Magnesium Deficiency Symptoms and Diagnosis

by Dr Mark Sircus (web)

Magnesium Thirst Magnesium Hunger

We thirst for magnesium rich water.

Magnesium deficiency is often misdiagnosed because it does not show up in blood tests – only 1% of the body’s magnesium is stored in the blood.

Most doctors and laboratories don’t even include magnesium status in routine blood tests. Thus, most doctors don’t know when their patients are deficient in magnesium, even though studies show that the majority of Americans are deficient in magnesium. Consider Dr. Norman Shealy’s statements, “Every known illness is associated with a magnesium deficiency” and that, “magnesium is the most critical mineral required for electrical stability of every cell in the body. A magnesium deficiency may be responsible for more diseases than any other nutrient.” The truth he states exposes a gapping hole in modern medicine that explains a good deal about iatrogenic death and disease. Because magnesium deficiency is largely overlooked, millions of Americans suffer needlessly or are having their symptoms treated with expensive drugs when they could be cured with magnesium supplementation.

One has to recognize the signs of magnesium thirst or hunger on their own since allopathic medicine is lost in this regard. It is really something much more subtle then hunger or thirst but it is comparable. In a world though where doctors and patients alike do not even pay attention to thirst and important issues of hydration it is not hopeful that we will find many recognizing and paying attention to magnesium thirst and hunger which is a dramatic way of expressing the concept of magnesium deficiency.

Few people are aware of the enormous role magnesium plays in our bodies. Magnesium is by far the most important mineral in the body, After oxygen, water, and basic food, magnesium may be the most important element needed by our bodies, vitally important yet hardly known. It is more important than calcium, potassium or sodium and regulates all three of them. Millions suffer daily from magnesium deficiency without even knowing it

In fact there happens to be a relationship between what we perceive as thirst and deficiencies in electrolytes. I remember a person asking, “Why am I dehydrated and thirsty when I drink so much water?” Thirst can mean not only lack of water but it can also mean that one is not getting enough nutrients and electrolytes. Magnesium, Potassium, Bicarbonate, Chloride and Sodium are some principle examples and that is one of the reasons magnesium chloride is so useful.

Magnesium Torment (Deficiency)

You know all those years when doctors used to tell their patients its all in your heads were years the medical profession was showing its ignorance. It is a torment to be magnesium deficient on one level or another. Even if it’s for the enthusiastic sport person whose athletic performance is down magnesium deficiency will disturb sleep and background stress levels and a host of other things that reflect on the quality of life. Doctors have not been using the appropriate test for magnesium – their serum blood tests just distort their perceptions. Magnesium has been off their radar screens through the decades that magnesium deficiencies have snowballed.

Symptoms of Magnesium Deficiency

The first symptoms of deficiency can be subtle – as most magnesium is stored in the tissues, leg cramps, foot pain, or muscle ‘twitches’ can be the first sign. Other early signs of deficiency include loss of appetite, nausea, vomiting, fatigue, and weakness. As magnesium deficiency worsens, numbness, tingling, seizures, personality changes, abnormal heart rhythms, and coronary spasms can occur.

A full outline of magnesium deficiency was beautifully presented in a recent article by Dr. Sidney Baker. “Magnesium deficiency can affect virtually every organ system of the body. With regard to skeletal muscle, one may experience twitches, cramps, muscle tension, muscle soreness, including back aches, neck pain, tension headaches and jaw joint (or TMJ) dysfunction. Also, one may experience chest tightness or a peculiar sensation that he can’t take a deep breath. Sometimes a person may sigh a lot.”

“Symptoms involving impaired contraction of smooth muscles include constipation; urinary spasms; menstrual cramps; difficulty swallowing or a lump in the throat-especially provoked by eating sugar; photophobia, especially difficulty adjusting to oncoming bright headlights in the absence of eye disease; and loud noise sensitivity from stapedius muscle tension in the ear.”

“Other symptoms and signs of magnesium deficiency and discuss laboratory testing for this common condition. Continuing with the symptoms of magnesium deficiency, the central nervous system is markedly affected. Symptoms include insomnia, anxiety, hyperactivity and restlessness with constant movement, panic attacks, agoraphobia, and premenstrual irritability. Magnesium deficiency symptoms involving the peripheral nervous system include numbness, tingling, and other abnormal sensations, such as zips, zaps and vibratory sensations.”

“Symptoms or signs of the cardiovascular system include palpitations, heart arrhythmias, and angina due to spasms of the coronary arteries, high blood pressure and mitral valve prolapse. Be aware that not all of the symptoms need to be present to presume magnesium deficiency; but, many of them often occur together. For example, people with mitral valve prolapse frequently have palpitations, anxiety, panic attacks and premenstrual symptoms. People with magnesium deficiency often seem to be “uptight.” Other general symptoms include a salt craving, both carbohydrate craving and carbohydrate intolerance, especially of chocolate, and breast tenderness.”

Magnesium is needed by every cell in the body including those of the brain and is one of the most important minerals when considering supplementation because of its vital role in hundreds of enzyme systems and functions related to reactions in cell metabolism, as well as being essential for the synthesis of proteins, for the utilization of fats and carbohydrates. Magnesium is needed not only for the production of specific detoxification enzymes but is also important for energy production related to cell detoxification. A magnesium deficiency can affect virtually every system of the body.

Like water we need magnesium everyday. There is an
eternal need for magnesium as well as water and when
magnesium is present in water life and health are enhanced.

One of the principle reason doctors write millions of prescriptions for tranquilizers each year is the nervousness, irritability, and jitters largely brought on by inadequate diets lacking magnesium.Persons only slightly deficient in magnesium become irritable, highly-strung, and sensitive to noise, hyper-excitable, apprehensive and belligerent. If the deficiency is more severe or prolonged, they may develop twitching, tremors, irregular pulse, insomnia, muscle weakness, jerkiness and leg and foot cramps.

If magnesium is severely deficient, the brain is particularly affected. Clouded thinking, confusion, disorientation, marked depression and even the terrifying hallucinations of delirium tremens are largely brought on by a lack of this nutrient and remedied when magnesium is given. Because large amounts of calcium are lost in the urine when magnesium is undersupplied, the lack of this nutrient indirectly becomes responsible for much rampant tooth decay, poor bone development, osteoporosis and slow healing of broken bones and fractures. With vitamin B6 (pyridoxine), magnesium helps to reduce and dissolve calcium phosphate kidney stones.

Magnesium deficiency may be a common factor associated with insulin resistance. Symptoms of MS that are also symptoms of magnesium deficiency include muscle spasms, weakness, twitching, muscle atrophy,  an inability to control the bladder, nystagmus (rapid eye movements), hearing loss, and osteoporosis.  People with MS have higher rates of epilepsy than controls.  Epilepsy has also been linked to magnesium deficiencies.[1]

Another good list of early warning symptoms is:

• Suggestive early warning signs of magnesium insufficiency:
• Physical and mental fatigue
• Persistent under-eye twitch
• Tension in the upper back, shoulders and neck
• Headaches
• Pre-menstrual fluid retention and/or breast tenderness 

• Possible manifestations of magnesium deficiency include:
• Low energy
• Fatigue
• Weakness
• Confusion
• Nervousness
• Anxiousness
• Irritability
• Seizures (and tantrums)
• Poor digestion
• PMS and hormonal imbalances
• Inability to sleep
• Muscle tension, spasm and cramps
• Calcification of organs
• Weakening of the bones
• Abnormal heart rhythm

Severe magnesium deficiency can result in low levels of calcium in the blood (hypocalcemia). Magnesium deficiency is also associated with low levels of potassium in the blood (hypokalemia). Magnesium levels drop at night, leading to poor REM (Rapid Eye Movement) sleep cycles and unrefreshed sleep. Headaches, blurred vision, mouth ulcers, fatigue and anxiety are also early signs of depletion.

We hear all the time about how heart disease is the number one health crisis in the country, about how high blood pressure is the “silent killer”, and about how ever increasing numbers of our citizens are having their lives and the lives of their families destroyed by diabetes, Alzheimer’s disease, and a host of other chronic diseases

Signs of severe magnesium deficiency include:

Extreme thirst 
Extreme hunger 
Frequent urination 
Sores or bruises that heal slowly
Dry, itchy skin
Unexplained weight loss
Blurry vision that changes from day to day
Unusual tiredness or drowsiness
Tingling or numbness in the hands or feet
Frequent or recurring skin, gum, bladder or vaginal yeast infections

But wait a minute, aren’t those the same symptoms for diabetes? Many people have diabetes for about 5 years before they show strong symptoms. By that time, some people already have eye, kidney, gum or nerve damage caused by the deteriorating condition of their cells due to insulin resistance and magnesium deficiency. Dump some mercury and arsenic on the mixture of etiologies and pronto we have the disease condition we call diabetes.

Magnesium deficiency is synonymous with diabetes
and is at the root of many if not all cardiovascular problems.

Magnesium deficiency is synonymous with diabetes and is at the root of many if not all cardiovascular problems.

Magnesium deficiency is a predictor of diabetes and heart disease both; diabetics both need more magnesium and lose more magnesium than most people. In two new studies, in both men and women, those who consumed the most magnesium in their diet were least likely to develop type 2 diabetes, according to a report in the January 2006 issue of the journal Diabetes Care. Until now, very few large studies have directly examined the long-term effects of dietary magnesium on diabetes. Dr. Simin Liu of the Harvard Medical School and School of Public Health in Boston says, “Our studies provided some direct evidence that greater intake of dietary magnesium may have a long-term protective effect on lowering risk,” said Liu, who was involved in both studies.

The thirst of diabetes is part of the body’s response to excessive urination. The excessive urination is the body’s attempt to get rid of the extra glucose in the blood. This excessive urination causes the increased thirst. But we have to look at what is causing this level of disharmony. We have to probe deeper into layers of cause. The body needs to dump glucose because of increasing insulin resistance and that resistance is being fueled directly by magnesium deficiency, which makes toxic insults more damaging to the tissues at the same time.

When diabetics get too high blood sugars, the body creates “ketones” as a by-product of breaking down fats. These ketones cause blood acidity which causes “acidosis” of the blood, leading to Diabetic Ketoacidosis (DKA), This is a very dangerous condition that can lead to coma and death. It is also called “diabetic acidosis”, “ketosis”, “ketoacidosis” or “diabetic coma”. DKA is a common way for new Type 1 diabetics to be diagnosed. If they fail to seek medical advice on symptoms like urination, which is driving thirst they can die of DKA.

Oral magnesium supplements reduce erythrocyte[2] dehydration.[3] In general optimal balances of electrolytes are necessary to maintain the best possible hydration. Diabetic thirst is initiated specifically by magnesium deficiency with relative calcium excess in the cells. Even water, our most basic nutrient starts having a hard time getting into the cells with more going out through the kidneys.

Autism and Magnesium Deficiency

When dealing with autism spectrum and other neurological disorders in children it is important to know the signs of low magnesium: restless, can’t keep still, body rocking, grinding teeth, hiccups, noise sensitive, poor attention span, poor concentration, irritable, aggressive, ready to explode, easily stressed. When it comes to children today we need to assume a large magnesium deficiency for several reasons. 1) The foods they are eating are stripped of magnesium because foods in general, as we shall see below are declining in mineral content in an alarming way. 2) The foods many children eat are highly processed junk foods that do not provide real nutrition to the body. 3) Because most children on the spectrum are not absorbing the minerals they need even when present in the gut. Magnesium absorption is dependent on intestinal health, which is compromised totally in leaky gut syndromes and other intestinal problems that the majority of autism syndrome disorders. 4) Because the oral supplements doctors rely on are not easily absorbed, because they are not in the right form and because magnesium in general is not administered easily orally.

Modern medicine is supposed to help people not hurt them but with their almost total ignorance of magnesium doctors end up hurting more than they help for many of the medical interventions drive down magnesium levels when they should be driving them up. Many if not most pharmaceutical drugs drive magnesium levels into very dangerous zones and surgery done without increasing magnesium levels is much more dangerous then surgery done with.

The foundation of medical arrogance is actually medical ignorance and the only reason ignorance and arrogance rule the playing field of medicine is a greed lust for power and money. Human nature seems to be at its worst in modern medicine when it should be at its best. It is sad that people have to suffer needlessly and extraordinarily tragic that allopathic medicine has turned its back on the Hippocratic Oath and all that it means.

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[1] http://www.nhfw.info/magnesium.html

[2] Red blood cells are also known as RBCs, red blood corpuscles (an archaic term), haematids or erythrocytes (from Greek erythros for “red” and kytos for “hollow”, with cyte translated as “cell” in modern usage). The capitalized term Red Blood Cells is the proper name in the US for erythrocytes in storage solution used in transfusion medicine.

[3] J. Clin. Invest. 100(7): 1847-1852 (1997). doi:10.1172/JCI119713. The American Society for Clinical Investigation

Take Magnesium for Better Performance: How It Affects Vitamin D, Calcium & Zinc

by Charles Poliquin (web)

Take magnesium for better athletic performance and get the most out of vitamin D and zinc at the same time. New research shows that magnesium enables optimal athletic performance because the body is better able to use energy and perform muscular contractions.

A recent study performed on elite handball players in the journal Magnesium Research found that supplementing with magnesium will increase red blood cell production, and it increases the availability of both zinc and magnesium to support energy production, muscle contractions, and removal of waste products produced by intense exercise.

Magnesium is redistributed throughout the body when you start exercising, which is one reason that studies trying to identify the optimal daily intake of magnesium for different populations have produced inconclusive results. What is clear is that athletes have greater need for magnesium, and 500 mg a day is a reasonable dose. Your needs be higher if you are a heavy sweater or experience symptoms of low magnesium such as muscle spasms, arrhythmias, or unexplained fatigue or weakness when training.

In addition to magnesium’s role in red blood cell production, it is also taken up by fat cells as fat is used for fuel. If you are deficient in magnesium, muscle contraction rate will be impaired because the calcium pump that transports calcium ions to the sarcoplasm of the muscle will be reduced. When this happens, you will feel fatigue, and reduced power and strength.

Zinc is also involved in optimal red blood cell production and it allows for the release of anabolic and fat burning hormones during exercise. It plays an interrelated role with magnesium and calcium, as seen by an interesting study that found that when intra-abdominal pressure is increased—a common occurrence when strength training—brain blood levels of magnesium, calcium and zinc are altered significantly. This study didn’t test optimal levels of these minerals; it only highlighted the close relationship they play physiologically.

In addition, magnesium activates cellular enzyme activity, allowing the body to convert vitamin D into its active form to help bone building. It also leads to the release of the hormone calcitonin, which helps to preserve bone structure and draw calcium out of the blood and soft tissues to be deposited in the bones.

With all of these physiological uses for magnesium, it’s no wonder that this mineral is one of the most important for athletes.  For best results with magnesium, vitamin D, and zinc take 500 mg/day of magnesium from a highly absorbable source such as magnesium glycinate. Researchers suggest that for women, a healthy calcium to magnesium dose is 1:1, whereas men probably do not need to get supplemental calcium since there is some evidence that it can lead to cardiovascular problems.
Also, ensure your vitamin D level is optimal by getting a vitamin D blood test (you want a level above 40 ng/ml).

To test your zinc level,  do a zinc taste test that works because we know that taste and smell are dependent on there being adequate zinc in the body. To do this test, get zinc sulfate and put about 1-2 teaspoons in a cup and sip it, holding it in the mouth. If it tastes just like water, you are very zinc deficient. If you taste something slightly metallic, you are moderately zinc deficient. If it tastes disgusting—strongly metallic and unpleasant—your levels are probably adequate. This test is subject to individual taste perception and it is not 100 percent valid, but it is a good place to start.

9 Steps to Perfect Health – #4: Supplement Wisely

by Chris Kresser (web)

In the first three articles in this series, we discussed which foods to eat and which foods to avoid. In this article we’re going to talk about when to supplement and how to do it wisely. We’ve got a lot of material to cover, so you might want to grab a cup of tea and get comfortable!

There are three principles to supplementing wisely:

• Get nutrients from food whenever possible.
• Take nutrients in their naturally occurring form whenever possible.
• Be selective with your supplementation.

Get nutrients from food whenever possible

Humans are adapted to getting nutrients from whole foods. Most nutrients require enzymes, synergistic co-factors and organic mineral-activators to be properly absorbed. While these are naturally present in foods, they are often not included in synthetic vitamins with isolated nutrients.

In a paper published in the American Journal of Clinical Nutrition called Food Synergy: An Operational Concept For Understanding Nutrition emphasizing the importance of obtaining nutrients from whole foods, the authors concluded:

A person or animal eating a diet consisting solely of purified nutrients in their Dietary Reference Intake amounts, without benefit of the coordination inherent in food, may not thrive and probably would not have optimal health. This review argues for the primacy of food over supplements in meeting nutritional requirements of the population.

They cautioned against the risk of reductionist thinking, which is common in conventional medicine and nutritional supplementation. Instead, they urge us to consider the importance of what they call “food synergy”:

The concept of food synergy is based on the proposition that the interrelations between constituents in foods are significant. This significance is dependent on the balance between constituents within the food, how well the constituents survive digestion, and the extent to which they appear biologically active at the cellular level.

They go on to provide evidence that whole foods are more effective than supplements in meeting nutrient needs:

• Tomato consumption has a greater effect on human prostrate tissue than an equivalent amount of lycopene.
• Whole pomegranates and broccoli had greater antiproliferative and in vitro chemical effects than did some of their individual constituents.
• Free radicals were reduced by consumption of brassica vegetables, independent of micronutrient mix.

In short: get nutrients from food, not supplements, whenever you can.

Take nutrients in their naturally occurring form whenever possible

Synthetic, isolated nutrients don’t always have the same effect on the body. It matters whether the nutrients have been produced by technologic or biological processes, because industrial processing sometimes creates an entirely new compound with different physiological actions. Trans fat produced in ruminant animals (such as conjugated linoleic acids in dairy products) are beneficial to health, whereas trans fats produced in the processing of industrial seed oils are highly toxic.

Folic acid is another example. The naturally occurring form of folate is not folic acid, a compound not normally found in food or nature, but tetrahydrofolate. While folic acid can be converted into folate, that conversion is poor in humans. It’s also important to note that unlike natural folate, folic acid does not cross the placenta. This is significant because folate is a crucial nutrient for pregnancy, and while folic acid can prevent neural tube defects it doesn’t have the other beneficial effects of folate. What’s more, several studies have shown that folic acid – but not natural folate – increases cancer risk. Unfortunately, folic acid is what’s often used in multivitamins, because it’s significantly cheaper than natural folate.

Be selective with your supplementation.

Multivitamins have become increasingly popular: half of Americans currently take one. But is this a good idea? Most studies show that multivitamins either provide no benefit, or may even cause harm. A study in the Archives of Internal Medicine showed that multivitamins have little to no influence on the risk of common cancers, CVD or total mortality in postmenopausal women. A now infamous meta-analysis in the Journal of American Medical Association, which looked at over 68 trials with 230,000 pooled participants, found that treatment with synthetic beta carotene, vitamin A and vitamin E may increase mortality.

The problem with multivitamins is that they contain too little of beneficial nutrients like magnesium, vitamin D and vitamin K2, and too much of potentially toxic nutrients like folic acid, calcium, iron and vitamin E. This means that multivitamins can actually cause nutrient imbalances that contribute to disease. Another problem is that multivitamin manufacturers often use the cheapest possible ingredients, such as folic acid instead of natural folate – the consequences of which we discussed above.

Which supplements may be necessary?

At this point you might be thinking I’m against supplementation entirely. Not so. No matter how well we eat, some nutrients are difficult to obtain enough of from food alone. There are also circumstances where are need for certain nutrients may increase, such as vitamin C during infections and magnesium with blood sugar imbalances or metabolic problems. In these cases, it makes sense to supplement selectively with beneficial nutrients.

The five nutrients I recommend most people supplement with are:

• Vitamin A
• Vitamin D
• Vitamin K2
• Magnesium
• Vitamin C

Vitamin A (Retinol)

Vitamin A is important catalyst for a variety of biochemical processes in the body. It’s required for assimilation of protein, minerals and water-soluble vitamins, and it also acts as antioxidant > protecting body against free-radical damage and diseases like cancer. Vitamin A plays a crucial role in reproduction, promoting full-term pregnancy and proper development of face (eyes, nose, dental arches & lips).

The RDA for vitamin A (2,600 IU) is woefully inadequate, and even then, over 25% of American consume less than half of the recommended amount. Native populations such as the traditional Inuit – which were free of modern, degenerative disease – got much more vitamin A than the average American. The Greenland Inuit of 1953, prior to much contact with the Western world, got about 35,000 IU of vitamin A per day.

Vitamin A (retinol) is only found in significant amounts in organ meats, which explains why many Americans don’t get enough of it. If you follow my recommendations in #2: Nourish Your Body, and you do eat organ meats (especially liver), you’re probably getting enough vitamin A and thus don’t need to supplement. However, if you’re like most Americans and you’ve never eaten liver in your life, you would benefit from supplementing with A.

There’s been a lot of discussion in the media about the toxicity of vitamin A. Some researchers and doctors now recommend avoiding cod liver oil because of this concern. Even Dr. Mercola has jumped on the “vitamin A is toxic” bandwagon. But is this true?

It is true that vitamin A is potentially toxic. Some evidence suggests that excess vitamin A increases the risk of osteoporosis. For example, this study showed both low and high serum A carried double risk of fractures as did optimal levels.

But if we dig deeper we find that excess vitamin A only causes problems against a backdrop of vitamin D deficiency. In his excellent article Vitamin A on Trial: Does Vitamin A Cause Osteoporosis, researcher Chris Masterjohn summarizes evidence demonstrating that vitamin D decreases the toxicity of and increases the dietary requirement for vitamin A. Studies show that supplementing with vitamin D radically increases the toxicity threshold of vitamin A. In a hypothetical 160 lb. person, vitamin D supplementation increases the toxicity threshold of vitamin A to more than 200,000 IU/d. You’d have to eat 22 ounces of beef liver or take 5 TBS of high vitamin CLO each day to get this amount. Not likely!

To meet vitamin A needs (assuming you’re not up for eating organ meats), I recommend taking high vitamin cod liver oil (CLO) to provide a dose of 10-15,000 IU per day. Cod liver oil is really more of a food than a supplement, but since it’s not a normal part of people’s diet we’ll consider it as a supplement. CLO is an ideal vitamin A source because it also contains vitamin D, which as we just learned, protects against the toxicity of A.

Vitamin D

Much has been written about the need for and benefits of vitamin D supplementation over the past several years – and with good reason. It’s absolutely critical for health, and up to 50% of Americans are deficient.

We can get vitamin D from two sources: food, and sunshine. Seafood is the only significant source of vitamin D, but you’d still have to eat a lot of it to get enough. 8-9 ounces of herring provides about 2,000 IU of vitamin D, which is a minimum daily requirement for most people to maintain adequate blood levels.

Sunlight converts a precursor called 7-dehydro-cholesterol in our skin to vitamin D3. This D3, along with the D3 we get from food, gets converted by the liver into 25-hyrdroxy-vitamin D (25D), which is what typically gets measured when you have a vitamin D test. The optimal 25D level is somewhere between 35 and 50 ng/mL.

Contrary to what some researchers and doctors have recommended, there’s no evidence that raising blood levels of 25D above 50 ng/mL is beneficial, and there’s some evidence that it may cause harm. Studies show that bone mineral density peaks at 45 ng/mL and then falls again as 25D levels rise above 45. Other studies have shown that the risk of kidney stones and CVD increase with high 25D levels, due to elevated serum calcium levels that accompany excess vitamin D.

However, we also know that vitamin A and vitamin K2 protect against vitamin D toxicity, and vice versa. As I explained in the vitamin A section, fat soluble vitamins exist in a synergistic relationship. It’s possible that the people in the studies above that experienced problems with excess 25D levels were deficient in vitamin A or K2, or both. This is why it’s so important to supplement with all of the fat-soluble vitamins together.

What about sunlight? Well, in summer mid-day sun with pale skin, 30 minutes of direct sunlight will produce 10-20,000 IU of vitamin D. But this is a best case scenario. With darker skin, or different times of year, or buildings that block the sunlight, or increased time spent indoors, we won’t be producing that much. It’s also true that aging, overweight and inflammation reduce our conversion of sunlight to vitamin D. This is why sunlight alone isn’t normally a sufficient source of vitamin D.

With this in mind, most people should supplement with D. The amount needed to maintain blood levels of 35-50 ng/mL varies depending on some of the factors I’ve listed above, but in my clinical experience it’s usually somewhere between 2,000 – 5,000 IU. With vitamin D, it’s important to test your levels, begin supplementation, and then re-test a few months later to determine the correct maintenance dose.

As with vitamin A, the best source of vitamin D is high-vitamin cod liver oil. It contains not only vitamins A & D, but also natural vitamin E and other quinones.

Vitamin K2

Vitamin K2 may be the most important vitamin most people have never heard of. It’s needed to activate proteins and it also regulates calcium metabolism (keeping it in the bones and teeth where it belongs, and out of the soft tissue where it doesn’t belong). Elevated blood calcium significantly increases the risk of cardiovascular disease (CVD), which explains why vitamin K2 has been shown to prevent atherosclerosis and heart attacks. It also strengthens bones.

Unfortunately, many (if not most) of Americans are deficient in vitamin K2. It’s important to point out that vitamin K2 is not the same as vitamin K1, which is found in green, leafy vegetables like kale and collards. Some K1 is converted into K2 in our bodies, but that conversion is inefficient in humans. It is efficient, however, in ruminant animals – which is why grass-fed dairy is the most convenient source of vitamin K2 in the diet. This is only true in animals raised on pasture, because it is eating the K1-rich grass that allows them to convert it into K2.

Most people should aim for at least 100 mcg/d from a combination of food and supplements. If you eat a large amount of cheese from grass-fed cows and pastured egg yolks, you may be able to get this amount from food alone. 100 g of hard cheese contains 67 mcg, and 6 pastured egg yolks contain about 32 mcg. Otherwise, supplementation is probably beneficial. I recommend a dosage of 1 mg/d in the MK-4 form, which is the form of vitamin K2 found in pastured dairy and the one shown to have the most benefit in clinical studies. There is another form, MK-7, that is found in fermented foods like natto, but it has not demonstrated the same properties as MK-4 in clinical studies.

Magnesium

There are few compounds in the body more important to overall health than magnesium. Over 300 enzymes need it, including every enzyme associated with ATP, and enzymes required to synthesize DNA, RNA and proteins. Magnesium also plays an important role in bone and cell membranes, as it helps to transport ions across the membrane surface.

Studies show that most Americans are deficient in magnesium. The median intake across all racial groups is far below the RDA, which is 420 mg/d for men and 320-400 mg/d for women. Although half of Americans take a multivitamin daily, most don’t contain enough magnesium to prevent deficiency.

Magnesium is also difficult to obtain from food. Nuts and seeds are the highest source, but it’s difficult to eat enough of them to meet magnesium needs without getting too much polyunsaturated fat. Another issue is that magnesium levels in food have dropped as modern soils have become increasingly depleted. What this means is that if you’re not supplementing with magnesium, you’re probably not getting enough.

And magnesium deficiency is no small thing. It has serious – even fatal – consequences. It produces symptoms like muscle cramps, heart arrhythmias, tremor, headaches & acid reflux, and it’s associated with CVD, hypertension, metabolic syndrome, diabetes, migraines, PMS, asthma, hypothyroidism. In fact, it’s hard to find a modern disease magnesium deficiency isn’t associated with.

Because of this, I think everyone should supplement with magnesium. Intake of 400 – 800 mg/d from a combination of food and supplements is an optimal range to shoot for. Since most people get less than 250 mg/d from food, a dose of 400 – 600 mg/d in supplement form is ideal. I recommend using chelated forms of magnesium like glycinate and malate, because they’re better absorbed and tend to have fewer side effects.

Vitamin C

Vitamin C is needed for building the structural components of the body, and for maintaining levels of glutathione, the master antioxidant in the body. But vitamin C deficiency is also common: studies suggest that 34% of men and 27% of women don’t get enough. This is especially true for the elderly and those struggling with chronic illness.

400 mg/d is the saturation range in healthy people, and that number is probably higher in the elderly and the sick. As with the other micronutrients in this article, it’s difficult to obtain adequate levels of vitamin C from the diet. Acerola cherries are the highest food source, with 1677 mg per 100g. A cup of cooked red peppers has 235 mg, which is one of the highest dietary sources.

I’m somewhat less certain about the need to supplement with vitamin C, but in general I recommend approximately 500 mg to 1 g of vitamin C each day. If you’re dealing with a chronic health challenge, or fighting an infection, you can take several grams a day with no toxic effects. It’s best to space the doses out to avoid diarrhea, however.

Other contenders

In addition to the fat-soluble vitamins A, D & K2, and magnesium and vitamin C, some may want to consider supplementing with selenium and iodine. Selenium plays important role in thyroid function, which affects every aspect of physiology. The recommended dose is approximately 200 mcg/d.

Selenium is plentiful in organ meats, ocean fish, and in brazil nuts. One brazil nut contains 100 mcg of selenium, but it also contains a whopping 1 g of omega-6 linoleic acid, which as you know from previous articles in the series, we want to limit significantly. This is why I don’t recommend brazil nuts as a source of selenium. Ocean fish are also good sources of selenium. 100 g of cod contains about 150 mcg.

Iodine also plays a crucial role in thyroid function, and it prevents brain damage and strengthens the immune system. The amount iodine needed for thyroid function is incredibly small: we need about a teaspoon of iodine over a lifetime to avoid deficiency. I’m not convinced humans need to supplement with iodine above what can be obtained from seafood, but some research does suggest that increased intake of iodine is beneficial. This is especially true if you’re fighting a chronic infection or dealing with a hypothyroidism caused by iodine deficiency.

But be careful: iodine can trigger and flare autoimmune diseases, especially Hashimoto’s and Graves’(autoimmune thyroid disease). In the U.S., 9 out of 10 women with hypothyroidism actually have Hashimoto’s, so the typical advice to supplement with iodine if you are hypothyroid is dangerous. I’ve written extensively about this in my special report on thyroid disease.

For those without autoimmune disease, a dose of 12.5 mg – 50 mg per day may be beneficial, but it’s best to work up slowly over time, beginning at a much lower dose.