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Vitamin D and Magnesium: Essential Partnership for Health

By Dr. Linda J. Dobberstein, DC, Board Certified in Clinical Nutrition

December 3, 2019

Vitamin D and Magnesium: Essential Partnership for Health
Many nutrients function in tandem in the body. Just like your body needs a balance with work and play, sleep and exercise, nutrients affect other nutrient functions and balance. For example, calcium and magnesium, zinc and copper, vitamin A and carotenes work together with each other. One such nutrient pair that has gotten more research recognition and understanding is vitamin D and magnesium. Both are needed as individual nutrients, but the presence or absence of one affects the other.

Vitamin D and magnesium are often substantially lacking in individuals, with such inadequacies that public health campaigns to educate on the need has occurred in many parts of the world. Replenishment of each nutrient is essential to hundreds of functions and gene signals in the body. Supplementation of each individual nutrient is essential, but scientists have recognized that if one nutrient is supplemented and the other nutrient is lacking and unrecognized, then further health challenges may occur.

In a recent publication of the Jan/Feb 2019 American Journal of Therapeutics, researchers concluded that “Magnesium is essential in the metabolism of vitamin D, and taking large doses of vitamin D can induce severe depletion of magnesium. Adequate magnesium supplementation should be considered as an important aspect of vitamin D therapy.” There is much to be learned still with this interactive pair of nutrients, but studies show a need for wise choices and balance.

Magnesium

Insufficient magnesium is a common concern amongst adults and children. A public health crisis was declared in 2018 due to insufficient magnesium intake. According to the 2005-2006 NHANES survey in the U.S. population, at least 50 percent of adults fail to meet the minimal RDA levels. A breakdown in statistics showed that 89 percent of teenage girls, 55-58 percent of 51 to 70-year-olds, and 70-80 percent of adults 71 years of age and older lacked adequate magnesium.

Magnesium blood tests provide almost no help in evaluation of what your body stores of magnesium actually contain. Normal serum magnesium levels may still occur even with moderate to severe depletion of body stores. The amount of magnesium found in the blood does not reflect tissue stores. Less than one percent of magnesium is found in the blood stream with the remainder stored in bones, muscles, and organs. If your serum magnesium levels are low or borderline low, your body stores are dangerously inadequate.

Magnesium is needed for heart function and rhythm, blood vessel relaxation and blood flow, cholesterol, blood sugar and cholesterol management, mitochondria and energy production, neurotransmitter production, bones, muscles, and electrolyte function. Your body requires magnesium for brain, nerve and cell membrane function and stability, mood and cognitive function, lung and respiratory function, RNA and DNA synthesis, gene expression, cell signaling, immune function, ovaries and more. Magnesium is critical to life and essential for hormonal activation of vitamin D.

You can read further about magnesium in the articles Insufficient Magnesium – Public Health Crisis Declared and Magnesium: A Notable Mineral Essential for Life.

Vitamin D

The vast majority of the U.S. population also lacks vitamin D. According to the NHANES 2003-2006 studies, an amazing 70 percent of U.S. residents failed to obtain the estimated average requirement of vitamin D. More recent information shows that about 75 percent of all adults worldwide have insufficient vitamin D levels (serum 25(OH)) of less 30ng/mL.

Vitamin D influences bone density and strength, muscle development, cell growth, balance and coordination. Vitamin D receptors are located throughout the immune system found on all immune cells, macrophages, T and B cells, etc.

Vitamin D helps keep the heart and lungs strong, supports blood flow, insulin and pancreatic function. Thyroid hormone along with cognitive function, mood, and nerve support require vitamin D. It activates thousands of gene signals in your body and helps slow unhealthy rapid cell growth. Longevity is associated with adequate vitamin D.

Do You Know Your Status?

The USA Endocrine Society recommends sufficient vitamin D3 blood levels to be at 30-100 ng/mL. Optimal levels are often considered between 50-80 ng/mL.

A Position Statement paper released in 2018 on vitamin D deficiency by the Italian Chapter of the American Association of Clinical Endocrinologists et al gave several guidelines on vitamin D. These professionals recognized that inadequate vitamin D intake is prevalent in all age groups. They recommend supplementation for those who lack adequate vitamin D, however, they did not recommend vitamin D testing for everyone.

Their position statement was “At the present time, there is not sufficient evidence to recommend screening individuals who are not at risk for deficiency.” They recommend testing for individuals at risk with bone, kidney, liver disease, obesity, malabsorption, pregnancy and breast feeding, and some elderly individuals.

Other high-risk individuals that were not included in their statement are those with gastrointestinal disorders, bariatric surgery, individuals with dark skin, and those with limited sun exposure. Several medications like cholesterol lowering statin medications, some antibiotics and antifungals adversely impact vitamin D levels.

Sunscreen use and some clothing blocks vitamin D from sunshine too. Many individuals also have gene SNPs that affect vitamin D receptor sites. This requires a higher intake of vitamin D to overcome the impaired receptor sites.

An estimated 75 percent of the global population fail to get enough vitamin D with sunlight or diet. Can you identify the one person out of four who might have adequate vitamin D status? I have talked with numerous individuals over the years who have no idea what their vitamin D level is or they expect their sunshine exposure to be adequate. They get tested and realize that they lacked adequate vitamin D stores even though they do not fall into any of the above risk categories. It is worth knowing your vitamin D status.

Magnesium – Vitamin D Interactions

Two key areas are under study on magnesium-vitamin D interactions. A primary focus is magnesium’s effect on how vitamin D becomes active into a hormone to regulate calcium metabolism. The second area is the effect on bone health.

Several enzymes are involved with the process of making vitamin D into a hormone by the kidneys and liver. These enzymes require a cofactor, i.e. magnesium to complete this process. Once vitamin D is activated, it in turn causes a reciprocal act, i.e. vitamin D helps absorb magnesium in the intestinal tract. If magnesium levels are lacking, then the hormone function of vitamin D is impaired. Vitamin D hormone function affects calcium metabolism and bone.

When vitamin D is taken without enough magnesium in the body, then a backlog of calcium and phosphorus may occur that causes other distress and even organ damage to the body. The impact of vitamin D and magnesium ripples into the balance with calcium and bone health. In addition, synthesis and activation of parathyroid hormone depends upon the magnesium-vitamin D interaction. The parathyroid gland consists of four tiny glands located around the thyroid gland that regulate calcium levels.

Bone cell function depends on magnesium. With insufficient magnesium intake, bone building cells (osteoblasts) are unable to do the work they need in order to build bone. These cells are blocked from working much like having a breakdown in an assembly line. On the other hand, the bone remodeling cells (osteoclasts) that help repair and breakdown old bone become more active with inadequate magnesium. More action of osteoclasts causes more bone loss.

This activity and balance between osteoblasts and osteoclasts is coordinated by vitamin D3. When there is enough magnesium, then vitamin D can do its job with its work with calcium and improve bone density.

Researchers have found that lack of magnesium with imbalanced intake or lack of vitamin D increases risk and worse outcomes with heart health and cancer risk.

Teammates Needed

Vitamin D and magnesium are part of a bigger team with other nutrients. Magnesium function also needs vitamin B1, selenium, vitamin B6 and potassium. Vitamin D needs other nutrients like calcium and vitamin K2.

Vitamin D natural dietary sources include cheese, egg yolks, mackerel, salmon, and tuna, beef liver, and cod liver oil. A vegetarian diet, a fast food, and processed food diet will lack adequate vitamin D intake.

Magnesium rich foods include greens, nuts, seeds, beans and legumes, whole grains, and some dairy products. Nutrient poor diets with processed foods, alcohol, high stress, and numerous medications deplete magnesium.

Supplementation with vitamin D3 may range from 400 IU to 5000 IU or more. Magnesium supplementation may range from 100- 600 mg or more per day. Magnesium quality makes a difference in absorption and effects in the body. We offer magnesium glycinate and magnesium malate which have a very high absorption and are gentle on the digestive tract.

Optimizing magnesium status helps optimize vitamin D status. To everything, there is a balance.

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