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Fractures are one of the leading causes of disability, and sometimes death, especially among the elderly. This is a worldwide problem. While calcium and vitamin D are primarily considered as the most important combination of nutrients for bone health and in preventing osteoporosis, many studies have reported on the role of magnesium in maintaining higher bone density, thus keeping your bones strong and healthy.
Studies have also investigated the role of magnesium in reducing the risk of fractures , but overall the evidence on the link between magnesium and fracture risk is not very clear. However, a 2017 study published in the European Journal of Epidemiology suggests that higher levels of magnesium in blood improves bone strength and reduces the risk of fractures in middle-aged Caucasian men. More specifically, the study found that high levels of magnesium cut down the risk of fractures by 44 per cent in men. At the same time, men with lower levels were found to have an increased risk of fractures, particularly hip fractures.
The study concluded “Low serum magnesium concentrations is independently associated with an increased risk of total and femoral fractures in middle-aged Caucasian men. Further research is needed to replicate these results in women and other populations as well as assess the potential relevance of serum magnesium in fracture prevention.” 
The researchers noted that most seniors with an increased risk of bone fractures have low levels of magnesium in their blood. This deficiency, however, is very difficult to identify as it is not associated with noticeable symptoms until it becomes a severe problem. In addition, conventional doctors don’t typically look for magnesium deficiency, which makes it further difficult to associate low levels with poor bone health.
What makes matters worse for the elderly is that eating a magnesium rich diet may not be a helpful strategy in improving their levels and preventing fracture risk. Given concentration of magnesium in the blood depends on the balance between intestinal absorption and kidney function, factors such as old age, inflammatory bowel disease, malabsorption issues, diabetes, certain medications and kidney damage could be a reason why dietary intake of magnesium may not improve serum magnesium in the population. The researchers said that addressing the underlying health conditions and supplementing with magnesium may be a necessary approach to maintain optimum levels of the mineral in the blood and protect against the potential risk of fractures.
Professor Jari Laukkanen, from the University of Eastern Finland, said: "The overall evidence suggests that increasing serum magnesium concentrations may protect against the future risk of fractures."
Let’s explore the connection between magnesium and bone health, starting with the role of magnesium in your overall well-being.
Magnesium: The Missing Link in Your Overall Health
The importance of magnesium to human health can be established by the fact that your body needs magnesium to facilitate more than 300 biochemical reactions. Most importantly, it is required for the synthesis of ATP, the main energy currency used by the cells to carry out all their functions including replication, growth, maintenance, synthesis of proteins, eliminating cellular waste and toxins out of the cell and ferrying substances like various ions across the cellular membrane. In addition, an ATP molecule must be attached to a magnesium ion in order to be utilized by the cells.
Magnesium is involved in a range of biological processes including:
- Production of ATP (energy) in the mitochondria
- Synthesis of DNA, RNA and other proteins
- DNA repair and stability
- Maintaining healthy balance of minerals, such as calcium, potassium and sodium
- Nerves and muscles functioning
- Vitamin D absorption
- Synthesis of glutathione
The Role of Magnesium in Bone Health
Calcium and vitamin D are not the only key nutrients that you need to make strong bones. With more than half of the total magnesium concentration in the body found in the bone tissue, it is a clear indication how magnesium too plays a pivotal role in maintaining your bone health.
Magnesium is required to convert vitamin D into its active form (calcitriol), that you need to properly utilize and absorb calcium. Magnesium also helps to activate enzymes that are needed to metabolize vitamin D. In addition, it stimulates calcitonin, a hormone secreted by the thyroid gland that regulates calcium levels in the blood. It pulls calcium from the soft tissues and keeps it directed towards the bones, thus improving bone density and integrity.
The precise pathways through which magnesium appears to be reducing the risk of fractures are not yet completely clear. However, the study above  highlighted certain mechanisms that appear useful in considering the association between magnesium and decreased risk of fractures. For example, magnesium helps to:
- Maintain healthy levels of calcium. You need magnesium to properly transport, absorb and utilize calcium.
- Improve the activity of osteoblasts, cells that are responsible for bone formation; and regulate the secretion of parathyroid hormone (PTH), that pulls calcium out of the bones and releases it into the bloodstream. 
- Maintain normal neurological and muscular function. This implies magnesium deficiency may show up as muscle weakness and seizures, which increases the risk of falls and fractures.
You can easily get magnesium from natural foods such as nuts, lentils, seeds, whole grains, fruits and green leafy vegetables. But the truth is our modern diet is typically lacking in most of these magnesium rich foods on a regular basis. In addition, additional stress in any form (emotional, physical or environmental) not only depletes magnesium from the body but also create an additional demand for magnesium so that the body can cope with the stress.
What causes magnesium deficiency?
- Diet low in magnesium
- Depletion of magnesium and other nutrients from farming soil
- Processed foods and beverages
- Chronic gut disorders
- Increased intake of calcium supplements
- Overuse of medications such as antibiotics, diuretics, corticosteroids and chemotherapy
- Excessive intake of alcohol
- Acute and chronic stress (emotional distress, trauma, surgery, infections and chronic diseases)
Magnesium deficiency has such an effect on every system in the body that low levels may result in symptoms ranging from fatigue, achy joints, nerve pain, muscle cramps, facial twitches, tremors, high blood pressure, irregular heartbeat, depression, anxiety, poor sleep, painful PMS, menstrual cramps and sensitivity to loud noises.
Studies suggest that low magnesium status may be associated with an increased risk of many serious conditions such as arteriosclerosis, congestive heart failure, sudden cardiac death, coronary heart disease, type 2 diabetes, insulin resistance, osteoporosis, asthma and preeclampsia.
Besides bone health, other health benefits of magnesium include:
- Relieves muscle cramps
- Supports heart health
- Lowers blood pressure
- Helpful in dealing with painful PMS
- Reduces the risk of metabolic syndrome and diabetes 
- Protects against radiation
- Regulates stress levels
- Promotes healthy sleep
- Helpful in headaches and migraines
Magnesium is getting quite popular for its role in relaxing tensed muscles and relieving painful muscle spasms. However, its benefits in heart health deserve a special mention too.
Magnesium and your heart
Not many people are aware that magnesium plays quite a crucial role in keeping your heart health in top shape. And it does so through various mechanisms:
- Lowers inflammation
- Prevents calcium deposition in the arteries, thus reducing the risk of atherosclerosis, angina and heart attack
- Regulates calcium levels, which helps in maintaining a steady heart rhythm.
- Lowers blood pressure in people with magnesium deficiency 
- Lowers the risk of metabolic syndrome 
- Regulates levels of stress hormones such as cortisol
- Helps in the production of neurotransmitters such as serotonin, gamma amino butyric acid (GABA), brain-derived neurotrophic factors (BDNF). These chemicals help improve mood, promote healthy sleep and relieves symptoms of anxiety and depression.
Unfortunately, it is not easy to diagnose magnesium deficiency. Only 1 % of the total magnesium stores in the body are located in the blood, which means testing for magnesium levels in the blood will not reflect your true magnesium levels.
The good news is that you can easily improve your magnesium levels with the help of a high-quality magnesium supplement. Typical oral magnesium supplements may cause gastrointestinal distress with symptoms like diarrhea, bloating and abdominal cramps. Magnesium oil that can be used directly on the skin, or Liposomal Magnesium products are far better options to achieve healthy levels of magnesium in the blood, thus getting optimal health benefits offered by this important mineral.
- Dahl et al. Nationwide data on municipal drinking water and hip fracture: could calcium and magnesium be protective? A NOREPOS study. Bone. 2013
- Kunutsor et al. Low serum magnesium levels are associated with increased risk of fractures: a long-term prospective cohort study. European Journal of Epidemiology. 2017
- University of Bristol. "Magnesium could prevent fractures, say researchers." ScienceDaily. ScienceDaily, 12 April 2017.
- Castiglioni S, Cazzaniga A, Albisetti W, Maier JA. Magnesium and osteoporosis: current state of knowledge and future research directions. Nutrients. 2013;5(8):3022–33.
- Adela Hruby, James B. Meigs, Christopher J. O’Donnell, Paul F. Jacques, Nicola M. McKeown. Higher magnesium intake reduces risk of impaired glucose and insulin metabolism, and progression from prediabetes to diabetes in middle-aged Americans. Diabetes Care 2013
- Xi Zhang, Yufeng Li, Liana C. Del Gobbo, Andrea Rosanoff, Jiawei Wang, Wen Zhang, Yiqing Song. Effects of Magnesium Supplementation on Blood Pressure. A Meta-Analysis of Randomized Double-Blind Placebo-Controlled Trials. Hypertension. 2016
- Dibaba DT, Xun P, eta al. Dietary magnesium intake and risk of metabolic syndrome: a meta-analysis. Diabetic Medicine. 2014