Diabetic neuropathies comprise a group of heterogeneous disorders caused by poorly managed or untreated T2D. Prolonged hyperglycemia (high blood sugar levels) induces increased production of free radicals, which can damage nerve fibres and cause nerve cell death. As such, patients with diabetic neuropathy often experience pain, numbness, hypersensitivity, and reduced function in the legs and arms. There is no known cure for this painful disease. Doctors generally suggest lifestyle changes, such as smoking cessation, weight loss, and blood pressure management. However, lifestyle changes may not always be enough to alleviate symptoms. Unfortunately, it is very difficult to treat neuropathic pain
Magnesium is one of those supplements that is very well known for its benefits throughout the natural health community. Magnesium is involved in over 300 biochemical processes in the body. One of its most important functions is that it plays a key role is producing energy, this makes it vitality important for all cellular functions and processes. It helps maintain normal muscle and nerve function, keeps heart rhythm regular, supports a healthy immune system, and keeps bones strong. Its wide range of health benefits and biological activity make it effective in addressing a number of common diseases and conditions including fibromyalgia, chronic pain, diabetes, osteoporosis, cardiovascular disease and headaches. Numerous studies have demonstrated that magnesium supplementation and correction of deficiency has improved the aforementioned conditions. The problem with this essential mineral is that most people do not have sufficient levels for optimal health. A gradual depletion of nutrients from our soils has left many vegetables with lower levels of magnesium. Another factor that contributes to magnesium deficiency is that it often is depleted by various common conditions (i.e. IBS, Crohn’s disease) and medications (i.e. proton pump inhibitors, diuretics).
For a more complete discussion please see the article “The Many Faces of Magnesium” in the Heart Health issue of Advances at our home on the web.
As a supplement, magnesium is most commonly found in small amounts in multivitamins and in certain over the counter laxatives. Minerals such as magnesium or calcium are combined with another molecule to stabilize the compound. Each combination, referred to as a chelate, (such as magnesium citrate) has different absorption, bioavailability and therapeutic value. These additional molecules can really impact the medicinal value of the magnesium and some even have beneficial effects in their own right. The most common forms and their benefits are listed below.
Magnesium oxide: Often used in milk of magnesia products since this form has a strong laxative effect. Even though this combination contains a large proportion of magnesium compared to the oxide molecule, it has poor bioavailability and readily causes loose stools; therefore it is considered the least optimal form to use as a supplement.
Magnesium sulfate: This form is often used as an intravenous preparation but it is not used in oral formulations. Since it does have some absorbability through the skin, it is also found in Epsom bath salts.
Magnesium citrate: A commonly used form that has a good bioavailability compared to oxide. It is also very rapidly absorbed in the digestive tract but it does have a stool loosening effect.1 This form is found in many supplements and remains a solid option for delivering magnesium into the body.
Magnesium Aspartate: This form has increased bioavailability compared to oxide and citrate. There were some promising clinical trials conducted in the 1960s that found a combination of magnesium and potassium aspartates had a positive effect on fatigue and they reduced muscle hyper-excitability.2 Physiologically this makes sense since both magnesium and aspartic acid are critical players in cellular energy production. This form is not commonly found but has been used for chronic fatigue syndrome.
Magnesium Glycinate: Glycine is a well-known calming amino acid. This combination has good bioavailability and does not have a laxative effect since glycine is actively transported through the intestinal wall. Due to the calming and relaxing effect of both glycine and magnesium, this combination has been used successfully for chronic pain and muscle hyper tonicity.3
Magnesium Malate: This less well-known combination has been studied for use in fibromyalgia. Since malate is a substrate in the cellular energy cycle, it can help improve ATP production; there is some preliminary evidence that it may reduce muscle pain and tender points in fibromyalgia patients.4
Magnesium Orotate: This is another relatively unknown chelate combination containing orotic acid. This form has good bioavailability has had been studied specifically for heart health. Orotates can penetrate cell membranes, enabling the effective delivery of the magnesium ion to the innermost layers of the cellular mitochondria and nucleus. Orotates themselves increase the formation of RNA and DNA which can help heart cells repair and therefore improve function. The combination has been shown to improve heart failure, symptoms of angina and exercise performance in clinical trials.5,6
Magnesium Taurate: Both magnesium and the amino acid taurine share the ability to improve cardiac function; each has a potentiating effect on insulin sensitivity and also a calming effect on neuromuscular excitability. The actions of both have striking similarities when it comes to cardiovascular health. They both have blood pressure reducing effects, stabilize nerve cells, improve the contraction of the heart muscle and have an anti-thrombotic effect.7 Additionally, low levels of vitamin B6 have been shown to further deplete both magnesium and taurine.
Magnesium-L-Threonate: This form of magnesium has recently been studied to improve memory and brain function. One preliminary study in animals found that it significantly enhanced both short-term and long-term memory, boosting scores by 15% for short-term memory and 54% for long-term memory compared to magnesium citrate.8 Based on this study, it appears that magnesium-L-threonate is a highly absorbable form of magnesium that can improve brain function. While this research is promising, more is needed to confirm its benefit.
Magnesium Pidolate (or picolinate): This form of magnesium has generated interest because it is very inexpensive and can easily be made into a liquid supplement. There really have not been any substantial research trials supporting its specific health benefits. The down side of this form is that the pidolate molecule does not have any additional health benefits.
Due to its broad ranging beneficial effects, magnesium has really emerged as a quintessential health supplement with an excellent safety profile. Various forms of magnesium can be employed for specific health concerns and to increase bioavailability. Consider the research evidence and activity of each form to choose one that is most appropriate for you.
Want to know more about magnesium? Check out part 2 here.
You may also be interested in: “Understanding Different Types of Calcium Part 1”
1) Coudray C, Rambeau M, Feillet-Coudray C, Gueux E, Tressol JC, Mazur A, Rayssiguier Y: Study of magnesium bioavailability from ten organic and inorganic Mg salts in Mg- depleted rats using a stable isotope approach. Magnes Res 2005;18:215–223.
2) Nagle FJ, Balke B, Ganslen RV, Davis AW. The mitigation of physical fatigue with “Spartase”. FAA Office of Aviation Medicine Reports. Rep Civ Aeromed Res Inst US. 1963 Jul;26:1-10.
3) Lamontagne C, Sewell JA, Vaillancourt R, Kuhzarani C, (2012) Rapid Resolution of Chronic Back Pain with Magnesium Glycinate in a Pediatric Patient. J Pain Relief 1:101
4) Abraham GE, Flechas JD. Management of Fibromyalgia: Rationale for the Use of Magnesium and Malic Acid. Journal of Nutritional Medicine (1992) 3, 49-59.
5) Stepura OB, Tomaeva FE, Zvereva TV. Orotic acid as a metabolic agent. Vestn Ross Akad Med Nauk. 2002; (2): 39-41.
6) Geiss KR, Stergiou N, Jester, Neuenfeld HU, Jester HG. Effects of magnesium orotate on exercise tolerance in patients with coronary heart disease. Cardiovasc Drugs Ther. 1998 Sep; 12 Suppl 2:153-6.
7) McCarty MF. Complementary Vascular-Protective Actions of Magnesium and Taurine: A Rationale for Magnesium Taurate. Medical Hypotheses (1996) 46. 89-100
8) Slutsky I, Abumaria N, Wu LJ, et al. Enhancement of learning and memory by elevating brain magnesium. Neuron. 2010 Jan 28;65(2):165-77