Magnesium

CAM (modulates glutamate, enhances melatonin).

  • Insomnia3
  • Bruxism1
  • Alcohol use disorder lowers magnesium and supplements improves liver health2
  • Only treats depression if magnesium deficiency

Features

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Handout

Dosing

Most uses: Magnesium 375-400 mg 1 qhs.

Insomnia: 200-300 mg with melatonin (can use with zinc 11.5 mg too).

Tourette’s tics: 300-500mg daily with vitamin B6 200mg daily.

Magnesium oxide is cheapest but can cause diarrhea (if so, use magnesium glycinate, citrate, chloride, or chelated forms)

Management

Improves sleep quality and initiation. May treat insomnia on its own but most studies combined it with melatonin.

Bruxism (teeth grinding) is a side effect of many psych meds and stress. Patient may notice jaw pain and their dentist may notice wearing away of teeth.

In alcohol use disorder, magnesium levels may be normal in the serum but deficient intracellularly.

CAUSES OF DEFICIENCY: Alcohol use disorder, protracted diarrhea, hyperthyroidism, chronic proton pump inhibitor use, breastfeeding

TOLERABILITY: Diarrhea, fatigue, nausea.

RISKS: Safe in doses below 400 mg. Toxicity can cause arrhythmias and seizures.

MEDICAL BENEFITS: Tourette Syndrome (tics), prediabetes, migraines, reflux.

EMR Text

Insomnia

Magnesium use based on multiple randomized controlled trials in insomnia, where it improved sleep initiation and sleep quality both on its own and in combination with melatonin (Carlos RM et al, Chronobiol Int. 2024;41(6):817-828).

Magnesium side effects reviewed with patient.

Bruxism

Magnesium use based on studies in bruxism (teeth grinding) (Ploceniak C, Rev Stomatol Chir Maxillofac. 1990;91 Suppl 1:127).

Magnesium side effects reviewed with patient.

Alcohol

Magnesium use based on studies where it improved liver health in the context of alcohol use disorder (Poikolainen K and Alho H, Subst Abuse Treat Prev Policy, 2008;25;3:1).

Magnesium side effects reviewed with patient.

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