deficiency? Well just get rid of the causes, right? We just talked about that. Get rid of the crappy diet, the sodas, the manage your chronic stress levels. Take a look at your medication. Are you taking acid blockers? Are you taking diuretics? What are you taking? Do you have certain health conditions that need to be addressed, whether it’s diabetes or heart disease or other hormonal dysfunctions that can be addressed that actually will help you deal with this from the root cause. So it’s really important to look at the causes and remove what’s causing the magnesium deficiency. Maybe it’s poor diet, maybe it’s taking stuff that’s causing magnesium loss. So what should you do to actually improve your magnesium levels and to address magnesium deficiency or insufficiency?
Well, first you want to eat magnesium rich foods. Then what are those? Well, dark green, leafy vegetables. Things like spinach, swiss char, kle, collars, all that stuff is great. Rugola, avocados, cold water, fish, mackerel, salmon, nuts are high in magnesium. Almonds, cashews, Brazil, nuts, pecans, walnut seeds like pumpkin cheese, seeds, dark chocolate. My favorite, one of my favorite sources of magnesium, actually, whole grains can be helpful. Non GMO soy can be helpful too. I like Tempe. So the diet can be a big factor in replenishing magnesium. Also, you want to find healthy waves to manage stress, right? So active relaxation, yoga, breath work, gratitude journals, riding your bike, working out, getting in the sauna, cold plunges. There’s a million ways to actually improve your stress response of whether it’s, I use binaural beats with something called NuCalm, which is some fun thing I’ve been trying, which basically puts you in a different neurotransmitter state in a different brainwave state.
Also, make sure you replenish your electrolytes. If you’re sweating and you’re exercising, you’re doing the sauna. Make sure you use electrolytes that have sodium, potassium and magnesium and then supplements. What about supplements? I think of all the supplements of all the things that I use, one of the most important is magnesium, probably the second in vitamin D and third would be fish oil. But it’s so important and most people have such improvements pretty quickly when they take it. And it can improve your sleep, it can reduce anxiety, it can reduce palpitations, it can we do muscle twitching. Muscle cramps. I mean so many things. Constipation. Now there’s a lot of different forms of magnesium, so you should be aware with all the different forms, but the dose should probably between 400 to a thousand milligrams of magnesium a day. Now there are many different forms of all different effects, so you have to try out what you need.
For example, my favorite basic one for everybody is magnesium glycinate. It’s broad spectrum. It works across a lot of things. It helps with sleep with relaxation. Anxiety, PMS, cardiovascular health, best taken at night. Magnesium citrate you can use if you have constipation. So that actually helps you go to the bathroom. Magnesium three innate better for the brain gets in the brain better. Anxiety and depression is why I use those four. Some are also better for muscles like magnesium to rate, which is great for muscle recovery, blood sugar regulation, heart health, magnesium, malate. Again, this is part of the mitochondria and energy cycle, so it helps energy and athletic performance. Magnesium sulfate, we use that. That’s Epsom salt, so you can absorb it through your skin. You can try my ultra bath, which is two cups of Epsom salt and 10 drops of lavender oil, hot water, soaking that for 10 to 20 minutes before you go to bed, you’ll sleep like a baby.
So basically just to review, magnesium is so important. It plays a critical role in optimal health and longevity and chronic disease prevention. Conventional medicine often focus on treating the acute issues and not understanding the root causes. You really shouldn’t be waiting for symptoms to appear to take charge your health. You really want to get to the root cause. But if you have any of these issues that I mentioned in this podcast, knowing your magnesium level and knowing your numbers here can help you really get ahold of this and help you engage in a more preventative approach with diet and lifestyle and supplements, which can increase the quality of your life. And who knows, maybe even save it and make sure you get the right magnesium test, which is part of the annual function panel. It’s the red blood cell magnesium. As I said, if I could, I’d see millions of patients with function health.
We’re aiming to democratize much of what I do, offering you the keys to your own health. We’re in a new era of medicine and democratize data-driven healthcare system, giving each of us access to our own health data and informed by the latest science and by the paradigm of functional medicine, there is nothing more important than taking ownership of your health. The function fills in the gaps in our strained healthcare system, starting with an all-in-one set of a hundred lab tests ranging from full hormone panels to deep cardiometabolic testing to nutritional assessments, heavy metals and lots more, including the red blood sound, magnesium. Now, many of these essential tests are not measured in your typical annual blood panel, and there’s no more navigating burdensome insurance. No more having to wait for your doctor’s appointment. No more need to consult Dr. Google to figure out what they mean.
Function offers clear actionable results tracked over time, empowering you to be the CEO of your own health. And the wait list for function is now open, and function is live across the United States and soon globally. We’re inviting new members to join our wait list every day. If you’re interested in taking control of your health, secure your spot on the wait list by visiting function health.com. All this is available for just $499 a year and includes the cost of over a hundred lab tests and a second test panel at six months. So transform your health is a function health right now to secure your spot on the wait list. So also, I’d love to hear your comments and questions. Share this with your friends and family. Subscribe wherever your podcasts. Follow me on all the social channels at Dr. Mark Hyman and let us know what your experience has been with Trying Magnesium or with some of the symptoms we’ve talked about. And hopefully we’ll see you next time on the Doctor’s Pharmacy. And thank you for tuning in to know your numbers. Thanks for listening today. If you love this podcast, please share it with your friends and family. Leave a comment on your own best practices on how you upgrade your health and subscribe wherever you get your podcasts. And follow me on all social media channels at Dr. Mark Hyman and we’ll see you next time on The Doctor’s Pharmacy.