Magnesium and Its Many Roles in Bone Health

Did you know?

The majority of the magnesium stored in your body is in bone, accounting for approximately 60% of total body magnesium. This magnesium is present on the surface of bone, and is available for the body to exchange into the blood as needed (1). It is very important for our bone health to make sure that we have adequate magnesium. Not only does magnesium have a structural role in bone maintenance, but it also influences bone-building cells and it modulates potential bone-damaging inflammation.

Low magnesium levels can jeopardize bone in many ways, including making the body resistant to the effects of vitamin D and the parathyroid hormone.

Magnesium and bone density

• Magnesium intake was positively associated with whole-body bone mineral density in a study of more than 2,000 people. (2)
• A large study found that women who consumed 422 mg or more of magnesium per day had significantly higher hip and whole-body BMD than those who consumed less than 206 mg daily. (3)
• In the Framingham study, higher intake of magnesium was associated with greater BMD in the hip for both men and women, and in the forearm for men. (4)
• Cheng et al. reported that for every 0.16 mmol/L increase in serum magnesium, bone density increased 8.78-fold. (5)

A large-scale study found that higher intakes of magnesium were associated with higher BMD, as shown in the graphs below. (6)

Magnesium and fracture

• Having low magnesium levels in the blood correlated to a 44% higher risk of bone fractures, particularly hip fractures, as reported in a 2017 study that looked at serum magnesium levels of 2,245 middle-aged men. Interestingly, none of the men with what they regarded as “high” magnesium levels (more than 2.3 mg/dL) fractured at all. (7)
• A 2018 study of more than 113,000 participants reported that hemodialysis patients with the highest serum magnesium levels had a 23% lower risk of hip fracture than those with the lowest serum magnesium (highest quartile vs. lowest). (8)
• Another study reported that the risk of fracture decreased significantly in those who had the highest magnesium intake: (9)
  • 53% decreased risk of fracture in men
  • 62% decreased risk of fracture in women

Magnesium supplementation and bone

• In one study, postmenopausal women on estrogen replacement therapy took a multivitamin and supplemented with an additional 400 mg/day of magnesium and 600 mg/day of calcium. In one year, they saw increased BMD at the heel compared with those who were only receiving estrogen replacement therapy. (10)
• Another study reported that postmenopausal women who supplemented daily with 1,830 mg magnesium citrate for 30 days saw decreased serum iPTH levels (a bone breakdown marker), increased osteocalcin (bone-building), and decreased urinary DPD (a bone breakdown marker), indicating that they had increased bone buildup while decreasing bone resorption or breakdown. (11)
• Healthy 8- to 14-year-old girls who supplemented with 300 mg magnesium per day for 12 months saw a significantly increased accrual of bone mineral content in the hip, compared with their peers in the placebo group. (12)

References:

1. Vormann, J. 2016. Magnesium: Nutrition and homoeostasis. AIMS Public Health 3(2):329–340. doi:10.3934/publichealth.2016.2.329.
2. Ryder, K. M., et al. 2005. Magnesium intake from food and supplements is associated with bone mineral density in healthy older white subjects. Journal of the American Geriatrics Society 53(11):1875–1880. doi:10.1111/j.1532-5415.2005.53561.x.
3. Orchard, T. S., et al. 2014. Magnesium intake, bone mineral density, and fractures: Results from the women’s health initiative observational study. The American Journal of Clinical Nutrition 99(4):926–933. doi:10.3945/ajcn.113.067488.
4. Tucker, K. L., et al. 1999. Potassium, magnesium, and fruit and vegetable intakes are associated with greater bone mineral density in elderly men and women. The American Journal of Clinical Nutrition 69(4):727–736. doi:10.1093/ajcn/69.4.727.
5. Cheng, W. W., et al. 2019. Mineral nutrition and the risk of chronic diseases: A Mendelian randomization study. Nutrients 11(2):378. doi:10.3390/nu11020378.
6. Welch, A. A., et al. 2017. Dietary magnesium may be protective for aging of bone and skeletal muscle in middle and younger older age men and women: Cross-sectional findings from the UK Biobank Cohort. Nutrients 9(11):1189. doi:10.3390/nu9111189.
7. Kunutsor, S. K., et al. 2017. Low serum magnesium levels are associated with increased risk of fractures: A long-term prospective cohort. European Journal of Epidemiology 32(7):593-603. doi: 10.1007/S10654-017-0242-2.
8. Sakaguchi, Y., et al. 2018. Magnesium and risk of hip fracture among patients undergoing hemodialysis. Journal of the American Society of Nephrology: JASN 29(3):991–999. doi:10.1681/ASN.2017080849.
9. Veronese, N., et al. 2017. Dietary magnesium intake and fracture risk: Data from a large prospective study. British Journal of Nutrition 117(11):1570-1576. doi:10.1017/S0007114517001350.
10. Abraham, G. E., and H. Grewal. 1990. A total dietary program emphasizing magnesium instead of calcium. Effect on the mineral density of calcaneous bone in postmenopausal women on hormonal therapy. The Journal of Reproductive Medicine 35(5):503–507.
11. Aydin, H., et al. 2010. Short-term oral magnesium supplementation suppresses bone turnover in postmenopausal osteoporotic women. Biological Trace Element Research 133(2):136–143. doi:10.1007/s12011-009-8416-8.
12. Carpenter, T. O., et al. 2006. A randomized controlled study of effects of dietary magnesium oxide supplementation on bone mineral content in healthy girls. The Journal of Clinical Endocrinology and Metabolism 91(12):4866–4872. doi:10.1210/jc.2006-1391.