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Magnesium increases Vitamin D, which increases Mg. Both increase bone – Oct 2019

Anabolic Effects of Vitamin D and Magnesium in Aging Bone

Review J Steroid Biochem Mol Biol, 193, 105400 Oct 2019, DOI: 10.1016/j.jsbmb.2019.105400
Sarah Erem 1, Azeddine Atfi 2, Mohammed S Razzaque 3

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Decreased bone mass and an increased risk of bone fractures become more common with age. This condition is often associated with osteoporosis and is caused by an imbalance of bone resorption and new bone formation. Lifestyle factors that affect the risk of osteoporosis include alcohol, diet, hormones, physical activity, and smoking. Calcium and vitamin D are particularly important for the age-related loss of bone density and skeletal muscle mass, but other minerals, such as magnesium, also have an important role. Here, we summarize how optimal magnesium and vitamin D balance improve health outcomes in the elderly, the role of magnesium and vitamin D on bone formation, and the implications of widespread deficiency of these factors in the United States and worldwide, particularly in the elderly population.


The micronutrient magnesium is essential for hundreds of essential cellular functions. Magnesium deficiency is associated with chronic diseases, including cardiovascular disease, metabolic syndrome, type II diabetes, and skeletal disorders. Osteoporosis is a particular concern among the elderly because insufficient intake of magnesium results in excess calcium release from bone, which further exacerbates bone fragility and increases the risk of fractures and falls. Dietary intake of magnesium in the US population is low, particularly among the elderly and ethnic minorities. Although the intake of calcium and vitamin D has been increasing in the United States for decades, there is relatively little information on the interactions between these three nutrients. High intake of calcium complicates the retention of magnesium, and low levels of magnesium can result in excess excretion of calcium. The optimal calcium-to-magnesium ratio is 2-2.8, but the increased consumption of calcium since the 1970's in the United States has increased the ratio to above 3.0, which has coincided with an increased rate of diabetes [128].
Low vitamin D levels are also associated with chronic diseases worldwide. The interaction between vitamin D and magnesium contributes to the risk of cardiovascular disease and colorectal cancer.
Magnesium directly interacts with the enzymes that synthesize, transport, and activate vitamin D (Figs. 2 and 3). Although there are several studies on the effects of vitamin D or magnesium deficiency and supplementation alone, there are comparatively fewer studies on the interactions between vitamin D and magnesium for human health. Increasing vitamin D and/or calcium with supplements without a concomitant increase in magnesium intake may have unforeseen deleterious effects.
Measuring magnesium levels in the body is challenging because the magnesium load test is cumbersome and time consuming. It also may not be suitable for those with chronic kidney diseases or other complications. In addition, serum magnesium may not accurately reflect the available magnesium in tissues and may vary widely between individuals, time-of-day, and under different disease conditions. Thus, new non-invasive tests are needed to accurately measure magnesium status in blood, bone, and soft tissue in order to identify and effectively treat magnesium-deficient patients and those with chronic diseases, such as osteoporosis, depression, and chronic migraines that are affected by magnesium levels.
Finally, there is a profound lack of awareness of the insufficient intake of magnesium in the United States population and worldwide as evidenced by the stunning under-consumption of magnesium particularly in the elderly and ethnic minorities. Moreover, the dearth of magnesium in the food supply and agricultural soils and the decrease in magnesium content in processed foods and in newer varieties of grains, fruits, and vegetables poses a further challenge for adequate magnesium consumption. Poorer communities and food-insecure individuals are also disadvantaged in their ability to maintain an optimal magnesium balance. These disparities exacerbate health problems in diseases related to magnesium deficiencies and are a global health concern.

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