Health Matters: Evidence on magnesium for muscle cramps unclear
As the science of medicine advances, and more research is performed, our understanding of the importance of nutrition deepens. As the cliche goes, we are what we eat. Our body fuels the minute-by-minute process of cellular growth and provides for tissue repair, via the consumption of solids and liquids. It’s what is in our foodstuffs, the actual molecular composition, that is so critical to health.
It can be denied no longer: what we eat matters greatly to our health. Yet, because of modern farming techniques, we are no longer getting the nutrients required for wellness from our food products. Even fresh produce has been found to be deficient in important vitamins and minerals. Consequently, you can’t depend on buying nutritious-type foods to get all the things you need from your diet.
Many Americans take vitamins on a regular basis, hoping to provide their body with all the important nutrients it needs for health. One that is associated with a long list of benefits is magnesium which has an important role in hundreds of metabolic reactions. It is an essential mineral, with many vital roles, one of which governs muscle function amongst many others.
The list of conditions supposedly aided by magnesium supplementation is extensive: as a sleep aid, in the treatment of migraine headaches, depression, high blood pressure, and many others. Predictably, the evidence for many of these attributes is limited to non-existent. Still, the idea of being “time-tested” does account for something.
A serious magnesium deficiency is rare in the US since it leads to some dramatic symptoms like nausea, vomiting, tingling and numbness, even cardiac rhythm problems. But subtle deficiencies are probably more common, although difficult to detect. Some good evidence associates a mild, chronic deficiency with adult-onset diabetes, stroke, heart disease, and migraines. Unfortunately, a simple blood draw does not allow for an accurate assessment of levels.
Magnesium supplementation appears to be helpful for seniors or anyone with osteopenia, which is thinning of bone. Excellent evidence exists on this topic, clearly establishing a link between supplementation and a reduced risk of fractures. Research has revealed its presence is necessary for the process of bone production. We find lower levels of magnesium in individuals who have osteoporosis.
Small clinical trials have been performed indicating magnesium’s benefits in the treatment of migraines, although evidence of this type doesn’t provide sufficient strength to make grand proclamations about magnesium supplementation. The American Academy of Neurology claims magnesium is “probably effective” at preventing migraines.
There have been numerous case studies reporting on the use of magnesium supplementation for muscle cramps. But because there hasn’t been any definitive research, no double-blinded, placebo controlled studies, no one can say for certain what are the effects of magnesium for this common complaint. Interestingly, modern medicine is not actually certain why exercise-induced cramps occur.
One explanation, the older theory, is that dehydration results in an electrolyte imbalance, referring to a variation in the water-salt balance. The newest explanation for why increasing muscle activity produces more cramps attributes the problem to nerves. There is a change in the workings of the nerve-muscle junction, causing the muscle to become over-excited and contract involuntarily.
We know that an abnormal foot type can result in greater stress to certain muscle groups running down to, or in, the foot. It may be those on the bottom of the arch or on any side of the foot or leg. These muscles will have to overwork in the stressful process of standing and walking. Although not considered an example of EAMC, Exercise-Associated Muscle Cramps, this is likely the same phenomenon. It doesn’t take much activity for a non-athletic senior citizen, with their reduced soft tissue health, to experience this cramping pain when their arch is collapsing every step.
Magnesium is present in nearly all foods in varying concentrations, with higher levels found in leafy vegetables, most legumes, and especially coffee. When the decision is made to supplement dietary sources, any of the commercially available forms, the citrate, carbonate or oxide, appear helpful. A dose varying between 250 and 1500 milligrams is typical and seems to be of benefit both in terms of bone mineral density and fracture risk.
Although various studies suggest magnesium is helpful in alleviating the occurrence of muscle cramps, definitive evidence remains lacking and many studies show no obvious benefit. Once again, when it comes to the many questions remaining on the topics of health and disease, including magnesium supplementation, more research is needed.
But there seems little downside to supplementation. Ingesting too much is difficult. And it is not expensive. And though the benefits are not conclusively proven, the list of potential aids from magnesium supplements seems significant (especially when you have an abnormal foot type!).
EDITORS NOTE: Dr. Conway McLean is a podiatric physician now practicing foot and ankle medicine in the Upper Peninsula, having assumed the practice of Dr. Ken Tabor. McLean has lectured internationally on surgery and wound care, and is board certified in both, with a sub-specialty in foot orthotic therapy. Dr. McLean welcomes questions, comments and suggestions at drcmclean@penmed.com.