Andrea Rosanoff, PhD, The importance of magnesium to heart health

A Look under the Microscope

Nutritional mag­ne­sium is deeply involved in energy pro­duc­tion, oxy­gen uptake, cen­tral ner­vous sys­tem func­tion, elec­trolyte bal­ance, glu­cose metab­o­lism and mus­cle activ­ity, includ­ing that all impor­tant muscle—the heart.

To closely exam­ine magnesium’s impor­tance to the heart mus­cle, we have to pull out our microscopes—yes, it gets right down to the cel­lu­lar and even the mol­e­c­u­lar level. “Magnesium plays an essen­tial role in many of the func­tions of energy pro­duc­tion itself,” Dr. Rosanoff says. “It is an inte­gral part of the energy and pro­tein molecules—without which the energy to con­tract and relax the heart does not occur properly.”

Magnesium is also an essen­tial ele­ment in the con­struc­tion of the cell mem­brane. In that the heart is com­posed of cells,     mag­ne­sium plays a role in the inte­gral strength of the heart mus­cle itself.

When mag­ne­sium lev­els begin to get too low the body tries very hard to adapt, but these basic func­tions of energy pro­duc­tion and cell struc­ture are affected. “Magnesium is impor­tant to so many aspects of the cell both in struc­ture and function—at the cel­lu­lar level, the micro­cel­lu­lar level and the pro­tein struc­ture level—that lack of mag­ne­sium will be first felt there,” Dr. Rosanoff says. Without enough mag­ne­sium, the cell is no longer able to keep up the proper num­ber of high-energy mol­e­cules to health­fully function.

But it doesn’t stop there. “Once mag­ne­sium falls down below a cer­tain level, just about every­thing starts to go,” Dr. Rosanoff says. “The sodium bal­ance starts to go and the elec­trolyte bal­ance starts to go. The cell is not able to have a fully inte­grated mem­brane sys­tem. Calcium and sodium start to rush into areas where they nor­mally would not be and the cell begins to lose its integrity of both its elec­tronic energy fields and its chem­istry. It just starts to get weaker and weaker because it doesn’t have the energy to do all the things it needs to do.”

Importance of Magnesium Levels

Now, pulling back out of our micro­scope, how are these occur­rences felt and how can they affect the indi­vid­ual? “If a per­son is not get­ting ade­quate mag­ne­sium for their indi­vid­ual needs, they can go into what we call a mar­ginal state,” Dr. Rosanoff says. “A cer­tain trauma or onslaught to that organ­ism can take the mag­ne­sium sta­tus from a mar­ginal into a depleted state, which can man­i­fest as hyper­ten­sion, high cho­les­terol, heart dis­ease and, if it hap­pens sud­denly, a heart attack.”

Such a trauma can be brought about by stren­u­ous exercise—something heart patients are encour­aged to do. Dr. Rosanoff only encour­ages peo­ple to exer­cise if they have an ade­quate mag­ne­sium level. “Exercise is really, really good,” she says. “It appears from recent research that exer­cise makes mag­ne­sium more avail­able, mov­ing it from areas that don’t cur­rently need it as much to areas that do need it. And one of those is, of course, the heart. But if mag­ne­sium is mar­ginal, exer­cise can cause problems.”

Calcium-Magnesium Balance

A low-magnesium con­di­tion can also be exac­er­bated by a high intake of calcium—promoted heav­ily today by many health pro­fes­sion­als. Calcium can­not be opti­mally uti­lized with­out a proper bal­ance of mag­ne­sium, and a high cal­cium intake with­out mag­ne­sium will fur­ther drain any reserves of magnesium.

Dr. Rosanoff is quick to point out that cal­cium is extremely nec­es­sary to heart and gen­eral health. “Calcium is nec­es­sary at the cel­lu­lar level for mus­cles to con­tract, for nerves to fire, for hor­mones to be secreted.”

“But—and this is new infor­ma­tion, really—calcium needs to be bal­anced with mag­ne­sium,” Dr. Rosanoff con­tin­ues. “If you give too much cal­cium and too lit­tle mag­ne­sium, what can tend to hap­pen is the excited fir­ing state of bio­chem­istry of the cell will tend to remain that way. In a stress sit­u­a­tion such as exer­cis­ing more vig­or­ously than usual or when some­one is sud­denly and unex­pect­edly fright­ened, mus­cle cells or nerve cells or hor­mone secret­ing cells can go into an over­re­ac­tion mode—the fight-or-flight mode. Without mag­ne­sium they don’t come back down to rest­ing state; they stay excited in that fir­ing mode.”

Magnesium and Cholesterol

Another prob­lem related to heart health, and one that has received con­sid­er­able atten­tion over the years, is cho­les­terol. A fatty sub­stance found in many areas of the body, cho­les­terol in large quan­ti­ties can be dan­ger­ous to health. Over time, it can build up on the walls of the arter­ies and can cause nar­row­ing or hard­en­ing, lead­ing to seri­ous heart problems.

Because cho­les­terol has obtained such a bad name, many may not know that it is actu­ally pro­duced in all cells nat­u­rally and has impor­tant bod­ily func­tions.  “Cholesterol comes about through a series of chem­i­cal reac­tions,” Dr. Rosanoff explains. “Cholesterol is impor­tant because it is a step­ping­stone to the body’s man­u­fac­ture of sex hor­mones like testos­terone and estrogen.”

One of the reac­tions involved in cho­les­terol pro­duc­tion is called the rate-limiting reac­tion because it keeps con­trol of the amount of cho­les­terol man­u­fac­tured. The rate-limiting reac­tion requires mag­ne­sium. “The enzyme for the rate-limiting reac­tion has two phases: an active phase and an inac­tive phase,” says Dr. Rosanoff. “The inac­tive phase has to have mag­ne­sium tied to it. If you don’t have enough mag­ne­sium in the cell, that enzyme can­not be deac­ti­vated. As a result, that con­trol point is weak­ened or absent; cho­les­terol con­tin­ues to be man­u­fac­tured and the cell can­not slow or stop it. This can result in a cho­les­terol buildup.”

Stress Requirements

“The mag­ne­sium require­ment dur­ing stress soars,” says Dr. Rosanoff. “This includes any kind of stress com­ing into the body from exer­cise, men­tal and emo­tional issues, high noise, chem­i­cals, or any other source.” Even some­one reg­u­larly tak­ing mag­ne­sium as part of a dietary pro­gram has far greater nutri­tional require­ments when they expe­ri­ence a stress episode of some sort.

Magnesium require­ments also rise dur­ing heal­ing from a bod­ily trauma such as injury or an oper­a­tion. “Part of any bod­ily heal­ing should include a really good source of mag­ne­sium as well as other essen­tial nutri­ents,” Dr. Rosanoff says.
Much study at the cel­lu­lar, bio­chem­i­cal and phys­i­o­log­i­cal lev­els has shown that the stress response vitally involves the influx of cal­cium into cells, result­ing in a dras­tic change in the cells’ inter­nal magnesium-to-calcium ratio. “In sim­ple solu­tions, such as salt water, all ions are evenly dis­persed,” says Dr. Rosanoff. (An ion is sim­ply an atom with an elec­tri­cal charge, and on a cel­lu­lar level ele­ments such as cal­cium and mag­ne­sium exist as ions.) “Not so in liv­ing cells. Ions are care­fully and metic­u­lously sep­a­rated in liv­ing cells, and this ion ‘pack­ag­ing’ is vital to life processes and health. Calcium ions, for the most part, are kept out­side cells while mag­ne­sium ions are kept mainly inside cells. The stress response changes this. During stress response, cal­cium ions rush inside the cell, and this alters the inter­nal magnesium-to-calcium ratio. This change in ratio exhibits wide effects because, while mag­ne­sium and cal­cium are very sim­i­lar in their chem­istry, bio­log­i­cally these two ele­ments func­tion and react very differently.”

Magnesium and cal­cium are two sides of a phys­i­o­log­i­cal coin: they are antag­o­nis­tic to one another yet oper­ate as a team. For exam­ple, cal­cium excites nerves; mag­ne­sium calms them down. Calcium makes mus­cles con­tract, but mag­ne­sium is nec­es­sary for mus­cles to relax. Calcium is nec­es­sary to the clot­ting reaction—essential for wound healing—but mag­ne­sium keeps the blood flow­ing freely and pre­vents abnor­mal thick­en­ing when clot­ting reac­tions would be dangerous.

Scientific study shows more and more that the under­ly­ing cel­lu­lar change enabling the stress response is a low magnesium-to-calcium ratio caused by a large and sud­den influx of cal­cium into cells. The stress response sub­sides when the cells’ mag­ne­sium returns to its dom­i­nant pres­ence inside cells, mov­ing extra cal­cium back to its “nor­mal” posi­tion, thus restor­ing the cells’ nor­mal ratio.

Why Don’t Doctors Know?

If mag­ne­sium is so impor­tant to heart health, you may won­der why you’ve never heard it from your med­ical doc­tor.
There are numer­ous rea­sons, but one of the most fun­da­men­tal lies with our edu­ca­tional sys­tem. Preventative nutri­tion is sim­ply not taken up seri­ously in med­ical edu­ca­tion. As for mag­ne­sium, Dr. Rosanoff her­self was taught very lit­tle about it in eight years of inten­sive study in Nutritional Science for her master’s and PhD degrees at UC Berkeley.

Researching mag­ne­sium defi­ciency and its true effects was a long road of dis­cov­ery for Dr. Rosanoff, result­ing in the even­tual pub­li­ca­tion of her and Dr. Seelig’s book.

Doctors are also a bit hob­bled by what may very well be a faulty test for mag­ne­sium defi­ciency. Dr. Rosanoff cites Professor Ron Elin, who in 2000 wrote a paper detail­ing the fact that the “stan­dard” level of mag­ne­sium for lab tests may have been obtained by test­ing on peo­ple who were mag­ne­sium defi­cient to begin with. Hence, a per­son may obtain a blood test that shows a “nor­mal” level of mag­ne­sium which in fact is a deficit.

For that rea­son, Dr. Rosanoff rec­om­mends that any­one get­ting a blood test for mag­ne­sium level not be sat­is­fied with the results until they are at least in the top half of what is con­sid­ered the “nor­mal” range.

“When faced with our stress­ful lifestyles, cou­pled with a soci­ety pre­sent­ing a chron­i­cally low magnesium/high cal­cium diet, what is our best defense?” Dr. Rosanoff poses. “For many of us, mag­ne­sium sup­ple­ments can help to pre­serve or restore a healthy magnesium-calcium bal­ance, so impor­tant to our health in these stress­ful times.”

Dr. Rosanoff con­tin­ues with her ground-breaking work on mag­ne­sium and we look for­ward to more of her con­tri­bu­tions in the future.