Can magnesium supplements alleviate anxiety and stress?

The effectiveness of supplements containing magnesium as a sedative is unproven, despite their popularity as over-the-counter remedies for relieving stress and treating anxiety.

The COVID-19 pandemic and recent events have exacerbated anxiety disorders, which were already common health problems before 2020. As a result, scientists are seeking new and safe drugs for anxiety that do not cause side effects and are suitable for children, pregnant women, and the elderly. Magnesium supplements are being explored as a potential solution.

Many supplements and medications combine magnesium with other bioactive components, such as minerals, vitamins, and brewer’s yeast, to enhance their effectiveness. Typically, a combination of magnesium and vitamin B6 is utilized as a sedative.

How are magnesium and anxiety related?

The human body requires magnesium for the synthesis of nucleic acids, energy metabolism, insulin secretion, and muscle contractions, among other essential functions. During the 1980s, researchers discovered that magnesium has an impact on the central nervous system. The CNS relies on two primary neurotransmitters, the excitatory glutamate and the inhibitory gamma-aminobutyric acid (GABA).

Theoretical investigations indicate that when neurons stimulated by glutamate become excessively active, individuals experience anxiety. Magnesium can mitigate the impact of glutamate while simultaneously amplifying the influence of GABA on nerve cells. This is critical in combating stress because a lack of GABA can cause anxiety.

Research has demonstrated that stress can diminish magnesium levels, which, in turn, may contribute to stress. When individuals encounter stress, their bodies generate specialized hormones to aid them in difficult situations. These hormones stimulate the cardiovascular and respiratory systems while enhancing brain activity.

However, stress hormones also decrease the concentration of magnesium in the bloodstream and lead to its excretion in urine. Endocrine glands that secrete stress hormones are particularly sensitive to magnesium deficiency, and they become more active when magnesium levels decrease. Consequently, the number of stress hormones rises, and the body loses even more magnesium, which increases anxiety levels. This creates a cycle of stress, magnesium depletion, increased stress, and further magnesium loss.

In summary, magnesium plays a role in regulating the nervous system. Although it is not yet a scientifically proven sedative, magnesium can have a calming effect by influencing the levels of neurotransmitters that affect stress and anxiety.

Does magnesium effectively combat anxiety?

A review article published in the journal Nutrients in 2017 examined the available scientific literature on the effects of magnesium supplements on anxiety treatment. The review authors identified a total of 6,573 publications on the topic. However, the review only included double-blind randomized clinical trials (RCTs) that involved individuals with mild anxiety and did not have any severe somatic illnesses. Additionally, the studies only included participants with identified magnesium deficiencies.

In RCTs, researchers divide participants into two groups: one group receives the study drug, while the other receives a placebo or a drug with proven efficacy. Neither the participants nor the medical staff are aware of who is receiving the placebo or the effective drug, and who is receiving the study drug.

The review article in Nutrients reported that, based on RCT criteria, only eight studies were eligible for inclusion out of the 6,573 initially identified. However, all of these studies had at least one of three major limitations that made them unreliable.

Statistical processing difficulties

The review authors evaluated the effectiveness of treatment in six out of eight studies using the Hamilton Anxiety Scale (HAM-A). They noted that the use of this scale led to errors in data processing.

Absence of placebo control

Three studies compared magnesium preparations with other drugs instead of a placebo. The reliability of research is reduced when a “dummy” control is absent since assessing the placebo effect is important for developing methods to treat psychiatric conditions like anxiety, depression, and addiction. However, the review authors analyzed all the studies that had a placebo group and found that the effectiveness of the “dummy” was comparable to that of magnesium preparations.

The use of magnesium in combination with other bioactive compounds

In seven out of eight studies, magnesium was supplemented with vitamin B6 or medicinal plants, with only one study using magnesium alone. Vitamin B6 was found to affect the function of neurotransmitters involved in the development of anxiety.

Therefore, the review authors concluded that the effectiveness of magnesium for even mild anxiety treatment remains unproven. Upon closer examination, clinical studies that appeared to meet modern quality standards were found to be not entirely reliable.

Studies on the relationship between magnesium and anxiety have not changed since the release of the review.

As of March 2022, only one study on the effect of magnesium on anxiety is available on the examine.com website, an independent database of biologically active supplements. However, this study is focused on the treatment of premenstrual syndrome, not stress and background anxiety.

The study published in the journal PLoS One in 2018 claimed to be a randomized and blinded trial that proved the effectiveness of magnesium supplements for treating anxiety. However, in reality, the experiment compared magnesium alone and magnesium + vitamin B6 using a blinded randomized method.

The study found that the effectiveness of magnesium and magnesium in combination with vitamin B6 in stress reduction was approximately the same. However, the study did not evaluate a placebo or other anti-anxiety medications. Therefore, it cannot be asserted that stress in the volunteers decreased due to magnesium intake. It is possible that their condition improved over time or due to some other reason.

In contrast, a 2021 study demonstrated the effectiveness of magnesium against social stress induced by the Trier Social Stress Test (TSST). Volunteers were asked to give a speech presenting themselves as job candidates, followed by performing mathematical operations in front of a jury, which was the primary stress factor.

The study was randomized, and volunteers were randomly assigned to groups. Additionally, a placebo control was used, where 25 out of 100 people received a dummy tablet instead of magnesium.

The experimental group consisted of 75 people divided into three subgroups, with all subgroups receiving magnesium, vitamins B6, B9, and B12. The difference between the subgroups was in the addition of green tea and rhodiola extracts.

The study results showed that the most effective stress reduction was achieved with a combination of magnesium, vitamins B6, B9, B12, green tea and rhodiola extracts. Therefore, the study did not prove the effectiveness of magnesium alone. It is possible that the stress reduction in participants was due to the action of vitamins or herbal extracts.

Is magnesium necessary for calming down?

Manufacturers who advertise magnesium supplements as an anti-anxiety remedy are being honest when they indicate that the medication only helps with anxiety if it arises from a microelement deficiency. Magnesium supplements do not fall under the classification of sedatives.

Hypomagnesemia, or an established magnesium deficiency, can present itself with trembling, convulsions, and heart rhythm disturbances. Although it can also be asymptomatic, hypomagnesemia usually develops from starvation, the intake of certain drugs, and severe illnesses such as Crohn’s disease, acute pancreatitis, and alcoholism.

Diagnosing magnesium deficiency requires a doctor’s evaluation and testing; self-diagnosis is not recommended. While manufacturers of “Magne B6” have a questionnaire on their website that can help identify potential deficiencies, they caution that the results are not a substitute for a professional diagnosis. Reliable diagnosis and treatment of magnesium deficiency should be carried out by a doctor.

Although fundamental research has shown that magnesium may have an impact on anxiety, there is no clinical evidence to support the effectiveness of microelement therapy for anxiety disorders. Neither domestic nor foreign clinical guidelines for anxiety treatment recommend magnesium supplements or a combination of magnesium and vitamin B6. It is therefore not advisable to attempt to treat anxiety with a microelement without consulting a doctor.