Magnesium:

Magnesium is a mineral needed by every cell of your body. About half of your body's magnesium stores are found inside cells of body tissues and organs, and half are combined with calcium and phosphorus in bone. Only 1 percent of the magnesium in your body is found in blood. Your body works very hard to keep blood levels of magnesium constant (1).

Magnesium is needed for more than 300 biochemical reactions in the body. It helps maintain normal muscle and nerve function, keeps heart rhythm steady, and bones strong. It is also involved in energy metabolism and protein synthesis.

What foods provide magnesium?

Green vegetables such as spinach provide magnesium because the center of the chlorophyll molecule contains magnesium. Nuts, seeds, and some whole grains are also good sources of magnesium.

Although magnesium is present in many foods, it usually occurs in small amounts. As with most nutrients, daily needs for magnesium cannot be met from a single food. Eating a wide variety of foods, including five servings of fruits and vegetables daily and plenty of whole grains, helps to ensure an adequate intake of magnesium.

The magnesium content of refined foods is usually low. Whole-wheat bread, for example, has twice as much magnesium as white bread because the magnesium-rich germ and bran are removed when white flour is processed.

Water can provide magnesium, but the amount varies according to the water supply. "Hard" water contains more magnesium than "soft" water. Dietary surveys do not estimate magnesium intake from water, which may lead to underestimating total magnesium intake and its variability .

What is the Recommended Dietary Allowance for magnesium?
The Recommended Dietary Allowance (RDA) is the average daily dietary intake level that is sufficient to meet the nutrient requirements of nearly all (97-98 percent) individuals in each life-stage and gender group. The 1999 RDAs for magnesium for adults, in milligrams (mg), are:

When can magnesium deficiency occur?
Even though dietary surveys suggest that many Americans do not consume magnesium in recommended amounts, magnesium deficiency is rarely seen in the United States in adults. When magnesium deficiency does occur, it is usually due to excessive loss of magnesium in urine, gastrointestinal system disorders that cause a loss of magnesium or limit magnesium absorption, or a chronically low intake of magnesium.

Treatment with diuretics (water pills), some antibiotics, and some medicine used to treat cancer, such as Cisplatin, can increase the loss of magnesium in urine. Poorly controlled diabetes increases loss of magnesium in urine, causing a depletion of magnesium stores. Alcohol also increases excretion of magnesium in urine, and a high alcohol intake has been associated with magnesium deficiency.

Gastrointestinal problems, such as malabsorption disorders, can cause magnesium depletion by preventing the body from using the magnesium in food. Chronic or excessive vomiting and diarrhea may also result in magnesium depletion.

Signs of magnesium deficiency include confusion, disorientation, loss of appetite, depression, muscle contractions and cramps, tingling, numbness, abnormal heart rhythms, coronary spasm, and seizures.

Who may need extra magnesium?
Healthy adults who eat a varied diet do not generally need to take a magnesium supplement. Magnesium supplementation is usually indicated when a specific health problem or condition causes an excessive loss of magnesium or limits magnesium absorption.

Extra magnesium may be required by individuals with conditions that cause excessive urinary loss of magnesium, chronic malabsorption, severe diarrhea and steatorrhea, and chronic or severe vomiting.

Loop and thiazide diuretics, such as Lasix, Bumex, Edecrin, and Hydrochlorothiazide, can increase loss of magnesium in urine. Medicines such as Cisplatin, which is widely used to treat cancer, and the antibiotics Gentamicin, Amphotericin, and Cyclosporin also cause the kidneys to excrete (lose) more magnesium in urine. Doctors routinely monitor magnesium levels of individuals who take these medicines and prescribe magnesium supplements if indicated.

Poorly controlled diabetes increases loss of magnesium in urine and may increase an individual's need for magnesium. A medical doctor would determine the need for extra magnesium in this situation. Routine supplementation with magnesium is not indicated for individuals with well-controlled diabetes.

People who abuse alcohol are at high risk for magnesium deficiency because alcohol increases urinary excretion of magnesium. Low blood levels of magnesium occur in 30 percent to 60 percent of alcoholics, and in nearly 90 percent of patients experiencing alcohol withdrawal. In addition, alcoholics who substitute alcohol for food will usually have lower magnesium intakes. Medical doctors routinely evaluate the need for extra magnesium in this population.

The loss of magnesium through diarrhea and fat malabsorption usually occurs after intestinal surgery or infection, but it can occur with chronic malabsorptive problems such as Crohn's disease, gluten sensitive enteropathy, and regional enteritis. Individuals with these conditions may need extra magnesium. The most common symptom of fat malabsorption, or steatorrhea, is passing greasy, offensive-smelling stools.

Occasional vomiting should not cause an excessive loss of magnesium, but conditions that cause frequent or severe vomiting may result in a loss of magnesium large enough to require supplementation. In these situations, your medical doctor would determine the need for a magnesium supplement.

Individuals with chronically low blood levels of potassium and calcium may have an underlying problem with magnesium deficiency. Adding magnesium supplements to their diets may make potassium and calcium supplementation more effective for them. Doctors routinely evaluate magnesium status when potassium and calcium levels are abnormal, and prescribe a magnesium supplement when indicated.

What is the best way to get extra magnesium?
Doctors will measure blood levels of magnesium whenever a magnesium deficiency is suspected. When levels are mildly depleted, increasing dietary intake of magnesium can help restore blood levels to normal. Eating at least five servings of fruits and vegetables daily, and choosing dark-green leafy vegetables often, as recommended by the Dietary Guidelines for Americans, the Food Guide Pyramid, and the Five-a-Day program, will help adults at-risk of having a magnesium deficiency consume recommended amounts of magnesium. When blood levels of magnesium are very low, an intravenous drip (IV drip) may be needed to return levels to normal. Magnesium tablets also may be prescribed, but some forms, in particular magnesium salts, can cause diarrhea. Your medical doctor or qualified health-care provider can recommend the best way to get extra magnesium when it is needed.

What are some current issues and controversies about magnesium?

Magnesium and blood pressure
Evidence suggests that magnesium may play an important role in regulating blood pressure. Diets that provide plenty of fruits and vegetables, which are good sources of potassium and magnesium, are consistently associated with lower blood pressure. The DASH study (Dietary Approaches to Stop Hypertension) suggested that high blood pressure could be significantly lowered by a diet high in magnesium, potassium, and calcium, and low in sodium and fat. In another study, the effect of various nutritional factors on incidence of high blood pressure was examined in over 30,000 U.S. male health professionals. After four years of follow-up, it was found that a greater magnesium intake was significantly associated with a lower risk of hypertension. The evidence is strong enough that the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends maintaining an adequate magnesium intake as a positive lifestyle modification for preventing and managing high blood pressure.

Magnesium and heart disease
Magnesium deficiency can cause metabolic changes that may contribute to heart attacks and strokes. There is also evidence that low body stores of magnesium increase the risk of abnormal heart rhythms, which may increase the risk of complications associated with a heart attack. Population surveys have associated higher blood levels of magnesium with lower risk of coronary heart disease. In addition, dietary surveys have suggested that a higher magnesium intake is associated with a lower risk of stroke. Further studies are needed to understand the complex relationships between dietary magnesium intake, indicators of magnesium status, and heart disease.

Magnesium and osteoporosis
Magnesium deficiency may be a risk factor for postmenopausal osteoporosis. This may be due to the fact that magnesium deficiency alters calcium metabolism and the hormone that regulates calcium. Several studies have suggested that magnesium supplementation may improve bone mineral densitY, but researchers believe that further investigation on the role of magnesium in bone metabolism and osteoporosis is needed.

Magnesium and diabetes
Magnesium is important to carbohydrate metabolism. It may influence the release and activity of insulin, the hormone that helps control blood glucose levels. Elevated blood glucose levels increase the loss of magnesium in the urine, which in turn lowers blood levels of magnesium. This explains why low blood levels of magnesium (hypomagnesemia) are seen in poorly controlled type 1 and type 2 diabetes.

In 1992, the American Diabetes Association issued a consensus statement that concluded: "Adequate dietary magnesium intake can generally be achieved by a nutritionally balanced meal plan as recommended by the American Diabetes Association." It recommended that "... only diabetic patients at high risk of hypomagnesemia should have total serum (blood) magnesium assessed, and such levels should be repleted (replaced) only if hypomagnesemia can be demonstrated".

What is the health risk of too much magnesium?
Dietary magnesium does not pose a health risk, however very high doses of magnesium supplements, which may be added to laxatives, can promote adverse effects such as diarrhea. Magnesium toxicity is more often associated with kidney failure, when the kidney loses the ability to remove excess magnesium. Very large doses of laxatives also have been associated with magnesium toxicity, even with normal kidney function. The elderly are at risk of magnesium toxicity because kidney function declines with age and they are more likely to take magnesium-containing laxatives and antacids.

Signs of excess magnesium can be similar to magnesium deficiency and include mental status changes, nausea, diarrhea, appetite loss, muscle weakness, difficulty breathing, extremely low blood pressure, and irregular heartbeat.

The Institute of Medicine of the National Academy of Sciences has established a tolerable upper intake level (UL) for supplementary magnesium for adolescents and adults at 350 mg daily. As intake increases above the UL, the risk of adverse effects increases (4).

Table of Food Sources of Magnesium (3)

Calcium & Magnesium:  Both elements share left / right-sided cell receptors and are essential to human health.  Calcium (Ca) and magnesium (Mg) have become the "Gold Standard" when discussing supplements, mineral ratios, paired cell receptors, or many nutrition-related health issues in general.     Calcium is now the most promoted nutrient by proponents of conventional, nutritional, and alternative medicine - yet at the same time, the assumed need is based purely on the speculation that the body's calcium intake is well below its requirements.   Of the approximately 1,000 g of calcium in the average 70 kg adult body, almost 98% is found in bone,   1% in teeth, and the rest is found in blood, extracellular fluids, and within cells where it is a co-factor for   a number of enzymes. Calcium promotes blood clotting by activating the protein fibrin, and along with   magnesium helps to regulate the heart beat, muscle tone, muscle contraction and nerve conduction.     Parathyroid hormone (PHT) secreted by the parathyroid gland and calcitonin secreted by the thyroid   gland maintain serum calcium levels at a range of between 8.5 to 10.5, whereby calcium is mobilized from bone reserves, and intestinal absorption of calcium is increased as needed.  The parathormone   can also affect renal functions to retain more calcium.  When blood calcium rises from too much para-   thyroid activity, calcitonin reduces availability of calcium from bone.     The calcium to phosphorus ratio in bone is about 2.5:1, while the ideal dietary phosphorus / calcium ratio is estimated to be about 1:1.  Many dietary factors reduce calcium uptake, such as foods high   in oxalic acid (spinach, rhubarb, chocolate), which can interfere with calcium absorption by forming   insoluble salts in the gut.  Phytic acid, or phytates found in whole grain products, foods rich in fiber,   excess caffeine from coffee, colas, tea..., as well as certain medications may all reduce the absorption   of calcium and other minerals, or leach calcium from bone.  Normal intake of protein, fats, and acidic   foods help calcium absorption, however high levels of these same sources increase calcium loss.     Chronic calcium deficiency is associated with some forms of hypertension, prostate and colorectal   cancer, some types of kidney stones, miscarriage, birth (heart) defects in children when the mother is   deficient in calcium during pregnancy, menstrual and pre-menstrual problems, various bone, joint and   periodontal diseases, sleep disturbances, mental health / depressive disorders, cardiovascular and/or   hemorrhagic diseases, and others (see bottom of page).   Elevated calcium levels are associated with arthritic / joint and vascular degeneration, calcification of   soft tissue, hypertension and stroke, an increase in VLDL triglycerides, gastrointestinal disturbances, mood and depressive disorders, chronic fatigue, increased alkalinity, and general mineral imbalances.   High calcium levels interfere with Vitamin D and subsequently inhibit the vitamin's cancer-protective effect unless extra amounts of Vitamin D are supplemented.     Magnesium: There are about 19 g of Mg in the average 70 kg adult body, of which approximately 65%   is found in bone and teeth, and the rest is distributed between the blood, body fluids, organs and other   tissue.  Magnesium is involved in the synthesis of protein, and it is an important co-factor in more than   300 enzymatic reactions in the human body, many of which contribute to the production of energy, and   with cardiovascular functions.  While calcium affects muscle contractions, magnesium balances that   effect and relaxes muscles.  Most of magnesium is inside the cell, and while iron is the central atom in   hemoglobin, magnesium is the central core of the chlorophyll molecule in plant tissue.     Although the process of absorption for magnesium is similar to that of calcium, some people absorb   or retain much more magnesium than calcium (or more calcium than magnesium), so the commonly   suggested supplemental intake ratio of 2:1 for calcium and magnesium is really an arbitrary value that   can change significantly under various individual circumstances. (see also Acu-Cell "Mineral Ratios").     Low levels of magnesium can be a causative, contributing, or aggravating factor with kidney stones   (usual recommendations for prevention are 400mg of magnesium oxide and 50mg of Vitamin B6 daily),   high blood pressure, mitral valve prolapse (MVP), arrhythmia, tachycardia, coronary artery spasm and   other types of heart problems, premenstrual syndrome (PMS) or menstrual cramps, tetany (sustained contractions, convulsions), (pre)eclampsia - particularly when too much iron and not enough folic acid was taken during pregnancy, insomnia, anxieties, chronic constipation, hyperactivity - particularly with children, and others (see bottom of page).   However, frequent and excessive use of magnesium sulfate (Epsom salt) or antacid remedies such   as Milk of Magnesia can eventually trigger a number of medical problems resulting from other minerals   such as calcium, sodium, iron, or potassium getting out of balance.  This is more prevalent with kidney   diseases and may include severe fatigue, depression, low blood pressure, gastrointestinal problems,   dizziness, dehydration / dry skin, diarrhea, muscular / joint problems and cardiovascular diseases.     Serum Calcium may change with kidney, or parathyroid diseases, but it doesn't change with high or low dietary calcium intake, subsequently it cannot be used as a deficiency or excess indicator --- the body simply makes up any additional needs from bone reserves.  Other methods to assess someone's   calcium requirements include a 24-hour urine collection (not accurate at all), or a bone scan.  The latter   doesn't measure calcium specifically either, but assesses overall bone density, which reflects the total content of all other minerals present in bone as well.  In other words - there is no standard, mainstream test available to accurately assess nutritional requirements for calcium, magnesium, and most other essential trace minerals outside of using intracellular measurements, for which White Blood Cell, Red Blood Cell, or Acu-Cell Analysis can be used.   However, as mentioned above, changes in serum calcium provide important information about various hormonal or organic disturbances, including excessive Vitamin D status, or the possible presence of cancer with elevated serum calcium levels.     Calcium and magnesium belong to a group of "parasympathetic" elements (which includes chromium and copper), that exhibit anti-inflammatory or degenerative properties at higher amounts, in contrast to elements such as potassium or iron, which are pro-inflammatory when high:      inflammatorydegenerative    <--------------------------------------- Ca, Mg, Cu, Cr -------------------------------------->    low amountshigh amounts        degenerativeinflammatory    <---------------------------------------- K, Fe, Mn, Zn  --------------------------------------->    low amountshigh amounts     An interesting aspect about these trace minerals is the similarity of medical conditions that result   from both, excessive, or deficient levels.  For instance, low calcium or copper levels increase the risk for vascular (cerebral) hemorrhage, while high levels promote vascular degeneration (arteriosclerosis).   With arthritis, low calcium or copper levels cause inflammatory types of joint disease, while high levels   cause degenerative (osteo-arthritic) joint damage.     Depression can be related to high and low levels of calcium and/or magnesium also, with low levels being oftentimes associated with anxieties as well.  After comparing the backgrounds of patients who required very high doses (4,000+mg) of calcium a day - just to barely reach normal levels, it turned out that a very large percentage had a history of benzodiazepine (tranquilizers / sedatives) use.   These drugs either affected their body's ability to utilize calcium and/or magnesium properly, or those   minerals levels in these patients had already been extremely deficient before taking any medications, provoking insomnia, anxieties, or other symptoms, and resulting in drugs (benzodiazepines) being prescribed instead of having the real cause (mineral deficiencies) corrected.  Unfortunately, this type   of symptomatic drug therapy continues to be a trademark of modern medicine.     Drugs such as Aspirin, or other NSAIDs increase magnesium (and sometimes calcium) requirements   also, but they are more dependent on frequency or dosages used, or on someone's kidney functions,   which are generally affected by these drugs.  At the same time, the extra requirements for magnesium or calcium are just an additional percentage of the Recommended Dietary (or Daily) Allowance (RDA).     Osteoporosis can result from both, low and high levels of calcium, magnesium, phosphorus, and also   chromium, copper, silicon and fluoride - but mostly as a result of their improper ratios to one another.   There are just as many patients with excessive, as with deficient calcium levels, whereby the treatment chiefly consists of having them supplement whichever co-factors are low in ratio to calcium, which may include manganese, phosphorus (protein), magnesium, zinc, Vitamin C..., or the use of acid-raising   digestive aids to increase solubility or bioavailability of calcium. (see also Acu-Cell "Osteoporosis").     Random intake of high amounts of calcium for the prevention of osteoporosis can be bad news for a   person's cardiovascular system, since it is frequently promoted without any individual assessment to   prove that it is indeed calcium which is really needed, and not any of several co-factors which help absorption of calcium into bone.  As mentioned already, the foremost treatment when dealing with mineral-related medical conditions is to correct their ratios.  Deficiency symptoms - particularly those involving calcium and copper - can still take place despite their levels being above-normal when either   associated, or interactive minerals are higher yet.     Individuals who exhibit below-normal calcium or magnesium levels get away with more atherogenic   (junk) diets compared to those with normal or higher levels, and I always point out to patients that once their calcium or magnesium levels are raised, they will have to watch their sugar and (trans) fat intake more.  The reasons are very simple:      Calcium  raises:VLDL TriglyceridesMagnesium  raises:LDL Cholesterol    Calcium  lowers:MCT & SCTMagnesium  lowers:HDL Cholesterol    Calcium  lowers:Total TriglyceridesMagnesium  lowers:Total Cholesterol    Calcium  lowers:PhosphorusMagnesium  lowers:Sodium      MCT = Medium Chain TriglyceridesSCT = Short Chain Triglycerides     For the above reasons, calcium and magnesium, at higher amounts, exhibit atherogenic properties.   They also lower phosphorus and sodium respectively, which, if lowered too much, will have an additive   effect of low phosphorus independently raising VLDL triglycerides, and low sodium independently   raising LDL cholesterol.  This degenerative effect produced by high levels of calcium and magnesium   generally takes place over a number of years - not just in a few months.   Short-term studies have demonstrated that magnesium may reverse atherosclerosis, however, while this may be true initially, it can have the exact opposite (LDL-promoting) effect in the long run.  This is   why it is so important to compare and evaluate nutritional studies which not only use identical amounts   and types of nutrients and the same testing methods, but also similar lengths of trials.  Obviously, human   and animal study results are not always interchangeable either.     High concentrations of magnesium have been shown to have antithrombotic action and to inhibit platelet aggregation and adhesion in vitro, while intravenous magnesium is known to inhibit platelet function in vivo, additive to Aspirin, so the antiplatelet effect of intravenously administered magnesium might be of benefit to those with acute coronary syndromes when given before the development of an occlusive thrombotic clot.  However, Myocardial Infarctions (heart attacks) can still take place either despite of, or because of long-term oral intake of high doses of magnesium if intracellular levels of   magnesium have gone excessively high, and sodium levels have gone excessively low.     To help boost calcium levels in individuals with chronically low calcium absorption, supplementing   Vitamin B5 (pantothenic acid) can be helpful in inhibiting the antagonistic action of phosphorus (if high), while taking extra Vitamin B2 (riboflavin) will increase magnesium uptake by inhibiting sodium and iron.   A Magnesium+Vitamin B2 combination can be effective in relieving one-sided migraines if caused by   elevated iron or sodium.  Titanium implants support calcium, but not magnesium retention.     Higher amounts of Vitamin B6 will also increase magnesium retention, although this only takes place   following long-term oral supplementation, while regular Vitamin B6 injections will quickly result in a   high magnesium / low calcium ratio.   If not matched to a patient's requirements (which happens frequently when Vitamin B6 + Vitamin B12 injections are given at Weight Loss Clinics), a severe calcium deficiency develops.  This by itself -   or when aggravated by an overstimulated thyroid from the regular Vitamin B6 + B12 shots - can result   in insomnia, heart palpitations, chest pains, anxieties, depression, mood swings, joint / muscle pains,   and other symptoms.  (see also Acu-Cell "Diets").     In low sodium types, regular intake of higher doses of Vitamin B6 creates a somewhat different picture,   where the raising effect on magnesium will also result in an increasingly higher magnesium / calcium ratio, however in addition to lowering lithium and eventually calcium levels, an abnormally high retention of magnesium will result in dramatically lower sodium and silicon, but increased phosphorus levels.   Common long-term effects include spinal degeneration at T1 (with right-sided symptoms in the upper   back / shoulder area) and at L2, along with general osteo-arthritic changes in various joints.   As a result, Vitamin B6 therapy should only be used for someone with an otherwise difficult-to-manage   low magnesium / high calcium ratio (where calcium is always high, and magnesium is always low).     With a low calcium / high magnesium ratio and a general acidic disposition, supplementing larger amounts of Vitamin C in the form of ascorbic acid can be a problem not only for those with a sensitive   stomach, but also for calcium uptake since too much acid results in calcium loss.  While some types of 'Buffered C' such as Calcium Ascorbate help in milder cases, Sodium Ascorbate would be another option in more severe cases, provided there is no sodium sensitivity, or a history of kidney disease.     Boron supplementation may be a consideration for individuals with chronically low calcium and magnesium levels, however since boron inhibits manganese, it would be best suited for those with congestive liver disease who generally exhibit higher manganese levels (manganese inhibits calcium and magnesium), but not for those whose manganese levels are already on the low side.   Adequate Vitamin D levels will assist intestinal absorption of calcium, magnesium and phosphorus.   Excessive intake of Vitamin D will result in above-normal serum calcium levels, and calcium loss from   bone.  So while supplementing much larger amounts of Vitamin D may protect from several types of   cancer or be indicated with certain neurodegenerative conditions such as multiple sclerosis, they can   unfortunately also lead to osteoporosis and calcification of arteries and other soft tissue.     Contrary to the claims of uninformed sources, Low Stomach Acid does not have an inhibiting effect   on calcium absorption, as even patients with no acid production (achlorhydria) absorb calcium normally,   regardless of whether it comes in the form of calcium citrate, calcium carbonate, or milk.  It is very high   stomach acid that may be cause for concern since it will frequently result in a cellular calcium loss, with the same rules applying to magnesium as well.  However, from their lowering effect on acid levels, high calcium and/or magnesium intake can have a significant impact on medical conditions that are affected by abnormally low stomach acid levels.     For instance, soft tissue calcification and spurs are more prevalent with low acid levels, and if infected with Helicobacter Pylori, the bacteria is always more active under low acid conditions also.  In addition,   long-term infections with H.Pylori, or salt-restricted diets can in some individuals reduce stomach acid   levels enough to affect / impair Vitamin B12 uptake.   As a result, the best types of calcium may be chosen based on an individual's tendency for low stomach   acid or constipation, for which calcium citrate is usually better suited, in contrast to a tendency for softer stools or high stomach acid, for which calcium carbonate or calcium oxide may be a better choice.     From more than 25 years of patient feedback on their tolerance, and from monitoring the absorption of   various types of calcium (and other minerals), I have personally found Amino Acid Chelated Calcium to   be the most consistently tolerated, while at the same time needing the least amount of supplementation   to meet requirements.   Nutritional texts stating that "calcium is best taken between meals or in the absence of foods when the stomach is more acidic" were likely written at a time when research findings were primarily based on the older urinary increment tests, but have long since proven invalid.  Scientific studies done with   Radioisotope Analysis or intracellular tests such as Acu-Cell Analysis show clearly that most types of calcium fall into the same 30-40% absorption range, regardless of solubility:      31% for calcium from milk,    32% for calcium acetate (most soluble form),25% elemental,    32% for calcium lactate13% elemental,    27% for calcium gluconate9.3% elemental,    30% for calcium citrate21% elemental,    39% for calcium carbonate(least soluble form)40% elemental,     The range of absorption narrows even further and increases percentage-wise when calcium is taken   in smaller doses of 300 mg - 500 mg throughout the day (as needed), which is particularly helpful for   people who are not able to absorb higher amounts (1,000+mg) of calcium in a single meal.  However   the largest single dose of the day is best taken in the evening since calcium requirements are greatest   during sleep, hence deficiency symptoms such as nocturnal leg cramps or insomnia...   When supplemented with food, overall uptake of all types of calcium is additionally up to 30% greater,   and absorption between calcium citrate and calcium carbonate for instance becomes virtually identical.   Inconsistencies are found only when calcium is supplemented in different forms, such as tablets versus   gelatin capsules, where the gelatin itself may not dissolve properly in a low acid environment.     AAACa / AdvaCAL Calcium - developed by Dr. Takuo Fujita, MD and colleagues - consists of a type   of patented oyster shell supplement that is made by heating calcium to about 800°C in a vacuum, which   breaks calcium carbonate up into calcium oxide and calcium hydroxide.   AACa (active absorbable calcium) is then combined with a heated algal ingredient (HAI) Cystophyllum Fusiforme to form AAACa, which results in better calcium absorption without the need for Vitamin D.   In a number of clinical trials, "AAACA was apparently more effective increasing trabecular bone density   than calcium carbonate or AACA (without the algal ingredient) containing the same amount of elemental   calcium." Some studies also propose that AAACa is capable of reversing bone loss and preventing   malformation of bone.  However, there are some aspects regarding AAACa therapy to consider:     • While the cost of calcium citrate is about 4 - 6x higher than calcium carbonate, the cost of AAACa is     about 40x higher than calcium carbonate!  The question is - does better absorption of AAACa justify     its very high cost if taking larger amounts of other types of calcium also meet calcium requirements?     • For individuals with normal calcium absorption and bone metabolism, the use of AAACa does not     seem to serve a useful purpose considering its exorbitant cost.  When calcium absorption had been     a major problem and several grams of calcium carbonate were needed to meet requirements, even     the 2,000 mg maximum suggested daily amount of AAACa still failed to normalize calcium levels,     which made the use of other types of calcium much more cost-efficient despite the larger doses that     were required.     • Since AACa without the HAI is not much better absorbed than other forms of calcium, it would make     sense to isolate the active ingredient of the Heated Algal that increases calcium absorption and test     it for long-term safety, because a), there seem to be notable changes in stomach acid, potassium,     copper, and other levels, even after just a very short trial with AAACa therapy, and b), some therapies     that are capable to increase bone density are also capable to increase the risk for cancer.     • Vitamin K (as K1 or K2) is also well-established as being able to reduce the risk for osteoporosis, or     - unlike other therapies - reverse bone loss without increasing the risk for cardiovascular disease and   stroke.  At the same time, it is non-toxic even when regularly supplemented at higher amounts, so the   addition of Vitamin K to any form of calcium therapy provides proven benefits for osteoporosis     and other health concerns.     Dr. Fujita, the developer of AAACa, holds some highly unconventional and unshared views on basic   aspects of calcium metabolism. In a 1999 interview, he proposed that:     • "All of us are calcium deficient."   • "The ratio of calcium to magnesium is not important, as long as we are taking enough of both."   • "Too much calcium intake is never dangerous, but too much magnesium can be.       So I think calcium is the only one of which you can take as much as you want and get away       with it, but you shouldn't take too much magnesium."   • "We don't need Vitamin D because HAI performs the same function and it's a natural product."   • "Milk is a very common source of calcium, but it also contains a lot of phosphorus, which       combines with calcium and prevents it from being absorbed..."     From a clinical perspective, AAACa comes closest in absorption and gastrointestinal action to calcium   citrate, in that - unlike calcium carbonate - it does not reduce, but may increase stomach acid levels,   and there is no risk for constipation, but a possibility for looser stools.  If calcium citrate is not tolerated   and cost is no object, AAACa can be a similarly-acting substitute.   In patients with normal stomach acid levels and calcium absorption, 2 - 2½ calcium carbonate tablets   of 500mg each, on average, raise cellular calcium levels as much as 6 AAACa tablets of 167mg each.   Very poor calcium absorption and subsequently severe calcium deficiency requires very high doses   of calcium, regardless of whether they consist of AACa, or any other type of calcium.   Because of superior absorption, Amino Acid Chelated Calcium requires the least supplementation,   although for patients with high stomach acid, Calcium Carbonate is still the best all-around choice.     AAACa formulations do not include Vitamin D, but use the HAI to increase absorption.  However, taking   larger amounts of calcium increases the risk of eventually causing a Vit D deficiency (unless someone's   requirements are met through UV exposure or other sources).  This in turn increases the risk for breast,   colorectal, prostate, lung, pancreatic and ovarian cancer, which Vitamin D is somewhat protective for.   The same applies to any other (chelated) calcium products that contain no Vit D and are supplemented   at higher amounts.     Coral Calcium is a heavily promoted product with lots of anecdotal success stories and the usual   unsubstantiated claims of miracle cures.  Because there are various forms of coral calcium available with many different mineral / nutritional formulations, there is no predictability as to the actual calcium uptake a patient may expect.  For those reasons, and some unwelcome side effects reported, patient response under controlled clinical settings has been mostly negative. (see Acu-Cell "Diets & MLM" for   details on Coral Calcium).     ***        Acid levels in the upper portion of the stomach affect calcium and iron absorption (usually in opposite   directions, depending on the type of minerals ingested), and vice versa, where calcium and iron intake affects stomach acid levels (also depending on the type of minerals consumed).  The same applies to   acid levels in the lower portion of the stomach, which affect magnesium and manganese absorption   (also in opposite directions), and vice versa, depending on the type of minerals consumed.   However, in the event of a high calcium / manganese ratio (both are antagonists), calcium may affect   lower acid levels as well, and in the event of a high magnesium / iron ratio (both are also antagonists),   upper stomach acid levels may be affected by magnesium through that same mechanism:
	Acid production in the upper stomach area can vary from the lower stomach area as a result of their   neurological disassociation, consequently spinal alignment problems at T12 can trigger acid-related stomach disturbances that won't respond to either acid-raising or acid-lowering remedies.  Only spinal   manipulation, or choosing the right minerals according to their acid-raising / lowering, or upper / lower   association will resolve those types of conditions.   High stomach acid can, in the long run, lower calcium and/or magnesium enough to cause chronic   insomnia, not only from the gastric discomfort, but also from an inability of the sufferer to reach deep   sleep, which is difficult to achieve with low calcium.  Chronic daytime fatigue is a frequent result.     Other than malabsorption of a number of important nutrients, or general indigestion or bloating, one   of the greatest threats arising out of long-term low stomach acid situations is the increasing risk for malignancies - not just gastric cancers, but many other types as well.  (see also Acu-Cell "Cancer").   The coincidence of many malignancies with corresponding low acid is nearly 100%.  This in itself calls   for prudence when enticed by the media - or even by a medical practitioner - to supplement very large   amounts of calcium or magnesium, without any analysis substantiating that such action is warranted. ¤        DRI / RDA  for Calcium & Magnesium  +  Vitamin A, D, K  Page 2  >>     ==============================================================================     General recommendations for nutritional supplementation:  To avoid stomach problems and promote   better tolerance, supplements should always be taken earlier, or in the middle of a larger meal.  When   taken on an empty stomach or after a meal, there is a greater risk of some tablets causing irritation, or eventually erosion of the esophageal sphincter, resulting in Gastroesophageal Reflux Disease (GERD).   It is also advisable not to lie down immediately after taking any pills.   When taking a very large daily amount of a single nutrient, it is better to split it up into smaller doses to   not interfere with the absorption of other nutrients in food, or nutrients supplemented at lower amounts.     ______________________________________________________________________________

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