Medical contributor:Overview
Osteopenia is the gradual loss of bone mass/density, which is sometimes due to aging. Osteopenia and osteoporosis are two different diagnoses and can be differentiated based on the measure of bone mineral density (BMD) - osteopenia is milder in comparison to osteoporosis though osteopenia may worsen and cause increased risk of skeletal fracture/further bone density loss.1
Diagnosing osteopenia involves looking as the BMD of hip, spine or forearm bones using x-ray.2
Osteopenia is linked with osteoporosis and other metabolic diseases, such as vitamin D deficiency and hyperthyroidism. Magnesium is another important element in the body - constituting about 50 to 60 % in bone tissue.4
How does magnesium affect osteopenia
Magnesium deficiency may have a direct impact on bone structure and health due to causing:
- Increasing osteoclasts (cells that break down and remodel bone tissue)
- Reducing bone stiffness (their structure becomes less solid and more flexible causing proneness to breakage)
- Decreasing osteoblasts (cells that make new bone and harden the bone tissue)
- Interference with vitamin D and parathyroid hormone (PTH) which enhances oxidative stress/inflammation, eventually causing bone loss
- Imbalanced calcium levels (due to vitamin D and PTH imbalances) which may result in hypocalcemia5
This is because hypomagnesemia (low magnesium) inhibits the secretion of PTH and makes target organs unresponsive to PTH. In turn, low PTH results in low vitamin D levels. Vitamin D itself also requires magnesium for its normal activity; hence, causing symptoms of a vitamin D deficiency. Hypomagnesemia may also be be caused by magnesium-deficient diets and predisposing genetics.4,6
Several studies have shown that magnesium supplementation improves bone health and prevents osteopenia.8,9 In all the studies, magnesium has been shown to benefit individuals in terms of reduction in fracture risk and BMD.6
Most studies agree that magnesium supplementation results in increased BMD; however, not all agree that magnesium has any relationship with reducing the occurrence of fractures. Taking magnesium supplements does however, result in improved bone tissue-turnover (bone repair and regeneration).10
Which magnesium is best for osteopenia
Studies published on magnesium (Mg) supplementation have shown that it can be used successfully in several different forms. It is not clear if any form is better than the other but those used include:
- Mg oxide
- Mg carbonate
- Mg citrate
The NHS also recommends eating magnesium-rich foods such as:
- Spinach
- Nuts
- Wholemeal bread
How much magnesium should I take for osteopenia
According to the US Food and Nutrition Board, the dosage of magnesium varies between 250 and 1800 mg per day.11
How much magnesium you should take depends on:
- Sex (assigned at birth)
- Age
- Any conditions you may have
The values for men are generally higher for those assigned male-at-birth (AMAB) than those assigned-female-at-birth (AFAB). However, certain conditions, such as breastfeeding, pregnancy or menopause may constitute you being recommended a higher supplementation dosage. Based on this recommendation, adults AMAB are recommended a dosage ranging from 400 to 420 mg/day. By contrast, adults AFAB are recommended a dosage ranging from 310 to 320 mg/day.
Children aged 6-12 months and 1-3 years are recommended to take no more than 250 mg/day of magnesium as recommended by EFSA document.12
It is important to check your magnesium levels as many people (approximately 20%) consume lower than the recommended amount of magnesium in their diet, hence the need for supplements. This way you can avoid magensium deficiency-related issues such as low bone density and increased risk of bone fracture.9
Side effects and other concerns
Taking magnesium greater than the recommended dietary allowance may be potentially risky. Some studies have shown that taking excess magnesium supplements can reuslt in:
- Reduced bone density in the longer term13
- Bone lesions7
In general, however, you should always consult your doctor and read the packet before taking any new supplements, especially if you have any moderate to serious health conditions.
Summary
Magnesium plays an important role in bone health, helping to maintain bone density and strength through interacting with and regulating vitamin D and parathyroid hormone (PTH). Reduced intake of magnesium or hypomagnesemia evidentially leads to reduced bone mineral density (BMD) and exposes bones to increased fracture risk. It is important to stay within the recommended dosage of magnesium for you as excessive intake can result in problems with bone health and could be detrimental to any other health conditions you may have.
References
- Karaguzel G, Holick MF. Diagnosis and treatment of osteopenia. Reviews in Endocrine and Metabolic Disorders. 2010;11(4):237-51.
- Kanis JA, Melton LJ, 3rd, Christiansen C, Johnston CC, Khaltaev N. The diagnosis of osteoporosis. J Bone Miner Res. 1994;9(8):1137-41.
- Rude RK, Singer FR, Gruber HE. Skeletal and hormonal effects of magnesium deficiency. J Am Coll Nutr. 2009;28(2):131-41.
- Capozzi A, Scambia G, Lello S. Calcium, vitamin D, vitamin K2, and magnesium supplementation and skeletal health. Maturitas. 2020;140:55-63.
- Castiglioni S, Cazzaniga A, Albisetti W, Maier JAM. Magnesium and osteoporosis: current state of knowledge and future research directions. Nutrients. 2013;5(8):3022-33.
- Porri D, Biesalski HK, Limitone A, Bertuzzo L, Cena H. Effect of magnesium supplementation on women's health and well-being. NFS Journal. 2021;23:30-6.
- Orchard TS, Larson JC, Alghothani N, Bout-Tabaku S, Cauley JA, Chen Z, et al. Magnesium intake, bone mineral density, and fractures: results from the Women's Health Initiative Observational Study. The American journal of clinical nutrition. 2014;99(4):926-33.
- Carpenter TO, DeLucia MC, Zhang JH, Bejnerowicz G, Tartamella L, Dziura J, et al. A randomized controlled study of effects of dietary magnesium oxide supplementation on bone mineral content in healthy girls. J Clin Endocrinol Metab. 2006;91(12):4866-72.
- Rondanelli M, Faliva MA, Tartara A, Gasparri C, Perna S, Infantino V, et al. An update on magnesium and bone health. BioMetals. 2021;34(4):715-36.
- Aydin H, Deyneli O, Yavuz D, Gözü H, Mutlu N, Kaygusuz I, et al. Short-term oral magnesium supplementation suppresses bone turnover in postmenopausal osteoporotic women. Biol Trace Elem Res. 2010;133(2):136-43.
- Institute of Medicine Standing Committee on the Scientific Evaluation of Dietary Reference I. The National Academies Collection: Reports funded by National Institutes of Health. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin
- D, and Fluoride. Washington (DC): National Academies Press (US)
- Copyright © 1997, National Academy of Sciences.; 1997.European Food Safety Authority (EFSA). Tolerable upper intake levels for vitamins and minerals. Scientific Committee on Food; Scientific Panel on Dietetic Products, Nutrition and Allergies 2006 [Available from: https://www.efsa.europa.eu/sites/default/files/efsa_rep/blobserver_assets/ndatolerableuil.pdf.
- Riond JL, Hartmann P, Steiner P, Ursprung R, Wanner M, Forrer R, et al. Long-term excessive magnesium supplementation is deleterious whereas suboptimal supply is beneficial for bones in rats. Magnes Res. 2000;13(4):249-64.
