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Magnesium in Prevention and Therapy
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2015 Sep 23
Uwe Gröber,1,* Joachim Schmidt,1 and Klaus Kisters1,2
2015 9·î23Æü

Magnesium is the fourth most abundant mineral in the body. It has been recognized as a cofactor for more than 300 enzymatic reactions, where it is crucial for adenosine triphosphate (ATP) metabolism. Magnesium is required for DNA and RNA synthesis, reproduction, and protein synthesis. 

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Moreover, magnesium is essential for the regulation of muscular contraction, blood pressure, insulin metabolism, cardiac excitability, vasomotor tone, nerve transmission and neuromuscular conduction. Imbalances in magnesium status—primarily hypomagnesemia as it is seen more common than hypermagnesemia—might result in unwanted neuromuscular, cardiac or nervous disorders. Based on magnesium¡Çs many functions within the human body, it plays an important role in prevention and treatment of many diseases.

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 Low levels of magnesium have been associated with a number of chronic diseases, such as Alzheimer¡Çs disease, insulin resistance and type-2 diabetes mellitus, hypertension, cardiovascular disease (e.g., stroke), migraine headaches, and attention deficit hyperactivity disorder (ADHD).

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1. Introduction
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Magnesium is an essential electrolyte for living organisms and is the fourth most abundant mineral in the human body. ¡ÊÃæÎ¬¡Ë

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Based on magnesium¡Çs many functions within the human body, it plays an important role in prevention and treatment of many diseases. Low levels of magnesium have been associated with a number of chronic and inflammatory diseases, such as Alzheimer¡Çs disease, asthma, attention deficit hyperactivity disorder (ADHD), insulin resistance, type-2 diabetes mellitus, hypertension, cardiovascular disease (e.g., stroke), migraine headaches, and osteoporosis 

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2. Functions of Magnesium
Magnesium is primarily found within the cell where it acts as a counter ion for the energy-rich ATP and nuclear acids. 
Magnesium is a cofactor in more than 300 enzyme systems that regulate diverse biochemical reactions in the body, including protein synthesis, muscle and nerve transmission, neuromuscular conduction, signal transduction, blood glucose control, and blood pressure regulation. ¡ÊÃæÎ¬¡Ë

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Magnesium is also necessary for structural function of proteins, nucleic acids or mitochondria. It is required for DNA and RNA synthesis, and for both aerobic and anaerobic energy production—oxidative phosphorylation and glycolysis—either indirectly as a part of magnesium-ATP complex, or directly as an enzyme activator.

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Magnesium also plays a key role in the active transport of calcium and potassium ions across cell membranes, a process that is important for nerve impulse conduction, muscle contraction, vasomotor tone and normal heart rhythm. ¡ÊÃæÎ¬¡Ë

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Moreover, it contributes to the structural development of bone and is required for the adenosine triphosphate-dependent synthesis of the most important intracellular antioxidant glutathione. The most important reservoir for magnesium is the bone (about 60% of total body magnesium), the remaining 40% is located extra- and intracellularly.

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 Magnesium excretion is mainly regulated by the kidney. About 100 mmol/L magnesium is filtered daily . The total magnesium content of the human body is reported to be ~20 mmol/kg of fat-free tissue. In other words, total magnesium in the average 70 kg adult with 20% (w/w) fat is ~1000 to 1120 mmol or ~24 g .

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Magnesium is beside sodium, potassium and calcium an important electrolyte for human metabolism. About 99% of total body magnesium is located in bone, muscles and non-muscular soft tissue . Approximately 50%–60% of magnesium resides as surface substituents of the hydroxyapatite mineral component of bone. Most of the remaining magnesium is contained in skeletal muscle and soft tissue. The magnesium content of bone decreases with age, and magnesium that is stored in this way is not completely bioavailable during magnesium deprivation.

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Intracellular magnesium concentrations range from 5–20 mmol/L; 1%–5% is ionized, the remainder is bound to proteins, negatively charged molecules and adenosine triphosphate (ATP)]. Extracellular magnesium accounts for about 1%–3% of total body magnesium which is primarily found in serum and red blood cells. Normal serum magnesium concentration is about 0.76–1.15 mmol/L . It is categorized into three fractions. It is either ionized (55%–70%), bound to protein (20%–30%) or complexed with anions (5%–15%) such as phosphate, bicarbonate and citrate or sulphate. Red blood cells/serum magnesium ratio is about 2.8 .

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