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Why MDs Don't Prescribe Magnesium

Carol Dean According to Carolyn Dean, MD, ND, “…there are hundreds of references from medical review journals [in Dr. Dean’s book, The Miracle of Magnesium]. I was able to show that many common symptoms for which we really have no drug treatment can be treated by magnesium. “Simple things like angina (chest pain caused by heart problems), muscle spasms, tics, insomnia, migraines—a list of twenty-two conditions. It’s well-known that during pregnancy, if a woman has seizures or hypertension—a condition called preeclampsia -- the treatment is intravenous magnesium. They can’t use drugs for fear of damaging the fetus, so they use something extremely safe and it always works. “But I’ve spoken to heart specialists and asked why they go all the way through the five different types of drugs used for acute heart attack patients, and then as number six give them magnesium. They say, ‘Well, when we finally get to the magnesium, it always works.” But they don’t give it first because it’s really not written up in the medical references. It’s not a drug, so it doesn’t make the “short list”. And when I ask, “Why don’t you use that first?” it’s almost like, “Drugs are powerful, and they’re what doctors give. Doctors don’t give supplements. They’re too common.’ “It’s just not something that even I learned about in medical school, so doctors do not feel comfortable, it seems, prescribing dietary supplements. When they go through six to ten years of medicals school and internships and residencies, they figure if they haven’t learned it in their training, then it doesn’t exist. They do not learn nutrition and they do not learn dietary supplements, and they shy away from them.”

Women's Heart Health and Magnesium

In the February, 2006, edition of Taste for Life magazine, Ann Louise Gittleman, PhD, CNS, writes about heart disease and women. In her article, the author cites that magnesium deficiency can lead to several heart conditions including irregular heartbeat, high blood pressure and even sudden death.

Dr. Gittleman says that magnesium is a natural calcium-channel blocker and dilates coronary arteries and peripheral arteries when available in sufficient levels and in balance with calcium.

She recommends an additional 400 mg of magnesium be added to the daily supplement regimen for women.

The Essential Nutrient Magnesium

by A. Rosanoff, Ph.D. at the Center for Magnesium Education & Research, LLC,

Magnesium is an essential nutrient for all living things. In plants it holds the central position in the all-important chlorophyll molecule which transforms sunlight’s energy into life’s form of chemical-energy, ATP (Adenosine Triphosphate).

Along with calcium and phosphorus, magnesium is considered a major element in human nutrition, as opposed to the trace elements such as Fe, Zn, Cr, Se, etc., and is one of the four electrolytes along with calcium (Ca), sodium (Na), and potassium (K).

Biochemically, a large part of magnesium’s essentiality comes from its combination with ATP—life’s high energy chemical battery. This Mg-ATP complex is required for the cells’ energy-producing structures (mitochondria) to produce ATP; the breakdown of food energy (glucose and fat) into water, carbon dioxide and energy as ATP.

When glucose and/or fatty acids are metabolized, the end products are ATP, water and carbon dioxide. We breathe out the carbon dioxide. The water goes into our system as we are 90+% water. The metabolism requires oxygen, which we breathe in; protein synthesis for growth and enzyme production; DNA replication and RNA synthesis.

While it was estimated in 1968 that magnesium was a required cofactor for over 300 enzyme systems, that number is now more reliably estimated at 700 – 800.

At the cellular level, magnesium joins with the other electrolyte ions in a cell-controlling dance. These ions are carefully and meticulously separated in living cells: calcium and sodium ions, for the most part, are kept outside cells while magnesium and potassium ions are kept mainly inside cells.

Energy in the form of the Mg-ATP complex is necessary to maintain this ionic “packaging” as well as to alter it in a regulated way when warranted. Magnesium has been called “nature’s physiological calcium channel blocker”. When this “blocker” function is breached or when magnesium becomes depleted within the cell from its normal level, calcium rises inside the cell.

This altered state results in a change in the intracellular Mg:Ca ratio, which appears to have an impact on cell function. For example, a lower-than-normal Mg:Ca ratio

• in blood vessel smooth muscle cells—causes vasoconstriction, arterial stiffness, and/or hypertension;

• in heart cells—causes enlargement (hypertrophy); • in blood platelet cells—causes increased aggregation, stickiness and clotting;

• makes fat and skeletal muscle cells less able to respond to insulin (insulin resistance);

• causes pancreatic beta cells to produce more insulin (causing hyperinsulinemia);

• increases nerve cell activity as well as the response of endocrine tissues.

In a life-threatening crisis, such reactions are warranted, necessary and can be life-saving as they allow an animal to perform with unusual strength and speed. Indeed, all these cellular responses to a low Mg:Ca cellular ratio can be aspects of the stress response or “fight-or-flight” reaction.

In healthy individuals, when the stress or crisis is over, magnesium increases inside cells to its normal level, its calcium blocker function is restored, calcium moves back outside cells reestablishing normal electrolyte “packaging”, and the stress response subsides. However, when these responses to a lower-than-normal Mg:Ca ratio are a result of a magnesium nutritional deficiency state, some predictable disease states can occur. These include:

I. Cardiovascular diseases. All the usual markers (or risk factors) for heart disease such as hypertension (high blood pressure), high total cholesterol, low HDL cholesterol, high LDL cholesterol, high homocysteine, and high C-reactive protein, can be the result of low magnesium status. Recent studies show that high anxiety and depression (symptoms of human magnesium deficiency) can predict heart disease even more than the traditional risk factors.

II. Hypertension. Chronic high blood pressure (essential hypertension) can be caused both directly and indirectly by a magnesium deficiency. Low magnesium:high calcium in blood vessel muscle cells cause them to contract which results in a hypertensive state. In addition, a low cellular magnesium impedes a healthy sodium to potassium ratio which is necessary for normal blood pressure.

III. Type 2 diabetes. Type 2 diabetes is seen as part of a syndrome, Syndrome X or metabolic syndrome, which includes hypertension, obesity, unhealthy blood cholesterol levels, and high blood sugar coupled with cells’ inability to properly respond to insulin (insulin resistance). These, with the exception of obesity, have been linked to low Mg:Ca cellular ratio, and the type of obesity most predictive of this syndrome, abdominal obesity, has been shown to be assuaged with a long term diet containing high magnesium foods and a regime of regular exercise

IV. Osteoporosis. Many people take calcium supplements to prevent depletion of minerals from bone that can lead to osteoporosis. To properly use this extra calcium, a body needs to have a healthy magnesium status. If magnesium is low, extra calcium can increase the severity of the magnesium deficiency which causes improper calcium metabolism as one of its symptoms. One of the first signs of a magnesium deficit can be low blood calcium.

Other disease states that may be associated with a magnesium deficiency include: asthma, PMS, pregnancy induced hypertension, migraine headache due to constriction of blood vessels in the head, depression, high anxiety.

Some of the initial problems seen in people who have or are developing magnesium deficiency are neuromuscular. These are presumably due to the abnormal muscular contraction-nerve firing states brought on by a low Mg:Ca cellular ratio which can be a result of chronic low magnesium intake, very high calcium intake, or a combination of the two.

Quantifying human magnesium status and the degree of magnesium deficiency in populations of the industrialized world is difficult given the current lack of a widespread biomarker. Commonly available tests of serum and red blood cell magnesium have not reliably been associated with overall nutritional magnesium status.

Most health professionals are taught and many believe that magnesium deficiency is rare, occurring mainly in alcoholism or with general malnutrition, and that most diets give a person enough magnesium given that magnesium is widespread in foods.

The research does not support this widespread view.

Diets of the industrialized world can be quite low in magnesium. Refined grains and refined sugar are among the lowest foods in Mg content, so when these are high in the diet, Mg intake can be quite low. Given the wide use of refined sugar and flour in processed foods, widespread use of calcium supplements, and the increased practice of fortifying foods with calcium, daily magnesium supplements can be protective.

Magnesium supplements can be found in various forms such as inorganic MgO and MgCl2, in tablets and capsules and in a better-absorbed organic form such as water soluble Magnesium Citrate.

Doctor Recommends Powdered Magnesium

According to Carolyn Dean, MD, ND, “The powdered form is probably the best because you start absorbing it straight away, even in the mouth. So, powdered first, and then capsules, and then tablets. The tablets usually have a lot of binders and fillers and are harder to dissolve than capsules.”

Doctor Links Diseases to Magnesium Deficiency

Carolyn Dean, MD, ND, and author of "The Miracle of Magnesium" states, “When I was doing research for The Miracle of Magnesium, I found that most if not all of the body's metabolic processes -- those chemical processes which turn food into energy -- require the interaction of various vitamins and minerals in order for them to even work. Many symptoms which trace back to lack of metabolism are caused by either vitamin and mineral deficiency or imbalance. So if medicine continues to focus on drugs to treat symptoms, rather than on possible causes based on deficiencies, they’ll continue to miss the boat on treating a lot of what I think are the 'chronic lifestyle diseases'.

"And beyond that, the US Food and Drug Administration (FDA) has an office called the Office of Dietary Supplements, and at a recent conference I had an opportunity to ask someone in this office about their basic purpose. Their basic goal is to study nutrients for the prevention of disease, not for the treatment of disease. So as long as the government’s focus is just to prevent deficiency diseases by simply providing the required daily allowance (RDA) of nutrients, we’ll never get to the point where we focus on the use of dietary supplements, such as magnesium, for the treatment of today’s common diseases. There are at least twenty-two different diseases and symptoms that I outline in The Miracle of Magnesium for which scientific proof exists of being caused by magnesium deficiency. “The recommended daily allowance (RDA), is about 350 mg per day, but most researchers say you need two and three times that amount, partly because it’s not in foods. If it is in foods, if you cook and process the foods in any way, you lose magnesium.”

Heart Disease and Low Magnesium

According to A. Rosanoff, Ph.D. of the Center for Magnesium Education and Research, “The most important marker for impending heart disease is a low magnesium to calcium ratio (Mg:Ca) in the cells. All the usual markers (or risk factors) for heart disease e.g. high total cholesterol, low HDL cholesterol, high LDL cholesterol, high homocysteine, high C-reactive protein, syndrome X with its high blood sugar, active type-II diabetes and hypertension, can all be the result of low magnesium status.” The vast scientific evidence backing this bold statement is summarized for the lay public in the book, The Magnesium Factor by Mildred S. Seelig, M.D. and Andrea Rosanoff, Ph.D.

Author Cites Uses of Natural Calm

According to Andrea Rosanoff, Ph. D, co-author of The Magnesium Factor, “Magnesium Citrate, the form of magnesium in Natural Calm, is an available form of magnesium readily absorbed when mixed with warm to hot water and taken as a drink.

It can provide a variable amount of a magnesium supplement: one/half teaspoon provides 100 mg magnesium in a calming drink, that can be repeated several times a day if more magnesium is necessary. Or, 1, 2 or 3 teaspoons giving 200, 400 or 600 mg respectively, can be taken in one drink if comfortably tolerated.

This magnesium supplement is also versatile:

• It can be taken by itself to provide the needed magnesium so many of us are not getting from our food sources.
• If one is taking a calcium supplement or enjoys a lot of dairy in the diet, it can provide the needed magnesium to balance calcium supplements and/or a high calcium diet.
• Even if one is taking a calcium supplement with magnesium and begins to have symptoms of a magnesium deficit, e.g. headache, hypertension, anxiety too high for the situation (See Appendix E of “The Magnesium Factor”), this magnesium supplement can provide necessary balance.
• During a high stress time, it can provide the amount of extra magnesium necessary to forestall magnesium depletion and damage from stress.

Calcium and its Relation to Magnesium

Calcium is an important nutrient essential to maintaining total body health. Your body needs it every day—not just to keep your bones and teeth strong, but to ensure proper functioning of muscles and nerves. It even helps your blood to clot. But can too much calcium be a problem? Yes, it can.

A matter of balance

Calcium deficiency can be a serious issue and has been heavily promoted through the media and advertising. But the hidden cause of calcium deficiency is the fact that available calcium is not being assimilated by the body due to a lack of magnesium.

Without a proper balance of these two minerals, magnesium gets depleted, which will result in the negative effects associated with lack of magnesium and a buildup of unassimilated calcium.

In addition to the many calcium (without magnesium) supplements on the market, calcium is now added to cereals, crackers, juice, antacids and other items (including soft drinks). None of these products contain magnesium to balance the added calcium.

Calcium, Magnesium and Stress

Calcium and magnesium are two different sides of a coin.

Calcium excites nerves while magnesium calms them down.

Calcium makes muscles contract. Magnesium is necessary for muscles to relax.

Calcium is needed for blood clotting but magnesium keeps the blood flowing freely.


It is vital to keep these minerals in balance. Too little magnesium to balance calcium can be both uncomfortable and unhealthy. To ward off the negative effects of a prolonged period of stress or over-reaction to stress, calcium needs to be balanced with adequate amounts of magnesium.

Going through a stressful period without sufficient magnesium can set up a deficit that, if not corrected, can linger, causing more stress (see symptoms of magnesium depletion listed on the green page of this brochure) and further health problems.

Today we have diets dangerously low in magnesium. Add the recent inclusion of nutritional calcium via supplements and food fortifications meant to stave off osteoporosis and many of us are getting inadequate magnesium plus too much calcium.
Women taking calcium supplements to prevent osteoporosis—without adequate magnesium—can actually lower the vital bone mineralization process. Magnesium is as important as calcium in the prevention of osteoporosis and is crucial to increasing bone mass.

Magnesium and Diabetes

Insulin is the hormone that helps with the regulation of glucose (sugar) metabolism. Magnesium has been found to improve insulin’s response to dietary sugar and to improve the action of insulin in regulating blood sugar levels.

According to the American Diabetes Association, projections of a continued rapid growth in the incidence of type 2 diabetes requires a cost-effective approach that can be widely employed to prevent or delay this major disorder.

Published in the journal Diabetes Care, two recent studies suggest that an increased intake of magnesium could have a role in reducing the risk of type 2 diabetes.

The National Institutes of Health, Office of Dietary Supplements, reports that there is an increased interest in the role of magnesium in preventing and managing disorders such as hypertension, cardiovascular disease and diabetes.

Magnesium and the Heart

According to noted author and researcher, Mildred S. Seelig, MD, “Most modern heart disease is caused by magnesium deficiency. A vast and convincing body of research, largely ignored, has convinced us and many of our colleagues of this fact. The diet of the industrial world is short on magnesium, and this is causing an epidemic of heart disease in the modern world.”

Dr. Seelig goes on to state, “Studies have linked low magnesium with many of the major risk factors for heart disease. Other studies show that the average Western processed-food diet is lower in magnesium than is commonly acknowledged. While several essential nutrients are imperative for heart and blood vessel health, the vast research on low magnesium and its impact on heart health has gone unheeded, so much so that much of the heart disease seen today is a direct result of low magnesium consumption.”

"The most important risk factor for impending heart disease is a low magnesium-to-calcium ratio in the cells. All the usual factors such as high cholesterol, active type 2 diabetes and hypertension can be the result of a low magnesium status. Magnesium inhibits platelet aggregation, thins the blood, blocks calcium uptake, relaxes blood vessels and moderately lowers blood pressure. It has been shown to reduce the risk of coronary heart disease and relieve symptoms in roughly 85 percent of mitral valve prolapse patients."

Osteoporosis, Calcium and Magnesium

Consider the following: What country has the highest rate of pasteurized milk consumption? That’s right—America.

Now, what country has the highest calcium supplement consumption? Correct again! America.

So, America must have the lowest occurrence of osteoporosis, calcium loss and bone fragility. Right? Wrong! We have the highest rate! Why?

Excess calcium combined with low magnesium. Taking more calcium will rarely remedy a calcium deficiency. This is clearly evident from recent research studies.

One study concludes that neither milk nor a high-calcium diet appears to reduce the rise of osteoporotic hip fractures in postmenopausal women.(1) Another study concluded that findings “do not support the hypothesis that higher consumption of milk or other food sources of calcium by adult women protect against hip or forearm fractures.”(2) It is magnesium that will handle the calcium deficiency as well as the lack of adequate magnesium, and it will dissolve excess calcium from the body while helping any needed calcium to assimilate.

Today we have diets dangerously low in magnesium. Factor in the recent addition of nutritional calcium via supplements and food fortifications that are meant to stave off osteoporosis, and many of us are getting inadequate magnesium plus too much calcium. Magnesium is crucial to increasing bone mass, as it is magnesium that allows calcium to assimilate.

People taking supplemental calcium should accompany their calcium with the magnesium necessary for absorption. Women taking calcium supplements to ward off osteoporosis, without adequate magnesium nutrition, can further exacerbate the effects of a magnesium deficit. (Calcium supplements taken without sufficient magnesium can actually LOWER the bone mineralization process.) Magnesium is as important as calcium in the prevention of osteoporosis and is vital to increasing bone mass.

References :
1. Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston (DF, WCW, and GAC), and the Departments of Nutrition (WCW) and Epidemiology (WCW and GAC), Harvard School of Public Health, Boston.
2. Diane Feskanich, Walter C. Willett, and Graham A. Colditz, “Calcium, vitamin D, milk consumption, and hip fractures: a prospective study among postmenopausal women, American Journal of Clinical Nutrition 77, no. 2 (February 2003): 504–11.

The Anatomy of Stress

by A. Rosanoff, Ph.D. at the Center for Magnesium Education & Research, LLC,

When stress becomes constant in our lives—be it mental, emotional, environmental or physical—the continual state of hypervigilence of our bodies and cells can be detrimental to our health. This is especially true when one is low in magnesium—often the case in today’s diet of highly processed foods. Going through a stressful period without sufficient magnesium can set up a deficit that, if not corrected, can linger, causing more stress and further health problems.

Without sufficient magnesium, the nerve cells cannot give or receive messages and become excitable and reactive. This causes a person to become stressed, highly sensitive and nervous. Feelings of nervousness, irritability and being unable to relax are signs of needing magnesium. The stress response involves the influx of calcium into cells, resulting in a drastic change in the cells’ internal magnesium-to-calcium ratio. Normal cells contain 10,000 times more magnesium than calcium ions. If the amount of cellular magnesium falls, however, calcium ions flow into the cell. With such an imbalance, calcium puts the cell into a hyperactive state. This can cause muscle contraction and lead to painful cramping. The muscles need magnesium in order to relax.

Low magnesium/high calcium levels can cause cells to physically change. High calcium makes bones stiff and hard, which is good, but in soft tissues it becomes a problem of calcification. This stiffness in artery and heart cells can hamper proper function and can be a factor in heart disease. Excess calcium is a very widespread problem. Excess calcium depletes magnesium in the body.

Noted author and researcher, Mildred S. Seelig, MD, explains “Calcium is an important essential nutrient, but it must be guarded and controlled, and balanced by adequate magnesium if it is not to cause damage to the cells and the body as a whole.” For these exact reasons excess calcium can become a real problem, while excess magnesium, on the other hand, is not a concern. Unlike calcium, magnesium does not build up in the body—excess amounts are simply flushed out.

Magnesium Vital to Energy

Energy in the body is produced in the form of ATP (adenosine triphosphate—present in all living tissue, provides energy for processes such as muscle contraction), through the process of cellular respiration. Magnesium is perhaps the most important nutrient co-factor involved in cellular respiration as it is actively involved in every single step. Carbohydrates, lipids and proteins cannot produce the source of muscle contraction energy—ATP—without the presence of magnesium. Optimal magnesium status can therefore facilitate oxygen and energy being delivered to working muscle tissue. Carolyn Dean, MD, ND, states “In my book [The Miracle of Magnesium], I talk about magnesium being 'the spark of life' in the body, and in fact it is responsible for creating the energy in the cells and the energy in the body. So when a person is feeling fatigued, it can actually be coming from a magnesium deficiency.

Too Little Magnesium Can Cause Health Problems

The Recommended Daily Allowance of magnesium (which is the minimum level needed to stave off deficiency symptoms—not the maximum levels) varies by age and gender. Children 1 to 3 years: 80 mg Children 4 to 8 years: 130 mg Children 9 to 13 years: 240 mg Boys 14 to 18: 410 mg Girls 14 to 18: 360 mg Men 19 to 30: 400 mg Women 19 to 30: 310 mg Pregnant women 19 to 30: 350 mg Men 31 plus: 420 mg Women 31 plus: 320 mg Pregnant women 31 plus: 360 mg.

A survey conducted by The Gallup Organization found that 72 percent of adult Americans fall short of the Recommended Dietary Allowance for magnesium.

Because magnesium is required for hundreds of enzymatic reactions (enzymes are protein molecules that stimulate every chemical reaction in the body), deficiency can cause a wide variety of symptoms, such as Low Energy • Fatigue • Weakness • PMS and Hormonal Imbalances Inability to Sleep • Weakening Bones • Muscle Tension, Spasms and Cramps Abnormal Heart Rhythms • Headaches • Anxiousness • Nervousness • Irritability.

Carolyn Dean, MD, ND, and author of The Miracle of Magnesium states, “The recommended daily allowance (RDA), is about 350 mg per day, but most researchers say you need two and three times that amount, partly because it’s not in foods. If it is in foods, if you cook and process the foods in any way, you lose magnesium.”


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