Life Extension Magazine®
The use of vitamin D has grown substantially over the past decade.1
That’s for good reason. Vitamin D is essential for immune function, heart health, and cognitive performance.2,3
Unfortunately, many people aren’t getting the full benefits of vitamin D because they have a low level of magnesium.
Researchers have documented the essential relationship between magnesium and vitamin D.4
It’s estimated that 45% of Americans are magnesium deficient.5
Magnesium is essential for converting vitamin D into its active form in the body.6,7 Magnesium also aids vitamin D transport in the blood.8,9
At the same time, maintaining sufficient levels of vitamin D helps magnesium achieve its many benefits.10-12
A growing number of human studies focusing on the use of both vitamin D and magnesium are confirming their combined benefits for immunity, muscle strength, heart health, and more.13-15
The Importance of Vitamin D and Magnesium
Vitamin D and the mineral magnesium each have well-known health benefits.
Low levels of vitamin D can lead to weak bones, along with increased risk for cardiovascular disease, metabolic disorders, and cognitive decline.16-18
Magnesium deficiency can result in muscle spasms and cramps.19 Low magnesium can also contribute to osteoporosis, irregular heart rhythms, and migraines.20
Oral intake of vitamin D and magnesium, individually, can help treat or lower risk for many of the same health concerns. These include:2,8,9,20,21
- Musculoskeletal disorders,
- Type II diabetes,
- Cardiovascular disease,
- Some cancers,
- Immune system problems, and
- Neurological conditions, such as depression and dementia.
But for vitamin D and magnesium to work optimally, they need each other.
Magnesium Activates Vitamin D
Vitamin D consumed orally or made in the skin from sun exposure is inactive.10
This is also true of both vitamin D2, which is obtained from plant sources, and vitamin D3, which is made in the skin or found in oily fish and eggs.22
Before vitamin D can perform its vital functions, it must be activated by a two-step process:10,23-25
In the liver, an enzyme called 25-hydroxylase converts vitamin D2 and D3 to 25-hydroxyvitamin D. This is the major circulating form of vitamin D measured in blood tests to assess vitamin D levels.
In the kidneys (and other tissues) another enzyme, 1-alpha-hydroxylase, converts 25-hydroxyvitamin D into active vitamin D.
Both of these enzymes need magnesium to function properly.6,7 Otherwise, vitamin D will remain in its inactive form, making it all but useless.
Magnesium also regulates 24-hydroxylase, an enzyme that helps inactivate vitamin D when there’s an excess supply.4,6
Transport and Regulation of Vitamin D
Magnesium enables vitamin D to bind to a carrier protein that transports it though the blood.6,8
Then, when active vitamin D arrives where it is needed, magnesium helps activate the receptors needed for cells to use vitamin D.20
Magnesium deficiency decreases the number of vitamin D receptors in cells, limiting the vitamin’s effects.20 Aging leads to a decrease in vitamin D receptors.26
Magnesium also boosts vitamin D activity by supporting synthesis and secretion of parathyroid hormone.4,8,10,11 This hormone stimulates the kidneys to convert vitamin D to its active form.22
Vitamin D’s Impact on Magnesium
The magnesium-vitamin D partnership isn’t a one-way street.
Vitamin D can enhance intestinal absorption of magnesium, particularly in people with low magnesium levels.10-12 This allows the mineral to be more efficiently used by the body.
In one human study, obese women given a vitamin D injection had a significant increase in their blood levels of magnesium.12
A Life-Saving Partnership
The link between vitamin D and magnesium can be seen in studies of longevity.
Vitamin D deficiency is known to be associated with a higher risk of death. In a large observational study, low magnesium levels made that risk even greater.27
In this study, 1,892 men (ages 42-60 years) were followed for an average of 22 years.
In men with low vitamin D levels, a lower magnesium intake (less than 414 mg per day) was associated with a 60% greater risk of death than for those with a higher magnesium intake.27
Further evidence of the link between the two nutrients comes from human studies of rickets, a softening or weakening of bones caused by severe and prolonged vitamin D deficiency.
In these studies, vitamin D intake alone failed to treat rickets. But adding magnesium to the regimen supported vitamin D activation and helped resolve the condition.4
In another recent study, 27 healthy, postmenopausal women were given 500 mg of magnesium daily for two months, while 25 matched women received placebo. Most of the women were vitamin D deficient, and many were low in some measures of magnesium.
This study showed that in response to magnesium supplementation (with no vitamin D), the number of women deficient in vitamin D decreased by about 20%.28
Bone and Teeth Health
Both vitamin D and magnesium are important for healthy bone mass and strength.19,29
Together, they are even more beneficial. Vitamin D promotes intestinal absorption of calcium and magnesium, which are vital components of bone that help prevent osteoporosis.
Insufficient magnesium can impair bone health by causing a reduction in parathyroid hormone levels and a decrease in active vitamin D levels.11
Vitamin D and magnesium also play key roles in replenishing the minerals in teeth. This may help prevent tooth loss.29,30
Optimizing vitamin D intake also promotes the success of dental implant surgery, an increasingly popular option for replacing missing teeth.31
Oral health has a wide impact on whole-body health due to the association between periodontal disease (gum inflammation) and systemic disease, including type II diabetes and cardiovascular disease.30
Vitamin D and magnesium help combat oral inflammation to prevent periodontal disease.29,32
What you need to know
Vitamin D and Magnesium: Partners in Health
- The vitamin D produced from sun exposure and consumed in food or through direct oral intake is inactive.
- Enzymes that activate vitamin D require the mineral magnesium to work properly. Magnesium also supports the transport of vitamin D throughout the body.
- Vitamin D can enhance magnesium absorption in the intestines.
- By working in partnership, magnesium and vitamin D support musculoskeletal and heart health and promote proper metabolic function.
Muscle Strength and Function
One of the most significant challenges in aging is sarcopenia, the loss of muscle mass, strength, and function. It frequently leads to falls and fractures in older adults.33
Chronic inflammation is one contributor to sarcopenia. Vitamin D and magnesium can help reduce inflammation and may prevent sarcopenia.14
Scientists have discovered that muscles have receptors for vitamin D. As people age, these tend to decline in number. Taking oral vitamin D increases the number of receptors in muscle tissue.34
In a study of 83 healthy, middle-aged women deficient in vitamin D, half the group received 50,000 IU of vitamin D weekly and 250 mg of magnesium daily for eight weeks. The rest of the group received placebos.
Women who received the vitamin D and magnesium had a significant increase in handgrip strength and overall mobility, compared to the placebo group. The treatment group also had a decrease in an important inflammatory marker, compared to the beginning of the study.14
Cardiometabolic Health
In observational studies, higher intake and blood levels of both vitamin D and magnesium have been linked with a lower risk of insulin resistance and type II diabetes.35,36
Vitamin D appears to improve insulin secretion from the pancreas, which has specific receptors for interacting with the vitamin.35 Magnesium also supports insulin secretion.37
Magnesium plays an important role in protecting cells from oxidative stress as well. Magnesium deficiency results in decreased production of glutathione, one of the body’s most potent antioxidants.37
Multiple studies conducted across several decades show that magnesium and vitamin D intake interacted in affecting vitamin D status.4,38,39
The vitamin and mineral intake also interacted with circulating vitamin D levels in the risk of cardiovascular mortality.4,6
Without enough magnesium and vitamin D, calcium isn’t properly routed to the bones. Instead, calcium is more likely to deposit in arteries, increasing risk of cardiovascular disease.11,40
Summary
The health benefits of vitamin D are well-established. But the effectiveness of vitamin D intake depends on getting enough magnesium, a nutrient on which nearly half of all Americans fall short.
The body needs magnesium to activate and transport vitamin D. In return, vitamin D can enhance magnesium absorption and retention.
Working together, magnesium and vitamin D can benefit musculoskeletal, metabolic, and heart health.
Vitamin D and magnesium are clearly both vital for overall health. Taking one without the other fails to take advantage of their full benefits.
If you have any questions on the scientific content of this article, please call a Life Extension® Wellness Specialist at 1-866-864-3027.
References
- Rooney MR, Harnack L, Michos ED, et al. Trends in Use of High-Dose Vitamin D Supplements Exceeding 1000 or 4000 International Units Daily, 1999-2014. JAMA. 2017 Jun 20;317(23):2448-50.
- Cannell JJ, Hollis BW. Use of vitamin D in clinical practice. Altern Med Rev. 2008 Mar;13(1):6-20.
- Hansdottir S, Monick MM, Hinde SL, et al. Respiratory epithelial cells convert inactive vitamin D to its active form: potential effects on host defense. J Immunol. 2008 Nov 15;181(10):7090-9.
- Dai Q, Zhu X, Manson JE, et al. Magnesium status and supplementation influence vitamin D status and metabolism: results from a randomized trial. Am J Clin Nutr. 2018 Dec 1;108(6):1249-58.
- Workinger JL, Doyle RP, Bortz J. Challenges in the Diagnosis of Magnesium Status. Nutrients. 2018 Sep 1;10(9):1202.
- Deng X, Song Y, Manson JE, et al. Magnesium, vitamin D status and mortality: results from US National Health and Nutrition Examination Survey (NHANES) 2001 to 2006 and NHANES III. BMC Med. 2013 Aug 27;11:187.
- Available at: https://lpi.oregonstate.edu/mic/vitamins/vitamin-D. Accessed April 27, 2021.
- Rosanoff A, Dai Q, Shapses SA. Essential Nutrient Interactions: Does Low or Suboptimal Magnesium Status Interact with Vitamin D and/or Calcium Status? Adv Nutr. 2016 Jan;7(1):25-43.
- Erem S, Atfi A, Razzaque MS. Anabolic effects of vitamin D and magnesium in aging bone. J Steroid Biochem Mol Biol. 2019 Oct;193:105400.
- Uwitonze AM, Razzaque MS. Role of Magnesium in Vitamin D Activation and Function. J Am Osteopath Assoc. 2018 Mar 1;118(3):181-9.
- Al Alawi AM, Majoni SW, Falhammar H. Magnesium and Human Health: Perspectives and Research Directions. Int J Endocrinol. 2018;2018:9041694.
- Farhanghi MA, Mahboob S, Ostadrahimi A. Obesity induced magnesium deficiency can be treated by vitamin D supplementation. J Pak Med Assoc. 2009 Apr;59(4):258-61.
- Abiri B, Vafa M. Effects of vitamin D and/or magnesium supplementation on mood, serum levels of BDNF, inflammatory biomarkers, and SIRT1 in obese women: a study protocol for a double-blind, randomized, placebo-controlled trial. Trials. 2020 Feb 26;21(1):225.
- Kheyruri F, Sarrafzadeh J, Hosseini AF, et al. Randomized Study of the Effects of Vitamin D and Magnesium Co-Supplementation on Muscle Strength and Function, Body Composition, and Inflammation in Vitamin D-Deficient Middle-Aged Women. Biol Trace Elem Res. 2020 Sep 21.
- Danik JS, Manson JE. Vitamin d and cardiovascular disease. Curr Treat Options Cardiovasc Med. 2012 Aug;14(4):414-24.
- Meehan M, Penckofer S. The Role of Vitamin D in the Aging Adult. J Aging Gerontol. 2014 Dec;2(2):60-71.
- Bennett AL, Lavie CJ. Vitamin D Metabolism and the Implications for Atherosclerosis. Adv Exp Med Biol. 2017;996:185-92.
- Annweiler C, Dursun E, Feron F, et al. Vitamin D and cognition in older adults: international consensus guidelines. Geriatr Psychol Neuropsychiatr Vieil. 2016 Sep 1;14(3):265-73.
- Razzaque MS. Magnesium: Are We Consuming Enough? Nutrients. 2018 Dec 2;10(12):1863.
- Reddy P, Edwards LR. Magnesium Supplementation in Vitamin D Deficiency. Am J Ther. 2019 Jan/Feb;26(1):e124-e32.
- Wintermeyer E, Ihle C, Ehnert S, et al. Crucial Role of Vitamin D in the Musculoskeletal System. Nutrients. 2016 Jun 1;8(6).
- Khundmiri SJ, Murray RD, Lederer E. PTH and Vitamin D. Compr Physiol. 2016 Mar 15;6(2):561-601.
- Underland L, Markowitz M, Gensure R. Calcium and Phosphate Hormones: Vitamin D, Parathyroid Hormone, and Fibroblast Growth Factor 23. Pediatr Rev. 2020 Jan;41(1):3-11.
- Heaney RP. Vitamin D in health and disease. Clin J Am Soc Nephrol. 2008 Sep;3(5):1535-41.
- Saponaro F, Saba A, Zucchi R. An Update on Vitamin D Metabolism. Int J Mol Sci. 2020 Sep 8;21(18):6573.
- Gallagher JC. Vitamin D and aging. Endocrinol Metab Clin North Am. 2013 Jun;42(2):319-32.
- Mursu J, Nurmi T, Voutilainen S, et al. The association between serum 25-hydroxyvitamin D3 concentration and risk of disease death in men: modification by magnesium intake. Eur J Epidemiol. 2015 Apr;30(4):343-7.
- Vazquez-Lorente H, Herrera-Quintana L, Molina-Lopez J, et al. Response of Vitamin D after Magnesium Intervention in a Postmenopausal Population from the Province of Granada, Spain. Nutrients. 2020 Jul 30;12(8).
- Uwitonze AM, Rahman S, Ojeh N, et al. Oral manifestations of magnesium and vitamin D inadequacy. J Steroid Biochem Mol Biol. 2020 Jun;200:105636.
- Uwitonze AM, Murererehe J, Ineza MC, et al. Effects of vitamin D status on oral health. J Steroid Biochem Mol Biol. 2018 Jan;175:190-4.
- Nastri L, Moretti A, Migliaccio S, et al. Do Dietary Supplements and Nutraceuticals Have Effects on Dental Implant Osseointegration? A Scoping Review. Nutrients. 2020 Jan 20;12(1).
- Meisel P, Schwahn C, Luedemann J, et al. Magnesium deficiency is associated with periodontal disease. J Dent Res. 2005 Oct;84(10):937-41.
- Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019 Jan 1;48(1):16-31.
- Cruz-Jentoft AJ, Dawson Hughes B, Scott D, et al. Nutritional strategies for maintaining muscle mass and strength from middle age to later life: A narrative review. Maturitas. 2020 Feb;132:57-64.
- Palacios C, Perez CM, Gonzalez-Sepulveda L, et al. Vitamin D, Calcium, Magnesium, and Potassium Consumption and Markers of Glucose Metabolism in the Hispanic Community Health Study/Study of Latinos. J Am Coll Nutr. 2020 Nov 30:1-10.
- Gandhe MB, Jain K, Gandhe SM. Evaluation of 25(OH) Vitamin D3 with Reference to Magnesium Status and Insulin Resistance in T2DM. J Clin Diagn Res. 2013 Nov;7(11):2438-41.
- Kostov K. Effects of Magnesium Deficiency on Mechanisms of Insulin Resistance in Type 2 Diabetes: Focusing on the Processes of Insulin Secretion and Signaling. Int J Mol Sci. 2019 Mar 18;20(6):1351.
- Rude RK, Adams JS, Ryzen E, et al. Low serum concentrations of 1,25-dihydroxyvitamin D in human magnesium deficiency. J Clin Endocrinol Metab. 1985 Nov;61(5):933-40.
- Fatemi S, Ryzen E, Flores J, et al. Effect of experimental human magnesium depletion on parathyroid hormone secretion and 1,25-dihydroxyvitamin D metabolism. J Clin Endocrinol Metab. 1991 Nov;73(5):1067-72.
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