Magnesium need soars with stress
Stresses can be emotional, such as fear, sadness and anger, or they can be environmental such as heat, cold, forced immobility and noise. There are also physical stresses such as extreme exercise, hunger, pain, illness, injury and medical interventions such as operations and tests invasive to the body. But all of these various stresses elicit a similar host of reactions in the human, a literal cascade of responses at the molecular, cell, tissue, organ and organ system levels. They involve hormones, enzymes, nerve transmissions, cell receptors, muscles, blood vessels, heart, kidney, stomach and more. A huge number of these reactions need magnesium to properly proceed, so as they all start speeding up, simultaneously, the body’s need for magnesium temporarily soars. As such, one’s reaction to acute stress really puts one’s magnesium status to the test. If magnesium nutrition is and has been adequate, the body’s store of it will mobilize to meet the sudden but temporary increased need. But, if the body’s magnesium is too low, its response to acute stress can become dangerous.
With prolonged, continual sources of stress, magnesium need remains abnormally high on a long term basis, and a suboptimal magnesium supply can rapidly run out. Even with seemingly adequate magnesium nutrition, decreased resistance to chronic stress, initially, can transform into a period of adaptation, a time when everything seems just fine. These periods of adaptation to a stressful way of life can go on for years, eluding one into believing they can have their stress and good health too. But after a certain point the decreased resistance returns, this time with irreversible damage as a result.

The Stress reaction needs magnesium
When stress occurs, the body puts out stress hormones into the bloodstream. These stress hormones, such as adrenaline, cause a dramatic lowering of blood magnesium as magnesium rushes from the blood into cells. This makes possible the instantaneous rises in the body’s heart rate, blood pressure, and other necessities for the “fright, fight or flight” reaction. During such high stress reactions, cells need a lot of magnesium. They need it to burn glucose and fats for the sudden rise in needed energy. They need it in large supplies for heightened nerve transmissions, protein synthesis and protection from oxidative stress. But cells in stress especially need magnesium to be present every time a high energy ATP molecule gives up its energy for a needed cell reaction, as well as to be present every time a new high energy ATP molecule is produced. We could say that ATP molecules act as life’s batteries, and that these batteries just won’t work without magnesium. The batteries and their magnesium are necessary at all times in life, but when stress hormones are circulating, these molecular batteries really have to work with extra intensity and speed. In a healthy body with full magnesium stores, enough magnesium is
available for all these varied, simultaneous reactions to speed up in response to circulating stress hormones. ATP has plenty of magnesium to keep it all functional at full speed. Blood  magnesium falls, but does not go too low because the magnesium stores back it up. But when stores of magnesium are low, a reaction to acute or prolonged chronic stress can put these stores to the test, and if too low they will fail.

Low Magnesium and stress can overly stress the heart
When stress hormones cause blood magnesium to drop, if it goes too low it can bring on arterial spasms. How? In studies where adrenaline is slowly infused into a body for 3 hours, plasma magnesium, calcium, potassium and sodium all drop, the magnesium and calcium in a gradual and continuous way. Low magnesium can result in high tension in blood vessel muscle cells, bringing about increased blood vessel constriction because calcium rushes into these cells when the proper magnesium concentration is lost. This has been shown to be especially true in heart blood vessels, making the heart a most sensitive organ to magnesium loss. After the adrenaline  infusion stops, the adrenaline in the blood drops after only 5 minutes, but the heart takes a half hour to slow to normal. The blood potassium will build back to normal in that same half hour, but the magnesium can stay low for days. You can see how an acute stress reaction could run out of magnesium if stores are low, endangering the heart. Likewise, chronic, severe stress that goes unabated can cause a low magnesium state with the same danger to the heart.

Magnesium deficit makes stress more stressful
Magnesium deficiencies exacerbate these reactions to acute stress, while a mildly high blood magnesium tones them down. In a magnesium deficient body, a given stress will elicit the release of more stress hormones than a body adequate in magnesium–quite a bit more. The stress response is thus even more intense, making the magnesium need even higher and less likely to be met.

Adrenaline release and magnesium deficit reinforce each other
Adrenaline will continue to circulate as long as a stress remains, constantly pumping magnesium from the blood into the cells. A blood magnesium decline is a stress, and directly initiates more adrenaline release. More adrenaline means more lowering of the blood’s magnesium which, in turn, stimulates more adrenaline. The result is a downward spiral for a body’s magnesium  availability which, in a person with marginal or low magnesium, can bring on a low magnesium crisis. We call this “low magnesium shock.” When magnesium stores of the body are healthy,
this pathogenic vicious circle does not occur. But when magnesium is borderline or deficient, the stress response can result in a dangerously low magnesium state that can bring on low magnesium shock with its severe effects such as heart attack and even sudden death. When stress comes to a magnesium deficient person, bringing on the downward spiral of low magnesium shock, the only ways to stop it are to
• stop the adrenaline response (with beta-blockers),
• keep the magnesium in tact or
• replace the body’s magnesium suddenly and dramatically via injection or an iv.

When body stores of magnesium are gone, these are the only way to stop the adrenaline flow and its downward spiral of magnesium status. No wonder oral magnesium supplements, before a traumatic event, can so help the body withstand a stressful episode. No wonder that magnesium therapy during the ultimate stress event, heart attack, lowers the death rate substantially.

Stress is especially hard on magnesium deficient cells
Another place stress puts magnesium status to the test is at the cell membranes. Cell membranes are made of fats and proteins that are held together with magnesium ions. If one is low in magnesium, the cell membranes may not be so strong. In a high stress situation, where adrenaline and other stress hormones are flowing, nerves are firing and ions such as calcium, potassium and sodium are rapidly flowing into or out of cells, the precious magnesium so important to the cell at this time can flow out of the cell through the faulty membranes, and
calcium rushes in to fill the void, causing injury and damage. The integrity of the cell is  compromised just as it is required to respond at its maximum capacity. If the leaking magnesium ends up in the blood serum, the kidneys may excrete it in the urine and the body has lost it forever. This is how, when magnesium is sub-optimal, stress can shove a slight deficiency over into a severe one, and it can happen rather rapidly. And this is how stress, coupled with a magnesium deficiency, can bring on heart disease.

Oral magnesium can prevent stress death
Livestock being transported–a very stressful event–die less if they are given magnesium supplements before the trip. Animal studies tell us that stressed animals without previous magnesium supplements will put out more than twice the stress hormones as animals supplemented with magnesium for as little as three days before given the exact same stress.
Without adequate magnesium, a stress can cause an overreaction of the body, releasing more stress hormones than are necessary and causing the body to overreact with possible damage to cells, blood vessels and heart muscle along with further depletion of the body’s precious magnesium. Can this knowledge be translated into prevention of death from stress? In the case of transporting pigs, those supplemented with extra magnesium died less than half as often as pigs getting the regular amount of magnesium. And the effect was even greater for piglets: those without extra magnesium died seven times as often as the piglets with magnesium supplements.
Also, magnesium supplements can reduce the effects of stress in humans, if those humans are low in magnesium to begin with. A person adequate in magnesium can handle acute stresses without undo harm. But one can expect that a time of acute stress will lower the body stores of magnesium. If these stores are not built up, the next bout of stress can be expected to lower them even more. After the stress event, blood levels of magnesium, which represent less than 1% of the total body magnesium, will go back to normal, and the body can appear healthy. But when the stores are gone or almost gone and a time of acute or chronic stress arrives, there is always the danger that, as the body uses the bloodstream’s magnesium for its immediate response to stress, that the blood magnesium can go too low for too long and bring on damage to both heart and blood vessels, even to the point of sudden death. Magnesium supplement during and after periods of acute stress can prevent both the overreaction to stress and the downward spiral of low magnesium shock as well as the endangering state of too low magnesium.

Type A behavior demands more magnesium
The type A personality can be characterized as a state of self-maintained stress. Knowing how stress impacts magnesium status, we can see how such type A people will be more at risk for heart disease than the calmer type B’s. In a given stress instance, type A’s make more stress hormones than type B people which makes them more sensitive to stress. At the end of a controlled stress event, type A students had larger amount of stress hormones in their urine, were slightly higher in blood magnesium because of losses from their cells, and also showed a slight decrease in their red blood cell magnesium when compared with type B’s under the exact same
stress. The type A subjects more readily lost their cellular magnesium and overall were more
sensitive to stress than the type B subjects. They make more stress hormones than type B
people, and in the long run are more apt to get a magnesium deficiency which makes them more
prone to heart and blood vessel problems. Type A people require more magnesium than type B
people since they not only react more easily to stress but also because of their heightened state of
“fight or flight” when stimulated by stress. And we know that stress causes magnesium needs to
soar. Type A people, as a result of their high reaction to stress, and as a result of their being in a
state of more or less constant self-induced stress, can display intermittent virtual magnesium
deficiency state which can lead to heart spasms, heart attacks and heart cell death. No wonder
our doctors tell us to meditate or engage in other stress reducing practices. In a magnesium
deficient world, stress can be and is a killer.
There is a genetic condition known as HLA-Bw35, and people with this gene have lower blood
magnesium values, and when tested for personality type, show more type A behavior than people
without this gene.

Chronic stress
We have seen how stress damage to the heart and blood vessels is made worse by a coexisting
magnesium deficiency. In prolonged stress, high levels of stress hormones can become chronic.
In the healthy individual with adequate magnesium, the initial physical signs of stress will
disappear as the body moves from the “alarm” into the “resistance” phase of chronic stress. Here
the body is successfully adapting to the stress as it increases its ability to resist against stress
stimuli. Many of us live here to one degree or another. And our doctors tell us constantly to take
time out with stress reducing activities. For if this goes on for too long, the pathological signs
reappear and become irreversible as they lead to death. Exhaustion has been reached. Is this
when body magnesium has been depleted and the adrenaline : magnesium downward spiral
begins? More study is necessary to make this conclusion.

Noise can make a magnesium deficit worse
In both animals and humans, noise has been shown to be a magnesium depleting stress. In fact,
noise stress can induce a magnesium deficiency in well-fed rats eating plenty of magnesium.
Even worse, magnesium deficient rats under noise stress are used as a model for studying the
convulsions of epilepsy. Other studies have shown that magnesium deficit in both animals and
humans can increase trauma created by too much noise. In such cases, magnesium and
potassium are both low in the heart muscle, so the heart cells accumulate too much calcium,
sodium and the amino acid hydroxyproline. This amino acid is the main component of collagen,
and in magnesium deficit under noise conditions, such hearts have been shown to have a build up
of collagen. We note that both low magnesium and noise alone can cause these trends, but when
both occur together, the effect can be huge. Supplementing with magnesium can help. When
magnesium is adequate, noise at even high levels failed to illicit adrenaline release, whereas in
magnesium deficit, noise at the same levels showed a dramatic rise in stress hormones. On a
practical level, women in a Serbo-Croatian textile plant were given magnesium rich mineral

water and showed less fatigue at the high noise plant with more job satisfaction and better
productivity. This exacerbation of noise stress by magnesium deficiency is not to be
underestimated, and is even associated with permanent hearing loss.
Even in healthy people, a short term exposure to a loud noise can increase urinary excretion of
magnesium. Such noises can come from industrial noises and low flying airplanes, initiating a
startle response in people that can increase heart rate, cardiac output, blood pressure and
magnesium metabolism. With repeated exposure after the initial startle, the reaction is often
intensified, being triggered by a lower sound level.

Heat Stress
Magnesium appears to play a role in the body’s response to acute heat stress and in the
acclimation process to heat. In acute heat stress, the body sweats a rather high magnesium sweat
that can add up to both magnesium and water loss. The loss of both magnesium and water can
lower one’s tolerance to heat strain. It’s interesting that exposure to oxygen during heat stress
can decrease the amount of magnesium lost in sweat, while it does not change the calcium or
potassium so lost. Nine healthy males followed in heat acclimation for 10 days showed that
magnesium shifts from the serum to mononuclear cells that stays there after the acclimation
period.

Exercise Stress
When exercise is excessive, oxygen is rapidly used up. When oxygen gets low in heart cells, it
triggers the release of stress hormones that are made, stored and released by the heart. This
response can occur when there is blockage in the heart, limiting its oxygen supply, or can come
about from low oxygen levels in the blood during heavy exercise. Running is a stress that elicits
stress hormone excretion, but when supplementing with magnesium, runners release less stress
hormone in response to their running stress.

Emotion and psychological stress can affect magnesium
Exposure to emotional stress shows significant rises in blood pressure, even when people are
taking anti-hypertensive medications. Heart rate goes up as does peripheral resistance in the
blood vessels, all part of an emotional response. Mental stress, when directly compared with
adrenaline stress, was found to be different in physiological response even though adrenaline was
released at the beginning of the mental stress. Even so, patients with heart disease were found to
be more likely to be anxious due to a psychological disorder than were healthy controls by as
much as 6- to ten-fold. We can easily speculate that mental, emotional and psychological stress
can have its impact on magnesium status as a chronic, unyielding fire that burns up huge amount
of magnesium, making anyone in such a state more likely to be deficient in magnesium and thus
more prone to heart ailments.

Oxidative Stress
The formation of free radicals in our bodies’ cells can damage vital molecules such as proteins,
essential fats, and even genetic DNA. Since such free radical formation is ongoing, these
chemicals build up with time, and a high level of free radicals has been associated with aging and
vulnerability to illness and injury. Doctors have been lately prescribing anti-oxidants and the
anti-oxidant vitamins A, C and E to help our cells resist this ongoing oxidative stress. One
natural biochemical we make is melatonin which protects naturally against this oxidative stress.
Since magnesium stimulates melatonin biosynthesis, helping to preserve the endogenous rhythm
of melatonin formation, magnesium has a protective effect when it comes to oxidative stress.
Studies now show that magnesium deficiency increases susceptibility to oxidative stress and that
free radical formation, which is higher in magnesium deficient tissue, causes part of the damage
associated with magnesium deficiency injury. What’s more, oxidative stress has more than once
been shown to be less when magnesium is in high supply and more when magnesium supply is
low. In one study on 50 patients exposed to acute oxidative poisoning, those receiving
magnesium therapy showed much less oxidative damage as well as half the death rate of those
not given magnesium. Anti-oxidants enhance the protective effect of magnesium.
Keeping a healthy level of magnesium in our cells is thus a primary protection not only for times
of adrenaline-induced stress which makes magnesium need soar, but also in ongoing and acute
oxidation stress where magnesium in adequate supply protects the vital cellular components from
oxidative damage and its resulting injury.

The stress of operations and hospital procedures can deplete magnesium
Imagine now someone with adequate magnesium going into the hospital for an operation. A
very stressful event. Fear and anxiety can be expected to induce adrenaline response before,
during and after such an event, using up magnesium at a rapid rate. If the person has enough
magnesium, he or she will heal, recover and go on with probably lower stores of magnesium, but
no serious danger of a low magnesium crisis. If their diet is adequate in magnesium, the drop in
magnesium body stores will be temporary as the body builds up again its reserve supply of this
element.
But what if the person going into the hospital for an operation is borderline or low in
magnesium? If not recognized and not replenished, the stress of the build-up, operation and
aftermath has a good chance of so depleting the patient’s low magnesium stores that recovery is
slow and incomplete, and the patient feels generally weak, with a poorer sense of well-being as a
result of the operation.
A person with even a slight magnesium deficiency in the same operation is in danger of being
thrown into low magnesium shock, the spiral down of magnesium status caused by adrenaline
release when magnesium is too low. In such a case, sudden death is not unheard of.
After an operation, patients, including infants, have a transient period of low magnesium in their
blood. Some have shown high amounts of magnesium and other nutrients in the urine after an
operation. Women in labor show a drop in blood magnesium too. This is because the
magnesium needed by cells has gone up drastically in response to the great stress of an operation
or childbirth. This is also true of patients in the emergency room and those in critical care.
Procedures less severe than an operation can also be an occasion of acute stress. One study

showed tracheal intubation to cause very high rises in blood pressure, except in those who had
been pretreated with magnesium. Once again we see how adequate magnesium reduces the
effects of stress.
Other studies have shown serum magnesium to slightly rise by day 3 after an operation, and to
return to normal by day 45. Fatigue went along with the rise in serum magnesium in this study.
Zn had the same effect. The trend was so strong that Zn and or Mg serum levels could be used
as a measurement of the status of fatigue in patients after surgery. We believe that this slight rise
in magnesium after day 3 is an indication of the body attempting to replenish the magnesium lost
during the operation and immediately post-op. Supplies from the stores in bone and muscle must
be sought in order to bring the body in its long term response to the stress of the operation back
into health and balance to where stress hormones can subside and balance be regained. If
magnesium, or other essential elements such as Zn, are low or non-existent in the stores, a bad
outcome can be expected.

Critical Illness and Injury as magnesium-burning stress
Patients with severe head injuries were shown to have lower plasma magnesium and calcium for
at least 7 days after injury. Patients with less severe head injuries had a similar decline in plasma
magnesium, but not calcium, but only for 3 days past the injury. The stress of pain can lower
serum magnesium, more so if the pain is severe. When we couple these facts with the fact that
low serum magnesium is common in hospitalized patients, we can conclude that the stress of
illness or injury has an impact on magnesium status such that patients low in magnesium can
show deficiency signs ranging from muscle weakness to heart arrhythmia and worse. Once
again, low serum magnesium implies a rise in cellular magnesium need and its resulting
depletion, and we know that stress hormones in an of themselves lower serum magnesium as part
of the stress response. Experiments on healthy subjects infused with adrenaline show this to be
the case. In these healthy subjects, magnesium was not unduly lost in the urine, showing how a
healthy, magnesium-adequate body and respond to stress hormones in a healthy, non-magnesium
depleting way. This is not true of the magnesium deficient patient. Maybe you’ve read of heart
disease patients who undergo an anxiety-ridden angioplasty procedure or bypass operation that is
followed by a heart attack. Question: How can such high-tech, carefully designed medical
procedures make things worse? The interaction of stress and magnesium answer the question. A
person with heart disease is low, borderline or deficient in magnesium. Such a person is
susceptible to the adrenaline/magnesium downward spiral when faced with a hugely stressful
situation. Angioplasty or a bypass operation provides such a situation as do other highly
technical medical procedures. When such procedures do not replace a person’s magnesium, they
are in danger of producing either low magnesium shock which manifests as a heart attack or
worsening the chronic low magnesium state which caused the trouble in the first place. This is
what happened to Joe. A severe stress reaction to the bypass operation so lowered his
magnesium stores that a terrifying and sudden noise could put him into low magnesium shock.
Had his magnesium stores been replenished, he may have enjoyed the “years more” promised by
the bypass procedure.

Stress ulcers and magnesium

Another problem brought on by hospital stress is stress ulcers–bleeding, painful ulcers in the
upper GI tract that can cause signification blood loss. It is am important complication that is
caused by the stress, and up to 80% of patients hospitalized for aortic surgery developed stress
ulcers. Magnesium protects against the development of stress ulcers, and treatment with
magnesium containing antacids has shown to be as effective as medications that inhibit
stomach’s ability to make acid.

What to do if you have a lot of stress
The first thing you need to do is to honestly assess the level of chronic stress in your life. Do
you live in the city or country? How much traffic do you have to cope with each day to shop,
work and play? How difficult are the politics at your workplace, clubs and/or social settings?
How violent or peaceful is your home? Do you have to cope with addictions be they alcohol,
drugs, gambling, food or other behaviors that imbalance? We are not going to suggest ways to
change these situations–this is the topic for other books, and there are many resources. But we
do suggest that you give yourself a realistic idea of how much stress your body needs to
withstand on a regular basis.
If you live in an urban area, meditation/relaxation exercises as a basic routine can certainly help
to lower your adrenaline level and preserve your magnesium. Yoga, meditation, laughter,
exercise that is fun, listening to music that you love, spending worry-free time with loved ones
and good friends can and should be an important part of your life. But, sometimes we cannot get
away from the noise or a very stressful lifestyle in general, and at some time in our lives we will
have to pass through an acutely stressful time. In these latter cases, magnesium supplements can
make a huge difference in how well our bodies cope with the stress and how healthy we are
when it’s over. For a healthy person in a temporary high stress situation, 200 mg magnesium per
day can replace the short term magnesium loss. Add this amount to whatever else you are taking
as a magnesium supplement as dictated by your general magnesium need. For those in a chronic
stress lifestyle, more magnesium may be necessary, depending upon the results of your
magnesium questionnaire and other risk factors your body is exhibiting. Take some time to go
assess your need by reading the general information in chapter 2 as well as pertinent chapters on
high cholesterol, hypertension, family history of heart disease, etc. Be sure to list all medications
you take and compare them with the list in Resource III of medications that can affect
magnesium status. Assess your diet using Resource I to see if you are getting a high, medium or
low amount of magnesium with your food. Then, determine how much of your magnesium need
comes from food and how much you should supplement. If living in an urban environment, full
of noise, or if you are a drummer, constantly sounding the cymbals next to your ear, or you work
or live in a high noise, high stress area, add anywhere from 200 to 500 mg magnesium to you
supplement need, depending upon the amount of stress you encounter as a general rule. Choose
the form of supplement best for you be it a magnesium containing salt, a liquid or a tablet. If you
take too much, your stools will loosen and you may get diarrhea. If this happens, back off on the
amount you are taking until your stools are comfortably loose. Be aware that stress has a huge
impact on your health if you are low in magnesium, and that magnesium can protect you against
the stress of noise, trauma, oxidative stress, hospital stays, medical procedures and emotional
stress. It will not take away the stress nor your need to deal with it, but it can make it so the
stress will not overly deplete your magnesium stores, leaving you in a weakened state when the stress subsides.
You may be living a high stress life and feel just fine about it. You are coping. You are healthy.
You seem resistant to the negative aspects of a modern, stressful life. As Selye has so well
pointed out, BE CAREFUL. You may be in the resistance stage of stress and feel like you could
go on forever without making any changes. But this is a false notion. If the stress is really
excessive and if you are truly in resistance stage, then sooner or later you will move into
exhaustion and permanent damage will be done to your body and health. We speculate that
magnesium adequacy can prolong the resistance stage of chronic stress and maybe even lessen
the impact of exhaustion. But this has not been tested and should not be relied upon. We rather
recommend that you supplement your magnesium carefully and diligently, but do not use it as a
way to avoid making necessary changes in a life filled with too much stress.
If you need to undergo a stressful medical procedure such as angioplasty, bypass or other
invasive test or procedure, talk with your doctor about using magnesium therapy before, during
and after the procedure. These have been shown to be effective in preventing adverse heart
episodes as well as sudden death plus instances of reoccurrence. The therapy consists of either
I.V. or I.M. magnesium sulfate, and must be administered by your doctor. Show the list of
references at the end of this chapter for magnesium therapy prevents bad outcomes of
stressful procedures to your doctor if she or he is not already familiar with these studies. At
this time, enlightened cardiac care units all use magnesium therapy.

A Story about Acute Stress with Low Magnesium
Joe was 60 when his doctor told him he needed a bypass operation. Terrified by hospitals, Joe
hated the prospect. But his family were confident and grateful that medical science could and
would extend his life, and his doctor was sincere in picking this particular procedure for Joe’s
case. “It’ll give him years more,” said the doctor, knowing that Joe was not a great candidate for
lifestyle changes. Into the hospital Joe went, literally clutching the rails on his hospital bed. He
was incredibly relieved upon awakening from the successful procedure, and gratefully went
home to rest and heal. He felt weak and barely able to cope, but he and his family were assured
that rest would take care of him. Within ten days, Joe was recovering nicely, beginning to cope
with the lessening pain and the changes he was facing. Suddenly, a loud, crashing car accident
occurred in front of his house, shattering Joe’s newly acquired calm. Within hours he was in the
emergency room with severe chest pains, and he died in spite of the very capable doctors’ best
efforts. How could this happen? The bypass operation was not a failure. It succeeded in
opening up Joe’s arteries, and there was no infection. But the jolts of stress from the operation,
hospitalization and anxiety before, during and after were so severe they depleted Joe’s
magnesium– to a point low enough that, in spite of newly cleared arteries, Joe died of a heart
attack. We must look closely at this vague sounding concept, “stress”, and find out how, when
and why it impacts our hearts.