Magnesium is crucial for bone health but it has a much broader scope than even I imagined when I first began researching it in the late 90s. Most people think that calcium is the most important factor in bone health. Vitamin D is also a necessary component. However, it’s not well known that magnesium is required to convert vitamin D into its active form so that it can turn on calcium absorption.
I became aware of the pivotal association between vitamin D and magnesium after receiving emails from people experiencing magnesium deficiency symptoms after they began taking high doses of Vitamin D. Some doctors are prescribing 50,000IU of Vitamin D in the synthetic D2 form instead of the previous standard of 400IU per day.
It turns out that all the enzymes metabolizing vitamin D require magnesium as a necessary co-factor.,  When you take high doses of Vitamin D and if you are already low in magnesium, the increased amount of metabolic work drains magnesium from its muscle storage sites. That’s probably why muscles are the first to suffer magnesium deficiency symptoms. Twitching, leg cramps, restless legs and Charlie horses. Angina and even heart attacks affecting the heart muscle are also magnesium deficiency symptoms.
One woman reported that her vitamin D levels remained chronically low (below 30) despite months of high dose supplementation with vitamin D. It wasn’t until she added magnesium that things changed quite dramatically. With magnesium supplementation, her last Vitamin D level was 67, which for her was a miracle. This increase surprised her endocrinologist as well. She also noticed a big difference in how she felt. She no longer had chronic “unexplained” muscle tenderness and could exercise longer on her treadmill and felt great.
The back story of vitamin D is that it is actually a hormone that assists in the absorption and trapping of calcium and directs it to the bones. Maybe scientists will realize in the future that when the body has enough calcium – or a level of calcium that’s higher than magnesium – then vitamin D levels will be low – because the body doesn’t require more calcium.
I think we should consider that part of the vitamin D deficiency epidemic is an underlying magnesium deficiency. That could mean that we don’t really need extraordinarily high doses of vitamin D but a combination of vitamin D along with magnesium to make the vitamin D work. I only recommend 1,000-2,000IU along with 600-900mg of elemental magnesium. But it must be a well-absorbed form – such as my ReMag.
My thoughts were echoed in a 2013 study called Magnesium, Vitamin D Status and Mortality with this conclusion: “Our preliminary findings indicate it is possible that magnesium intake alone or its interaction with vitamin D intake may contribute to vitamin D status. The associations between serum 25(OH)D and risk of mortality may be modified by the intake level of magnesium.” (NEW 2 BMC Medicine 2013, 11:187)
What about calcium? Magnesium stimulates the hormone calcitonin, which helps to preserve bone structure by drawing calcium out of the blood and soft tissues back into the bones. This action helps lower the likelihood of osteoporosis, some forms of arthritis, heart attack and kidney stones. If you’re taking lots of calcium and not much magnesium, you are susceptible to these conditions because there isn’t enough magnesium to stimulate calcitonin.
Almost half the population of the U.S. (including 70 percent of adult women) uses dietary supplements containing calcium. In general, we absorb less than half of the calcium from our food. Supplements are even less absorbed, calcium carbonate has a 4% absorption rate. The excess is responsible for an increase in calcification in the body. Calcium causes constipation and builds up in soft tissues where it can harden (calcify). The sites of calcification include artery walls, kidneys, gallbladder, muscles and breast tissue.
Recommendations for calcium intake vary greatly. In the U.S., adults are advised to take 1,200 mg per day of supplemental calcium over an above their intake through food and water. And women over 50 are told to take up to 1,500 mg. Adding to the load are many foods that are fortified with calcium, including orange juice, sports drinks, and breakfast cereals. In the United Kingdom, the RDA is a much more sensible 700 mg daily, while the World Health Organization recommends only 400-500 mg.
In 2011 a British Medical Journal meta-analysis sounded the alarm that “Risks outweigh benefits for calcium supplements.” The study confirms that calcium supplements do more harm than good. They cause more cardiovascular events (such as heart attacks and stroke) than the number of fractures they prevent.
The seven authors of the study expressed concern that with so many people taking calcium supplements “even a small increase in the incidence of cardiovascular disease could translate into a large burden of disease in the population.” They even go so far as to “suggest that a reassessment of the role of calcium supplements in the prevention and treatment of osteoporosis is warranted.”
That’s a huge admission of failure of the main treatment for osteoporosis—high dose calcium supplementation. In fact, researchers in a study of postmenopausal women with high milk intake speculate that high levels of calcium may actually be a cause of osteoporosis and osteoporotic bone fractures.
The researchers fail to realize that it’s not just high dose calcium but the lack of magnesium that’s the underlying problem. So they can’t give a blanket statement that calcium is bad for bones; calcium is required for bones – but so is magnesium. The effectiveness and benefits of calcium in preventing and treating osteoporosis are enormously impaired in the absence of adequate levels of magnesium. Magnesium keeps calcium dissolved in the blood. Too much calcium along with too little magnesium can cause some forms of arthritis, kidney stones, osteoporosis and calcification of the arteries, leading to heart attack and cardiovascular disease.
Why have we become a nation of calcium pill poppers? Because it’s the agreed-upon solution to osteoporosis and the mantra of the dairy industry that “Everybody needs milk.” Even the commonly agreed-upon ratio of 2:1 calcium to magnesium found in many supplements is a major stumbling block to overcome the over-calcification of our population. In fact, this ratio is a myth. This so-called recommendation traces back to French scientist Jean Durlach who warned that the 2:1 ratio was a “never to be exceeded” level when considering calcium intake from all sources (food, water, and supplements). His warning has been greatly misunderstood or mistranslated and is taken as a recommendation of a 2:1 calcium-to-magnesium imbalance instead of something to avoid.
The fact that most people do not get their minimum daily requirement of magnesium exacerbates the situation. A hundred years ago we enjoyed a diet high in magnesium with a daily intake of 500 mg. today we are lucky to get 200mg. However, calcium in the diet has never been higher. This high calcium – low magnesium diet when coupled with calcium supplementation can give a calcium to magnesium imbalance of 10:1 or even higher. Which constitutes a walking time bomb of impaired bone health and heart disease.