Updated: Nov 3, 2021
by Dannette Kallay, MD
Magnesium is at the top of the list of important minerals in the body. It is needed by every cell and is required for the function of over 600 enzymatic reactions including energy metabolism, the synthesis of fatty acids and proteins, proper insulin response and transmission of nerve impulses. Adequate magnesium levels help muscle fibers relax and play a crucial role in brain function. Magnesium promotes relaxation by inhibitory modulation of the stimulating neurotransmitter glutamate and, therefore, affects the function of GABA, a neurotransmitter responsible for calming the brain. Magnesium’s role in smooth muscle relaxation due to its effect on ion channels has long been established.
Magnesium is absorbed in the gut from the diet. Foods high in fiber are often good sources of magnesium. Best foods for magnesium include leafy greens, beans, nuts, seeds, and whole grains. Unfortunately, due to the depletion of magnesium in our soil and diets devoid of magnesium rich foods, many Americans are thought to have low magnesium levels. Symptoms of low magnesium may include increased irritability, sleep disturbance, loss of memory and concentration. Research suggests that low levels of magnesium may exist in children with ADD/ADHD and autism spectrum disorder.
Due to the fact that most of the body’s magnesium resides in the bones, muscles, and red blood cells, serum magnesium levels are often inaccurate. Special tests like RBC magnesium better reflect true levels inside the cells. Due to the low side effect profile and safety of magnesium, levels are often unnecessary.
While increasing magnesium rich foods in the diet is of utmost importance, this may be a mineral to consider supplementation. The safety of magnesium is well established with the most likely adverse effect being diarrhea, however, excessive doses in children may be harmful and should be avoided.
A good question to ask is, “Which magnesium?” Oral magnesium supplements are typically chelated to an amino acid for better absorption and increased stability which allows for more of the nutrient to be properly utilized by the body. Magnesium oxide is the least well absorbed in the gut and the most likely to cause loose stools. Magnesium citrate is usually better tolerated and may have some effect on constipation. Magnesium glycinate is generally well absorbed by the GI tract and may improve sleep quality. Magnesium sulfate is absorbed topically through the skin and is used to help with muscle aches and to promote muscle relaxation.
When evaluating a pediatric patient, I may recommend a magnesium supplement after discussing specific ways to increase magnesium rich foods in a child’s diet. As stated earlier, supplementation may be necessary to achieve adequate cellular levels. The form of magnesium is chosen based on the context of each patient. There are many options available from oral powders that dissolve in water to topical sprays. There are some supplements that combine magnesium with other nutritional supplements such as GABA, Vitamin B6, and L-theanine to provide a synergistic effect. With any child or adolescent this is an important mineral to consider. At the end of the day, we could all use a hot bath with a couple of handfuls of Epsom Salts!