Magnesium and Calcium in Osteoporosis

Magnesium, Calcium & Osteoporosis

Magnesium is essential for strong bones and teeth. The strong magnesium and calcium relationship is not fully understood by most people, yet is crucial to bone health and prevention of osteoporosis. The following article fully explains the calcium magnesium balance and how to take advantage of magnesium for bone health.

The Calcium and Magnesium Relationship

Magnesium is in fact necessary for the absorption of calcium into bones and teeth.

Magnesium itself is an important mineral in bone matrix and is required to maintain high bone density. Magnesium deficiencies develop when calcium intakes are relatively higher than magnesium intakes.

Deficiencies also develop when the body cannot maintain a proper magnesium calcium balance, or “ratio” of calcium to magnesium, whether due to an overabundance of calcium or a lack of magnesium. It is notable, for example, that higher than normal blood levels of calcium cause excretion both of calcium and magnesium.1 Individuals having minimally adequate levels of magnesium, yet overabundant levels of calcium may excrete enough magnesium along with excess calcium to cause magnesium deficiency.2

The primary reason magnesium is required for the proper absorption of calcium relates to the complex relationship of magnesium to calcium.

Magnesium and calcium are known as “paired” minerals whose uptake and assimilation are closely related. It is known that calcium intakes above 2.6 grams per day are associated with reduced uptakes and utilization of magnesium, and thereby cause increased requirements for magnesium in the body.3 In addition, it is essential that a proper ratio of calcium to magnesium intake be maintained.

The Magnesium Calcium Balance: A Second Look

Research suggests that standard American diets usually provide a greater than greater than 4:1 ratio of calcium to magnesium.4

While many health recommendations specify a ratio of 2:1 calcium to magnesium, Dr. Mark Sircus, author of Transdermal Magnesium Therapy, notes that this ratio is probably too high given that studies of Paleolithic diets (i.e., “caveman” diets) indicate an intake ratio closer to 1:1.5

These figures indicate that the average person not only fails to obtain adequate dietary magnesium, but also obtains an overabundance of calcium relative to magnesium. An overabundance of calcium relative to magnesium prevents the absorption of calcium into bones and teeth.

Lacking magnesium, calcium is deposited into soft tissues at the expense of skeletal structures and teeth. This scenario explains how an overabundance of calcium relative to magnesium results in magnesium deficiencies, weaker bones and teeth, and calcification of soft-tissues that can adversely impact health.

Osteoporosis, Calcium and Tissue Calcification

The process by which magnesium deficiency leads to weaker bones and teeth relates to the need for the body to maintain the proper concentration gradient of calcium to magnesium within cells and extracellular fluid.

When magnesium levels remain high, the body produces abundant energy (as ATP) for cellular processes. When provided with sufficient energy, cells can maintain the proper concentration gradient of magnesium and calcium. The body relies on the enyzme ATPase to utilize energy (as ATP) to transport magnesium into cells and pump excess calcium from cells.

It is this pumping mechanism of ATPase that maintains the proper concentration gradient of magnesium (high within cells) to calcium (high in extracellular fluid) required for normal body function. The normal gradient is approximately 10,000 times more calcium outside of cells than within cells.6 If this concentration gradient is compromised in favor of calcium, then levels of intracellular calcium increase beyond normal levels, causing a relative deficiency of magnesium.7 When this happens, ATPase must work harder to pump calcium from cells, a task that becomes more difficult as the relative concentrations of magnesium decline. As magnesium levels decline, energy production falls and there is less energy available to maintain the pumping mechanism of ATPase.

The accumulation of calcium ultimately overwhelms cells and they lose the ability to remove excess calcium.

As cells fill with calcium, the stage is set for calcium deposits to accumulate within cells. As these deposits accumulate in cells and become larger deposits within soft tissues, less calcium is available for assimilation into bones and teeth.

This describes the process whereby demineralization of bones and teeth is accompanied by calcification of soft tissues.

Magnesium deficiency results in soft tissues burdened with abnormal calcium deposits that reduce functionality and adversely affect health, and deprive bones and teeth of calcium essential for maintaining their proper mineralization.

Magnesium, Bone Health and Calcium Uptake

Magnesium deficiency also results in weaker bones and teeth because magnesium regulates the uptake and use of calcium and other minerals. If magnesium is deficient, then bones and teeth weaken partly because reduced levels of calcium are available for uptake.

This means that despite more than adequate calcium intake, individuals deficient in magnesium can develop osteopenia, osteoporosis, fracture-prone bones, skeletal conditions, and demineralization of hard tissues. These adverse effects and conditions become more prevalent as magnesium intake declines relative to calcium intake. For example, the prevalence of osteoporosis has increased as calcium intake climbs and magnesium intake declines.8

Dr. Sircus notes that western populations with relatively high calcium intake of about 1,000 mg daily (mostly from dairy products) exhibit widespread incidence of osteoporosis and tooth decay.9 In contrast, many Asian and African populations have a low daily intake of calcium (300 mg), yet exhibit low incidence of osteoporosis. For example, the lowest known incidence of osteoporosis in the world is among African Bantu women whose intake of calcium is approximately 200 to 300 milligrams of calcium per day.10

Magnesium, Calcium and Hormone Regulation

Low levels of magnesium facilitate the movement of calcium from bones into soft tissues. Conversely, adequate levels of magnesium allow calcium to move from soft tissues into bones and teeth.

The mechanisms by which magnesium creates strong bones include its role in stimulating the hormone thyrocalcitonin. Thyrocalcitonin preserves bone structures by drawing calcium from blood and soft tissues and moving it back into bones.11 This movement of calcium away from soft tissues helps prevent kidney stones and certain forms of arthritis.12

Magnesium also keeps bones strong because it suppresses parathyroid hormone, which contributes to breakdown of bone.13 In addition, the body uses magnesium both to convert vitamin D into its active form (needed for proper calcium absorption) and to activate the enzyme alkaline phosphatase, which is required for new bone formation.14 Abundant levels of magnesium in the body translate into increased calcium levels in bones, higher bone density, and greater bone mineralization.

While magnesium enables cells to absorb calcium and maintain high levels of calcium in bones and teeth (and thereby prevent soft tissue calcification), it is well understood that magnesium itself is an important mineral within bone matrix.

Healthy bones contain more magnesium when compared to bones exhibiting osteoporosis.15For example, at least one study found few differences in levels of calcium, phosphorus, and fluoride between normal bones and bones exhibiting osteoporosis.16 The major difference was the magnesium content of bones.

  • Whereas healthy bones contained 1.26% magnesium,
  • Osteoporitic bones only contained 0.62% magnesium.17

These facts indicate the importance of sustaining the magnesium levels required to build and maintain the strength of hard tissues. While magnesium deficiency causes migration of calcium into soft tissues and leads to decreased calcium content of hard tissues, it also creates significant structural weakness in the matrix of bones and teeth. Increasing magnesium intake is known to improve bone density and to reduce the risk of osteoporosis.18 In one study, higher magnesium intakes were positively associated with higher bone mineral density throughout the body.19 Two percent increases in whole-body bone mineral density (BMD) were noted for every one hundred milligram increase in daily magnesium intake.20

A higher percentage of magnesium phosphate in teeth corresponds with increased tooth hardness.21 Research suggests an association between magnesium and periodontitis. In a dental study of subjects over forty years of age, subjects given magnesium showed less attachment loss and more remaining teeth than controls.22 The study concluded that increased serum ratios of magnesium to calcium were positively associated with reduced probing depth, less attachment loss, and higher numbers of remaining teeth.23

Magnesium and Bone Fractures

Another aspect of bone health provided by magnesium is flexibility. Whereas calcium is found in greater abundance within the more rigid structures of bones, magnesium promotes greater flexibility and is found in greater abundance in softer structures within bones, such as bone matrix.24

Bone matrix contains protein and magnesium, which provides bones with a certain amount of flexibility. Bones that lack magnesium are less dense, less flexible, and more brittle than bones that contain proper levels of magnesium. Brittle bones are especially susceptible to fractures precisely because they lack the flexibility that magnesium provides to their structure. Magnesium protects bones by providing built-in resistance to brittleness.25

Magnesium and Osteoporosis

Magnesium, calcium and osteoporosis have received increasing attention due to the intricacies of the magnesium-calcium relationship and new research exploring therapeutic balance between these two vital minerals. While osteoporosis and calcium have a long history of awareness, only recently are wider audiences realizing the importance of magnesium to bone health.

Magnesium’s osteoporosis links are biologically related to three important cellular functions:

  • Taking excess calcium out of tissue for availability for bone absorption,
  • Stimulating hormones which regulate bone formation and calcium absorption, and
  • Providing flexibility to the bone matrix.

Now more than ever the calcium and magnesium relationship is clear, and magnesium and osteoporosis must be considered an important factor in maintaining healthy bone function both in the early formative years and throughout later life.

  1. Sircus, Mark, Ac., OMD. Transdermal Magnesium Therapy (2007), 54. []
  2. Sircus, 54. []
  3. Sircus, 51. []
  4. Sircus, 52. []
  5. Sircus, 52. []
  6. Sircus, 49. []
  7. Sircus, 49. []
  8. Sircus, 53. []
  9. Sircus, 53. []
  10. Sircus, 53. []
  11. Dean, Carolyn, MD, ND. The Magnesium Miracle (2007 ed.), 149; Sircus, 6. []
  12. Dean, 149. []
  13. Dean, 150. []
  14. Dean, 150. []
  15. Sircus, 58 []
  16. Sircus, 58. []
  17. Sircus, 58. []
  18. Trabecular bone density in a two year controlled trial of peroral magnesium in osteoporosis. Stendig-Lindberg G., Tepper R., Leichter I. Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Israel. Magnes Res. 1993 Jun; 6(2): 155-163. []
  19. Sircus, 56-57. []
  20. Sircus, 57. []
  21. Sircus, 57. []
  22. Sircus, 215. []
  23. Sircus, 215. []
  24. Seelig, Mildred S., PhD, MPH and Andrea Rosanoff, PhD. The Magnesium Factor (2003), 15. []
  25. Seelig, 15. []

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