Is magnesium supplementation effective in reducing anxiety symptoms?

Magnesium Supplementation for Anxiety

Magnesium supplementation is likely beneficial for reducing anxiety symptoms, particularly in individuals with low magnesium status, with liquid or dissolvable forms being better tolerated than pills. 1

Evidence for Efficacy

• The majority of clinical studies examining magnesium supplementation for anxiety have demonstrated improvement in at least one anxiety-related parameter, with five out of seven studies measuring anxiety outcomes reporting positive results 2
• Existing evidence suggests a beneficial effect of magnesium on subjective anxiety, particularly in anxiety-vulnerable populations 3
• Magnesium levels are often lower in individuals with certain mental disorders, especially depression, which frequently co-occurs with anxiety 4

Recommended Dosing and Administration

• Start with the recommended daily allowance (350 mg daily for women; 420 mg daily for men) and increase gradually according to tolerance 1
• Liquid or dissolvable magnesium products are usually better tolerated than pills 1
• Organic magnesium salts (aspartate, citrate, lactate) have higher bioavailability than magnesium oxide or hydroxide 1
• Magnesium oxide (12 mmol) administered at night may help with absorption, as nighttime is when intestinal transit is slowest 1

Clinical Considerations

• Magnesium supplementation may provide additional benefits beyond anxiety reduction:

  • May improve sleep quality, which could indirectly benefit anxiety symptoms 1, 2
  • Can help manage hypomagnesemia, which can cause irritability and other neurological symptoms 1

• In an 8-week randomized controlled trial, magnesium supplementation (with or without vitamin B6) significantly improved anxiety scores in individuals with stress and low magnesium levels 5

• Potential side effects of excessive magnesium supplementation include:

  • Gastrointestinal intolerance
  • Muscle weakness
  • Flushing
  • Hypotension
  • Bradycardia
  • Blurred vision
  • Cognitive effects 1

Limitations of Current Evidence

• Heterogeneity in study designs, dosages, formulations, and durations of magnesium interventions complicates interpretation of results 2
• Some studies included additional, potentially active ingredients alongside magnesium 2
• The quality of existing evidence is generally poor, with many studies having small sample sizes 3
• Negative results were more common in populations with underlying endocrine factors contributing to anxiety symptoms (e.g., premenstrual symptoms, postpartum women) 2

Clinical Algorithm

1. Consider magnesium supplementation for patients with mild to moderate anxiety symptoms, particularly if:

   • They prefer natural approaches to anxiety management 6
   • They have symptoms suggesting possible magnesium deficiency (insomnia, irritability) 4

2. Start with recommended daily allowance (350 mg for women, 420 mg for men) 1

3. Choose liquid or dissolvable forms of organic magnesium salts (citrate, aspartate, lactate) for better absorption 1

4. Administer at night to improve absorption 1

5. Monitor for improvement in anxiety symptoms over 4-8 weeks, as most benefits are observed within this timeframe 5

6. If well-tolerated, dosage can be gradually increased according to response and tolerance 1

7. Discontinue if side effects occur (gastrointestinal issues, hypotension, etc.) 1