From Workinger 2018. “The average mineral content of calcium, magnesium, and iron in cabbage, lettuce, tomatoes, and spinach has dropped 80–90% between 1914 and 2018.”

Magnesium is ubiquitous in the earth’s crust, dissolved in the running water of streams and rivers, taken up by plants from the soil. It is also a mineral that is essential for human health as it participates in numerous physiologic processes. Despite its ubiquity in the environment, lack of magnesium in the human body increases potential for common health conditions including hypertension; heart arrhythmias such as atrial fibrillation, multifocal atrial tachycardia, life-threatening ventricular arrhythmias; bone thinning and fractures; the vasospasm (vessel spasm) of migraine headaches; and chaotic muscle contraction (cramps or “charlie horses”).

In hospitals, intravenous magnesium is administered emergently for life-threatening heart rhythms and for pre-eclampsia and eclampsia in pregnant mothers that threaten the life of both mother and baby. Infusions of magnesium in these situations are life-saving. A dangerous heart rhythm called “Tornado de pointes,” for instance, that causes the heart to stop pumping and the person to lose consciousness and die within minutes, is miraculously reversed by an intravenous infusion of magnesium. Likewise, the hypertension and seizures of eclampsia during late pregnancy are immediately reversed with intravenous magnesium. If you present to the emergency room with a migraine headache, an intravenous infusion of magnesium is among the most common initial therapies.

There are also less severe degrees of magnesium deficiency that are not life-threatening but nonetheless cause substantial aggravation and suffering, but are typically “treated” with various  pharmaceuticals or procedures.

How did we get here, having to manage magnesium deficiency as emergencies with intravenous infusions, prescribing silly drugs like Fosamax or Bonita for osteoporosis, anticoagulants and antiarrhythmic drugs for atrial fibrillation, numerous anti-hypertensive drugs for high blood pressure, drugs to manage the vasospasm of migraine headaches that are costly and often dangerous, when restoration of magnesium has potential to reduce or reverse all of these conditions?

The above graph depicts the reduction in magnesium and other minerals in several common vegetables that has developed over the last century: magnesium content in food has plummeted. The reduction in magnesium content in produce is believed to be due to depletion of magnesium in soil from over-farming and the use of magnesium-binding phosphate-based synthetic fertilizers. While nuts and seeds are traditionally higher in magnesium content, updates need to be performed to determine whether these foods have also experienced a reduction in magnesium content. We also filter drinking water by necessity, of course, due to contamination by sewage, pesticides, herbicides, and, more recently, pharmaceuticals. Water filtration, whether performed by your city or in your home, is very effective in removing virtually all magnesium and other minerals.

Put it all together: You cannot obtain sufficient amounts of magnesium by drinking water or eating healthy foods (unless grown yourself). Pharmaceuticals such as diuretics, stomach acid-blocking proton pump inhibitors (PPIs), and contraceptives also add to inadequate magnesium availability. If you have banished all wheat and grains from your diet, you have an advantage because, by doing so, you have eliminated grain phytates that bind magnesium in the gut and make them unavailable. But even that is not enough. This is why we supplement magnesium.

Just as we supplement vitamin D because there is almost none in food, we work indoors, wear clothes covering most body surface area when we go outside, and because we lose the ability to activate vitamin D in the skin upon sun exposure as we age, so modern life has conspired to dramatically reduce your intake of magnesium. While your doctor is happy to hand out prescriptions for antihypertensive drugs, muscle relaxants, migraine drugs and others, or treat you with intravenous magnesium when a catastrophic event develops, magnesium supplementation is something you must manage on your own.