Please Note: This article represents the second part of this 3-articles series concerning magnesium and calcium, and the potential benefits of their supplementation. The third and final part (a discussion of calcium) will be presented in next month’s issue of Nature’s Therapies. If you missed Magnesium: Part I, you can read the full article by clicking on the following link. Magnesium: Part I
What Is Osteoporosis?
Osteoporosis, which literally means porous bones, is a term that primarily refers to age-related bone loss. Affecting both women and men, it is characterized by a reduction in the density of the skeleton, resulting in an increase in the fragility of the body’s bony structure. The bones break more easily and are harder to mend. In osteoporosis, the bones have lost a significant amount of their mineral content—primarily calcium—making them weaker, and more brittle and susceptible to fractures. Commonly, fractures occur in the back (spine), hips, and wrists, but any bone in the body can be affected by osteoporosis.
Most body cells have a limited lifespan and when they wear out are shed and replaced by new cells. In the case of osteoporosis, the breaking down of bone cells, and thus bone resorption, proceeds at a faster pace than the building-up process. The term bone resorption refers to bone breakdown by bone cells called osteoclasts that results in the release of calcium and phosphate into the blood.
Osteoporosis in both sexes over 70 years of age is termed primary senile osteoporosis. Bone loss in postmenopausal women is called primary postmenopausal osteoporosis. When bone loss is caused by protracted immobilization (e.g., of an injured limb) or weightlessness (e.g., confinement to a bed), it is referred to as secondary osteoporosis.
Osteoporosis causes 1.5 million fractures each year, including 90% of all fractures in those people 65 years or older. It is a major factor in periodontal disease in older individuals, partly due to osteoporotic bone loss from the jawbone.
Due to the postmenopausal decline in the levels of estrogens and progesterone (which help maintain normal calcium metabolism and bone mass), spinal osteoporosis is four times as common, and hip fractures are far more common among women than men. Between 5% and 10% of men over 50-years-of-age develop osteoporosis.
Research suggests that 50% of postmenopausal women will develop some level of osteoporosis, with women over 60 having a risk of hip fracture that is equal to the combined risk of breast, ovarian and uterine ovarian cancer. Spine fractures alone affect 500,000 mostly post-menopausal women each year. Each year, over a million women sustain an osteoporotic bone fracture; half of them suffer a hip fracture and never regain the ability to walk, and 13% die within 6 months of the event.
Risk Factors and Symptoms
In addition to hormonal deficiencies, other causative factors of this disorder include: long-term, excessive intake of protein and refined sugar; deficiency of vital nutrients such as calcium, magnesium and Vitamin D; inadequate digestion and nutrient assimilation; stress, resulting in a chronic overproduction of certain adrenal hormones; low thyroid function; lack of exercise; sunlight deficiency; smoking; excessive use of caffeine; alcohol; antacids; corticosteroids.
Osteoporosis may initially be asymptomatic, but as it progresses, it gives rise to a variety of symptoms, including: bone pain (especially of the jaw, back and pelvis); muscle pain; severe back pain (due to vertebral collapse and subsequent compression fractures); bone fracture with little apparent provocation; dowager’s hump; excessive plaque formation on teeth; osteoarthritis; brittle or soft fingernails.
Magnesium Deficiency and Osteoporosis
Millions of people take calcium and magnesium supplementally, but often, incorrectly. Aggressive marketing by some pharmaceutical firms promoting their brands of supplemental calcium as being crucial to osteoporosis prevention has contributed to the common perception that it is far more important to take supplemental calcium than magnesium. This is a potentially risky misconception.
Magnesium plays an important role in maintaining healthy bones, and magnesium supplementation can contribute to increased bone density and help prevent the onset of osteoporosis. Magnesium is actually required for proper calcium utilization in the body. It is nature’s calcium channel blocker that helps to regulate the intracellular flow of calcium ions.
Magnesium is as essential as calcium for normal bone metabolism. One study found that magnesium was a pivotal factor in helping to prevent hip fractures in older women. Frank magnesium deficiency is commonly noted in individuals with osteoporosis. In fact, some laboratory studies suggest that whereas experimental calcium-deficiency induces osteomalacia: a disease of adults characterized by softening of the bones due to demineralization, magnesium-deficiency induces osteoporosis.
Magnesium, Parathyroid Hormone and Calcitonin
The parathyroid glands, located behind the thyroid gland in the neck, secrete a hormone called parathyroid hormone (PTH) which is the most important endocrine regulator of calcium and phosphorus concentration in extracellular fluid, and it plays a key role in bone density. PTH’s major target cells are found in the bone and kidneys.
One of PTH’s primary jobs is to bring calcium ion concentrations in blood and extracellular fluid back within the normal range when they fall below normal. PTH increases calcium concentration in three ways: 1) enhances absorption of calcium from the small intestine by stimulating production of the active form of vitamin D in the kidney (Vitamin D induces synthesis of a calcium-binding protein in intestinal epithelial cells that facilitates efficient absorption of calcium into blood.) 2) suppresses calcium loss in urine (thus conserving calcium in blood), and 3) mobilizes calcium from bone into the blood. It also encourages soft tissue calcium uptake and phosphate excretion by the kidneys.
Parathyroid hormone stimulates osteoclasts to break down bone in order to liberate calcium into the blood. It is the excessive mobilization of calcium from bone that makes the hyper-secretion of PTH a factor in osteoporosis.
Calcitonin, secreted by the thyroid gland, is another hormone that participates in calcium and phosphorus metabolism. Calcitonin suppresses bone resorption by inhibiting the activity of the osteoclasts (as noted previously, these are the bone cells that “digest” bone matrix, thus releasing calcium and phosphorus into blood). Calcitonin lowers the level of calcium in the blood by assisting the body in absorbing calcium into bones and blocking soft tissue calcium uptake.
Bone is in a constant state of remodeling: old bone is broken down by osteoclasts and new bone is formed by the action of bone-building cells called osteoblasts. Calcitonin not only inhibits the bone-breakdown activity of the osteoclasts, but it also promotes the bone-building activity of the osteoblasts.
In allopathic medicine, calcitonin is given to lower the calcium levels in cases of: hypercalcemia (high blood calcium); osteoporosis, to increase bone density and decrease the risk of a fracture; Paget’s disease to decrease bone turnover and bone pain.
Magnesium is required to keep the secretion of both PTH and calcitonin within constructive limits, with the net effect of inhibiting destructive calcium removal from bone and deterring calcium deposition in soft tissues. Magnesium suppresses hyper-secretion of PTH and sustains optimal calcitonin secretion thus helping to prevent osteoporosis and helping to remove calcium from our soft tissues.
Magnesium and The Pituitary and Adrenal Glands
Magnesium is also required for normal pituitary gland function. Lacking sufficient magnesium, the pituitary gland cannot efficiently play its role in the regulation of all the other endocrine glands, including the adrenal glands. As noted above, adrenal over-activity, often due to protracted mental stress, is an important factor in the development of osteoporosis. Unregulated production and secretion of adrenal hormones (especially glucocorticoids) accelerates bone resorption.
Not only is magnesium required to enable the pituitary gland to keep adrenal gland activity within constructive limits, the mineral’s sedative action counteracts the stimulating effects of certain adrenal hormones.
Estrogen and Magnesium
Prior to menopause, the higher circulating level of estrogens suppresses PTH-mediated mobilization of bone-minerals. Estrogen protects the bones by inhibiting both PTH release and its demineralizing action upon bones. It has been observed that postmenopausal women have higher blood- and urine-magnesium levels than do pre-menopausal women. These elevated levels in the former are due to the mobilization of magnesium from bone.
When estrogen is administered to postmenopausal women, blood- and urine-magnesium levels revert to pre-menopausal levels because of the blocking of the further mobilization of bone-magnesium. Therefore, one possible mechanism by which estrogen maintains bone density is via maintenance of bone-magnesium reserve.
Estrogen’s enhancement of magnesium-uptake by soft tissues and bone helps to explain how estrogen protects pre-menopausal women from both osteoporosis and heart disease (magnesium is one of the most important nutrients regarding prevention of heart disease). It also helps to explain the increased prevalence of these diseases when estrogen secretion declines dramatically after menopause.
Importantly, if magnesium intake is low, estrogen-induced shifts of magnesium out of circulation and into bone can be problematic. The resultant lowering of blood-magnesium levels can increase the blood’s calcium : magnesium ratio. Calcium is required for normal blood-clotting. However, high blood-calcium and concomitant low blood-magnesium encourages a propensity to the formation of blood clots within the blood vessels (referred to as thrombosis). This risk of thrombosis is exacerbated by the taking of calcium supplements without compensating for a magnesium shortfall.
Magnesium, Calcium, Vitamin D, and Bones and Teeth
Magnesium not only helps the body to metabolize calcium, it converts dietary vitamin D to calcitriol (the active dihydroxy metabolite of vitamin D), helps to maintain the integrity of skeletal bone-crystal formation, and it is required for the binding of both calcium and fluorine to bone and tooth enamel. Lacking magnesium, both calcium and fluorine cannot be properly utilized by bones and teeth, thus, they are excreted from the body.
Clinical evidence demonstrates that magnesium deficiency, common among women with primary postmenopausal osteoporosis, contributes to poor responsiveness by the body to vitamin D. This inhibits vitamin D’s role in intestinal calcium absorption.
Research has shown that when women with severe primary postmenopausal osteoporosis were given large doses of calcium, they developed positive calcium balance without any evidence of improvement in the osteoporosis pathology. In the presence of magnesium deficiency, calcium-loading can cause the deposition of calcium in soft tissue and interfere with magnesium-retention, thus exacerbating the extant magnesium deficiency. This helps to explain why as much as 10% of calcium in the tissues of elderly individuals is found outside the skeletal system. It should be borne in mind that normally 99% of calcium is in teeth and bones with only 1% found in blood, extracellular fluids, and within cells of all tissues where it helps to regulate key metabolic functions.
Early 20th century nutritionist Otto Carque, in his 1933 classic Vital Facts About Foods writes: “Bones contain about 1% magnesium phosphate and teeth about 1.5% per cent. The ivory tusks of elephants contain 2% magnesium phosphate, and the billiard balls made from them are almost indestructible. The teeth of carnivorous animals contain nearly 5% magnesium phosphate, and for this reason, they are able to crush and grind the bones of their prey without difficulty.”
The Cell Salt Magnesium Phosphate
In addition to highlighting the importance of supplemental magnesium in any osteoporosis prevention or treatment protocol, Carque’s discussion also points toward the importance of the cell salt magnesium phosphate (Mag phos.) in that regard.
In the early 19th century, the great German homeopath W.H. Schuessler made a discovery, the importance of which has never been appreciated nor applied clinically by the mainstream medical establishment. Schuessler, by way of analyzing the ash of cremated human remains, discovered the presence of twelve proportionately occurring mineral salts.
When living tissue is reduced to ash, all the organic matter is destroyed; all that remains are minerals since they are combustible only at very high temperatures of between 4,000° – 10,000° centigrade. Chemical and spectral analyses can then be used to determine the identity of these minerals.
Schuessler eventually performed similar qualitative and quantitative analyses of various bodily fluids such as blood, lymph and breast-milk. Once again, he discovered a proportionate presence of these same twelve mineral salts.
Based upon these discoveries, Schuessler theorized that these mineral salts were the essential building blocks of life. He felt that the function of all the billions of body cells hinged upon the presence of these mineral salts in proper proportion. Therefore, said salts became known as the “cell salts.”
Mag phos. is also a crucial cell salt in the treatment of nerve and muscles disorders, especially when the associated symptoms have a spasmodic character. Other primary cell salts regarding osteoporosis are Calcium fluoride (Calc fluor.), Calcium phosphate (Calc phos.), and Silica (Silicea).
Magnesium Intake and Bone Fractures
Noted orthopedic surgeon Lewis B. Barnett, M.D. conducted very important research regarding magnesium, calcium and osteoporosis. In 1950, he began a comparative study of the incidence of fractures of the femur (thigh bone) in Hereford, Texas where incidence was rare, and in Dallas where the fractures were common.
Furthermore, those fractures of the femur that occurred in the Hereford area involved individuals whose fractures healed within two months, with an average age of 82.5. On the other hand, the fractures among Dallas individuals occurred at an average age of 63, and required a healing time of 6.3 months, and in some cases never mended.
Soil- and water-content of the two areas led Barnett to conclude that the mineral-content of the water supply was a major factor in the differences found in bone health among the residents of Hereford and Dallas. Importantly, Hereford water contained only four parts per million of calcium compared to the 23 parts per million in Dallas water. The differences in the fluorine, iodine, and phosphorus content of the water were insignificant.
The crucial mineral factor was the magnesium-content. Whereas Dallas water contained eight parts per million of magnesium, Hereford water contained 16 parts per million. Hence, the water that supplied the area whose residents suffered far less osteoporotic bone fractures had twice as much magnesium, but only 1/6 as much calcium.
Barnett then proceeded to analyze the mineral composition of bone of residents (500 women, average age 55) of these same two Texas locales and found that while the magnesium-content of bone was .05% among those from Dallas, among those from Hereford, it was 1.76%, more than 3 times higher.
Barnett also examined the mineral-content of bone of those with healthy bones and compared it with the same in those with severe osteoporosis. He found that while there was no significant difference in calcium-, phosphorus-, and fluoride-content between the two groups, the magnesium-content of those with healthy bones was 1.26% compared to .62% among those with severe osteoporosis.
All of this evidence led Dr. Barnett to conclude that “… the mineral [magnesium] is important–perhaps the most important single element–in bone health.”
Although 99% of total body calcium is contained within the bones, there is a poor statistical correlation between calcium intake and relative bone density. Counter-intuitively, some studies have found that the lowest hip-fracture rates in postmenopausal women are found in those populations with the lowest calcium intakes. One study found that vegetarian postmenopausal women (who generally consume less calcium, but twice as much magnesium) had greater bone density than non-vegetarian women.
The Growing Magnesium-Deficiency Epidemic
In Magnesium: Part I, I described the growing magnesium-deficiency epidemic, and that discussion bears repetition here:
In the U.S., the average intake of magnesium has fallen by over 50% in the last century. U.S. government surveys found that the typical American diet provides less than half of the recommended daily amount of magnesium. Some authorities estimate that 80% of the population is magnesium-deficient.
The refining of grains may result in the loss of more than 75% of original magnesium-content. Additionally, the rise in the popularity of processed foods (processing strips much of the mineral-content from foods), and the depletion of magnesium-rich soil by chemical fertilizers, are also major contributors in the decline of bio-available magnesium in the modern diet. This dietary shortfall is exacerbated by the tendency to load up on supplemental calcium while ignoring magnesium as a bulwark against osteoporosis. Importantly in this reference, a build-up of calcium in the body causes magnesium to be flushed out of the cells.
Magnesium-excretion is increased by the use of refined sugar, alcohol, caffeine and various prescription drugs, including birth-control pills and diuretics. The antibiotics: Gentamicin, Amphotericin, and Cyclosporin; diuretics, such as Lasix, Bumex, Edecrin and Hydrochlorothiazide; and the chemotherapy drug Cisplatin all tend to increase loss of magnesium via the urine.
Additionally, a great deal of magnesium is lost as a result of excessive vomiting (e.g., as occurs with bulimia, morning sickness and chemotherapy) and chronic diarrhea (as occurs in many cases of irritable bowel syndrome (IBS) �- magnesium-deficiency is commonly a contributor to the development of IBS). Also, long-term consumption of distilled water or reverse osmosis-treated water can contribute to magnesium loss.
The Question of Calcium Supplementation and Osteoporosis
Certainly, the body needs calcium. It is as vital a nutrient as magnesium. A diet rich in both bio-available forms of magnesium and calcium (as well as other minerals, including boron, fluorine, phosphorus, strontium and zinc) is definitely crucial in both the prevention and treatment of osteoporosis.
Supplemental calcium is certainly worthy of consideration, especially in any protocol that addresses osteoporosis. However, absent an understanding of the dangers of magnesium-deficiency, and the synergistic, yet competitive, relationship between magnesium and calcium, supplementation with calcium alone can prove problematic.
All too often, doctors and drug companies (in their magazine ads and television commercials) emphasize the need for calcium in the prevention and treatment of osteoporosis with nary a mention of magnesium, which is coequally crucial. Studies suggest that a human being can adapt to a relatively low calcium intake by increasing the mineral’s absorption from the small intestine and decreasing its excretion via the kidneys. However, no efficient physiological mechanisms have been identified for rapid adaptation to low magnesium intake.
While magnesium assists in the assimilation and retention of calcium, excess calcium prevents magnesium from being absorbed. Therefore, a large calcium intake without a compensatory increase in magnesium intake will restrict magnesium assimilation and ultimately foster a magnesium-deficiency. Given the importance of magnesium not only in the prevention and treatment of osteoporosis, but heart disease and cancer prevention as well, this would pose a grave risk to more than your bones.
Important Note: People with any degree of impaired kidney function should use magnesium supplements only under the supervision of a physician. In concert, kidney dysfunction and magnesium supplementation may lead to potentially dangerous hypermagnesemia (excessive blood levels of magnesium). Other possible contraindications for magnesium supplementation include myasthenia gravis, excessively slow heart rate, and bowel obstruction.
In the next issue of Nature’s Therapies Journal I will provide a detailed discussion of calcium and calcium supplementation.
Below, I have included important information from Magnesium: Part I, including information about magnesium supplements and the unique ones re: quality, formulation and assimilation that I have personally formulated. Given the immense importance of magnesium, I suggest you review this material again.
Notable Food Sources of Magnesium:
kelp; nuts: almonds, cashews, Brazil, walnuts, filberts, pistachio and pecans; sesame seeds; Lima beans; dried peas; red beans; soybeans; millet; wheat; brown rice; rye; lentils; seafood; dark green vegetables in general; kale; spinach; beet greens; coconut; figs; dried banana.
Important Magnesium Synergists:
Adequate healthful dietary fats and protein; calcium; B-complex vitamins; vitamin C; vitamin D; adequate hydrochloric acid and potassium.
Dr. Berkowsky’s Premium Nutrition Magnesium Formulas:
How They Are Made And Why They Are Extraordinary On Many Levels
For nearly 25 years I have served as product formulator for Nature’s Design, a cutting-edge company which offers product lines (including Premium Nutrition) of exquisite quality nutritional and herbal supplements. I have formulated these products to work with the body’s vital force rather than overruling it.
My formulating strategy is not to inefficiently supply mega-doses of potentially useful nutrients, but rather, to provide highly utilizable, synergistically enhanced nutrients and other biochemical moieties in a form and quantity that efficiently supports the body’s “inner physician” in its duties of maintenance and repair. The key principles in this context are highest quality ingredients and manufacture, and intra-ingredient balance and synergy.
To date, I have formulated two unique magnesium formulas: Premium Nutrition’s LifeMag and Premium Magnesium Plus. (I am currently working on a third one, which will be available in mid-2009). These two products have been used by many thousands of people over the last 20-years, and their enormous popularity continues to grow. We commonly hear from people who report they have never found another magnesium product that can serve as an adequate substitute for either of these products. Many people refer to them as “life-changing.”
Both of these magnesium products contain magnesium citrate and amino acid chelated forms of magnesium. In order for a mineral to be absorbed from the small intestine (the primary site of nutrient absorption) into the blood, it has to be attached to a substance that serves as a mineral transporter that will carry it through the intestinal wall into the blood, and then, from the blood into the cells.
Magnesium citrate is formed by the bonding of elemental magnesium and citric acid. The latter is an organic acid found in many fruits, which effectively bonds to many minerals and trace nutrients and serves as a very effective transporter across the gastrointestinal mucosa (the lining which covers the inside of the stomach and intestines). Citrates are highly bioavailable; therefore, large doses are not required to ensure efficacious uptake into the blood.
A mineral chelator is a substance that tightly bonds with a mineral atom and transports the mineral through the gastrointestinal mucosa, the blood vessel wall and/or the cell membrane. This bound-pair, consisting of chelator and mineral atom, is referred to as a mineral chelate.
Amino acids (the building blocks of proteins) are high quality mineral chelators that are recognized by the gastrointestinal mucosa and/or cell membrane as a desirable molecule, and thus, are readily absorbed along with their mineral payloads.
Due to a dedicated amino acid transport system found in cells of the intestinal wall, amino acids are particularly well-absorbed through the gastrointestinal mucosa. Therefore, when a mineral atom is strongly bonded with amino acids, it is far more efficiently absorbed into the blood than it would be in the form of an inorganic salt, such as magnesium oxide or magnesium carbonate.
In fact, chelation of minerals in digested food with amino acids is a process that occurs naturally in the gut. In other words, it is one of the fundamental ways the body facilitates the absorption of minerals into the system. Thus, laboratory-produced amino acid chelated minerals mimic one of the body’s own preferred methods of enhancing mineral absorption.
Also, amino acid chelation of minerals helps to counter competitive interactions that can occur between different minerals (e.g., between calcium and magnesium) when they are taken as inorganic salts (e.g., dolomite). In the small intestine, minerals such as calcium, magnesium and zinc will naturally compete for the same transporters to ferry them across the intestinal membrane into the blood. Thus, a relatively large amount of one of these minerals may block the absorption of much smaller amounts of the others if they are simultaneously present at the site of absorption. As amino acid chelated minerals are already bonded to their own transporters, the problem of intra-mineral competition is greatly reduced.
An amino acid consists of an amino group of atoms, an acid group, and an R-group. Variations among R-groups determine the character of the different amino acids, such as alanine, aspartic acid, lysine and tyrosine. When formulating products containing amino acid chelates, I select specific amino acids according to the functions they serve in the body and their relative effectiveness as mineral transporters. Then, I balance the proportions of each of the amino acid chelates to create a mineral formula that is well-absorbed, dynamic in activity, finely balanced and very comfortable and nurturing to the body.
Both Premium Nutrition’s LifeMag and Premium Magnesium Plus are at the very top of the quality range of commercially available magnesium formulas. Each contains magnesium citrate and full spectrum, highly bonded amino acid chelates. Additionally, while LifeMag contains magnesium aspartate and magnesium lysinate, Magnesium Plus contains magnesium alaninate, magnesium lysinate and magnesium tyrosinate.
Magnesium Plus also features a matrix of magnesium-rich herbs that contain natural magnesium co-factors, making this preparation, essentially, a magnesium food. In this way the absorption and utilization of the magnesium is enhanced. The following herbs are in this formula: chickweed, marshmallow root, horsetail concentrate, Irish moss and oat straw.
Over the years, both of these products have developed large fan bases. Determining which one is most suitable for a given individual is largely a trial and error process (many people not only do well with both, but actually use both at the same time). However, a basic rule of thumb is that while Magnesium Plus, with its herbal base, is somewhat more dynamic in action, LifeMag is the best place to start for those individuals who may be sensitive to herbs or have sensitive systems. Of course, if a person’s health-building regimen is being guided by a health professional, that person can help to determine which one of these magnesium formulas may be more personally suitable.
Please note: The information presented herein, including ailment-related comments, are for informational purposes only; health concern matters require supervision by a physician. The author, publisher and others associated with this article cannot be responsible for the misuse of information herein.