In clinic I often meet perimenopausal women who have shoulder or elbow pain and restriction, such as frozen shoulder.  I had bursitis and tendonitis in my shoulder 3 years ago.  It was painful and scary, disrupting my sleep and restricting my movement.

Like many of the women I speak to, I was told it is something women of ‘my age’ commonly get (it is) and a steroid injection will help (it did).

I wasn’t satisfied with that – why?  Why do women between 40-50 get this sort of issue?

I searched the literature and there is no simple answer.  However, as I work with more and more women of this age group, I find that suboptimal levels of minerals, and particularly magnesium, play a big part.

 

Why would I have low levels of magnesium?

It is estimated that over 50% of the US population do not meet the estimated average requirement for magnesium, so why is this?^{1,2, 3}

The magnesium content of vegetables has decreased by 24% between 1940 and 1999 ³ as modern farming methods deplete the soil of minerals. Food processing also reduces the magnesium content of food.  Our drinking water supply is clean but lacking in natural minerals ³ from natural wells.

Perimenopausal women often take calcium supplements to ward off osteoporosis. Minerals are required in a particular ratio and calcium supplementation can increase magnesium excretion ^2,3.  Alcohol also increases excretion of magnesium.

Stress depletes magnesium (and show me a woman who is not juggling many balls at this age).

Too much exercise can deplete magnesium.

The contraceptive pill, antidepressants ⁴ and some other medications deplete magnesium.

I find that busy women tend towards eating salad vegetables rather than cooking green leafy vegetables that are good sources of this mineral.

A good level of stomach acid is needed to absorb minerals.  Stomach acid can decline with age and stress levels.

 

What are signs of low magnesium?

Magnesium supports over 300 processes in our body so the impact of low levels can be widespread.  It supports energy production, blood sugar management, bone health, digestive motility, and blood pressure ^1,2,3,5. Common symptoms of suboptimal levels include:

muscle cramps

fatigue

headaches

loss of appetite

insomnia

a predisposition to stress

craving chocolate or sugary snacks

 

How much do I need?

The Recommended Daily Allowance (RDA) for women is 320 mg/day.

 

Where do I find it?

Green leafy vegetables (lightly cooked to help absorption) and nuts and seeds are good sources.

 

Food, Standard Serving Size   Pumpkin seed kernels, ¼ cup Amaranth grain (cooked), 1 cup Brazil nuts, 1oz – 6 nuts Almonds, 1oz – 23 almonds Spinach (boiled), ½ cup Swiss chard (steamed), ½ cup Cashews, 1oz – 16 cashew nuts Black beans (cooked), ½ cup Edamame (shelled, cooked), ½ cup Molasses, 1 tbs Hazelnuts, 1oz – 21 hazelnuts Avocado, 1 cup Brown rice (cooked), ½ cup

Average Magnesium Content (mg)   162 160 107 80 78 75 74 60 50 48 46 44 43

 

If you feel you may be low in magnesium, include these foods daily. Remember to chew well to help digestion.  As most nutrients work in balance together then it is safest to look for a good multivitamin and mineral product with an appropriate level of magnesium.  Bone health requires vitamin D, K and calcium as well as magnesium ^3,6.

 

Did you know…..

Hens low in magnesium produce eggs with weak shells.  Scientists found that prior to the extinction of dinosaurs there was a significant decrease in the magnesium content of egg fossils. This may have played a role in their decline ⁷!

 

References

1. Nielsen FH (2010). Magnesium, inflammation and obesity in chronic disease. Nutr Rev. 68(6):333-40
2. Rosanoff A, Weaver CM, Rude RK (2012). Suboptimal magnesium status in the US: are the health consequences underestimated? Nutr Rev. 70(3):153-64
3. Dinicolantonio, J. and Land, S. (2021) The Mineral Fix, Chapter 6: Magnesium, calcium and phophorus: softening up the arteries and hardening the bones.
4. Wu A, Bencaz AF, et al (2012). SSRI treatment and risk of fractures: a meta-analysis of cohort case-control studies. Osteoporos Int. 23(1):365-75
5. Farsinejad-Marj M, Saneei P, Esmaillzadeh A (2016). Dietary magnesium intake, bone mineral density and risk of fracture: a systematic review and meta-analysis. Osteoporos Int. 27(4):1389-99
6. Rude RK, Singer FR, Gruber HE (2009). Skeletal and hormonal effects of magnesium deficiency. J Am Coll Nutr. 28(2):131-41
7. Durlach (1991) ‘Magnesium and extinction of dinosaurs. Was magnesium deficit a major cause?’ Magnesium Research, 4(3-4), pp201-202.