Magnesium and Stress
The Important Role of Nutritional Magnesium and Calcium Balance in Humans
Living with Stress
By A. Rosanoff, Ph.D.
Part I. The Stress Response
The stress reaction is a host of responses necessary for any animal to live
in the world. Magnesium and stress can be intricately tied together. Commonly called the "fight or flight" reaction, we as humans
often experience it in rapid heartbeat and increased breathing rate. It
comes when we exercise more vigorously than usual, or when we are suddenly
and unexpectedly frightened.1
We are all different. We show a range in how strongly we experience the
stress response. Most of us are usually calm and experience the stress
response when an unexpected noise frightens us to alertness, or we run to
first base as fast as we can in a benefit baseball game which is not on our
usual playtime schedule. We breathe harder for awhile and notice out hearts
beating faster and harder than usual, but after awhile these responses all
calm down, and we are again in our usual state-out of the stress response.
Others of us are very low key, and it takes a lot to disturb our
physiological calm. Still others of us are very sensitive to triggers of the
stress response and go into it "at the drop of a hat" and to a greater
degree than do calmer people. For some, parts of the stress response are
almost always engaged-never really calming down all the way-giving one a
hyper vigilant or anxious demeanor.
When a stress trigger occurs, the body puts out stress hormones, magnesium
and calcium, among other things, into the bloodstream2. At the same time,
nerve cells begin to "fire", telling heart and muscles to "speed up, NOW!!!"
These blood, nerve and organ changes make possible the instantaneous and
collective rise in the body's heart rate, blood pressure, and other
necessities for the "fight or flight" reaction.1
Much research has been done on the stress response, especially on the
effects of stress hormones, such as adrenaline (also called epinephrine) on
body, organ and cell. You can get an idea of how widespread the stress
response is-affecting every aspect of physiology-by noting some of the
reactions to adrenaline, one of the major stress hormones.14 See Table 1.
The Effects of Adrenaline: Adrenaline (also called epinephrine) is one of
the body's major stress hormones. When adrenaline is released into the
bloodstream, it has simultaneous, rapid, and widespread effects on the body.
* widespread effects on circulation, muscles and sugar metabolism
* raised heart rate
* increased heart output
* increased rate and depth of breathing
* increased metabolic rate
* increased force of muscular contraction
* delayed muscular fatigue
* reduced blood flow to bladder (muscular walls relax and sphincters
* reduced blood flow to intestines
* increased blood pressure
* increased sugar (glucose) in the blood
* increased break-down of glucose for energy*, especially in muscle cells
* increased free fatty acids in the blood*
* more oxidation of fatty acids to produce energy*
* more ATP (the cells' primary energy compound) produced*
* blood vessels constrict
Much study at the cellular, biochemical and physiological levels have 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
In simple solutions, such as salt water, all ions are evenly dispersed. 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 Mg:Ca 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 come as a
team. For example,
* Calcium excites nerves, magnesium calms them down. Thus understanding magnesium and stress is important.
* Calcium makes muscles contract, but magnesium is necessary for muscles to
* Calcium is necessary to the clotting reaction-so necessary 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 Mg:Ca 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 outside cells to its "normal" position, thus restoring the
cells' normal Mg:Ca ratio. This underlying principle is present in studies
of nerve cell-stress hormone response,4 organs such as hearts,3 the high
blood pressure response to stress5,6,7,8 and the blood clotting reaction
during stress,9,10,11,12 among many others. See Table 2.
Magnesium and calcium are an "antagonistic" team in the "fight or flight" re
Blood cell clumping(platelet aggregation)
Other Blood clotting reactions
In the normal healthy state, the stress response occurs when necessary, and
subsides when the crisis or trigger is over. Since magnesium and calcium-two
essential nutrients that must be obtained by the body from its dietary
environment-are so essential to this important response, it is not
surprising that nutritional magnesium and calcium status can affect the
response. Let's see how.
In the normal, unstressed state, cellular Mg:Ca ratio is high. If this
cannot be maintained due to lack of adequate body magnesium or an
overwhelming amount of body calcium, the ratio may not be able to maintain
or return itself to its healthy, non-stressed ratio. In such a case, the
stress response, in the absence of an appropriate trigger, can occur. This
can be seen when nutritional magnesium deficits cause high blood pressure
5,6 or increased blood "stickiness" (platelet aggregation).9 Additionally,
since a low Mg:Ca ratio can increase adrenaline secretion as well as cells'
response to adrenaline, a too low magnesium state can keep the stress
response from subsiding in a timely way.1,14Even worse, when body magnesium
becomes drastically low, this becomes a stress trigger in itself,1 alarming
the body into further stress response without enough magnesium to back it
up, resulting in a low magnesium-high stress crisis that can end in sudden
death.1,14,15 In the industrialized world we live in a state of chronic,
on-going stress. This environmental reality increases our daily need for
magnesium in order to maintain a healthy stress response that can calm when
Part II. Heart Disease is Often a Magnesium Deficiency
Clearly, an adequate amount of nutritional magnesium in-proper balance with
adequate nutritional calcium-is key to a healthy stress response. And yet,
today we have diets dangerously low in magnesium.13 Add the recent additions
of nutritional calcium via supplements and food fortifications meant to
stave off osteoporosis, and many of us are getting inadequate magnesium plus
too much calcium. The result is a large occurrence of heart
Not all, but much of the heart disease in the industrialized world can be
explained by the low magnesium state of these societies.13 People with heart
disease-for the most part-are people who are in a state of magnesium that is
borderline or deficient. Many studies on heart disease patients exist due to
medicine's effort to understand and treat this widespread malady. Although
not intended as such, this body of research shows us what stress can do to a
person in a magnesium deficient state.
Part III. Mental and Emotional Stress Deplete Magnesium
It is commonly accepted that certain traditional risk factors for heart
disease exist. These include high cholesterol, high blood pressure, family
history of heart disease, and other factors, all of which can be linked to a
shortage of nutritional magnesium.14 Recent studies tell us that
stresses-both sudden and chronic-with their high magnesium requirements, are
also strong risk factors for heart disease.
The sudden stress of the L.A. earthquake19 World Trade Center attack20
showed an upsurge of adverse heart events in people with heart disease. Even
heart patients living in Florida, hundreds of miles away from the WTC
attack, showed more adverse heart events in response to 9/11 than in usual
times.21 Again, adverse heart events in this largely magnesium deficient
population show that the triggered stress response tested their magnesium
status and found it wanting.
Emotional stress22 and phobic anxiety23 cause heart problems in patients
with heart disease-a population we know to be mostly low in their
nutritional magnesium status. Chronic states of emotional stress including a
history of childhood abuse, neglect or family dysfunction,24 depression,25
and panic disorder26 must now be added to the list of traditional risk
factors for heart disease such as high blood pressure and high cholesterol.
Depression can be a symptom of low magnesium status.14 So can anxiety, panic
attacks, irritability, hyperactivity, and over-sensitivity to loud noises.14
Do these newly found risk factors cause heart disease, or are they risk
factors because they, as well as heart disease, can all be aspects of low
magnesium status? These chronic sources of stress can increase the human
need for magnesium as well as be caused by its deficit.
Emotional stress triggers in susceptible people can even bring on sudden
death due to heart attack,27 presumably by initiating a stress/low-magnesium
crisis. Such emotional "triggers" include work stress, high-pressure
deadlines, social isolation and loneliness, low socioeconomic status,
anxiety, war, fear of war, anger and rage.28 Identical stress triggers cause
more human heart attacks regardless of age, race, gender, or geographic
location, including continent.29
Mental stress, such as working out a math problem,30 can be shown to have
impact upon the magnesium-stress response connection since it can bring on
heart attacks in people with heart disease.
Part IV. Stress, Magnesium and Aging
We are hearing a lot about stress in the health media, and rightly so as
this constant companion to our lives brings on the fight or flight syndrome,
a stress response that, when activated, has been shown to shorten
lifespan.34 When we realize that the stress response is exacerbated when we
are low in magnesium, that we are living on low-magnesium foods for the most
part, and that our lifestyles are more and more filled with chronic stresses
and stressful events, we are not surprised to see that several aspects of
magnesium deficiency are remarkably like aspects of the aging process.35
When faced with our stressful lifestyles, coupled with a society presenting
a chronically low-magnesium/high-calcium diet, what is our best defense? For
many of us, magnesium supplements can help to preserve or restore a healthy
Mg:Ca balance, so important to our health in these stressful times.
A good idea would be to replace your current calcium supplements with a Cal-mag supplement like Mag365 plus Calcium.
1. "Magnesium plays a vital role in the stress reaction; stress can deplete
the body of magnesium; low magnesium both triggers and increases the stress
response; adequate magnesium allows the stress reaction to naturally
Seelig, M. S. (1994). "Consequences of magnesium deficiency on the
enhancement of stress reactions; preventive and therapeutic implications (a
review)." J Am Coll Nutr 13(5): 429-446.
2. "Stress causes blood adrenaline, calcium and magnesium to go up."
Body, J. J., P. E. Cryer, et al. (1983). "Epinephrine is a hypophosphatemic
hormone in man. Physiological effects of circulating epinephrine on plasma
calcium, magnesium, phosphorus, parathyroid hormone, and calcitonin." J Clin
Invest 71(3): 572-8.
3. "In isolated rat hearts, high calcium stimulates the adrenaline response
while high Magnesium slows it down."
Levin, R.M., N. Haugaard, et al. (1976). "Opposing actions of calcium and
magnesium ions on the metabolic effects of epinephrine in rat heart."
Biochem Pharmacol 25(17): 1963-9.
4. "In whole rat physiology and rat nerve cells, Magnesium limits stress
hormone release by blocking calcium entry into nerve cells."
Shimosawa, T., K. Takano, et al. (2004). "Magnesium inhibits norepinephrine
release by blocking N-type calcium channels at peripheral sympathetic nerve
endings." Hypertension 44(6): 897-902.
5. "Rats on a magnesium deficient diet show high blood pressure. The inside
diameter of their blood vessels becomes smaller as the degree of magnesium
deficiency becomes larger."
Altura, B.M., B. T. Altura, et al. (1984). "Magnesium deficiency and
hypertension: correlation between magnesium-deficient diets and
microcirculatory changes in situ." Science 223(4642): 1315-7.
6. "Blood pressure can be made to rise in rats via a chemical treatment that
causes a rise in cellular calcium.
Supplementing these animals with magnesium prevented the blood pressure rise
and kept the cellular calcium level normal."
Kh, R., M. Khullar, et al. (2000). "Effect of oral magnesium supplementation
on blood pressure, platelet aggregation and calcium handling in
deoxycorticosterone acetate induced hypertension in rats." J Hypertens
7. "High magnesium makes isolated dog heart arteries relax, while low
magnesium makes them contract as well as over-react to stress and other
Turlapaty, P. D. and B. M. Altura (1980). "Magnesium deficiency produces
spasms of coronary arteries: relationship to etiology of sudden death
ischemic heart disease." Science 208(4440): 198-200.
8. "Low magnesium causes blood vessel contraction in isolated human
umbilical blood vessels."
Altura, B. M., B. T. Altura, et al. (1983). "Magnesium deficiency-induced
spasms of umbilical vessels: relation to preeclampsia, hypertension, growth
Science 221(4608): 376-8.
9. "In humans, low magnesium intake makes platelet aggregation rate go up.
Oral magnesium supplements can bring the rate back down." Nadler, J. L., T.
Buchanan, et al. (1993). "Magnesium deficiency produces insulin resistance
and increased thromboxane synthesis."Hypertension 21(6 Pt 2): 1024-9.
10. "Platelet aggregation in human blood, one aspect of the stress reaction,
requires calcium to proceed, but too much or too little calcium will not
allow these cells to aggregate. High concentrations of magnesium forestall
aggregation even when adequate calcium is present."
Herrmann, R.G.,W. B. Lacefield, et al. (1970). "Effect of ionic calcium and
magnesium on human platelet aggregation." Proc Soc Exp Biol Med 135(1):
11. "As magnesium goes up, platelet aggregation and activation in human
blood cells goes down."
Hwang, D. L., C. F. Yen, et al. (1992). "Effect of extra cellular magnesium
on platelet activation and intracellular calcium mobilization." Am J
12. "Coagulation does not change with normal levels of serum magnesium.
Sacha, T. and A. B. Skotnicki (1997). "[The effect of magnesium on blood
coagulation-state of the art literature review from1959 to 1995]." Przegl
Lek 54(2): 122-5.
13. "Much of the heart disease in the modern world is a magnesium
Marier, J. R. (1982). "Quantitative Factors Regarding Magnesium Status in
the Modern-Day World."
Magnesium 1: 3-15.
14. "All risk factors for heart disease can be simply explained as a
Seelig, M. S. and A. Rosanoff (2003). The Magnesium Factor. New York, Avery
15. "Magnesium deficiency can cause heart disease, including sudden cardiac
Frost, F. J. (2004). "Studies of Minerals and Cardiac Health in Selected
16. "Areas with a high calcium: magnesium ratio in drinking water show heart
calcification in humans who have died of heart disease."
Bloom, S. and L. Peric-Golia (1989). "Geographic variation in the incidence
of myocardial calcification associated with acute myocardial infarction."
Hum Pathol 20(8): 726-31.
17/18. "Finland in the 1970's had one of the highest death rates due to
heart disease. After a 20-year program that included the raising of
magnesium intakes, the country had one of the lowest death rates due to
heart disease." 17. Karppanen, H., R. Pennanen, et al. (1978). "Minerals,
coronary heart disease and sudden coronary death." Adv Cardiol 25: 9-24.
18. Karppanen, H. and E. Mervaala (1996).
Adherence to and population impact of non-pharmacological and
pharmacological antihypertensive therapy." J Hum Hypertens 10 Suppl 1:
19. "Sudden stress (earthquake) can bring on heart attack in susceptible
Leor, J., W. K. Poole, et al. (1996). "FT: Sudden Cardiac Death Triggered by
an Earthquake." N Engl J Med 334(7): 413-419.
20. "The sudden stress of the 9-11 WTC attack brought on serious heart
Steinberg, J. S., A. Arshad, et al. (2004). "Increased incidence of
life-threatening ventricular arrhythmias in implantable defibrillator
patients after the World Trade Center attack." JAmCollCardiol 44(6):
21. "Even sudden stress via "the news" can bring on heart distress in
susceptible people living far away from the scene of the actual crisis."
Shedd, O. L., S. F. Sears, Jr, et al. (2004). "The World Trade Center
attack: Increased frequency of defibrillator shocks for ventricular
arrhythmias in patients living remotely from New York City." J Am
Coll Cardiol 44(6): 1265-1267.
"Emotional Stress Can Impact the Heart"
Wittstein, I. S., D. R. Thiemann, et al. (2005).
"Neurohumoral features of myocardial stunning due to sudden emotional
stress. "NEngl JMed 352(6): 539-48.
23. "Phobic Anxiety is a risk factor for heart attack death in women as well
Albert, C. M., C. U. Chae, et al. (2005). "Phobic Anxiety and Risk of
Coronary Heart Disease and Sudden Cardiac Death Among Women."
24. "Childhood abuse, neglect and family dysfunction are risk factors for
Dong, M., W. H. Giles, et al. (2004). "Insights into causal pathways for
ischemic heart disease: adverse childhood experiences study." Circulation
25. "Depression is a risk factor for heart disease."
Rumsfeld, J. S., P. G. Jones, et al. (2005). "Depression predicts mortality
and hospitalization in patients with myocardial infarction complicated by
heart failure." Am Heart J 150(5): 961-7.
26. "Panic disorder is a risk factor for heart disease."
Gomez-Caminero, A., W. A. Blumentals, et al. (2005). "Does Panic Disorder
Increase the Risk of Coronary Heart Disease? A Cohort Study of a National
Managed Care Database." Psychosom Med 67(5): 688-691. 27. "Stress, like
alcohol, can lower magnesium status enough to bring on a heart attack in
elderly people with heart disease."
Myers, A. and H. A. Dewar (1975). "Circumstances attending 100 sudden deaths
from coronary artery disease with coroner's necropsies." Br Heart J 37(11):
28. "Emotional triggers that can bring on heart attacks include work stress,
high-pressure deadlines, loneliness, money worries, anxiety and depression,
war or fear of war, anger, rage."
Strike, P. C. and A. Steptoe (2005). "Behavioral and Emotional Triggers of
Acute Coronary Syndromes:
A Systematic Review and Critique." Psychosom Med 67(2):179-186.
29. "Psychologically stressed or depressed people, regardless of race,
gender, or geographic location, have more heart attacks than people not
living with work, home or financial stress."
Rosengren, A., S. Hawken, et al. (2004). "Association of psychosocial risk
factors with risk of acute myocardial infarction in 11119 cases and 13648
controls from 52 countries (the INTERHEART study): case-control study."
Lancet 364(9438): 953-62.
30. "Mental stress can impact hearts."
Strike, P. C. and A. Steptoe (2003). "FT: Systematic review of mental
stress-induced myocardial ischaemia." Eur Heart J 24(8): 690-703.
31. "ECG patterns predictably change from normal with a magnesium
Seelig, M. (1969). "Electrographic Patterns of Magnesium Depletion Appearing
in Alcoholic Heart Disease." Annals of the Academy of Sciences 162(2):
32. "Vigorous exercise in a normally inactive person brings on cardiac death
more often than in regularly active persons."
Siscovick, D. S., N. S. Weiss, et al. (1984). "The incidence of primary
cardiac arrest during vigorous exercise." N Engl J Med 311(14):874-7.
33. "Even when magnesium status is low, regular exercise maintains magnesium
in the muscles used for physical exercise (in rats)." Brilla, L. R., J. H.
Fredrickson, et al. (1989). "Effect of Hypomagnesemia and Exercise on Slowly
Exchanging Pools of Magnesium. "Metabolism 38(8):797-800.
34. "Activation of the stress response can shorten life span." Mobbs, C. V.
(2004). "Not Wisely but Too Well: Aging as a Cost of Neuroendocrine
Activity." Sci. Aging Knowl. Environ. 2004(35): pe33-.
35. "Aspects of low magnesium status are remarkably like aspects of aging."
Saito, N. and S. Nishiyama (2005). "[Aging and magnesium]." Clin Calcium