OPINION | Magnesium: An underrated mineral for improved sleep and mental health

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  • A magnesium deficiency may be the cause of problems like insomnia and psychological issues.
  • Taking a magnesium supplement may work better than psychoactive drugs. 
  • Magnesium deficiency has become widespread due to poor farming practices and the refinement of foods.

Many of us know the frustration of struggling to fall asleep or stay asleep, or having a partner or child with sleep difficulties.

Poor quality sleep can impact every aspect of our daily lives, including our professional performance and personal relationships, and can increase the risk of health problems like obesity, hypertension and heart attacks, as well as depression and anxiety.

Often interlinked with sleep problems, adults and children increasingly struggle with mental health and neurobiological issues such as anxiety, depression and attention-deficit/hyperactivity disorder (ADHD). We probably all know somebody affected by these conditions.

Drugs not always the answer

Not everybody is comfortable with the idea of taking psychoactive drugs to treat these conditions, and many who have tried have been left frustrated and dissatisfied with the lack of treatment success, or with the unpleasant side effects. The good news is that there is solid scientific evidence to suggest that magnesium supplementation may provide excellent support in alleviating many of these issues.

Magnesium plays many crucial roles in the body, but ,unfortunately, a deficiency of this mineral is very common. Magnesium is found in many plant-based foods such as grains, seeds, nuts, leafy greens and even cocoa, but the magnesium content of these foods has declined over recent decades due to poor agricultural practices. In addition, food processing often removes the parts of the plant with high magnesium content, which means that processed foods are low in magnesium (and other nutrients). Combined, these two factors may easily result in a magnesium deficiency.

Magnesium is stored in many cells and tissues in the body, as well as in blood cells and blood plasma. As a result, it is sometimes difficult to determine whether a person is magnesium deficient, as a blood test is not a representative measurement of whole-body magnesium levels. However, magnesium intake can be estimated through nutrition questionnaires, and the combined results of numerous studies have indicated that low magnesium intake may be associated with depression. Low magnesium status has also been identified in children with ADHD, more so than in their non-ADHD peers.

Positive mental health effects

One of the many roles of magnesium in the body is its influence on the actions of neurotransmitters (messengers in the brain). Glutamate signalling via NMDA receptors in the brain forms an important part of memory and learning, but can also be excitatory (over-stimulating). Magnesium helps to keep this signalling under control, and also mimics the actions of GABA, a neurotransmitter with anti-anxiety effects.

So, does this mean that magnesium supplementation may actually relieve depression and anxiety? There is definitely good evidence to suggest that this may be the case. Magnesium is a mineral (metal), which has to be combined with other molecules in order to be taken up in the body. Many studies have shown positive mental health effects as a result of different forms of magnesium supplements.

Patients with diagnosed depression experienced a reduction in their depression symptoms after supplementation with magnesium chloride or magnesium oxide. Adults with clinically-diagnosed stress, anxiety and depression also reported a reduction in their anxiety and depression symptoms after taking a magnesium lactate supplement, and achieved even better outcomes when this was combined with vitamin B6, especially in severely stressed individuals.

A combination supplement of magnesium oxide and vitamin B6 also relieved self-reported anxiety-related premenstrual symptoms such as mood swings and irritability, and a combination magnesium oxide/zinc sulphate supplement reduced depression and anxiety in adults with heart disease and type 2 diabetes. Perhaps even more importantly, studies have found that a magnesium orotate and magnesium sulphate intravenous infusion can help alleviate depression that has otherwise not responded to conventional pharmacological treatment such as selective serotonin reuptake inhibitors.

Better sleep at night

For individuals with ADHD, there may also be some hope on the horizon. Already in 1997, it was demonstrated that six months of magnesium supplementation could relieve various measures of hyperactivity in children with ADHD. More recently, it was found that a supplement combining omega-3, omega-6, zinc and magnesium citrate relieved symptoms of hyperactivity, impulsivity, emotional disturbances and sleep disorders in young children with ADHD, while another study showed that a vitamin D/magnesium supplement also relieved many of the emotional and social problems of children with ADHD. The magnesium supplement formulation L-TAMS (L-threonic acid magnesium salt) has also achieved a reduction in the severity of ADHD symptoms in adults.

Magnesium supplementation may also help to relieve a variety of sleep disorders that prevent us from having a restful night. A clinical trial involving elderly patients who suffered from primary insomnia reported that they experienced better sleep at night, as well as improved alertness and quality of life during the day, after taking a supplement of melatonin, magnesium and zinc (although melatonin alone is also prescribed for treatment of insomnia).

It has also been documented that magnesium oxide supplementation reversed age-related sleep disturbances that originate from changes in brain wave activity and the neuroendocrine system (actions of neurotransmitters in the brain, as well as hormones circulating in the body) as we age. A supplement product containing L-TAMS was also found in a trial to reduce and reverse cognitive decline in older adults, and together these trials indicate that magnesium supplementation may have a variety of health benefits during ageing.

A better quality of life

Magnesium oxide supplementation was also found to relieve periodic limb movement during sleep, restless leg syndrome and consequently improved quality of sleep. Unfortunately, one trial found that this supplementation did not reduce the incidence of nocturnal leg cramps, which can also cause night-time disturbance. Two other trials found that magnesium citrate could relieve chronic persistent nocturnal leg cramps in the general population as well as in pregnant women.

In most of these studies, positive effects were measured within weeks, and in men, women and children. Oral magnesium supplements are available at pharmacies and supermarkets, and are regarded as safe when used at the recommended dosage.

And while I would certainly not recommend that you abandon your prescription medication without first consulting your doctor, adding a magnesium supplement to your daily routine may be an affordable and convenient way of getting more benefit out of your medication, or may just be something simple to try at home to improve your family’s quality of life, health and mental well-being.

*Dr Hanél Sadie-Van Gijsen is affiliated with the Centre for Cardio-metabolic Research in Africa (CARMA) in the Division of Medical Physiology at the Faculty of Medicine and Health Sciences at Stellenbosch University.

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