If you keep up with your leafy greens you need not worry about magnesium

Susan VanBeuge, a nurse practitioner in Las Vegas, occasionally hears this from her patients: “I get leg cramps and my friend said I should take magnesium.” UNLV dietitian Jessica Knurick’s clients also bring up dietary magnesium, more so these days than in the past.

What’s going on with the mineral that rarely crosses our radar?

It seems some of us are not getting enough of the stuff. According to the U.S. Department of Agriculture, 57 percent of Americans age 2 and older are not taking in adequate amounts of magnesium from food. Men older than 70 and teenage girls are especially unlikely to be getting enough.

That certainly sounds worrisome.

We need magnesium to stay healthy. The mineral is necessary for more than 300 biochemical reactions in the body. It helps regulate all sorts of things — muscle and nerve function, blood pressure and blood sugar levels. Magnesium helps make protein, bone and DNA.

Even though magnesium is ubiquitous in plant-based foods, most of us don’t get enough of it from diet alone. (Had any green, leafy vegetables so far today?) For men, the requirement is 400 to 420 milligrams per day. For women, it’s 310 to 320 milligrams. The older we get, the more we need.

If, as the government says, we’re not getting enough magnesium in our diets, should we be taking supplements?

The dietary supplement industry, for one, answers with a resounding yes. Manufacturers boast that magnesium, which is available in pill form or as a topical spray, can do all sorts of good things for us, from helping us get a good night’s sleep to eliminating aches and pains and fighting off seasonal colds.

Magnesium deficiency is an issue for people with certain health conditions, such as gastrointestinal disease, Type 2 diabetes, hyperthyroidism and pancreatitis, according to the University of Maryland Medical Center. Alcoholics can be at risk. So can older people, because as we age our body absorbs less and excretes more of the stuff.

But health professionals aren’t convinced that magnesium supplements are necessary — at least not for most of us.

“I would venture to say that the healthy American or someone with a generally healthy diet will probably not be likely to have a deficiency in magnesium,” said Dana Hunnes, senior dietitian at Ronald Reagan UCLA Medical Center and adjunct assistant professor at the Fielding School of Public Health at UCLA.

Hunnes’ viewpoint seems to reflect the consensus in the world of health and medicine.

But, if we’re not getting enough magnesium in our diets, why aren’t we deficient?

For starters, more than one-third of Americans take vitamin and mineral supplements, according to the National Institutes of Health. When the amount of magnesium people get from those supplements is added to dietary magnesium, the total is generally above recommended amounts.

Another factor has to do with the way the human body works. Our kidneys excrete magnesium into the urine each day. When we’re a little low on the stuff, our kidneys compensate by excreting less.

If magnesium remains a concern, you should talk to your medical provider. Early signs of magnesium deficiency include loss of appetite, nausea, vomiting, fatigue and weakness, according to the NIH.

Worsening magnesium deficiency is a more serious matter, with symptoms that include numbness, tingling, seizures, abnormal heart rhythms, personality changes and — just as VanBeuge’s patients have mentioned — muscle cramps and contractions.

Determining one’s magnesium status, which refers to the amount we have in our bodies, isn’t the easiest thing to do.

Serum magnesium tests, which measure the level of magnesium in blood, are not routinely performed in hospitals or clinics. Even if they were, such tests wouldn’t necessarily give an accurate reflection of magnesium content in our body, according to the NIH Office of Dietary Supplements. Why? Of the total amount of magnesium in the body, only 1 percent resides in blood serum; most lives inside cells or in bone, where it’s difficult to measure.

If a patient asks VanBeuge whether her leg cramps have anything to do with magnesium, she usually responds this way: “Let’s do a bit more assessment.”

“Leg cramps could be a lot of other things, so I’ll ask them questions about their diet. Oftentimes I will check labs and I may do an ultrasound. There are a lot of different things I might check,” VanBeuge said.

What’s wrong with starting on a regimen of magnesium supplements, just in case?

“There’s a possibility of gastrointestinal distress or discomfort if you’re taking too much,” Hunnes explained.

Keep in mind that magnesium is an ingredient in laxatives such as Phillip’s Milk of Magnesia. The gastrointestinal distress that Hunnes mentioned could be accompanied by diarrhea.

“It’s important that people don’t go overboard trying to compensate for a deficiency they might not have,” advised Mandisha Waiters, a clinical dietitian at University Medical Center in Las Vegas.

As for getting your magnesium from a topical spray, Peter DiPrete, also a UMC dietitian, said medical studies to date are silent on the efficacy of that form of the mineral.

If you’re worried about magnesium, maybe it’s best to take a step back and look at your diet. Cheetos, french fries and Whoppers don’t make the list of magnesium-rich foods. “If your diet is very high in processed foods you’re likely going to be deficient,” Knurick said.

Rich sources of magnesium include legumes such as black beans, whole grains and green leafy vegetables such as spinach and kale. Many kinds of nuts are high in magnesium, among them cashews, almonds, and pine and Brazil nuts. A handful, or 1 ounce, of almonds satisfies about one-fifth of your daily requirement of magnesium, as does a cup of boiled spinach.

While not as rich as the foods mentioned above, other good sources of magnesium are peanuts, whole-wheat flour, oat flour, bananas and skin-on baked potatoes. Many cereals are fortified with magnesium: A bowl of Cheerios satisfies 8 percent of your daily needs.

The good thing about getting magnesium from your diet rather than supplements is that if you get too much, your body will just flush it out in urine. Plus, you’ll be doing yourself a favor in terms of overall health.

“I’m constantly recommending to patients that they increase intake of fruit and vegetables, legumes, nuts, seeds, those kinds of things,” Hunnes said. “Not only are they good for the magnesium content in the body, but from a health perspective, in terms of mitigating chronic disease, plant-based diets tend to be better.”