The Missing Element in Depression
What is the most common elemental deficiency in my practice? Magnesium. This is probably the most underutilized “medicine” out there for restless legs, constipation, kidney stones, leg cramps, menstrual cramps, asthma and many other medical conditions including treatment resistant depression. It has tons of research available to support its use in these and m
any other medical conditions but often it is overlooked because I personally feel we as doctors have not been educated on its benefits except for “emergency” cases. It is not a drug so there are no people sitting in tubs on a cliff holding hands and talking about its benefits on TV and there is no Magnesium Lobby group to push its cause so I will try to champion the miracle mineral here.
Magnesium is the most utilized mineral in the body and is responsible for actions ranging from relaxation and decalcification of the arteries to utilizing sugar in the cell all the way to improving mood. We cannot survive without it. In my practice it plays an essential role. After first addressing inflammation in the gut(see my post on gluten sensitivity) I then address magnesium status as the second step in almost all treatment plans especially for those patients with depression and anxiety. Matter of fact, this mineral is essential for relaxation and mood. Magnesium is better than the anti depressants in studies with postpartum depression and treatment resistant depression. Interestingly, treatment resistant depression is not a Zoloft deficiency to start with but more likely is a magnesium deficiency. Treatment resistant depression is largely due to magnesium deficiency and there is quite a bit of data to back this up. By adding magnesium to their current regimens almost 80 percent had resolution of their symptoms of depression. Not only good for mood disorders, it also has amazing effects on the brain in general. Magnesium repairs the brain following stroke. One study showed a 50% improvement on mental functioning with administering magnesium one year after the stroke! Another brain issue is migraines and you guessed it, magnesium is an effective cure. It is always my first and most effective intervention for migraine. “Wow, magnesium is awesome” you say,” and I will have my doctor check my levels right away.” As the sports announcer Lee Corsco says “Not so fast my friend…”
It is hard to measure total body stores since 99% is in the tissues and only 1% is in the blood, where our testing is performed. We can be depleted of magnesium in our body compartments but our blood shows we are normal which is only 1% of our total stores. We will use that 99% to keep the 1% in the normal range and our brain tissue may be very low and our blood levels be normal. So what to do? Assume you are magnesium deficient as most of us are (over 80%) and this can be explained by our diet and exposures.
Back in the days of clubbing our women over their head and dragging them back to our cave (not cool now except in Arkansas where this is still very vogue)*, we had a lot more magnesium in our diet. In fact the ratio of magnesium to calcium was 1:1. It is now near 1:6. This ratio has worsened with the introduction of row crop farming on a large scale. We have mineral depleted soil and it has very little organic matter so the food we grow in it is less than complete in nutrition. One of the major minerals we are missing in our processed food is magnesium. We are also wasting it with stress, caffeine intake and not able to replace it with our processed food. Another unseen cause of depletion of magnesium is ironically diuretic meds (hydrochlorothiazide is one of the most common) used to treat high blood pressure which causes long term magnesium depletion which causes high blood pressure. We doctors be jeanusisses. So long story short-we are a generally magnesium depleted society and we need to get some now at some “Superstore.” Once again, not so fast my friend.
Ok, so I’ve got nothing against a certain conglomerate chain of stores where you can buy anything except maybe crack pipes, (except the way it treats its employees and runs small business out of business so maybe I do), but in regards to magnesium this is not your best source to buy it. Magnesium comes in a lot of different forms and if you want to actually absorb it you will need the right kind. Your doctors office (nutritional oriented doctors office that is) or higher end health food store or specialty pharmacy is the place to start. Magnesium Taurate is probably my favorite but is the hardest to find. The taurate portion of the magnesium chelate is very calming to the brain and works in synergy with magnesium to help with mood. My next favorite is Magnesium Glycinate and is a little easier to find and is cheaper than Taurate. It does little to create GI upset like Mag Oxide and is very effective in higher doses without side effects of diarrhea. Next there is Magnesium Citrate which is good for constipation and but still allows absorption of magnesium, unlike Mag Oxide, but can cause loose stools in high doses. Magnesium citrate is cheaper than the previously mentioned magnesium chelates and overall is good all around magnesium. Finally there is magnesium oxide which is what the cheaper magnesium brands are made of. You get a lot of concentrated magnesium in one pill but only absorb about 4% of it. This should only be really used for constipation and not replacement. If cheap is more important than whether it works effectively, then you should choose this one (see you at the crapper). When choosing your magnesium be careful is not combined with mag oxide which is used to decrease costs and lessens efficacy of the good magnesium.
Another way to get magnesium is topically with magnesium chloride oil or Epsom salts baths. Topical magnesium replaces magnesium faster than if taken by mouth and gets body back to normal levels in 1-2 months instead of 6-12 months like oral magnesium does. ” Oh wow, you mean I have to keep taking pills for more than one day”. Yes, and you have to take quite a few pills a day for many months to get where you need to be in total body load if you are depleted.
Now we have the kinds of magnesium, although the above is not a complete list, how much should we take? The best way to go is start by taking Epsom Salt baths-2 cups in hot tub x 30 mins. This is cheap and you can get at any store. Topical magnesium oil is easily found at health food stores and can be applied daily or twice a day. The chelated magnesiums (taurate, glycinate, and citrate) are usually in 100-150 mg per capsule dosages so I recommend 600-900 mg a day and if you can tolerate it you can go even higher (loose stool is a tip off you need to back down a pill or two). The obvious question is whether you can take too much? The answer, not really, unless you have chronic kidney disease then would go with much smaller doses and you would want to be monitored by a physician. If you do not have kidney disease you will be able to excrete any excess magnesium in urine or your stool. Other instances where you would want to be careful is excessively slow heart rate (works to slow down heart which is usually good and works well for atrial fibrillation), myasthenia gravis, or bowel obstruction (can’t eliminate excess).
Long article made even longer, magnesium is the first place to start for depression. It is a long undervalued mineral missing in our diet due to years of depletion in our soil. It is easily replaced inexpensively. Magnesium does a body good.
* Being from Louisiana it is my job to make fun of Arkansas, so if anyone there is reading this please know I am proud of you for reading this
(Disclaimer-I am looking to start a Magesium Lobby Group-so send money)
Awesome info, thanks doc. I’ll support any lobby group you lead;)
Can’t begin to tell you how much Mag. has done for me. We also put Epsom Salts in our hot tub. Every time we are in it we get another shot of Mag.
You have my support as an awesome doc.
Thank you for the positive feedback and the new idea of using the hot tub for increased exposure to magnesium.
Really awesome information. I have been on hydrochlorthiazide for years and my high blood pressure has not been managed satisfactorily. Finally was sent to a kidney specialist because my kidneys are getting damaged. Am getting off of the hydrochlorthiazide and having problems with ankle swelling; just started taking Magnesium Malate, take epsom baths on a regular basis. I’m 77 y.o. and hope to stick around for a few more years, so will up my dosage of magnesium, any further suggestions appreciated
Magnesium Malate is a great magnesium and I forgot to mention it. I would caution you with kidney issues to actually follow magnesium levels in the blood when you get your kidney labs done as usually safe, but with decreased kidney function you do not excrete excess magnesium as well. That is one of the major caveats with magnesium. I have never had a patient have an issue with it but I monitor it none the less in my kidney patients. I think two things to start with that should be very safe for your hypertension is CoEnzyme Q10 100 mg a day or Ubiquinol (the active form of Coenzyme Q10) at 50 mg a day and Vitamin D 2000 units a day. These will be safe for you and a lot of research to support their use in hypertension with good results. There are of course many other supplements which help such as green tea extract, N Acetyl Cysteine etc but start with these two as well as a diet with very little processed foods and 8 hours of sleep and you should see improvement not only in your hypertension but in your edema. Good luck with your health and age is nothing but a number (takes someone 41 to say that of course and you can’t reach me through the internet to hit me for such a cliche’ saying) so keep focusing on maximizing your health and making the most of each day.
I am definitely going to try this. When I saw the word asthma it caught my attention. I have had a chronic cough for 7 years. I have had every test you can imagine and have been told I have asthma. The cough is sometimes just awful and embarrassing. I hope magnesium is my miracle “drug”. Thanks
There is definitely a lot of data to support its use in asthma and one of the treatments which I found to be most effective in hard to treat asthmatics in the hospital was magnesium-always wondered back then why we didn’t start with it first…
Thanks for the articles!! I’m really enjoying them and passing them along!
Thank you for the encouragement
My mom called today to tell me my 89-year old father couldn’t figure out how to put gas in the car today. She’s, of course, worried sick about his very slowly, but increasing signs of dementia. I read your newsletter referencing Type 3 Diabetes and then this on magnesium. Thanks so much for all the good information in your well-written articles.
Hi, there–
I’ve just returned from a therapeutic cruise to the Mediterranean. Too bad I can’t count it as a tax deduction! Anyway, thanks so much for this helpful article on magnesium. I’ve been taking hot epsom salts baths at my home here in Michigan, where I have a deep hot tub! My question: Will the two cups of epsom salts get too diluted if I put about 9-10 inches of water in the hot tub?
Wish I were there to hear your first presentation!
Every little bit counts but I don’t think it should be too diluted.
Dr. Morris do you have an opinion on the dehydration theory of these young male athletes “dropping dead” from exhaustion and dehydration on the football field for early fall training? It actually happens in the summer and there’s plenty of water available. A young man aged 17 died on the practice field two summers ago here in Louisville. The parents sued the coach and school. No mention was made about the boy’s electrolyte status and no autopsy or post mordem studies were done. My suspicion, could this not have been a severe case of K+/Mg+ deficiencies? Daily rehearsal in the hot sun finally taking it’s toll. If so why would we not see more of this occurrence. I have my suspicions but that’s all they are.. suspicions.
I agree that these are electrolyte issues and the most common electrolyte I suspect is magnesium. Most of these athletes drink tons of caffeine hidden in Mt. Dew, Red Bull, etc and then have loss of Magnesium and potassium as it has diuretic effect. They don’t replenish this with our Standard American Diet and Viola! you have serious problems. Magnesium is essential in calming the nerves in the heart and without it arrhythmias develop and you have sudden death. It is also the chief cause of cramps in athletes. Thanks for the insight.
What amount of magnesium taurate would you recommend for a 17 year old male who suffers from depression?
Would start with 500-600 mg a day. I of course would make sure he is on 2000 to 4000 of Vitamin D3 as well with a good B complex (Has 5 MTHF-special kind of folic acid) and fish oil at 2-3 grams per day. Remove gluten and dairy and you may be amazed at the improvement with these simple steps. If you need help with supplements you can call our office as we have these sometimes hard to find supplements available. Hope he does better.
Is Magnesium available in liquid form? I’m not sure I’m absorbing the mag citrate I’m taking. I used the gel a couple of years ago which worked well, but was quite a hassle. With all of the other things I have to use topically and get the timing just right, a liquid magnesium supplement might be easier. Does that exist and is it effective for those of us with absorption issues?
If absorption is issue then whether liquid or capsule is not going to matter much. I know topical is hard but it is the most effective way to address deficiency.
Dr Morris…I was wondering what vitamins you recommend for 13 year old twin boys that are having trouble in school with learning issues..they are having trouble remembering things and being able to stay focused on what is being taught in school. Please help me.
This is a multifactorial disease and actually I will be putting out article today on ADHD and sleep so definitely read that. I would remove all red and yellow dyes as well as dairy and gluten before focusing just on supplements. With that said a good multivitamin with activated folic acid and b vitamins like Pure One from Pure Encaps is a cornerstone of treatment. The next is DHA, rhodiola rosea and magnesium (lots of good research). I would also look at cause of ADHD-read Ultramind Solution by Mark Hyman, MD for much more info that I think you will find helpful.
Dr. Morris – in reading your comment about magnesium and reduced kidney function,I must apologize. I completely forgot that when I went to donate a kidney for a friend, they told me I couldn’t because my kidneys were only operating at 65%. They said that was fine for me but not if I had only one kidney. Given your comments, I’m wondering if I should discontinue the magnesium or any other supplements until I see you again.
You should be fine with your current regimen. To be more specific with kidney disease, to cause problems the kidney disease has to be severe and yours by no means, would be considered severe and you should have no problems eliminating magnesium.
Dr. Morris,
I suffer from debilitating migraines, constipation, depression/anxiety, kidney stones(those aren’t that frequent, more to do with a med. I am on. I also have MTHFR, so am taking Deplin to get the metabolized folic acid – that’s a great pill. Anyway, I was just in the hospital for a migraine that lasted for 6 days and one of the treatments they gave me was a Magnesium drip in my IV. Although my migraine didn’t go away at the time, it did help with my constipation. I started doing research and found your article. I’m really excited about the possibilities of Magnesium. I’ve ordered some Magnesium Taurate & oil & have taken one Epsom salt bath. I have taken Magnesium oxide in the past for constipation, but it just kind of helped. After reading your article I can see why. Do you ever recommend Niacin for migraines? I have heard of this because it helps open up your capillaries. Also, how do you find out if you have inflammatory bowel disease? I feel like my whole bowel system is messed up. It hasn’t been regular in years. Also, based on the information I’ve given you, if you could recommend how much oil & mag taurate I should take & if I can do them both at the same time. I’m ready for this to work! Thank you!!!
As not able to give much advice outside of my article, but I can tell you some of your questions would require a patient visit as a lot of factors go into making sound recommendations. I can say, as I did in my article, if you do not have the previously listed conditions, you are not going to really overdose on Magnesium but I still keep most peoples oral intake between 600-900 mg a day and take oil as recommended on bottle. The bowel issues are usually very treatable and one of my articles addresses one cause in gluten. Hope this helps and hope you find a doctor who can help you get through your numerous issues, which all sound treatable with a nutritional approach.
Thank you for the article on magnesium! You have answered all my questions about it and confirmed my suspicions about over usage of the capsules!
Taking the magnesium has cleared up my vertigo problems and made me feel better in many ways! Thank you!
I like this post, enjoyed this one thankyou for putting up