Magnesium plays a role in over 300 biochemical reactions, therefore affecting almost every system of the body when levels are insufficient. In her latest webinar, Dr Danielle Crida focuses on the important role magnesium plays in all stages of a woman’s life, supporting: - Menstrual cramps - A healthy pregnancy and postpartum - Menopausal symptoms, such as hot flushes and mood changes - Women-predominant conditions, e.g. osteoporosis and thyroid conditions

1. Magnesium – the missing mineral
for women’s health ?
Dr Danielle Crida MBChB, Dip Nutr
Nutritionist, Igennus Healthcare Nutrition
1
Mg

2. Contents
• Magnesium – recap of the basics
• Magnesium in the diet
• Magnesium deficiency
• Dysmenorrhoea
• Menstrual migraines
• PMS
• Endometriosis
• PCOS
• Pregnancy
o Normal pregnancy
o Preeclampsia & eclampsia
o Preterm labour
o Postnatal depression
• Menopause
o Hot flushes
o Low energy
o Mood symptoms
o Bone health
o Postmenopausal colon cancer
• Thyroid health
• Choosing a quality magnesium supplement

3. Magnesium – the basics
• 4th most abundant cation in the body
• Cofactor for enzymes – role in over 300 biochemical reactions
including energy production, protein synthesis, blood glucose control
• Role in active transport of ions across cell membranes, e.g.
potassium & calcium – conduction of nerve impulses, muscle
contraction, maintaining vasomotor tone and normal heart rhythm
• Structural role: bones, proteins, enzymes, DNA, RNA
• Immunological functions, e.g. lymphocyte proliferation and
macrophage activation
• 99% total body magnesium stores intracellular – bones, muscles &
soft tissue – therefore blood levels not completely representative
• Serum Mg tightly regulated by balance between intestinal
absorption, renal excretion and bone buffer

4. Magnesium in the diet
• Daily reference intake 375mg per day
• Richest dietary sources: wholegrains, green leafy vegetables, beans,
nuts & seeds, seafood & cocoa
• Drinking water ~10% of intake
• Intake may be higher in vegetarians & vegans
• Declining mineral levels in soil
• Processing and refining decreases magnesium

5. Magnesium deficiency
• Decreased intake
UK: 1 in 5 women aged 19-34 years and more than half of teenage girls have intakes
below the LRNI (51% of 11-14 age group and 53% of 15-18 age group) and more
than 20% of boys aged 11-14 years are also at risk of low intakes. (British Nutrition
Foundation)
• Decreased absorption
Oxalates, phytates, caffeine, alcohol, carbonated drinks
PPIs
Chronic gastrointestinal disease
• Increased excretion
Drugs e.g. diuretics
Stress
Kidney disease
• SNPs – affecting absorption & distribution
• With age:
Mg deposits in bone and soft tissue decrease
Mg absorption in the gut also decreases, along with decreased reabsorption and
increased excretion in urine
Mg

6. Hypermagnesaemia
• Only with excessive
intake + kidney failure
• Low blood pressure
• Muscle paralysis
• Bowel paralysis
Hypomagnesaemia
Insufficiency:
• Asymptomatic or minor,
vague symptoms or
health conditions often
not linked to Mg
insufficiency
Deficiency:
• Muscle weakness/cramps
• Tetany
• Seizures
• Cardiac arrhythmias

7. Magnesium and
its role in
women’s health
conditions
Fabio Parazzini, Mirella Di Martino, Paolo Pellegrino. Magnesium in the
gynecological practice: a literature review. Magnesium Research.
2017;30(1):1-7. doi:10.1684/mrh.2017.0419
Mg

8. Dysmenorrhoea
• Painful uterine cramps that precede or accompany menses
• 20% of women: severe enough to interfere with daily activities
• Related to myometrial hypercontractility, arteriolar vasoconstriction
and inflammatory compounds
After ovulation:
Omega-6 fatty
acids build up in
cell membranes
Before menses
progesterone
levels drop
Omega-6 fatty
acids
(including
arachidonic
acid) released
Prostaglandins
and
leukotrienes
induce
inflammatory
response
Cramps
Nausea
Vomitting
Bloating
Headaches
Proctor ML, Farquhar CM. Dysmenorrhoea. BMJ Clin Evid.
2007;2007:0813

9. Magnesium in young girls with dysmenorrhoea
A study comparing
presence or absence of
dysmenorrhoea found
that serum magnesium
levels of those with
dysmenorrhoea were
significantly lower.
Chhabra S (2017). Primary Dysmenorrhea and Serum Magnesium In
Young Girls A Pilot Study. Nessa J Gynecology (2017); Journal of
Gynaecology, Volume 1, Issue 3.

10. Magnesium to treat dysmenorrhoea
3 placebo-controlled studies included in a Cochrane review
(Davis 1988) (Fontana 1990) (Seifert 1989)
• Mg significantly more effective than placebo for pain relief
• Less need for additional medication
• Absence from work greatly decreased
• In one of the studies , over 6 months, 21/25 women showed decline in
symptoms, and prostaglandin in menstrual blood dropped by 45%
(Seifert)
 Magnesium is a promising treatment for dysmenorrhoea. Dose and
regimen unclear due to variation in studies.
Open label study: (Benassi 1992)
• Magnesium greatly reduced symptoms compared to pre-treatment
control cyclesProctor M, Murphy PA. Herbal and dietary therapies for primary and secondary
dysmenorrhoea. Cochrane Database of Systematic Reviews 2001, Issue 2. Art. No.:
CD002124. DOI: 10.1002/14651858.CD002124.

11. Menstrual migraines
• ~50% of women have suffered
migraines related to
menstrual cycle
• With or without aura
• Usually more debilitating, more prone to recurrence, and
less responsive to acute treatment than non-menstrual
migraine attacks
• Mechanism: related to fall in oestrogen, which modulates
neuronal activity and receptor density
• Normal plasma levels of magnesium required for proper
function of blood vessels; hypomagnesaemia is a factor
predisposing to vascular spasm

12. Menstrual migraines - relationship to
magnesium
• Hypothesis: magnesium deficiency and serum Ca:Mg ratio important
relationship to migraines
• 61 female migraine sufferers: magnesium and calcium measured
during and between migraine attacks
• Incidence of magnesium deficiency:
 45% during menstrual migraines
 15% during non-menstrual attacks
 14% during menstruation without a migraine
 15% between menstruations and migraine attacks
• Serum calcium levels were normal, but the Ca:Mg ratio was
elevated in menstrual migraine
Mauskop A, Altura BT & Altura BM. Serum ionized magnesium levels and serum ionized
calcium/ionized magnesium ratios in women with menstrual migraine. Headache. 2002
Apr;42(4):242-8.

13. Magnesium supplementation for migraine
• Therapeutic or preventative
• 2 theories for role of prophylactic magnesium:
- Hypothesis 1: Lack of magnesium promotes platelet hyperaggregation and
cortical spreading depression, impairs serotonin receptor function and influences
neurotransmitter synthesis and release.
- Hypothesis 2: Emotional and physical stressors can trigger migraines; more likely to
trigger an attack when migraine threshold lower in peri-menstrual period.
Magnesium is depleted under conditions of stress and magnesium supplementation
improves emotional stress response.
Study 1: Migraines in general (Peikart)
•Placebo-controlled; daily oral Mg for12 weeks:
•41.6% reduction in frequency of migraines in Mg arm vs 15.8% in placebo
•Number of days with migraine & drug consumption decreased significantly
Study 2: Menstrual migraine (Facchinetti)
•2 cycles – no treatment
•2 cycles oral Mg or placebo cycle day 15 to menses onset
•Intracellular Mg levels were decreased in menstrual migraine sufferers
•Fewer days with headache and fewer other premenstrual complaints in Mg vs placebo
•Pain decreased in both groups but significantly more in magnesium group
•Mg supplementation increased Mg level in white blood cells (WBC), with no change in plasma or red blood
cells
•Inverse correlation between pain and Mg concentration in WBC
Magnesium prophylaxis of menstrual migraine: effects on intracellular magnesium.
Facchinetti F1, Sances G, Borella P, Genazzani AR, Nappi G.

14. Premenstrual syndrome and magnesium
levels
• Physical & emotional symptoms
during luteal phase
• Affects 80-90% of females during
reproductive years
• Rosenstein (1994): Evaluated Mg levels across menstrual cycle in
women with and without PMS
 Significantly lower RBC & MBC (mononuclear blood cell) Mg
concentrations in PMS patients at various time points in menstrual
cycle, not only during luteal phase
Rosenstein, Donald L. et al. (1994) Magnesium measures across the
menstrual cycle in premenstrual syndrome. Biological Psychiatry, Volume
35, Issue 8, 557 - 561

15. Magnesium for PMS
• Study 1: (Facchinetti, 2017) 20 women Mg vs placebo from day 15 of menstrual cycle
to onset of menses  symptoms significantly reduced
• Study 2: (Walker) 200mg magnesium oxide vs placebo for 2 months, with crossover
 1st month: no change; 2nd month: significant reduction of symptoms (weight gain,
swelling of extremities, breast tenderness, abdominal bloating) with Mg
supplementation
• Study 3: (Quaranta, 2007) 250mg/d slow release Mg from cycle day 20 until menses
onset). Given for 3 cycles  decreased premenstrual symptoms by ~1/3
• Study 4: (Fathizadeh, 2010) Magnesium oxide 250mg/day  significantly reduced
premenstrual symptom score; effect amplified if given together with vitamin B6
40mg/day
• Study 5: (De Souza, 2000) magnesium/B6 – B6 and Mg more effective than Mg
alone, especially for anxiety-related premenstrual symptoms (nervous tension, mood
swings, irritability or anxiety)
 Magnesium, especially when combined with vitamin B6, is effective for
PMS
At least 2 months may be needed to appreciate benefits

16. Endometriosis
•10-15% premenopausal women
•Endometrial cells found outside uterus – grow, then break down and bleed
causing inflammation, pain & scar tissue
•Significantly decreased magnesium intake compared to
controls (Schink, 2019) (Harris, 2013)
•Magnesium used up in abundant amounts during
menstruation and stress - endometriosis a state
of physical stress
•Therapeutically, magnesium relieves cramping by its
effect on smooth muscle and fallopian tubes.
Useful for accompanying anxiety and depression
•Schink, M et al. (2019) Different nutrient intake and prevalence of gastrointestinal
comorbidities in women with endometriosis. Journal of physiology and pharmacology
DOI: 10.26402/jpp.2019.2.09
•Harris HR, Chavarro JE, Malspeis S, Willett WC, Missmer SA. Dairy-food, calcium, magnesium, and vitamin D
intake and endometriosis: a prospective cohort study. Am J Epidemiol. 2013;177(5):420–430.
doi:10.1093/aje/kws247

17. Lower Mg intake may predispose to PCOS and those with
PCOS and lower Mg intake more likely to develop insulin
resistance, inflammation and raised testosterone
Polycystic ovarian syndrome
• Higher intake of magnesium associated with lower incidence PCOS
Eslamian G, Hekmatdoost A. Nutrient Patterns and Risk of Polycystic Ovary Syndrome. J Reprod Infertil. 2019;20(3):161–168.
• Women with PCOS often have insulin resistance, worsened by obesity
• In women with PCOS, those with insulin resistance consumed less fibre, less
magnesium and greater glycaemic loads
• Magnesium intake also negatively correlated with CRP (inflammation),
testosterone and positively correlated with HDL
Low intakes of dietary fiber and magnesium are associated with insulin resistance and hyperandrogenism in polycystic ovary
syndrome: A cohort study. Cutler DA, Pride SM, Cheung AP. Low intakes of dietary fiber and magnesium are associated with
insulin resistance and hyperandrogenism in polycystic ovary syndrome: A cohort study. Food Sci Nutr. 2019;7(4):1426–1437.
Published 2019 Feb 27. doi:10.1002/fsn3.977

18. Magnesium for PCOS
• Randomised double-blind placebo-controlled trial
250mg/d magnesium + 400mg/d vitamin E or placebo
for 12 weeks
• Supplementation resulted in:
 significant reduction in hirsutism and CRP
 significant increase in plasma nitric oxide and total
antioxidant capacity
Shokrpour, M & Asemi,Z (2019) Biol Trace Elem Res. The Effects of Magnesium and Vitamin E Co-
Supplementation on Hormonal Status and Biomarkers of Inflammation and Oxidative Stress in Women
with Polycystic Ovary Syndrome. 2019 Sep;191(1):54-60. doi: 10.1007/s12011-018-1602-9. Epub 2018
Dec 18.

19. Pregnancy, pre-eclampsia and magnesium
• Mg homeostasis in pregnancy challenged by increased
metabolism, inflammation in placenta &
blood vessels and increased demand from foetus
• In normal pregnancies Mg responsive genes are
upregulated, suggesting relative decrease in Mg
• Blood pressure increase is related to
increased urinary Mg excretion
• In pregnancies complicated by pre-eclampsia,
Mg homeostasis is dysfunctional
• Women with pre-eclampsia have lower Mg levels in RBC membranes, brain, muscle and
maternal and umbilical cord blood
 Supplementation with Mg has shown beneficial effects on high blood pressure & pre-
eclampsia, and decreased premature births & low birth weight infants in some studies
Rylander, R (2014) Magnesium in pregnancy blood pressure and pre-eclampsia - A review. Pregnancy Hypertens. 2014
Apr;4(2):146-9. doi: 10.1016/j.preghy.2014.01.002
Kisters, K et al (1998) Plasma and membrane Ca2+ and Mg2+ concentrations in normal pregnancy and in
preeclampsia.
Gynecol Obstet Invest. 1998;46(3):158-63.
Resnick, LM et al. (2004) Cellular-Free Magnesium Depletion in Brain and Muscle of Normal and Preeclamptic
Pregnancy. Hypertension. 2004;44:322–326. doi.org/10.1161/01.HYP.0000137592.76535.8c

20. Magnesium in the antenatal ward
Intravenous/intramuscular magnesium sulphate
Preterm labour:
• Suppresses preterm labour due to calcium channel
blocking activity- relaxing smooth muscle of uterus
Eclampsia/threatened eclampsia:
• Used to prevent seizures or further seizures

21. Postnatal depression
• Mg influences nervous system
via its role in the release and
metabolism of neurotransmitters
• Lower serum magnesium levels are
associated with depression and magnesium has
anti-depressant effects
• If women go into pregnancy magnesium-depleted,
further increase on demands in pregnancy may lead
to postpartum magnesium deficiency, with a greater
risk of postpartum depression
Etebary, S et al. (2010) Postpartum depression and role of serum trace
elements. Iran J Psychiatry. 2010 Spring;5(2):40-6

22. Menopause & magnesium - applications
• Hot flushes
• Low energy
• Mood symptoms
• Bone health

23. Magnesium & hot flushes
• Studies with magnesium oxide (MgO) in women with
breast cancer and hot flushes
• Study 1 (Herrada 2010): Open-label, 400mg MgO 3x
daily for 4 weeks
o 45% - complete resolution
o 45% - 50% reduction
o 10% - no change
• Study 2 (Park 2011): Open-label 400 or 800mg
MgO/day
o 56% had a >50% reduction in hot flush score
o 76% had a >25% reduction
o Fatigue, sweating and distress were all significantly
reduced
• Study 3 (Park 2015): Larger placebo-controlled study,
800mg /1200mg MgO/day
o Mg oxide did improve symptoms but no more effective
than placebo

24. Mood symptoms – depression, anxiety,
mood swings
• Affect up to 90% peri- and postmenopausal women
• Magnesium deficiency has been related to the onset and the
severity of depression and anxiety in animal models:
o Magnesium-deficient diet was proven to enhance depression
and anxiety-related behaviour
o Magnesium supplementation was reported to induce an
antidepressant effect
• Postmenopausal women with depressive symptoms had
significantly lower magnesium levels than healthy controls
(Stanisławska 2014)
Stanislawska M., Szkup-Jablonska M., Jurczak A. The severity of depressive symptoms vs. serum Mg and Zn
levels in
postmenopausal women. Biol Trace Elem Res. 2014;157:30-35.

25. Magnesium and anxiety
• In 2013, there were 8.2
million cases of anxiety
in the UK
• In England women are
almost twice as likely
as men to be
diagnosed with anxiety
disorders
• The one-week prevalence of generalised anxiety in
England is 6.6%
https://www.nopanic.org.uk/anxiety-statistics/

26. Magnesium & anxiety:
physiology
Magnesium:
• Inhibits NMDA receptor
stimulation in the brain
• Promotes GABAA
receptor function
• Modulates hormonal activity associated with stress
& anxiety: reduces secretion of ACTH, cortisol and
adrenaline from the pituitary and adrenal glands
Abumaria, N et al. (2011) Effects of elevation of brain magnesium on fear conditioning, fear extinction, and synaptic
plasticity
in the infralimbic prefrontal cortex and lateral amygdala. Journal of Neuroscience, 31(42), 14871-14881.
Sartori, S et al (2012). Magnesium deficiency induces anxiety and HPA axis dysregulation: modulation by
therapeutic drug treatment. Neuropharmacology, 62(1), 304-312.
Möykkynen, T et al. (2001).Magnesium potentiation of the function of native and recombinant GABAA
receptors. Neuroreport, 12(10), 2175-2179.

27. Osteoporosis & magnesium
• Magnesium deficiency is a known risk factor for osteoporosis
Lack of magnesium:
o decreases osteoblast and increases osteoclast activity
Through inflammation
In magnesium deficiency, TNFα, IL-1s and IL-6 are increased in both serum and bone marrow
microenvironments.
Through increased oxidative stress
Partly as a consequence of inflammation and partly due to reduced antioxidant defences
o prevents optimal crystal formation (Ayuk 2014)
o increases number of osteoclasts generated from bone marrow precursors
o promotes endothelial dysfunction
• Mean dietary intake of Mg, Zn and Ca in postmenopausal women with low bone
density significantly lower than the RDA (Mahdavi-Roshan 2015)
• Oral magnesium supplementation raises serum levels of osteocalcin and significantly
decreases markers of bone resorption (Aydin 2010)
 Current evidence suggests that magnesium is an important nutrient for bone
health and that optimising its intake might represent an effective and
low-cost preventive measure against osteoporosis

28. Magnesium throughout life for bone health
• Mg beneficial in osteoporotic women
• Building healthy bone throughout life:
pre-adolescent dietary Mg intake
positively relates to BMD in young
adulthood
• Mg supplementation for 12 months: positive effect on accrual
of hip bone mass of peripubertal Caucasian girls
Castiglioni S, Cazzaniga A, Albisetti W, Maier JA. Magnesium and osteoporosis: current state of
knowledge and future research directions. Nutrients. 2013;5(8):3022–3033.
Published 2013 Jul 31. doi:10.3390/nu5083022

29. Postmenopausal colon cancer
• 140,601 women enrolled in Women’s
Health Initiative study for ~13 years
• 2,381 colorectal cancer (CRC)
• Self-reported dietary
and supplemental Mg intake
• Inverse relationship between highest
total Mg intake compared to lowest
risk of colon CRC, borderline significant
relationship for rectal CRC
• Findings from this study support the hypothesis that magnesium
intake around 400 mg/day from both dietary and supplemental
sources is associated with a lower incidence of CRC in
postmenopausal women
Gorczyca et al. Association between magnesium intake and risk of colorectal
cancer among postmenopausal women. Cancer Causes Control. (2015)
DOI 10.1007/s10552-015-0669-2

30. Magnesium & colon cancer - physiology
• Mg is a regulator of DNA repair
• Mg deficiency leads to increased
susceptibility to oxidative stress and
inflammation
• Chronic inflammation leads to endothelial
dysfunction shown to stimulate cancer cell
proliferation and invasiveness
• Mechanisms of Mg’s protective effect could
also relate to Mg’s reduction in
gastrointestinal transit time and insulin

31. Thyroid health
• Magnesium plays a role in
production of thyroid hormone
• Deficiency is a cause of goitre
Moncayo, R & H (2017) A post-publication analysis of the idealized upper reference value of 2.5 mIU/L for
TSH: Time to support the thyroid axis with magnesium and iron especially in the setting of reproduction
medicine. BBA Clinical Volume 7, June 2017, Pages 115-119. doi.org/10.1016/j.bbacli.2017.03.003

32. Choosing a quality magnesium supplement
• Absorbable & synergistic carriers
• Choosing carriers for enhanced benefits
• Elemental magnesium fraction
• Buffers vs blends vs fully reacted
• Fractional absorption & split-dosing

33. Magnesium ions are highly reactive, unstable and easily
form compounds with other substances – hence,
magnesium supplements are never ‘pure’ magnesium.
Magnesium ions bind with negatively charged molecules
(anions) to form salts or can bind with amino acids to form
amino acid complexes.
Organic complexes Bisglycinate, taurate
Organic soluble salts Citrate, lactate, gluconate
Inorganic soluble salts Chloride, sulfate
Inorganic insoluble salts Oxide, carbonate
Increasingbioavailability
Choosing absorbable and synergistic
‘carriers’

34. Magnesium
source
Magnesium
content
Solubility Bioavailability
Oxide 60% Insoluble Low
Sulfate 20% Moderately soluble Low
Carbonate 28.5% Insoluble Low
Chloride 25% Soluble High
Citrate 16% Soluble High
Gluconate 6% Soluble High
Glycinate 10% Soluble High
Aspartate 8% Soluble High
Taurinate 6.5% Soluble High
Many cheap products will use oxide or blends of oxide, with the focus on
delivering a product with a high elemental fraction, while disregarding its
extremely poor bioavailability estimated at ~4%.
Comparison of element fractions from different
magnesium sources

35. With magnesium salts (e.g. citrate) magnesium ions are
liberated by the acidic environment of the stomach and
the ‘free’ ions move through the gastrointestinal tract
The magnesium ions liberated from magnesium salts then
have two pathways for absorption:
Jahnen-Dechent W, Ketteler M. Magnesium basics. Clin Kidney J. 2012
Feb;5(Suppl 1):i3-i14
 Paracellular transport accounts for
the majority (80% - 90%) of
magnesium uptake and is pH
dependent.
 Transcellular transport is a minor
route of uptake and occurs when
magnesium intake is low (and
occurs mainly in the caecum and
colon).

36. Overwhelming a single pathway of absorption with a
single source of magnesium will significantly limit
magnesium uptake. This can be overcome by
simply increasing the routes of passage.
We use three forms of magnesium and choose the
most absorbable and synergistic carriers. By
combining magnesium citrate salt with magnesium
chelates (glycine and taurine), we target 2 additional
pathways related to protein uptake not ion channels
(meaning magnesium gets a ‘free-pass’):
– Dipeptide channels (for peptides composed of
two amino-acid residues)
– Amino acid transporters (for single amino
acids)
Gly
Mg
Gly
Magnesium
bisglycinate targets
dipeptide channels
Tau
Mg
Magnesium taurinate
targets amino acid
transporters

37. Magnesium citrate salts are a great source of soluble,
bioavailable magnesium (with a high elemental load)
but you need to keep the pH low!
Taurine and glycine (as pH buffers) help keep the pH lower
for longer along the gastrointestinal tract, which can aid in
the paracellular absorption of ions from magnesium citrate.
Gl
y Tau
MgMg Mg
Gl
y
Magnesium
bisglycinate
targets
dipeptide
channels
Magnesium
taurinate targets
amino acid
transporters
Magnesium citrate creates
free magnesium ions that
target paracellular and
transcellular routes of uptake
Mg

38. Enhanced carrier benefits with a blend of
magnesium citrate, taurate & bisglycinate
• Glycine is involved in collagen, creatine, glutathione & haemoglobin
production, while also acting as an inhibitory neurotransmitter. The two
glycine molecules in magnesium bisglycinate occupy the reactive sites
of magnesium, preventing it from forming insoluble complexes (with
phytates & oxalates), thereby helping to increase uptake and retention
of magnesium
• Taurine acts as an antioxidant and helps improve insulin sensitivity but
is possibly best known for its cardiovascular benefits and for its positive
influence on bone metabolism
• In addition, taurine & glycine act as pH buffers, creating the optimal
environment to aid magnesium uptake from citrate
• Citrate feeds into the citric acid (Krebs) cycle to support energy

39. – Magnesium blends simply blend magnesium
oxide with a carrier such as citrate.
– Fully reacted magnesiums form complexes and
are directly bound to the carrier. Only fully reacted
products contain no magnesium oxide.
– Buffered products combine fully reacted
magnesium with magnesium oxide (better than
blends, but not as good as fully reacted).
Mg Citrate
Oxide
Mg
Citrate
Mg
Citrate
Mg
Oxide
So we can see how fully reacted magnesium is the superior choice!

40. Split dosing increases magnesium uptake and
retention more effectively than single dosing
The relative absorption of magnesium is inversely related to the
ingested dose – so the quantity of magnesium in the digestive tract is
the major factor controlling the amount of magnesium absorbed:
– Magnesium absorption is not the same as magnesium retention
– High plasma levels can lead to increased magnesium excretion
– Low-dose magnesium taken several times a day is better
absorbed and retained
– Low elemental magnesium is also less likely to cause diarrhoea
(reduced even more by using buffers and fully reacted forms)
Taking 300 mg magnesium as 3 x 100 mg will raise magnesium
status more effectively than one single 300 mg dose!

41. Additional References
• Aydin, H et al.(2010) Short-term oral magnesium supplementation suppresses bone turnover in postmenopausal
osteoporotic women. Biol Trace Elem Res. 2010 Feb;133(2):136-43. doi: 10.1007/s12011-009-8416-8. Epub 2009
Jun 2.
• Ayuk, J & Gittoes, N. J. (2014). Contemporary view of the clinical relevance of magnesium homeostasis. Annals of
Clinical Biochemistry, 51(2), 179–188. https://doi.org/10.1177/0004563213517628
• Castiglioni S, Cazzaniga A, Albisetti W, Maier JA. Magnesium and osteoporosis: current state of knowledge and
future research directions. Nutrients. 2013;5(8):3022–3033. Published 2013 Jul 31. doi:10.3390/nu5083022
• De Souza et al. A synergistic effect of a daily supplement for 1 month of 200 mg magnesium plus 50 mg vitamin
B6 for the relief of anxiety-related premenstrual symptoms: a randomized, double-blind, crossover study. Womens
Health Gend Based Med. 2000 Mar;9(2):131-9.
• Facchinetti, F et al. (1991) Magnesium prophylaxis of menstrual migraine: effects on intracellular magnesium.
Headache. 1991 May;31(5):298-301
• Fathizadeh N et al (2010). Evaluating the effect of magnesium and magnesium plus vitamin B6 supplement on the
severity of premenstrual syndrome. Iran J Nurs Midwifery Res. 2010;15(Suppl 1):401–405.
• Gorczyca et al. Association between magnesium intake and risk of colorectal cancer among postmenopausal
women. Cancer Causes Control. (2015) DOI 10.1007/s10552-015-0669-2
• Herrada J, Gupta A, Campos-Gines AF, et al. Oral magnesium oxide for treatment of hot flashes in women
undergoing treatment for breast cancer: A pilot study. Chicago: 2010 ASCO Annual Meeting; 2010.
• Mahdavi-Roshan M, Ebrahimi M, Ebrahimi A. Copper, magnesium, zinc and calcium status in osteopenic and
osteoporotic post-menopausal women. Clin Cases Miner Bone Metab. 2015;12(1):18–21.
doi:10.11138/ccmbm/2015.12.1.018
• Parazzini, F., Di Martino, M. & Pellegrino,P. Magnesium in the gynecological practice: a literature review.
Magnesium Research. 2017;30(1):1-7. doi:10.1684/mrh.2017.0419
• Park H, Parker GL, Boardman CH, Morris MM, Smith TJ. A pilot phase II trial of magnesium supplements to
reduce menopausal hot flashes in breast cancer patients. Support Care Cancer. 2011;19(6):859–863.
doi:10.1007/s00520-011-1099-7
• Park H, Qin R, Smith TJ, et al. North Central Cancer Treatment Group N10C2 (Alliance): a double-blind placebo-
controlled study of magnesium supplements to reduce menopausal hot flashes. Menopause. 2015;22(6):627–632.
doi:10.1097/GME.0000000000000374
• Quaranta,S et al. Pilot study of the efficacy and safety of a modified-release magnesium 250 mg tablet
(Sincromag) for the treatment of premenstrual syndrome. Clin Drug Investig. 2007;27(1):51-8.
• Seifert B et al. Magnesium – a new therapeutic alternative in primary dysmenorrhoea. Zentralbl Gynakol.
1989;111(11):755-60.
• Smith (2009) “Magnesium Supplements for Menopausal Hot Flashes.” Journal of Clinical Oncology,
27(7), pp. 1151–1152