The Magnesium Deficiency Crisis

An Invisible Epidemic

“At the best of times, only about one-half (or as little as one-third) of the magnesium that is contained in food and water is absorbed; the rest is eliminated in the stool or urine. Add to this the fact that very little magnesium exists in the majority of farmland in the United States and thus in the food supply, plus the recent widespread recognition of the condition called leaky gut and the disruption of the intestinal microbiome, and you have a magnesium deficiency disaster. All this is happening at a time when 80 percent of the U.S. population does not even obtain the meager RDA of magnesium, making magnesium deficiency symptoms epidemic.”[1]

— Carolyn Dean, MD, ND, The Magnesium Miracle

“Subclinical magnesium deficiency increases the risk of numerous types of cardiovascular disease, costs nations around the world an incalculable amount of healthcare costs and suffering, and should be considered a public health crisis.”[2]

— DiNicolantonio, O’Keefe, and Wilson

“This quiet, unballyhooed pioneer and genius in the field of nutrition demonstrates that countless human ills stem from the fact that impoverished soil of America no longer provides plant foods with the mineral elements essential to human nourishment and health! To overcome this alarming condition, he doctors sick soils and, by seeming miracles, raises truly healthy and health-giving fruits and vegetables.”[3]

— Rex Beach, 1936

Introduction

Magnesium is an essential mineral that plays a pivotal role in human health. It regulates the activity of over 300 enzymes and influences approximately 80% of known metabolic functions.[4] Its wide-ranging impact includes supporting energy production, maintaining muscle and nerve function, regulating blood sugar levels, and contributing to bone health. It is required to synthesize DNA, RNA, and the antioxidant glutathione. Despite its critical importance, magnesium remains one of the most underappreciated and under-researched nutrients in human health and nutrition.

Functions of magnesium

Current estimates reveal a widespread deficiency, with approximately 45% of Americans falling short of adequate magnesium levels. Alarmingly, nearly 60% of adults fail to meet the Average Dietary Intake (ADI), which underscores the prevalence of suboptimal magnesium consumption.[5] Depleted soils from intensive farming practices contribute to reduced magnesium content in the food supply, making it nearly impossible to achieve sufficient dietary intake alone. The modern diet, dominated by highly processed foods, has exacerbated this issue. In addition, many medications magnify an already terrible magnesium deficiency situation.

Magnesium Deficiency and Health

Magnesium deficiency has far-reaching health consequences, impacting nearly every system in the body.[6] It is often called the “invisible deficiency” due to its subtle onset and the wide range of nonspecific symptoms it produces. General symptoms can include anxiety, lethargy, irritability, poor stress tolerance, sleep disturbances, and impaired athletic performance. Many individuals also experience muscle cramps, spasms, or stiffness, particularly in the calves, feet, or facial muscles. These symptoms are more than just inconvenient—they reflect the mineral’s essential role in muscle relaxation and neuromuscular function.

The nervous system and cardiovascular health are particularly vulnerable to magnesium deficiency. Neurological effects can range from heightened nervousness and sensitivity to neurotransmitters to more severe conditions like migraines, tremors, seizures, or memory difficulties. The cardiovascular system can suffer from arrhythmias, hypertension, coronary artery spasms, and even an increased risk of sudden cardiac death. Magnesium also influences electrolyte balance, including potassium and calcium levels, exacerbating heart and metabolic complications risks. Metabolic disturbances linked to magnesium deficiency include increased triglycerides and cholesterol, insulin resistance, and a higher likelihood of developing metabolic syndrome.

In pregnancy, magnesium plays a vital role in reducing complications such as eclampsia, preterm labor, and even miscarriage. Chronic deficiency has also been associated with conditions such as osteoporosis, asthma, and chronic fatigue syndrome. Furthermore, gastrointestinal symptoms such as constipation and reduced glucose tolerance highlight the mineral's role in digestion and energy metabolism. Overall, magnesium deficiency’s broad systemic effects underline its critical role in maintaining health, emphasizing the importance of adequate magnesium intake for disease prevention and overall well-being. Skeletal muscles, heart, teeth, bones, and many other organs require magnesium to sustain their physiologic functions.[7]

Magnesium serum levels represent just 0.8% of the body's total magnesium, making them a poor indicator of the 99.2% stored in tissues, which reflects true magnesium status. As a result, blood tests for magnesium are unreliable. The absence of a standardized test to accurately assess magnesium levels remains a significant challenge and contributes to magnesium's underappreciation compared to other macronutrients.[8]

“Hypomagnesemia [low magnesium] is a relatively common occurrence in clinical medicine. That it often goes unrecognized is due to the fact that magnesium levels are rarely evaluated since few clinicians are aware of the many clinical states in which deficiency, or excess, of this ion may occur.”[9]

Magnesium: Deficiency signs and symptoms

Industrial Agriculture

Depleted soils from intensive farming practices contribute to reduced magnesium content in the food supply, compounding the challenges of achieving sufficient dietary intake alone. Nearly 90 years ago, concerns about mineral deficiencies in soils were being recognized. In 1936, a report on U.S. soils was submitted as part of a Congressional investigation into farming practices. Leading experts of the time had been sounding the alarm, warning that soil depletion was contributing to a significant decline in the nation’s health. They linked the impoverished soils to a noticeable rise in degenerative diseases, underscoring the urgent need to address the impact of agricultural practices on public well-being.

“Do you know that most of us today are suffering from certain dangerous diet deficiencies which cannot be remedied until the depleted soils from which our foods come are brought into proper mineral balance? The alarming fact is that foods, fruits and vegetables and grains, now being raised on millions of acres of land that no longer contain enough of certain needed minerals, are starving us - no matter how much of them we eat! This talk about minerals is novel and quite startling. In fact, a realization of the importance of minerals in food is so new that the textbooks on nutritional dietetics contain very little about it. Nevertheless, it is something that concerns all of us, and the further we delve into it the more startling it becomes.

You would think, wouldn't you, that a carrot is a carrot - that one is about as good as another as far as nourishment is concerned? But it isn't; one carrot may look and taste like another and yet be lacking in the particular mineral element which our system requires and which carrots are supposed to contain. Laboratory tests prove that the fruits, the vegetables, the grains, the eggs, and even the milk and the meats of today are not what they were a few generations ago. No man of today can eat enough fruits and vegetables to supply his system with the minerals he requires for perfect health, because his stomach isn't big enough to hold them! And we are running to big stomachs.

No longer does a balanced and fully nourishing diet consist merely of so many calories or certain vitamins or a fixed proportion of starches, proteins, or carbohydrates. We now know that it must contain, in addition, something like a score of mineral salts.”[10]

The depletion of minerals in farmland, as emphasized in the 1936 Senate report, is likely a key contributor to the widespread magnesium deficiency affecting many Americans today.

Today, the condition of farmland soils is significantly worse than in 1936.

Unfortunately, the issue of soil degradation has remained largely unaddressed in the United States. Kirkpatrick Sale, writing in The Nation, highlighted how the post-World War II era saw the aggressive repurposing of wartime technologies for agricultural use. This transition prioritized industrial efficiency and large-scale production, often at the expense of soil health, ultimately leading to the long-term depletion of essential nutrients in our food systems.

“When U.S. industrialism turned to agriculture after World War II, for example, it went at it with all that it had just learned on the battlefield, using tractors modeled on wartime tanks to cut up vast fields, cropdusters modeled on wartime planes to spray poisons, and pesticides and herbicides developed from wartime chemical weapons and defoliants to destroy unwanted species. It was a war on the land, sweeping and sophisticated as modern mechanization can be, capable of depleting topsoil at the rate of three billion tons a year and water at the rate of 10 billion gallons a year.”[11]

Before World War II, agricultural chemicals were rarely used. By 1995, however, U.S. agriculture relied heavily on them, applying over 45 million tons of chemical fertilizers and 770 million pounds of synthetic pesticides. Today, 95% of U.S. crops are grown using chemical fertilizers and pesticides.[12] Increased use of pesticides and fertilizers changes soil qualities, reducing the content of magnesium and other minerals needed to grow crops and vegetables.[13]

Over the past century, many fruits and vegetables have experienced a dramatic decline in mineral and nutrient content. Research suggests that magnesium levels in vegetables have decreased by an alarming 80–90% in both the United States and England, as illustrated in the chart.[14]

The average mineral content of calcium, magnesium, and iron in cabbage, lettuce, tomatoes, and spinach has dropped 80–90% between 1914 and 2018

A study on historical changes in the mineral content of fruits and vegetables in the UK from 1940 to 2019 shows a long-term decline, with levels remaining lower than in 1940. The most significant reductions over this 80-year period were in sodium (Na), iron (Fe), copper (Cu), and magnesium (Mg).[15] Modern commercial agriculture produces very different varieties of food than those grown in the early twentieth century, as the focus has been on quantity and profits over nutritional quality.

“Today most varieties have been bred to improve their productivity and profitability and this focus on yield has largely ignored any implications for nutritional quality. Davis, in his analysis of US horticulture, noted that significant yield increases have been achieved since the Second World War, but that during this same time period mineral losses were greatest in vegetables.”[16]

Many fertilizers contain toxic heavy metals that enter the soil and are absorbed by plants. Phosphate fertilizers, for example, are often contaminated with cadmium. Similarly, trace mineral fertilizers and liming materials made from industrial waste can carry various heavy metals. Over time, repeated use of these fertilizers leads to a buildup of heavy metals in the soil, which in turn contaminates the crops grown on it.[17]

Industrial food

Modern diets, which are believed to consist of up to 60% processed foods, play a significant role in causing nutrient deficiencies.[18] Common processing methods, such as grain bleaching and vegetable cooking, can result in losing up to 80% of magnesium content. Additionally, certain dietary components exacerbate magnesium deficiency. Beverages like soft drinks, which are high in phosphoric acid, and low-protein diets (less than 30 mg/day) hinder magnesium absorption. Refined oils, grains, and sugar lose most of their magnesium during processing.[19]

Common stimulants like caffeine and alcohol increase renal excretion of magnesium, heightening the body's magnesium requirements. Fluoride, present in the drinking water of 74% of Americans, interferes with magnesium absorption by binding to it and forming insoluble complexes.

Drugs: Making the problem worse

Common medications can significantly impact magnesium levels in the body, often leading to or exacerbating deficiencies. Antacids, such as omeprazole, increase the pH of the gastrointestinal (GI) tract, which can impair magnesium absorption.[20] Antibiotics like ciprofloxacin may bind magnesium, forming complexes that reduce its bioavailability. Oral contraceptives can also contribute to magnesium depletion due to the formation of complexes that hinder absorption. Studies have shown that key nutrient depletions associated with oral contraceptive use include folic acid, vitamins B2, B6, B12, C, and E, as well as the minerals magnesium, selenium, and zinc.[21]

A 2018 study found that a significant number of patients, over 50%, who developed torsades de pointes (TdP) were actively taking proton pump inhibitors (PPIs). Additionally, those with TdP who were on PPIs had notably lower magnesium levels than those with TdP who did not use PPIs. TdP is a severe heart rhythm disorder that can progress to ventricular fibrillation and potentially lead to sudden cardiac death.[22]

Diuretics, including furosemide and bumetanide, increase renal excretion, further depleting magnesium stores. Other medications, such as certain chemotherapeutic agents and immunosuppressants, may similarly disrupt magnesium balance. The table summarizes the effects of various medications on magnesium status.[23]

[Drug-induced magnesium loss and hypomagnesemia]

Organically Grown Food

Organic farming employs various methods to maintain soil fertility while promoting long-term sustainability and ecological balance. These methods include:

1. Crop Rotation: Alternating crops to prevent the depletion of specific nutrients that a single crop might overuse, ensuring balanced soil nutrition.

2. Cover Crops: Growing crops like clover or rye during off-seasons to protect against soil erosion, improve soil structure, and suppress weeds.

3. Green Manures: Planting specific crops, such as legumes, that are plowed back into the soil to enrich it with nutrients, especially nitrogen.

4. Composting: Adding aged animal manures and plant residues (compost) to the soil enhances organic matter, improves soil texture, and provides a steady supply of nutrients for plants.

The defining characteristic of these practices is their reliance on organic matter, which supports soil structure, increases water retention, and provides a food source for microorganisms. This approach fosters a natural, slow release of nutrients over time, avoiding sudden nutrient surges that can disrupt the soil ecosystem.

In contrast, chemical fertilizers primarily supply a limited range of minerals—nitrogen, phosphorus, and potassium (NPK)—with occasional trace minerals added. These fertilizers dissolve quickly in soil water, delivering large amounts of nutrients to plants all at once. While this can boost short-term plant growth, it often leads to over-fertilization, where plants receive more nutrients than they can use. Excess nutrients can leach into waterways, contributing to environmental problems such as eutrophication.

Moreover, the reliance on chemical fertilizers can reduce soil health over time. Unlike organic methods that build up soil structure and microbial activity, chemical fertilizers do not replenish organic matter. While some farmers using chemical fertilizers may employ erosion control techniques, such as contour plowing or terracing, these measures often do not address the long-term degradation of soil fertility.

A study, Nutritional Quality of Organic Versus Conventional Fruits, Vegetables, and Grains, found that organic crops contain higher levels of magnesium, iron, phosphorus, and vitamin C and lower nitrate levels than conventional crops. Additionally, organic crops showed trends of lower protein content but higher quality, more nutritionally significant minerals, and reduced levels of certain heavy metals.[24]

Mean percent additional mineral content in organic compared to conventional crops

Sweat, Sunshine, and Booze

Magnesium utilization is affected by many different factors. Even beneficial habits like regular strenuous exercise can lead to magnesium loss through sweat and urine.[25]

Sunshine triggers the production of vitamin D in the skin when ultraviolet B (UVB) rays interact with cholesterol in the skin, converting it into vitamin D3. The liver and kidneys then process this form of vitamin D into its active form. Magnesium is a vital cofactor for the synthesis and activation of vitamin D, which enhances magnesium absorption in the intestines, creating a feed-forward loop that helps maintain magnesium homeostasis. Imbalances in either of these nutrients can lead to a range of health issues, including skeletal deformities, cardiovascular disorders, and metabolic syndrome.[26]

Chronic alcohol use has been found to damage cells, cause erosion of the mucosal lining, and lead to the loss of the protective layer at the tips of the villi in the intestines. This damage can result in deficiencies of essential vitamins such as A, B1 (thiamine), B2 (riboflavin), B6 (pyridoxine), C, D, E, and K, as well as minerals and trace elements like magnesium, folate, calcium, phosphate, iron, zinc, and selenium. These deficiencies can negatively affect various bodily functions.[27]

The Invisible Epidemic

As highlighted in 1936, not all carrots—or foods—are created equal. A carrot grown over a century ago was richer in magnesium and other vital trace minerals than its modern counterpart. Our relentless pursuit of quantity and profit over quality has depleted our soils and our foods nutritionally impoverished. Compounding this issue, industrial food processing strips away even more nutrients. To make matters worse, medications, alcohol, and lifestyle factors such as insufficient sunshine further cause magnesium depletion.

While this massive silent nutritional epidemic is largely ignored by big agriculture, big food, and big pharma, it is not without solutions. By making personal, mindful choices, we can begin to address the widespread magnesium deficiency, reclaim our health, and tackle this silent nutritional epidemic.

· Choose organically grown foods whenever possible.

· Limit or eliminate processed foods.

· Avoid unnecessary medications.

· Avoid alcohol consumption.

· Get plenty of sunshine.

· Incorporate magnesium-rich foods into your diet.

· Use magnesium supplements such as magnesium glycinate or magnesium citrate.

Foods rich in magnesium include almonds, bananas, beans, broccoli, brown rice, cashews, egg yolk, fish oil, flaxseed, leafy greens, milk, mushrooms, various nuts, oatmeal, pumpkin seeds, sesame seeds, soybeans, sunflower seeds, sweet corn, tofu, and whole grains.[28]

By embracing these changes, we can not only protect ourselves from the consequences of magnesium deficiency but also promote a more balanced, resilient, and vibrant life.

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[1] Carolyn Dean, MD, ND, The Magnesium Miracle

[2] James J DiNicolantonio, James H O’Keefe, and William Wilson, “Subclinical magnesium deficiency: a principal driver of cardiovascular disease and a public health crisis,” Open Heart, January 12, 2018, https://openheart.bmj.com/content/5/1/e000668

[3] Rex Beach, “Modern Miracle Men,” 1936, United States Senate Document #264 74th Congress, 2d session, United States Government Printing Office in Washington, D.C., https://projects.sare.org/wp-content/uploads/united-states-senate-document-264.pdf

[4] Magnesium: Magnesium Fact Sheet for Health Professionals, National Institutes of Health Office of Dietary Supplements, https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional

[5] Jayme L. Workinger 1, Robert. P. Doyle and Jonathan Bortz, “Challenges in the Diagnosis of Magnesium Status,” Nutrients, September 1, 2018, https://pmc.ncbi.nlm.nih.gov/articles/PMC6163803

[6] Gröber, U., Schmidt, J., & Kisters, K., “Magnesium in Prevention and Therapy.” Nutrients, September 23, 2015, pp. 8199–8226, https://pmc.ncbi.nlm.nih.gov/articles/PMC4586582/#sec6-nutrients-07-05388

[7] Anne Marie Uwitonze and Mohammed S. Razzaque, “Role of Magnesium in Vitamin D Activation and Function,” Journal of Osteopathic Medicine, March 1, 2018, https://www.degruyter.com/document/doi/10.7556/jaoa.2018.037/html

[8] Jayme L. Workinger 1, Robert. P. Doyle and Jonathan Bortz, “Challenges in the Diagnosis of Magnesium Status,” Nutrients, September 1, 2018, https://pmc.ncbi.nlm.nih.gov/articles/PMC6163803

[9] James J DiNicolantonio, James H O’Keefe, and William Wilson, “Subclinical magnesium deficiency: a principal driver of cardiovascular disease and a public health crisis,” Open Heart, January 12, 2018, https://openheart.bmj.com/content/5/1/e000668

[10] Rex Beach, “Modern Miracle Men,” 1936, United States Senate Document #264 74th Congress, 2d session, United States Government Printing Office in Washington, D.C., https://projects.sare.org/wp-content/uploads/united-states-senate-document-264.pdf

[11] Kirkpatrick Sale, “Lessons from the Luddites,” The Nation, June 5, 1995, https://ftp.worldpossible.org/endless/eos-rachel/RACHEL/RACHEL/modules/en-learnsaylor/course/sale_lessons_1995.pdf

[12] Virginia Worthington, MS, Sc. D, CNS, “Nutritional Quality of Organic Versus Conventional Fruits, Vegetables, and Grains,” The Journal of Alternative and Complementary Medicine, vol. 7, no. 2, 2001, pp. 161–173, https://ucanr.edu/datastoreFiles/608-794.pdf

[13] Anne Marie Uwitonze and Mohammed S. Razzaque, “Role of Magnesium in Vitamin D Activation and Function,” Journal of Osteopathic Medicine, March 1, 2018,

https://www.degruyter.com/document/doi/10.7556/jaoa.2018.037/html

[14] Jayme L. Workinger 1, Robert. P. Doyle and Jonathan Bortz, “Challenges in the Diagnosis of Magnesium Status,” Nutrients, September 1, 2018, https://pmc.ncbi.nlm.nih.gov/articles/PMC6163803

[15] Anne-Marie Berenice Mayer, Liz Trenchard, and Francis Rayns, “Historical changes in the mineral content of fruit and vegetables in the UK from 1940 to 2019: a concern for human nutrition and agriculture,” International Journal of Food Sciences and Nutrition, 2022, vol. 73, no. 3, pp. 315–326, https://www.tandfonline.com/doi/full/10.1080/09637486.2021.1981831

[16] Anne-Marie Berenice Mayer, Liz Trenchard, and Francis Rayns, “Historical changes in the mineral content of fruit and vegetables in the UK from 1940 to 2019: a concern for human nutrition and agriculture,” International Journal of Food Sciences and Nutrition, 2022, vol. 73, no. 3, pp. 315–326, https://www.tandfonline.com/doi/full/10.1080/09637486.2021.1981831

[17] Virginia Worthington, MS, Sc. D, CNS, “Nutritional Quality of Organic Versus Conventional Fruits, Vegetables, and Grains,” The Journal of Alternative and Complementary Medicine, vol. 7, no. 2, 2001, pp. 161–173, https://ucanr.edu/datastoreFiles/608-794.pdf

[18] Jayme L. Workinger 1, Robert. P. Doyle and Jonathan Bortz, “Challenges in the Diagnosis of Magnesium Status,” Nutrients, September 1, 2018, https://pmc.ncbi.nlm.nih.gov/articles/PMC6163803

[19] Anne Marie Uwitonze and Mohammed S. Razzaque, “Role of Magnesium in Vitamin D Activation and Function,” Journal of Osteopathic Medicine, March 1, 2018,

https://www.degruyter.com/document/doi/10.7556/jaoa.2018.037/html +

[20] Jayme L. Workinger 1, Robert. P. Doyle and Jonathan Bortz, “Challenges in the Diagnosis of Magnesium Status,” Nutrients, September 1, 2018, https://pmc.ncbi.nlm.nih.gov/articles/PMC6163803

[21] M Palmery, A Saraceno, A Vaiarelli, and G Carlomagno, “Oral contraceptives and changes in nutritional requirements,” European review for medical and pharmacological science, July 2013, pp. 1804-1813, https://www.europeanreview.org/article/4579

[22] Pietro E. Lazzerini1, et al., “Proton Pump Inhibitors and Serum Magnesium Levels in Patients With Torsades de Pointes,” Frontiers in Pharmacology, April 19, 2018, https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2018.00363/full

[23] Gröber, U., Schmidt, J., & Kisters, K., “Magnesium in Prevention and Therapy.” Nutrients, September 23, 2015, pp. 8199–8226, https://pmc.ncbi.nlm.nih.gov/articles/PMC4586582/#sec6-nutrients-07-05388

[24] Virginia Worthington, MS, Sc. D, CNS, “Nutritional Quality of Organic Versus Conventional Fruits, Vegetables, and Grains,” The Journal of Alternative and Complementary Medicine, vol. 7, no. 2, 2001, pp. 161–173, https://ucanr.edu/datastoreFiles/608-794.pdf

[25] Anne Marie Uwitonze and Mohammed S. Razzaque, “Role of Magnesium in Vitamin D Activation and Function,” Journal of Osteopathic Medicine, March 1, 2018,

https://www.degruyter.com/document/doi/10.7556/jaoa.2018.037/html

[26] Anne Marie Uwitonze and Mohammed S. Razzaque, “Role of Magnesium in Vitamin D Activation and Function,” Journal of Osteopathic Medicine, March 1, 2018,

https://www.degruyter.com/document/doi/10.7556/jaoa.2018.037/html

[27] Keith Pohl, Prebashan Moodley and Ashwin D. Dhanda, “Alcohol’s Impact on the Gut and Liver,” Nutrients, vol. 13, no. 9, September 11, 2021, https://www.mdpi.com/2072-6643/13/9/3170

[28] Anne Marie Uwitonze and Mohammed S. Razzaque, “Role of Magnesium in Vitamin D Activation and Function,” Journal of Osteopathic Medicine, March 1, 2018,

https://www.degruyter.com/document/doi/10.7556/jaoa.2018.037/html