The Warning Signs of Magnesium Deficiency & How To Fix It For Longevity | Dr. Mark Hyman

20% of the population is living with full-blown magnesium deficiency. Now, how do you know if you have magnesium deficiency? We're gonna talk about one of the most important things that is missed by traditional medicine. It's so easy to treat. It creates so much suffering that most people don't know about. And then about 45% of Americans are severely deficient in or insufficient in it. 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, engine, 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 the symptoms, you gotta 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 in 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, 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, to your gut and constipation, to menstrual issues and cramps and muscles. I mean, it's literally everything. And, and in low levels or sub-optimal levels, impact every area of our health, increase our risk for chronic disease. So it's not just kind of 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 run at what 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 lectures. I say, you know, this guy dropped his keys. on the street and his friend comes over and sees him looking under this lamppost. He goes, well, why, what are you looking for? What are you doing? He says, well, I'm looking for my keys. He said, where'd you drop them? He said, why are you dropping them down the street? But he said, why are you looking over here? He says, well, the lights better here under the lamppost. So that's how medicine is. It's easy to test your magnesium, but it's not the right way to find out if you're low or not. I mean, if it's low on your magnesium, you're really, really low. By the time it gets low, you're in trouble. 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 or diseases, then we get tested. But the transition from wellness to illness can 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. The best test, which is really not practical, is something called a magnesium loading test, which is a 24 hour urine test. 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 anything, it means they're alone 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 a 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, if you're insufficient or low and people should be over five and and now 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, right? 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 ATP, 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, you're insulin resistant and your blood sugar is 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 you're not just for muscle health and contraction and relaxation of muscles, but also bone strength and bone density. It's also critical in making hormones such as testosterone, progesterone, estrogen. It's important in the sense that this of neurotransmitters in your brain. It's involved in calming and relaxation and, and inhibits the release of what we call excitatory neurotransmitters. It's also involved in DNA repair. It's involved in fluid and electrolyte balance, right, with calcium, sodium, potassium and hydration, which is why it's often in electrolytes. So, it's really important for electrolyte replacement. It's critical for heart, right? 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 was 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, 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 called 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 of magnesium. You heard of that. And it also it's used to prep for colonoscopy such as 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 kind of 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? 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. you know, it's declining soil quality. It's resulted in almost a 50% 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, you know, 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, pee out magnesium. Also, the recommended levels are to prevent deficiency diseases. The RDA, we call the RDA, is about 300 to 420 milligrams. It's just too low. It's said to prevent deficiencies, 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 250 milligrams of magnesium and 42% have low levels in healthy college students. Also, there's a number of groups that are at higher risk for magnesium deficiency. 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 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 levels. 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 postmenopausal 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 pee out magnesium. Often things that are used to treat high blood pressure like diuretics. If you look at hospitalized patients, 65% of people who are critically ill who were 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, it's an incredibly safe a 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 just 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 want if you're needing to keep levels stable. So if your whole body is 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 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, you know, comprehensive testing. what's going on with all their biomarkers. And we look at red blood cell magnesium. It's 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, and 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 a 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 you're going to measure magnesium. 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, BUN, 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 can be an indicator of low magnesium. If you're high in sodium and other clue that you might have a low magnesium. if your blood sugar is high, your insulin is high, your A1C, your average blood sugar is high, blood sugar control, that's a sign of low magnesium. So a lot of things you can look at to kind of get a clue that you might be magnesium deficient. Another hormone that's important that you should look at is parathyroid hormone. We also think it's important to look at that. And magnesium can be involved in the release of parathyroid hormone from the parathyroid gland in the neck. And if your parathyroid levels are low, you're gonna have low magnesium. So it's important to look at all this stuff, look at your EKG, look at your heart function. So there's a lot of ways to look at Magnesium, but the key is red blood cell magnesium to start. What are the root causes of having an abnormal magnesium or low, 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, in soda, right? Cola is particularly food additives. Uh, and there are all, all these things are used in ultra processed foods and that causes us to basically pee out magnesium, coffee and alcohol. also make us lose magnesium and too much calcium from supplements. 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. We have celiac, inflammatory bowel disease, colitis, Crohn's. If you have diarrhea, you lose magnesium. If you're have diabetes and you're peeing too much, you lose magnesium or 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 gonna, 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 and other deficiencies of nutrients like vitamin B6 or vitamin D or selenium often will cause us to have low magnesium. All right, so what are the things we talked about? Let's just kind of go over those. What are the things we should be worried about that can be related to magnesium deficiency? Well, cardiometabolic disease, type 2 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 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 in 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 build up 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, not enough 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, if that high intake of magnesium and end 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, linked to cataracts, it's linked to headaches, obviously. In fact, American Academy of 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. 'cause 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, ADHD. 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 it. If you take magnesium at night, you'll sleep well and Epsom salt bath did the same thing you can get through your skin. If you have hormone issues like PMS, often a low magnesium issue or PCOS, fibromyalgia, as I mentioned, asthma, twitchy 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 problems with your adrenals, overtaking an 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 are 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 I B magnesium to women who are pre-term labor, we watch the respirations because it slows down your respirations, it slows down your breathing, it slows down your heart, it relax everything. so the idea is if 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 address that actually will help you deal with this from the root cause. So, 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. What are those? Well, dark green leafy vegetables, things like spinach, swiss charge, kale collars, all that stuff is great. Arugula, avocados, cold water fish, mackerel, salmon, nuts are high in magnesium, almonds, cashews, Brazil nuts, pecans, walnuts, seeds like pumpkin, chia 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 tempeh. So, diet can be a big factor in replenishing magnesium. Also, you wanna find healthy ways to manage stress, right? active relaxation, yoga, breath work, gratitude journals, riding your bike, working out, getting in sauna, cold plunges. There's a million ways to actually improve your stress response. So whether it's, I use binaural beats with something called Newcom, which is some fun thing I've been trying, which basically puts you in a different neurotransmitter state, a different brainwave state. Also, make sure you replenish your electrolytes. If you're sweating, you're exercising, you're doing the sauna, make sure you use electrolytes with sodium, potassium, and magnesium. And then supplements. What about supplements? I think, you know, of all the supplements, of all the things that I use, one of the most important is magnesium. Probably the second in, 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 produce 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 1000 milligrams of magnesium a day. Now, there are many different forms of all different effects, so you have to figure 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 that help 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 threonate, better for the brain, gets in the brain better. Anxiety and depression is, is why I use those for. Some are also greater better for muscles like magnesium torate, 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. 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 focuses on treating the acute issues and not understanding the root causes. You really shouldn't be waiting for symptoms to appear to take charge of your health. You really wanna 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 a hold of this and, and help you engage in a more preventive 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. If you love that last video, you're gonna love the next one. Check it here. It supports your muscle strength and function, really important for muscle health, supports your brain health, your mood, cognitive function, neurotransmitters like serotonin, dopamine, cognitive function in terms of neuroprotection against things like Alzheimer's and Parkinson's. It also helps your.