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Hello my friends! Let’s talk about Vitamin D and Magnesium. Two of the most important nutrients for the 21st century. In these episodes, you’re going to learn some things about Vitamin D and Magnesium that you’ve probably never heard before. In fact, I’m nearly 100% certain of that. The scientific research team led by a scientist named NR Parva states that, Vitamin D deficiency is becoming epidemic in the United States, and if we were to use the same statistical measures and apply it to the nutrient called Magnesium, then we’d have to say the same of Magnesium as well.
Every time a nutrient gets mentioned on TV or in popular media, I pretty much immediately get people contacting me from countries all over the world asking me about that nutrient. For many people, it’s the first time they’ve heard about it or they know very little about it generally. So, they want to know if they should be taking that nutrient that they saw on the popular media. The problem with getting your nutrition information from TV shows and other forms of popular media is that, they’re rarely objective. Television shows earn their money through advertisement and the higher the shows are rated, the more money they can charge to their advertisers.
Unfortunately, this means that most media is typically more concerned with ratings than representing information objectively. Journalism students are typically taught the phrase, ‘If it bleeds it leads.’ That’s not about facts that’s not about objectivity, that’s about catching people’s attention. Unfortunately, most people are more likely to be captured by extremes than by objectivity. Objective data typically falls somewhere in the middle of the spectrum versus one extreme or the other. Simply speaking, objectivity is rarely extreme and sometimes not the best thing for ratings, okay.
Let’s talk about Vitamin D and again, this is going to be broken into sections. Remember, I did promise my subscribers that I would cover all nutrients from A to Z. I didn’t promise that I would do it in alphabetical order. So, with Vitamin D in mind, that’s where we’re going to start. Before a laboratory test became available to practicing physicians, the belief that virtually no one needed to supplement Vitamin D and certainly no one would ever need to supplement more than 400 international units of Vitamin D in a single day. That belief was almost universal.
In fact, physicians were cautioned to avoid giving too much Vitamin D. Because they were told it could become toxic. Well, that’s true just about everything can become toxic if you get too much of it. In fact, if you drink too much clean pure water even that could become toxic, but we’re talking about ridiculous amounts obviously. So, the 400 IU rule was observed pretty strictly for a very long time for decades. Once physicians began to test people for Vitamin D, that tired old belief was shattered very quickly. To the great surprise of all the physicians that I’ve spoken with, the new blood test was showing very high percentages of people who needed more Vitamin D.
And in fact, physicians were finding that they needed to recommend not hundreds of units, but thousands of international units per week just to get their patients back up to adequate levels. Later on, I’m going to explain the difference to you between deficiencies and less than adequate levels, but we won’t cover that right now. When the world’s first minimum daily requirement was established for Vitamin D, that was back in 1941 by the US National Academy of Sciences. The world was very different than it is today. Diet and dietary choices as well as work activities and recreational activities were all very different than they are today.
In the 1940s, most people of all ages got a good deal more sunlight than they get today. Children played outside versus being glued to a video game console or computer or their cell phones nearly every waking hour of the day. Outdoor activities were the norm versus sitting in your living room. watching television. Although the process of turning whole grain into refined white flour began around 1870, most foods in the human diet were not significantly altered until many decades later. It seems as science advances in the 21st century that there are never ending ways to alter our food from its natural state.
In 1941, corporate farming was yet to be invented, much has changed since that time. Since medical physicians receive almost no training in nutrition, they rely on information from government agencies, medical associations and the various science journals to make their decisions on their patient’s nutritional needs. Throughout the history of medicine, doctors have been basically taught that if you eat right, you’ll get everything you need. In principle, this sounds great and I wish it was that simple. The fact is most people don’t make good dietary choices. For more than 50 years, people have been given misinformation about diet.
Most of that misinformation was unintentional by various medical experts acting as the health expert on TV shows and other forms of media. Advising on things that they were not experts in. The result is, the average person doesn’t have sufficient accurate information to make good dietary choices. Remember as they say in the computer world, ‘Garbage in garbage out’. If your information input is inaccurate, the conclusion that you draw from that information will almost certainly also be inaccurate.
When I was in practice, I would always ask my patients about their diet when I did the initial intake. That’s the first meeting that you have in the clinic with the patient. Almost 100% of the people who were not well, would tell me that they eat right. They make good choices in their diet, they believed that because they were acting on misinformation that they thought was true and correct. Because for God sakes they saw it on TV. It must be true or Dr so and so said it therefore it must be true. Most of the time this is simply not the case there are of course many reasons for those people not being well when they come to see a health care practitioner. Diet is a significant contributing factor in my opinion in most cases. But there are a variety of possibilities obviously.
The problem is the average person has so much conflicting information. They don’t know how to make the right choices. Even doctors are often confused on this topic. I know this because I’ve been teaching doctors for more than 30 years. Assuming that you made perfect choices, which of course is pretty unlikely. You still may come up short according to more recent scientific study. There’s something else to consider. As I said many times in an attempt to explain to people, how nutrient cofactors work with other nutritional cofactors. That biochemistry is kind of like the kids connect the dot games. In that game of course, you can’t see the full picture until you’ve connected all of the dots.
As I said in one of my previous publications, no nutrient is an island onto itself. Forgive me for paraphrasing on that. All nutrients have co-factors my friends. So, for those people who think because they have internet access and they can go on the internet and look up something by who knows who, to give you information about nutrition that they’re suddenly nutritional experts: They’ve got a lot to learn. Nutritional biochemistry is very complicated, human digestion very complicated. I’m going to do the best I can to make this simple and easy to understand and hopefully to keep your attention as we’re going through this list of episodes.
So, this brings us back to the question. Do you really need to supplement Vitamin D? Physicians now know how to routinely test for Vitamin D, but they’ve not been taught that Vitamin D cannot be utilized by the body if you are deficient in Magnesium. So, should we be asking the question, do you need to supplement Magnesium? I’ll come back to that and that’s why I’ve decided to do this series of episodes talking about Vitamin D and Magnesium together. Because without Magnesium, Vitamin D is not going to be utilized by your body. And you probably don’t know a great deal about Magnesium. So, we’re going to cover them both in this blog.
I left you with two questions. Do you really need to supplement vitamin D? Do you really need to supplement magnesium? Well, that’s what we’re going to talk about in this episode. Remember, Parva and his research team states that “Vitamin D deficiency is becoming an epidemic in the US. The people most likely to be deficient are African Americans, and Hispanic Americans.” I’ll give you more information on why a little bit later. Regardless of race, people who are obese or who suffer from diabetes, are also at high risk of vitamin D deficiency.
Depending on the study that you consult, you’ll find anywhere between 39% and up to 42% of the US population are believed to be deficient in vitamin D. This is huge, and does present a very serious health concern. I’m using US statistics, but keep in mind that people are people. We are all biochemically the same. We’re all human beings. And you can take this data to the country that you live in, for the most part, maybe not the specific percentages, but the concepts, the ideas, the understandings you can use in any country.
In section one of this blog, I briefly talked about changes in conditions between the 21st century and previous centuries. Almost all jobs now are indoors. Our young people have become addicted to their digital devices, and social media. Versus their grandparents, who as children did most of their activities of their youth, primarily outdoors and in the sunlight. Sun exposure is without question a factor in the increasing number of people in the 21st century, who are vitamin D deficient.
Vitamin D is after all called the sunshine vitamin, because it can be converted from sunlight through an amazing process that requires magnesium. A person who is deficient in magnesium is almost certainly still going to be deficient in vitamin D, even if they are supplementing vitamin D. Perhaps this is why so many physicians have patients on thousands of units per week chronically, and their vitamin D deficiency doesn’t seem to get solved. Are those prescribing doctors aware of the magnesium connection? The answer is most likely no.
Scientists believe that darker skin is an adaptation to protect people from ultraviolet radiation from the sun. This theory is based on the fact that at the equator, you have the highest rate of sun exposure and solar radiation. And the closer any genetic group is to the equator, the darker their skin tone. The reverse is also true. As you go north into the Arctic Circle as an example, the skin tone of genetic groups native to those areas gets lighter. There is less sunlight available as they go north. So, in order to absorb vitamin D from the sun, skin has to be lighter. Rickets, as an example, which is a disease caused by vitamin D deficiency was very common in areas such as the United Kingdom prior to vitamin D supplementation — because they’ve had limited sunlight due to weather conditions as well as their geographic location. But one of the reasons that vitamin D deficiency is more common on average, as individual skin is darker is that the darker skin is blocking absorption like a natural sunscreen.
In this series, I’ll discuss how vitamin D affects your health. And it will become obvious to African Americans, Hispanic Americans, and other individuals whose genetics are from areas such as the Indian subcontinent and other areas where skin tones are darker why they have certain health situations that occur to them more frequently than they do to Caucasians. It’s not a conspiracy, it’s just biology. What has not been discussed in any popular media that I’m aware of, is that at least 50% of Americans are deficient in magnesium.
Some researchers believe that number is as high as 70%. In order for vitamin D to be utilized by the body, it has to work through a rather complex system of enzyme activity. All of these enzymes require magnesium. So, if you’re deficient in magnesium, you will almost certainly be deficient in vitamin D no matter how much vitamin D you are supplementing, or how much vitamin D containing foods you’re eating. Does your doctor know that? The answer is probably no.
The blood test for vitamin D is very straightforward. It’s what’s called a serum analysis. Serum is just a fancy way of saying blood. Doctors are also taught in medical school that a serum analysis of magnesium is adequate to determine if you have normal magnesium levels in your body. This unfortunately, is not correct. Only approximately 1% of the total of magnesium found in anyone’s body will be moving freely in their blood. So, a serum analysis is only going to tell you about the status of a maximum of 1% of your total magnesium.
You see, magnesium is an intracellular mineral. That is to say it needs to be inside of a cell in order to function. To have the most accurate assessment of magnesium in your body, you need a test called red blood cell magnesium or RBC mag. Most insurance companies that I’m aware of don’t cover the test, and most physicians don’t know why they should do the test, because they’re told that serum analysis will give them what they need. Once again, this is not correct.
When I was in practice, I found that RBC mag, and it’s written just that way, the letters RBC for red blood cell and mag, short for magnesium, was indeed the most accurate way to assess functional magnesium levels. Routine serum analysis would almost always show normal, when in fact the patient required more magnesium. I found this routinely with patients who had cardiac issues including arrhythmia, as well as those complaining of muscle cramps, muscle spasms, facial twitching, anxiety, difficulty in sleeping and more issues. I will explain this in the series how magnesium affects those health issues and much more in future episodes of The Nugent Report.
A healthy body should contain about 25 grams of magnesium on average. So, folks, that’s 25,000 milligrams between 50 and 60% of your body’s total magnesium will be stored in your bones because magnesium is essential to strong healthy bones. Besides the 1% found in the blood, of course, the remaining level will be in various tissues and cells. So, here’s a logical multiple choice question. Since vitamin D cannot be utilized by the body without magnesium, and at least 50% of people are getting insufficient magnesium, is the main problem for vitamin D deficiency, A, lack of sunlight, B, poor dietary choices, C, magnesium deficiency, or D, all of the above? The science indicates it’s D, all of the above.
According to recent studies, 48% of the population is getting less than adequate levels of magnesium from diet. But there are other factors that contribute to deficiencies magnesium that you may not be aware of and perhaps your doctor is not aware of. People with gastrointestinal diseases, type two diabetes, alcoholics, or those who have, let’s say chronic use of alcohol, but they are not dependent at this point. All of these people are very probably getting less than adequate amounts of magnesium to cope with their particular situations. In fact, these are the indicators that would be most likely associated with deficiencies in magnesium.
Additionally, there are various pharmaceutical drugs that can lower your magnesium including virtually all of the prescription drugs and over the counter products used to reduce heartburn for acid reflux disease. How many physicians who prescribe drugs like Nexium or Prilosec, or other proton pump inhibitors, typically listed as PPIs; how many of them also check magnesium levels and recommend magnesium supplementation? I did a straw poll of a number of people, 36 people, actually. And of course, a straw poll is not a scientific study. Okay. But I found it interesting that of the 36 people I asked who were all taking one of the prescription drugs for acid reflux, 100% of them said, no one had ever told them anything about magnesium. And as far as they knew, their doctors had never tested their magnesium levels. Well, you know what? Even if their doctors had done a serum magnesium, that may not have given them adequate information.
There are conditions where physicians have no choice but to prescribe proton pump inhibitors. I’m not telling you not to take them, that’s between you and your physician. If you need them, you need them. But be aware that magnesium has more than 600 different functions in the human body, much more than bone density, much more than utilization of vitamin D. 600 different functions, folks. Chronic use of PPIs could lead to osteoporosis because those PPIs contribute to magnesium deficiency. And calcium ions can’t be transported to the bone without magnesium. That’s only one of many issues when we’re discussing the benefits of magnesium.
In this section, I’ll be throwing a lot of numbers and values your way, but don’t panic. It’s my goal on the Nugent report to make sure that you have transcripts written, supportive data tables or hotlinks to tables. When I give you a whole bunch of numbers, I don’t want you to stress out, attempting to remember the numbers, just enjoy the episode and then go to drnugent.com to look for the numbers that you have in mind.
I want you to remember that The Nugent Report is a labor of love, and it’s not my day job. And in fact, I have two very talented, very dedicated individuals helping me on this website, and it’s not their day job either. So we’re posting these things as soon as we can. And if things don’t come out as fast as you want them to just try and be patient, please. Now back to vitamin D. As I mentioned in previous episodes, once a lab test for physicians was developed so that they could easily test vitamin D levels of their patients, the general perspective on vitamin D supplementation changed almost diametrically before the test existed. And I can remember frequently arguing with medical physicians about vitamin D supplementation. No, a very significant percentage of patients. According to study, as much as 42% are deficient in vitamin D and physicians who have been taught that vitamin D supplementation wasn’t necessary, or perhaps even toxic.
Now they find themselves recommending thousands of units for patients each week. Remember garbage in, garbage out. If the data you’re using to, with to make your decision is flawed and not accurate, it’s highly probable that your conclusion. So be flawed and inaccurate. Okay. The first step, when you have a health question, any health question, not just about vitamin D is to get the appropriate tests from the appropriate practitioner, go to a doctor who knows what they’re doing in the case of vitamin D testing. Any physician can do this for you. When you see your physician, ask them for a vitamin D blood test, a serum analysis these days it’s pretty routine. And it’s unlikely that you’ll get any arguments. When any lab test comes back from any lab, it’ll be pretty simple, right? On the printout. It will say low, normal or high. This is not rocket science.
This blog speaks many times about inadequate levels versus deficiencies. There is a distinction and that distinction is important when making decisions for your health. So let’s apply that to vitamin D. If your blood test comes back with less than 30 millimoles per liter, and by the way, that is written as lowercase MMOL forward slash upper case L so 30 millimoles per liter, less than that amount, that means it’s low. And this is typically associated with deficiencies that can lead to serious health issues. If your test comes back between 30 and 50 millimoles per liter, it’s classified as being less than adequate for bone health in already healthy individuals and amounts greater than or equal to 50 will be considered adequate for bone health, as well as general health for already healthy individuals. Now don’t panic. If I said those numbers too fast, remember the tables or hotline sports tables will be provided for you on drnugent.com.
It’s probably a good idea for me to go through some terms for you right now, because it occurs to me that you’ll be looking at labels. You’ll be looking at literature, you’ll be seeing things on the internet and you might see some abbreviations that will just leave you confused. So let’s do some terms and definitions right now, for many, everybody was used to looking at a dietary supplement label and they were looking for the RDA and that’s the required dietary allowance. But then there was the RDI, which means required daily intake. And then there’s the DRI, which is the dietary reference intake that by the way, is created by the food nutrition board FMB, which is part of the Institute of medicine of the national academies. And by the way, the national academies used to be called the National Academy of Sciences.
Are you confused yet? Well, hang on, there’s more, there’s also the AI and the EAR and finally the UL. Well, that is a lot to sort out, but I’m going to try and simplify each of these definitions for UDR I that’s the dietary reference intake. That’s a set of values designed for assessing nutrition intake for all ready and healthy people. Then there’s the RDA or required dietary allowance. And that’s the average daily level of intake deemed to be adequate. There’s a word again, to meet the nutrient requirements for about 97 to 98% of healthy people. The RDA is typically used to plan diets that are nutritionally sufficient. Then there’s the AI or adequate intake. The adequate intake is the level of assumed to ensure nutritional adequacy. This value is used where there isn’t enough human clinical evidence to develop the RDA.
This brings up the difference between inadequate dietary levels and deficiencies. Very often people are rated as having inadequate levels of nutrition to maintain normal health. However, a deficiency would be a level that would contribute to a significant health issue. So be aware when you’re reading the differences between inadequate and deficient, by the way, some authors are going to list it in the positive, and they’re going to use the words adequate or sufficient lots of stuff here. Well, moving on, we have two more, that’s the EAR or estimated average required. Now that’s the daily average level of intake estimated to meet the requirements of 50% of already healthy individuals, EAR is typically used to assess and plan the nutrient intakes of groups of people rather than individuals, so that roots can achieve adequate diets, but the EAR can also be used to evaluate nutrient intakes off individuals.
Finally, we have the UL, which actually is an abbreviation for tolerable upper intake level. Now that’s the safe, maximum daily intake level, which is unlikely to cause adverse effects throughout my career. Countless times people have told me that they thought, if they went over the RDA, that they were automatically toxic, they were in danger. They were afraid capers. There’s quite a span between the RDA and the UL of most nutrients. Again, tables or links to tables will be provided for you on Dr. mnuchin.com. So don’t panic, and won’t be there. Now, if you take a look at one of those tables for the dealer requirements, what you’re going to find is that in this case, the case of vitamin D the nutrient requirements for males and females is the same RDA. That’s not typical by the way, generally, you’ll find that with nutrients, it differs by age and gender, but in this case, it varies only by age and pretty significantly, by the way, sometimes you’re going to see vitamin D rated in, I use or international units.
And other times you’ll see it listed as micrograms, which is abbreviated as lowercase, M C, G. I know what you’re thinking. Why doesn’t everyone just get on the same page and just do it for simplicity sake? Just one thing, don’t hold your breath on that folks. There’s actually reasons for all this. So what you’re going to notice on the table is that between the ages of 0 and 12 months, the requirement is 400 IQ. Then it jumps up to 600 IQ all the way up to eight 70, and then starting at age 70 forward for the rest of your life. It increases for another 200 international units per day at business. Because as you age, you become less efficient at synthesizing vitamin D from sunlight. It’s again, one of those verses of age, but, you know, aging is really preferable to the alternative.
In the last section, we talked about blood testing for vitamin D and we talked about requirements and some important definitions. In this section, we’re going to be talking about sources of vitamin D conversion from sunlight, a little bit about seafood and the benefits of vitamin D. Let’s talk about how you get vitamin D. The body is an amazingly adaptive organic machine. I’m not going to argue with anybody about how the adaptations occur or why the adaptations occur. The fact is we are adaptive. We have an adaptive nature. That’s the fact vitamin D is crucially important to your health and you aren’t designed to convert vitamin D from sunlight, although you do it less efficiently as you age, and you should get your vitamin D then from sunlight and preferably food. If those first two options don’t provide you with enough vitamin D, you have to use a food supplement.
It’s the only sensible alternative. The science is very strong and very clear about the need for vitamin D for healthy bones and teeth. I think just about everybody knows that, but you may not know that it’s also very important for your immune system and it’s even important for your mental health and thought processes. So vitamin D is a pretty amazing and pretty important nutrient. Now there’s a very significant amount of science to show us that as we age our ability to digest and absorb our nutrients, as well as our body’s efficiency in producing new cells, decreases steadily. Remember that strong, healthy bones require vitamin D not just calcium and not just magnesium. And as the bones get soft, we begin to see the obvious results in the aging population. Also, as we age, as I mentioned, our ability to synthesize vitamin D from sunlight decreases, this is why the RDA for vitamin D started at 8 70 and up increases by an additional 200 international units each day.
The typical source, as I’ve mentioned, the vitamin D it’s why they call it. The sunshine vitamin is sunlight. And the most abundant source of vitamin D from food is from seafood. Well, everybody’s been told for more than 50 years now that you should eat more seafood and less land animal. And the argument is all about cholesterol and heart disease, and I’ll have different publications about that. Let’s talk about seafood. In my lectures, all around the world, I have frequently discussed the environmental decline of our planet and the ever increasing level of toxins in our waterways. There are some lakes in North America where you are warned not to eat the fish at all the food and drug administration, the FDA in the United States. They actually have a list of fish, other website that you should not eat at all.
If you’re pregnant, you shouldn’t eat, or you should limit your amount, and then they have a list of fish that you should limit, the amount that you consume. The folks, unlike my fish, I do. And all I’m here to do is to give you objective data. The decision is yours. You’re an adult. You decide, hopefully you’ll make wise decisions. You can’t do that unless you start with objective data. And this is while you’re learning information on these episodes on The Nugent Report, much of which you’ve never heard before, because it’s important for your health decisions. I have a real thing about tuna. I love tuna, and I probably eat too much of it until that’s a decision that I make. You’ll find on the FDA website. As I say, they list the various fish.
I mean, everybody’s been told for more than 50 years that, well, gosh, seafood is the healthiest, right? Okay. Common sense. Seafood has no choice, but to be totally immersed in the water, just as the air we breathe is our atmosphere. The water is their atmosphere. And any toxin in that atmosphere is going to get into their tissue. In fact, there’s a lot of sea life that has to breathe by passing water through their tissue, which of course the water containing toxin will know as toxin through their tissue. I’m talking about all kinds of toxins and we won’t have other episodes on environmental toxins at water and food. And here we’ll talk about those in future publications, but I can tell you right now, my friends, that there are toxins that you probably don’t even want to think about right now found in a lot of waterways.
In most cases, you can’t see or smell or taste the toxin until it becomes at such ridiculous levels that it’s far above safe intake levels far above. So the majority of the time we don’t see the toxin in the air or the water. We don’t taste it. You don’t smell it. There were only a few hundred chemicals that have been tested for safety and the majority have not been tested. We just make assumptions. Doesn’t sound very good, does it? So with this in mind, you’re going to have seafood. That’s going to have in it, whatever it was swimming, it sounds kind of unappetizing. Doesn’t it again, you’re going to have to make your own decisions. And I strongly suggest that you check that list of fish that you should either not eat, or you should live it. This is getting to be a much more serious problem than people know, or perhaps I should say, then people want to know if you love the outdoors as I do.
I love nature, I just love nature. And that poem, I think that I shall never see a thing as beautiful as a tree, that’s the way I feel too, I love nature. And it, it brings tears to my eyes. That’s what I think about what’s going on. But again, that’ll be different publications. Back on track with vitamin D. So we’re going to have to limit our seafood intake. And even if we didn’t, could you get enough Vitamin D? Could you eat enough seafood to get enough vitamin D if you are not properly synthesized in your vitamin D from sunlight, remembering that in the 21st century, the vast majority of work and recreational activities are indoor rather than outdoor. And in order for you to synthesize vitamin D from sunlight, you also require magnesium.
That’s why these episodes are vitamin D and magnesium together, depending on which scientific study you read, some of them will tell you that at least 50% of the adult population is not getting enough magnesium daily. Some studies will say up to 70% suffice it to say the majority of people are not getting enough magnesium every day. This is the reason that these two nutrients vitamin to get magnesium need to be discussed together. Let’s go back to sunlight for a moment. Remember in a previous section, I discussed the fact that darker skin is a genetic adaptation to protect an individual from the potentially harmful effects of solar radiation, but genetic groups whose origin is closer to the equator will have darker skin. And then as you move farther away from the equator skin tones get lighter. Again, that’s a genetic adaptation, lighter skin tones are going to absorb vitamin D more efficiently than darker, and the darker the skin tone, the less likely you are to efficiently synthesize vitamin D from sunlight. And the reverse is also true. So imagine the health problems that one might have, if they’re getting insufficient levels of vitamin D from sunlight or from diet.
Once again, as I said, hundreds of times in my global lectures, the modern diet simply does not provide sufficient nutrient for the majority of people. And most people do not make good dietary choices. So in the 21st century, so implementation is not a luxury. It’s a necessity for the individual really cares about their health. When it’s not provided through diet, it has to be provided through a dietary supplement. In the next section, we’ll do the same thing with magnesium that we did for vitamin D.
What we’re going to do in this part is we’re going to be answering some questions about how much magnesium you need by age and gender, what the food sources of magnesium or, and the benefits of magnesium but first: What is magnesium? Well, magnesium is an essential mineral, as I’ve explained previously, essential means your body must have it, but your body cannot make it. So it must be obtained from a source outside of your body. In the case of magnesium, preferably it would be from food, but as I will discuss, the majority of people are not getting sufficient magnesium from diet alone. So we must also discuss the idea of food supplements since the body is incapable of producing minerals, the list of essential minerals are well quite low.
In fact, you would think they’re all of equal importance. If your health will decline and that decline could eventually result in death because you are significantly deficient in an essential mineral, then they must all be of little value, right? Well, maybe not. In fact, magnesium is towards the very top of my list. If I could find the time, I could probably take some real joy at writing an entire book about magnesium and its functions. However, a podcast must be by its nature. Magnesium is one of those nutrients where I would say to someone in a social setting, don’t get me started on that mineral because it could take me hours to explain it. In my lectures globally many people have heard me talk about enzymes and in most cases, the discussions have been around digestive enzymes.
However, there are thousands of enzymes. Only a small number have anything to do with digestion. Remembering my statement that no nutrient is an island onto itself. Magnesium is one of those examples. Magnesium is an essential cofactor in at least 300 different enzymes. The systems regulate a very wide range of crucial functions in the body. Some of which we will cover in the next few minutes, magnesium is an intracellular mineral. That means it functions inside of cells, not just in serum or blood. So as an essential mineral it’s essential for really an astounding number of biochemical reactions in your body. And we may only be able to touch on the surface of those in this spot. The majority of people that I’ve interacted with more than 40 countries seem to have their understanding of magnesium, generally limited to LC of utilization. There are a few exceptions, of course, however, it’s rare to find someone who understands the broad range of functions of this incredibly important mineral.
Through my career every time I’ve recommended magnesium, the first literally knee-jerk reaction that I’ll get will be something to the effect of when I take a calcium magnesium product or there’s calcium magnesium in my multiple vitamin, then I have to explain to them that calcium will use up whatever magnesium it requires for transport. And if you require additional magnesium or specific functions of calcium, magnesium supplement will typically not do the job. It’s absolutely true that calcium ions cannot be transported without magnesium. And therefore magnesium is as important for bone health as calcium is. In fact, there are some experts who are telling us that the modern diet provides too much calcium. I talk more on that here, but if you haven’t heard that before, they’re telling us that the modern diet is giving us far too much calcium for many people and far too little magnesium. Some of those experts are recommending that we stopped supplementing calcium and increased supplementation of magnesium.
I’ll discuss this idea in further detail later, but anyone who’s ever had a heart attack or a heart attack victim has at least some limited knowledge of the importance of potassium. However you may not know that potassium like calcium can only be transported by interacting with magnesium few people know. And I can tell you from my lectures, that few doctors know that magnesium is also a central for blood sugar control, blood pressure regulation, protein synthesis. Yes, normal, healthy levels of blood sugar and blood pressure are both impacted and are significantly dependent on the presence of magnesium. The process, as it relates to blood sugar is called glycolysis. And it’s an enzymatic process, which involves magnesium in 10 primary steps. Each with a separate enzyme. I won’t get into the full complexity of glycolysis in this podcast, but rather just give you some basics.
You will recognize some of the things that I’m about to discuss. It begins with glucose, which is then converted. And then the steps continue so that you have the production of something called ATP, the full name of it, which is an Adenosine triphosphate, also results in the production of something called an NDH. This multi-step process is too complex to cover the podcast, but suffice it to say that energy production through glycolysis will not occur with a magnesium. Yes, the very same mineral required for relaxation and sleep is also required to produce energy. It’s all about which enzyme systems it’s reacting with. Magnesium is also essential for managing oxidative stress.
When you hear the letters DNA, of course, it conjures up lots of genetics, which is correct, but you may not know that magnesium is required for its production. In fact, magnesium is required for the synthesis of both DNA, the Deoxyribonucleic acid, and RNA that’s Ribonucleic acid. Magnesium is also vital for muscle function. The most important muscle of your body obviously is your heart muscle, and magnesium is required for nervous system function. It is also essential for the regulation of your heart rhythm. Sometimes arrhythmia or the heart out of rhythm means that you have a deficiency in magnesium, but that is not always the case. There’s a caution here for everyone. Arrhythmia can be caused by a number of different factors. So if you’re experiencing irregular heartbeat, contact your physician right away, don’t fool around with this, get an expert opinion at the appropriate tests as quickly as possible.
What about muscle cramps? Well, again, most people think calcium first calcium causes your muscles to contract and magnesium causes your muscles to relax. Very often muscle spasms and muscle cramping is due to having insufficient magnesium in the muscle. Adding more calcium for the cramps may actually make things worse. Remember the previous discussion on blood tests with magnesium. Although serum calcium is an accurate way to evaluate your calcium levels, serum magnesium is typically not. It has been my experience at working with physicians for decades, that many of them had no idea how crucial magnesium was or that patients in particular situations required supplemental magnesium, because they relied on serum magnesium as their only gauge, which almost always shows normal since only 1% of your body’s total magnesium is in your blood. This goes back to one of my earlier questions in this publication.
When someone is showing a deficiency on vitamin D, do they really need magnesium supplementation? It’s been my experience that they often do. On drnugent.com you will find the tables you need for reference, the dealer requirements from the food nutrition board or F and B of the American national academies and the food sources from the US department of agriculture, better known as the USDA. Magnesium is required at every age and as you will see from the reference charts on this website, there are some pretty significant increases in magnesium required at certain ages, starting with the minimum requirement for infants up to six months, old of 30 milligrams daily, by the time a person reaches the age of 31 males require a minimum of 420 milligrams and females 320 milligrams. As I mentioned before, generally but not always, males require higher levels of most nutrients than females.
If you’re pregnant or nursing, you will want to consult the chart because that differs not only between those two factors, but also with age. And those two factors is I always say the best way to get your nutrition is from food, that after all is the way your body was designed. However, as we’ve already established, the modern diet often provides a less than adequate levels of various nutrients and that’s why we turn to supplements. On drnugent.com. You will see a chart of common food sources for magnesium provided by the national institutes of health, how you adjust your personal diet and the choices you make is entirely up to you. But if you’re getting less than adequate levels of magnesium from your dietary choices, you need to start supplementing magnesium right away, depending on which source you consult. You may see authors that say as few as 48% of people, or as many as 70% of the population are getting less than adequate levels of magnesium from diet alone.
The reason these numbers vary so much, just because of the way they’re making their comparisons, suffice it to say the majority of people are probably not getting sufficient magnesium from diet alone. My experience from using RBC magnesium, as well as serum magnesium, is that the numbers lean closer to the 70% mark, but we’re not going to split hairs in this podcast. I’ve provided you with the information regarding the minimum daily requirements and the food sources. So now the rest is up to you ensure that you get the appropriate tests. If you’re experiencing any symptoms such as heart arrhythmia, make sure that you see your physician and get the appropriate tests don’t fool around with this. My friends, your health is your most valuable thing.
In this section, we are going to conclude our series on vitamin D and magnesium. You may remember in section 3, I explained to you the differences between a nutrient deficiency and nutrient inadequacy. That section addressed the vitamin D, but in this section, we’ll focus on magnesium. First we’ll address deficiencies. Magnesium deficiency typically needs to become quite severe before a person starts to show any symptoms. One of the many duties of the kidneys is to limit the amount of magnesium that can be excreted at any time. Individuals who are alcohol dependent or who consume consistently high levels of alcohol are among the first to become magnesium deficient. Another group that’s at risk, but rarely gets the attention that they require, in my opinion, are individuals who are using proton pump inhibitors or PPIs have also discussed this. Previously, these drugs are used to kill the acid producing pumps in the stomach are typically prescribed for chronic heartburn and acid reflux.
They also contribute very significantly to magnesium deficiency. In my opinion, it’s prudent for individuals to supplement magnesium. If they’re using PPIs chronically the prescribing physician may or may not be aware of this. Once again, remember the amount of magnesium in your blood is only 1% of the total magnesium. And if that’s the only investigation your physician is doing, it’s probable that he or she may not know that you need to supplement more magnesium people with type two diabetes, by the way, are also often prone to magnesium deficiencies. If you’re in one of these categories, I would advise to ask your physician, if he or she thinks that you should be supplementing magnesium at request the appropriate tests, ultimately your health decisions should be made jointly between you and your physician. At this point, you might be thinking, how would I know if I’m deficient? What kind of indicators might I look for?
Once again, my first recommendation is consult your physician and get the appropriate tests. But there are some indicators that might motivate you to talk to your physician, perhaps a little bit sooner. Keep in mind that nutritional biochemistry is not a set of absolutes and symptoms can vary between individuals. So having one on the long list of symptoms, doesn’t confirm that you have a deficiency, nor is it necessary for you to have all of the symptoms to confer that you have a deficiency. So I’ll give you a list of things, fatigue, weakness, nausea, vomiting, loss of appetite. These are all common. And they’re common in the early stages of deficiency. The longer the deficiency goes on and the more deficient you become, you may begin to experience symptoms that relate to the nervous system, such as numbness or tingling, or even seizures in extreme cases. Remembering that muscles require magnesium to relax, calcium causes your muscles to contract.
You may begin to experience muscle contractions that some people describe as Charlie horses. Muscle cramps may occur if you are deficient in magnesium. Remembering that magnesium is essential to brain health, you may be experiencing personality changes, particularly anxiety. Returning to the idea that your heart is the most important muscle cardiac arrhythmia may also occur. Once again, as I’ve cautioned before cardiac arrhythmia may have several different causes. So consult your physician if your heart is not beating in normal rhythm and make sure that you get the appropriate tests from that physician. Remember also that magnesium is required for the transport of calcium and potassium. This may result in something called hypocalcemia, which is low calcium or hypokalemia, which is low potassium. And finally, remember my theory that many people with vitamin D deficiencies actually require magnesium supplementation to solve those deficiencies.
There are also several gastrointestinal disorders that can cause chronic diarrhea and fat malabsorption individuals who suffer from these conditions may find themselves deficient in magnesium. It’s also important to note that individuals who have had gastrointestinal bypass or resection, they also become magnesium deficient as mentioned previously, magnesium is essential to produce energy through glycolysis. It’s also essential to maintain normal, healthy blood sugar through a rather complex set of steps in type two diabetics, depending on the amount of insulin that they are producing, as well as people with insulin resistance, the kidneys may excrete higher than normal amounts of magnesium as a result of these concentrations of glucose in the kidneys. So this can also contribute to magnesium deficiency. According to study, as we age, our intake of magnesium reduces to compound the problem. Typically magnesium absorption decreases and magnesium excretion from the kidneys increases. And these can be significant contributing factors to magnesium deficiency in the elderly.
Let’s talk about high blood pressure. There are those in the nutritional community that will swear by magnesium or lowering blood pressure. If you study the mechanics, it’s very logical to assume that it would have a positive effect on blood pressure. There are some medical studies. However, that show that the effect is small, although positive. Why is there a difference? The study is only as good as its design. And as I’ve mentioned before, and will no doubt say often in the future, garbage in garbage out, that’s a common phrase taught to new information technology students in college. It applies to scientific study as well. You can have a brilliant researcher. The researcher may be a master of statistics, but if that researcher begins with a design or begins with information, which is flawed, then their testing method is going to be flood. They will end up with a flood result since magnesium is an intracellular mineral, and only 1% of your body’s total magnesium is found in the serum.
The studies that measuring serum magnesium as their only gauge for change already sacrificed the possibility of having complete data and virtually in none of those cases with any researchers I’ve spoken with. Were they aware that there are better ways to test for magnesium, including what I’ve previously discussed regarding red blood cell magnesium tests? So whenever I look at a study on magnesium absorption, the first thing I look at is their testing methods. There are many forms of magnesium available for supplementation as well, and that can also affect the results of a scientific study. Some forms of magnesium supplements are not well absorbed. Well, others have almost astounding absorption rates. Sometimes when there’s a lack of solid data, assumptions are made based on correlation. As an example, patients using proton pump inhibitors for acid reflux may become deficient in magnesium over time. However, we must also factor in that they are continuing to age as well.
This means that their ability to efficiently digest is almost certainly decreasing with age at the same time. So we need to separate the reduction in magnesium absorption due to age factors versus reduction in magnesium absorption, due to acid reflux, drugs, or magnesium absorption, as it’s known in various forms of magnesium dietary supplements, all of these variables have to be considered in the beginning of this series of podcasts on magnesium and vitamin D. We of course started speaking about osteoporosis. Most people, when you say bone health, the reflex response is to think calcium. However, as we have previously covered, magnesium is required to transport calcium ions to the bone. And magnesium is also required for the conversion and utilization of vitamin D. So this brings us back to the beginning. Scientific studies are quite expensive. There has to be a significant motivation to spend that money.
This is why are more studies on drugs than there are on nutrients. It’s also why some nutrients have very few studies women all over the planet have been thoroughly psychologically conditioned to believe that they need more calcium for bone health. Most of them have no idea that other nutrients are required. So many studies on calcium bone, but many fewer on magnesium in bone health. One notable study done on post-menopausal women showed that adding 290 milligrams a day of magnesium in the form of magnesium citrate supplementation suppressed bone cell turnover, as compared to the placebo. What does that mean in play? Likely it means that this is an indicator of supplemental magnesium decreasing bone loss in post-menopausal women. By the way, calcium citrate is not as well absorbed as some other forms of calcium. So the numbers in this study have they used a different, better absorbed form of calcium might’ve been much stronger. Remember garbage in, garbage out.
Finally, let’s end this segment about magnesium by talking about the potential toxicity if you take too much. Throughout my career, I’ve been asked the same common questions. When talking about dietary supplements, what do I take? How much do I take? How long will it take for me to get results? And also ask questions about safety on a pretty regular basis. One of those questions is how much is too much? Magnesium toxicity is quite rare. Toxic effects of magnesium or typically experienced in doses greater than 5,000 milligrams per day. That’s for people with normal kidney function. But for those with impaired kidney function, symptoms of toxicity may come at much lower amounts. But my friends, this concludes the series on vitamin D and magnesium. I hope you found this information useful. I hope you will apply it to your personal health program.
Until next time, be safe, be sensible, be objective.
-Dr. Steve Nugent
I hope you enjoyed this blog from The Nugent Report. Visit our website at drnugent.com for more objective facts about health and nutrition and email your questions and feedback to info@drnugent.com. Be sure to follow us on Facebook, Twitter, and Instagram at the Nugent report. Stay informed, get the facts with the Nugent report.
Don’t have a lot of time to read? Listen on the go! This blog is a consolidation of Dr. Nugent’s popular Vitamin D and Magnesium podcast series, which you can listen to here.
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维生素D和镁
《纽金特报告》中最受欢迎的六集关于维生素D和镁的讲座现在编辑整合为一篇的文章，在这个系列中，纽金特博士不仅谈及这些营养素的价值，同时围绕着营养方面大家普遍的缺乏的一些常识进行讨论。这样大家可以了解一些需要知道的事实并可以以此来为自己做出一些的判断。
史蒂夫.纽金特：听众朋友们好，欢迎关于维生素D和镁系列讲座。维生素D和镁是21世纪最重要的两种营养素。在本系列中，你将了解到一些你之前可能从未听说的，关于维生素D和镁的知识。实际上，我几乎可以百分之百确定这一点。由科学家NR Parva领导的科研团队指出，维生素D缺乏症正在美国流行。而如果我们用同样的统计方法，将其应用到营养素镁上，那么我们也不得不说镁也是如此。
每当电视或大众媒体上提到一种营养素时，来自世界各地的人们几乎都会马上与我联系，向我咨询有关这种营养素的信息。 对于许多人来说，这是他们第一次听说这种营养素或对此了解甚少。 因此，他们想知道自己是否应该摄入那种在大众媒体上看到的营养素。 但是，从电视节目和其他大众媒体获取营养信息的问题在于，这些信息很少是客观的。 电视节目通过广告赚钱，节目的收视率越高，就可以向广告商收取更多的广告费。
不幸的是，这意味着大多数媒体通常更关注收视率，而不是客观地反映信息。新闻专业的学生通常会被灌输一句话：”流血的新闻才能上头条“。这里强调的不是事实，也不是客观性，而是要吸引人们的眼球。不幸的是，大多数人更容易被极端消息而不是客观事实所吸引。客观的数据通常处于中间位置，而不是在一个极端或另一个极端。简单来说，客观性很少有极端，有时也不是收视率的最佳选择，对吧。
让我们来谈谈维生素D，这将是一个涵盖多期播客的系列节目。我确实答应过订阅者，我会介绍所有营养素。不过，我可没有承诺会按字母顺序依次介绍。所以，考虑到维生素D的重要性，我们先从它开始谈起。在执业医师可以进行实验室测试之前，几乎没有人认为我们需要补充维生素D，更不要说需要在一天内补充超过400国际单位（IU）的维生素D。这种看法几乎是普遍存在的。
事实上，医生被告诫要避免给患者开过多的维生素D，因为过多的维生素D可能会有毒。诚然，如果你摄入过多，几乎所有的东西都会变得有毒。实际上，如果你喝了太多干净的纯净水，纯净水甚至也可能变得有毒，显然我们谈论的是无比庞大的摄入量。所以，在几十年的时间里，医生非常严格地遵守了400IU规定。当医生开始对人们进行维生素D的研究后，这种陈旧的信念很快就被打破了。让所有和我交流过的医生都感到非常惊讶的是，新的血液检查结果显示，需要补充维生素D的人群比例非常高。
事实上，医生发现，要让维生素D缺乏患者恢复到足够的水平，推荐数百个单位远远不够，他们需要推荐每周摄入数千个国际单位的维生素D。稍后，我会解释缺乏和低于足够水平之间的区别，现在先不谈这个。我想说的是，世界上第一个维生素D每日最低需要量，是在1941年由美国国家科学院提出的。那时的世界与今天截然不同。无论是饮食、饮食选择还是工作和娱乐活动，都与今天大不相同。
20世纪40年代，不论哪个年龄段，大多数人都会经常晒太阳，沐浴在阳光中的机会比今天的人多很多。孩子们在户外玩耍，而不是像今天的孩子几乎每时每刻都玩游戏机、电脑或手机上。那时，户外活动才是常态，而不是像如今大家都坐在客厅里看电视。虽然将全谷物变成精白面粉的过程始于1870年左右。但人类饮食中的大多数食物直到几十年后才发生重大变化。随着21世纪科学的进步，似乎永远都有办法改变食物的天然状态。
1941年时，农业企业化经营还没出现，不过从那时起，很多事情都开始发生变化。由于医生几乎没有接受过营养方面的任何培训。他们依靠政府机构、医学协会和各种科学杂志提供的信息来决定患者的营养需求。在整个医学史上，医生们基本上都受到教导说，只要吃对了，你就能得到你所需要的一切营养。原则上，这一说法听起来不错，我也希望道理是如此简单。但事实却是，大多数人都没有正确选择饮食。50多年来，人们一直在饮食方面不断接收错误信息。
这些错误信息大多是各种医学专家无意造成的，他们在电视节目和其他形式的媒体上充当健康专家，对他们其实并不擅长的事情提出建议。这样一来，普通人就无法获得足够准确的信息，从而做出良好的饮食选择。请记住，就像计算机行业流行的说法：”废料入、废品出”。如果输入的信息不准确，那么你从这些信息中得出的结论几乎肯定也是不准确的。
我执业的时候，每次接收病人时，总是会在初次问诊时询问他们的饮食情况。这是我在诊所里与病人的第一次见面。几乎100%的人都会告诉我，他们吃得很好。这些病人相信，他们在饮食上做出了很好的选择。他们不知道自己的选择是建立在错误信息的基础上，他们认为那些错误信息是真实、正确的。因为他们认为在电视上看到的就一定是真的，或者某某博士是这么说的，所以就一定是真的。但在大多数情况下，那些根本不是事实，当然还有很多原因让这些人感觉不适、前来问诊。但在我看来，大多数情况下，饮食是造成身体不适的重要因素。显然，还有其他多种潜在因素。
问题在于，普通人获得了太多自相矛盾的信息。他们不知道如何做出正确选择。即使是医生也经常对这个话题感到困惑。我知道这一点是因为我教了30多年医生。假设你做出了完美选择，当然这不太可能。根据最新的科学研究结果，你仍然可能会存在不足。还有其他因素需要考虑在内。正如我尝试向人们解释的时候，曾多次强调，这些营养辅助因子是如何与其他营养辅助因子一起发挥作用的。这种生物化学原理有点像孩子们玩的连点游戏。在这种游戏中，你只有把所有的点都连接起来，才能看到图片全貌，
正如我在以前出版书籍中所说的，营养素自身并不是孤岛。请原谅我转述自己的话，朋友们，所有的营养素都有共同的作用因素。所以，对于那些认为自己能上网、能查阅资料，能提供营养信息的人来说，突然之间他们就成了营养专家。但是其实他们还有很多东西要学。营养生物化学非常复杂，人体消化作用也非常复杂。我将尽我所能把这些原理变得简单易懂，希望我们录制的这一系列播客，能让你集中注意力倾听。
那么，让我们回到这个问题上。你真的需要补充维生素D吗？现在的医生都知道如何常规检测维生素D，但他们没有接受过教导，如果人体缺乏镁，那么维生素D就不能被人体利用。这样，我们是否应该问另一个问题，你需要补充镁吗？我会谈到这个问题，这也是为什么我决定在这个系列播客中把维生素D和镁放在一起讨论的原因。如果没有镁，维生素D是不会被身体利用的。而你可能对镁了解不多。因此，我们将在接下来的几集中同时介绍镁和维生素D。
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在上一讲结束时，我给大家留了两个问题。大家是否真的需要补充维生素D？大家是否真的需要补充镁？好，本期节目就来回答这两个问题。请记住，Parva及其研究小组指出：“维生素D缺乏症正在美国流行开来。最有可能缺乏维生素D的人群是非洲裔美国人和西班牙裔美国人。”稍后，我会更详细地解释其中的原因。对各个种族的人群而言，肥胖人士或糖尿病患者也极易缺乏维生素D。
各种研究资料显示，39%到42%的美国人口缺乏维生素D。这个比例十分惊人，并带来了严重的健康问题。我采用的是美国统计数据，但请记住，各种族人群没有本质差别。从生物化学角度而言，我们都一样——我们都是人类。这一数据在大多数情况下也适用于你所在的国家，也许具体的百分比有所差异，但这些概念、想法、理解在所有国家都适用。
在本系列的第一讲中，我简要谈到了21世纪相对于过去几个世纪的变化。现在，几乎所有的工作都在室内进行。年轻人沉迷于数字设备和社交媒体，而他们的祖父母年轻时候主要是在户外和阳光下进行各种活动。21世纪有越来越多的人缺乏维生素D，毫无疑问，其中一个因素是阳光照射不足。
维生素D又被称为“阳光维生素”——借助镁和一个神奇的过程，阳光便可以转化为维生素D。几乎毫无例外的是，缺乏镁的人也会缺乏维生素D，即使补充维生素D也无补于事。许多病人遵照医嘱每周长期服用数千单位的维生素D，但维生素D缺乏并没有得到缓解，也许，他们的症结在于缺乏镁。开具处方的医生知道镁的关联作用吗？答案可能是否定的。
科学家们认为，皮肤变黑是一种适应行为，是为了使人免受太阳紫外线的辐射。这一理论的事实依据是：赤道具有最强的日光照射和辐射，越接近赤道的人种，肤色就越深，反之亦然。例如，越接近北极圈，当地的人种肤色就越浅。越靠北的地方得到的阳光越少。因此，为从阳光中吸收维生素D，肤色必须要更浅。例如，佝偻病是一种由维生素D缺乏引起的疾病，在补充维生素D之前，佝偻病在英国等地区非常普遍，由于天气条件和地理位置，这些地方日照有限。其实维生素D缺乏症在深肤色人群中更常见，其中一个原因是，深色皮肤如同天然防晒霜，阻挡了吸收。
在本系列中，我将探讨维生素D对健康的影响。我要向大家说明的是，为什么非裔美国人、西班牙裔美国人以及来自印度次大陆和其他深肤色地区的人群，会比白种人更容易出现某些健康问题。这不是阴谋论，只是生物学。据我所知，尚未有大众媒体报道过至少有50%的美国人缺乏镁元素。
一些研究人员认为，这个数字高达70%。为使维生素D被身体利用，镁元素必须经历相当复杂的酶活动。所有这些酶都需要镁元素。因此，缺乏镁几乎意味着缺乏维生素D，无论补充多少维生素D，吃多少含有维生素D的食物，都无补于事。你的医生知道这些吗？答案可能是否定的。
血液维生素D检测十分简单，称为“血清分析”。血清只是血液的一种花式称谓。医生们在医学院里学到，血清中的镁分析足以确定体内镁水平是否正常。可惜这一知识并不正确。人体内的镁总量，只有大约1%会在血液中自由流动。因此，血清分析最多只能表明镁总量1%的状况。
要知道，镁是一种细胞内矿物。这就是说，它只有在细胞内才能发挥作用。要对体内的镁进行最准确的评估，需要进行红血球镁检测。据我所知，大多数保险公司不涵盖这项检测，且大多数医生不知为何应当做这项检测，因为他们以为血清分析已经足够。再说一次，这并不正确。
我在执业期间发现，红血球镁检测确实是评估功能性镁水平的最准确方法。常规血清分析几乎总是显示正常，但事实上病人需要摄入更多镁元素。我发现，有心律失常等心脏问题以及肌肉痉挛、肌肉抽搐、面部抽搐、焦虑、入睡困难等问题的病人，经常是这种情况。我将通过这个系列节目，在未来几期解释镁元素对这些健康问题产生的影响。
健康的身体平均应含有约25克的镁。这等于25000毫克，而50％至60％的镁储存在骨骼中，因为镁是保证骨骼强健的关键。当然，除了血液中的1%，其余的镁都储存在各种组织和细胞中。下面我出一个考验逻辑思维的选择题。没有镁，维生素D就不能被身体利用；至少50%的人镁含量不足；那么，维生素D缺乏的主要原因是：A：缺乏阳光；B：膳食不当；C：缺乏镁；D：以上全部？科学的回答是D。
根据最近的研究，48%的人口从饮食中获得的镁元素不足。但是，还存在其他你或者你的医生都忽视的镁缺乏原因。胃肠道疾病患者，二型糖尿病患者，酗酒者，或者长期饮酒但现已不再有依赖症状的人群，这些人可能无法获取足量的镁元素来满足自身的特殊状况。事实上，这些是最有可能与镁缺乏有关的指标。
此外，各种药物会降低体内镁含量，包括几乎所有处方药以及用于减少胃灼热的反酸疾病非处方药产品。多少医生会开出耐信、奥美拉唑或其他质子泵抑制剂，又有多少医生同时检查镁元素水平并建议补充镁元素？我对36人进行了民间调查。当然，民间调查并非科学研究。但我发现一个有趣的现象，我访问的这36个人都在服用一种治疗反酸的处方药，所有人都说，从未有人跟他们提及过镁。此外，据他们所知，医生们从未检测过他们的镁含量。但你知道吗？即使医生为他们做了血清镁检测，可能依然无法提供充分的信息。
在一些情况下，医生必须要开质子泵抑制剂。我不是说不能服用质子泵抑制剂，这是患者和医生之间的事。真的需要就是真的需要。但一定要认知到的是镁在人体中具有多达600多种不同的功能，而不单单是确保骨密度和进维生素D吸收。长期使用质子泵抑制剂可能导致骨质疏松症，因为这些质子泵抑制剂导致了镁元素缺乏。而没有镁，钙离子无法被输送到骨骼中。当我们讨论镁的功能时，这只是其中一个方面。
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在本期节目中，我会抛出大量数字和数值，但大家没必要惊慌。作为Dr. Nugent报告的主讲人，我会为大家提供文字素材、支持性数据表格以及链接。当我列举大量数字时，希望大家不要费力去记这些数字，你们只需享受本期节目，随后登录drnugent.com便可获取相关的数字。
希望大家记住，这个营养报告是我的兴趣所在，而非我的正职。实际上，有两个才华出众、高度敬业的人在帮助我打理这个网站，同样，这也不是他们的正职。我们总是尽可能快地发布相关内容。如果大家依然觉得发布不够及时，那么还请大家再耐心等待。本期我们继续讲维生素D。我在上几讲中提到，如果医生可以进行实验室检测，他们便可轻易测出患者的维生素D水平，在实验室检测出现之前，大众对维生素D补充剂的观点是截然不同的。我记得自己总是跟内科医生争论维生素D补充剂的问题。也不全是内科医生，其实极大比例是病人。根据研究，多达42%的人群缺乏维生素D，而医生们却被如此高质：维生素D补充剂全无必要，甚至可能有毒。
现在，他们建议病人每周摄入数千个单位的维生素D。请记住，胡乱摄入的结果是胡乱排出。如果你的决策依据是有问题的、不正确的，那么，你的结论就很可能存在问题且不正确。好，如果出现健康问题，任何健康问题，不仅仅是维生素D方面的问题，第一步要做的是，从正确的医生那里进行正确的检测，去找一位了解维生素D检测的医生。所有医生都能做到这点。看医生时，要求进行维生素D血液检测，当下，血清分析是一种常规检测。你们无需争执。只需实验室给出一个检测结果，这是轻而易举的事情，对不对？检测结果可以打印出来。结果无非是偏低、正常、偏高。这不是一件复杂的事。
我之后还会再次讲到。这个播客可能会多次谈到水平不足及缺乏的问题。这其中有所差别，并且这一差别会影响到大家的健康抉择。我们通过维生素D来展开这一观点。如果血液检测结果显示，维生素D的含量低于每升30毫摩尔（顺便说一下，这个单位是小写的mmol，加正斜杠，加大写的L），则意味着水平偏低。而这通常与导致严重健康问题的维生素D缺乏症相关；如果在每升30至50毫摩尔之间，则意味着不够健康人群维持骨骼健康；大于或等于50毫摩尔意味着足够健康人维持骨骼健康及整体健康。大家不要惊慌。如果大家没有记下这些数字，请访问drnugent.com查阅相关表格或链接。
或许我应该帮大家梳理一些术语，因为我突然想到，大家会查看标签。大家看文献或者上网时，可能会看到一些不太理解的缩略语。所以，我们现在来看一些术语和定义。所有人都习惯查看膳食补充剂标签，寻找RDA，也就是建议膳食摄取量。后来又有了RDI，也就是建议每日摄取量。然后又有了DRI，也就是膳食参考摄入量，顺便说一下，这一概念是由食品营养委员会FMB创造，FMB属于国家学会医学研究所，而国家学会的前身是国家科学院。
大家是不是已经有点迷惑了？再坚持一下，下面还有，包括AI、EAR以及UL。我们需要理清很多概念，我会尝试简化每个定义，其中，UDR是指膳食参考摄入量，旨在评估健康人群的营养摄入量；然后是RDA，即建议膳食摄取量。它是指足量的平均每日摄入量，代表着约97%到98%的健康人群的营养需求。我们可以参照RDA制备营养充足的饮食；然后是AI，即足量摄入。它是指认定的可达到营养充足的水平。足量摄入适用于无法借助充分的人类临床证据制定RDA的情况。
这就引出了膳食水平不足和缺乏之间的区别。人们经常被判定为营养水平不足，无法维持健康。然而，营养缺乏将会导致重大的健康问题。因此，当大家在读到有关不足和缺乏之间的区别时，一定要注意，有些作者会进行正面描述，他们会使用“充足”、“足够”、“大量”等字眼。好，我们继续讲解剩余的两个概念，一个是EAR，即估计平均所需。它是指可满足50%健康人群需求的估计每日平均摄入量，通常用于评估和规划群体而非个人的营养摄入量，保证群体饮食摄入充足，但EAR也可用于评估个人的营养摄入量。
最后一个概念是UL，它实际上是指可耐受最高摄入量。这是安全的最大日摄入量水平，不太可能引起不良影响。我曾无数次听人说，如果超过RDA，人体会中毒，会陷入危险。他们很担忧。RDA与UL中的大多数营养元素需求存在很大差异。Dr. mnuchin.com上同样也会提供相关表格或链接。大家不要担心记不住。现在，如果大家看一下其中一个表格，便会发现，在这种情况下，在RDA中，男性和女性的维生素D营养需求相同。这并不常见，一般来说，营养素需求会因年龄和性别而异，但在这种情况下，它只因年龄而异，而且相当明显。顺便说一下，有时大家会发现，维生素D的数值使用的是国际单位计量。
有时又会用微克，缩写形式是小写的mcg。我知道大家的内心想法。为什么不能统一一下，免得这么复杂？大家不要过分苛责。这其中包含几个原因。大家会在表格上注意到：0到12个月之间的需求量是400 IQ，后来升到600 IQ，再升到870，然后从70岁到生命结束，一直处于上升状态。它每天额外增加200个国际单位。因为随着年龄增长，人体中阳光合成维生素D的效率会降低。这是衰老的另一个副作用，但是，衰老总好过于早逝。大家知道，下一阶段就是离开人世。我们之后将探讨维生素D的来源、将阳光转化为维生素D，以及维生素D的益处。下次见。我是Dr. Steve Nugent，请大家多保重，保持理智，保持客观。
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在本期节目中，我们将探讨人体主要从阳光中转化获得维生素D，再简要谈一下海鲜以及维生素D的益处。我们来聊一下维生素D的获取途径。人体是一个具体神奇适应性的有机体。我不准备讨论什么是适应性或者为什么人体具有适应性。事实情况就是我们具有适应性并且适应性是我们的本能。事实上，维生素D对人体健康至关重要。人们生来就可以将阳光转换成维生素D，但随着年龄增长，人体转换维生素D的效率会降低。所以人体也应当从阳光以及食物中获取维生素D。如果阳光和食物不能提供足够的维生素D，就必须服用食品补充剂。
这是唯一明智的选择。关于维生素D对健康骨骼和牙齿的作用，科学提供了强大而明确的证据。我想，大家应当都知道这一点，但大家可能不知道，维生素D对免疫系统乃至心理健康和思维也很重要。所以说，维生素D是一种相当神奇和重要的营养物质。现在，有众多科学证据表明，随着年龄的增长，我们消化和吸收营养的能力，以及产生新细胞的效率，都在不断下降。请记住，强壮健康的骨骼需要维生素D，而单纯的钙或镁无法满足需求。我们可以在老年人口中看到明显的骨骼变软的现象。随着年龄的增长，我们从阳光中合成维生素D的能力也在下降，所以这也是RDA中维生素D的起始需求量是870，但之后每天却另增200国际单位的原因。
正如我提到的，维生素D的主要来源是阳光，因此它又被称为“阳光维生素”。维生素D含量最丰富的食物是海鲜。50多年来，大家一直接收的观点是：多吃海鲜，少吃陆地动物。其中的论点始终围绕胆固醇和心脏病，我们未来会录制有关这一主题的节目，届时会呈现让人大吃一惊的事实，但现在，我们只谈海鲜。我在世界各地经常谈论地球环境的恶化以及水道中不断增加的毒素水平。FDA（美国食品和药物管理局）警告，北美一些湖泊中的鱼类不可食用。实际上，FDA网站提供了一个不可食用鱼类的清单。
FDA还提供了怀孕期间不能吃或应少吃的鱼类清单以及建议摄入量。各位，我喜欢吃鱼，但是我确实减少了摄入。我只管为大家提供客观数据，然后由大家自己做决定。大家都是成年人，可以自己做选择，但希望你的决定是明智的。如果没有客观数据，大家很难做到明智。大家通过我节目里的营养报告了解信息，相信里面的很多内容大家都是第一次听说，而它们恰恰影响着健康决策。我自己就是，我特别喜欢金枪鱼，而且可能还过量摄入了，但最终我决定减少摄入金枪鱼，毕竟FDA网站上就列出了金枪鱼…我说过，他们列出了各种鱼类。他们标明了摄入量和限定量，他们为什么这样做？
过去50多年里，大家接收的信息始终是：海鲜是最健康的，对不对？是的。这似乎是常识。海鲜终日浸泡在水中，我们离不开空气，它们离不开水。水就是它们的空气。而水中的任何毒素都会进入它们的组织。事实上，许多海洋生物的呼吸方式是让水穿过身体组织，含有毒素的水自然毫不例外。水中的毒素各种各样，我们未来会推出相关节目，探讨水中及食物中所含的环境毒素，但我现在可以告诉大家，很多水道中发现了大家想都不敢想的一些毒素。
在大多数情况下，我们无法看到、闻到或尝到毒素，除非它们的含量水平已经十分夸张。所以大多数时候，我们看不到、尝不到、闻不到空气或水中的毒素。只有几百种化学品接受过安全检测，大多数化学品甚至都未被安全检测过。我们只是做假设。这听起来不太妙，对不对？记住，这就是大家吃的海鲜。不管它们生活在哪片水域，都会含有毒素，这听起来有点倒胃口。对不对？大家需要自己做决定。我强烈建议大家查看一下那份不可摄入鱼类的清单。这个问题的严重性超越了人们的认知，或者我应该说，超越了像我一样热爱户外的人事的认知。《我热爱大自然，我就是热爱大自然》，这首诗里作者说：我认为树是最美丽的事物，这就是我的感觉，我爱大自然。大自然的美让我热泪盈眶。
这也是我的所思所感，但这是另外的话题。现在我们说回维生素D。所以综合来看，我们必须限制我们的海鲜摄入量。限制了海鲜摄入量会影响我们摄入足够的维生素D吗？在21世纪，绝大多数的工作和娱乐活动都在室内，所以部分人可能会希望仅仅通过摄入足量海鲜来获取足量维生素D。但这不可能。如果既不从阳光中合成维生素D，也不补充营养素补充剂，仅仅通过吃海鲜的话，我们一定会维生素D不足。为了从阳光中合成维生素D，我们还需要镁。
因此我们的节目同时聚焦维生素D和镁。一些科学研究指出，至少50%的成年人镁元素不足。我们每日摄入的镁不足。一些研究认为，这一比例高达70%，这表明，大多数人每天都未摄入足量的镁。维生素D和镁两种营养素真的非常需要被捆绑在一起讨论。我们暂时先说回阳光。在上一期节目中，我提到过这样一个事实：深肤色是一种遗传适应，可以保护个体免受太阳辐射带来的潜在有害影响。基因组源自赤道的人肤色更深，反之更浅。还有这样一种遗传适应：肤色较浅的人比肤色较深的人更能有效吸收维生素D。肤色越深，就越无法高效地将阳光合成维生素D，反之亦然。大家可以设想一下如果一个人从阳光或饮食中无法获得足够的维生素D，他可能会遇到怎样的健康问题。
再次强调一下，我在世界各地的讲座中已经说过，现代饮食无法为多数人提供足够的营养，而且大多数人的饮食选择并不理想。在21世纪，补充剂不是一种奢侈品。对于真正关心自身健康的人来说，它是一种必需品。如果饮食无法提供，就需要由饮食补充剂提供。在下一期节目中，我们将以同样的方式探讨镁元素。下期见。我是Dr. Steve Nugent。请大家多保重，保持理智，保持客观。
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在这一讲，我们要回答一些问题：不同年龄和性别对镁元素的需求量有什么差异？镁的食物来源有哪些？镁有什么作用？但首先，我们先来回答什么是镁？镁是一种必需矿物质，我之前解释过，“必需”意味着人体需要但却无法自己产生，因此只能从外界获取。就镁而言，最好通过食物获取，但正如我将要谈论的，大多数人仅通过饮食无法获得足够的镁。因此，我们还必须讨论食品补充剂，因为人体无法产生矿物质，必需矿物质的清单比较短。
事实上，你会认为，所有必需矿物质具有同等的重要性。如果矿物质含量减少，健康状况也会下降，严重缺乏一种必需矿物质，可能会最终导致死亡。这么来看，它们都是有同等价值的，对吧？也许不对。事实上，在我的清单上，镁的重要性十分靠前。如果我有时间，我可能会十分乐意写一整本关于镁及其功能的书籍。但播客有着播客的特点。如果在公众场合被问及镁方面的问题，我会回答：不要让我讨论镁这种矿物质，因为一时讲不完。这期播客也需要几个小时。在我的全球演讲中，很多人都听过我谈论酶，大多数情况下，我都是围绕消化酶展开的。
然而，酶有成千上万种。只有一小部分酶与消化有关。记住我的话，任何营养素都不是孤立存在的。镁就是其中一个例子。镁是至少300种酶必不可少的辅因子。这些系统调节着众多关键人体功能。在接下来的几分钟内，我们会讲到其中一些酶。镁是一种细胞内矿物质。这意味着，它不仅可以在血清或血液中发挥作用，还可以在细胞内发挥作用。因此，作为一种细胞内矿物质，它对人体内的众多生物化学反应而言必不可少。我们在这里可能只能粗浅探讨一下。我到过40多个国家，接触过的大多数人对镁的理解通常都局限于镁在腹腔镜胆囊切除手术中的应用。当然，也有少数例外，然而，很少有人真正了解这种重要矿物质的广泛功能。
在我的职业生涯中，每当我推荐镁时，大家的本能回答是：我在服用钙镁产品，或者，我的复合维生素中含有钙镁，那时我就必须向他们解释，那些镁全部都用于运输钙了。如果大家需要补镁或者补钙，镁补充剂通常不起作用。没有镁，就无法运输钙离子，这毋庸置疑。因此，镁对骨骼健康的重要性不亚于钙。事实上，一些专家正试图告诉我们，现代饮食中的钙质含量过多。我知道，大家之前没有听说过这种说法，但他们正在告诉我们，对许多人而言，现代饮食提供了过多钙，镁却极少。其中一些专家建议，我们应当停止补钙，而增加镁的补充。
我将在后面详细谈论这个观点。经历过心脏病发作的人或心脏病患者都多多少少知道钾的重要性，但大家可能不知道，像钙一样，钾只能通过与镁的相互作用来实现运输——很少有人知道这点。而且我可以告诉大家，很少有医生知道，镁还是血糖控制、血压调节、蛋白质合成的关键矿物质。是的，正常健康的血糖和血压水平都明显依赖于镁。这个过程因为与血糖有关，因此被称为糖酵解。这是一种酶解过程，有10个主要步骤涉及到镁。每个步骤都涉及一种酶。本期播客不会讨论糖酵解的复杂过程，而是提供一些基本知识。
我下面要讨论的内容大家可能会觉得熟悉。首先从葡萄糖谈起，葡萄糖被氧化的时候会产生ATP，ATP的全称是三磷酸腺苷，它可产生NADH，也就是尼古丁核苷酸烟碱酰胺腺嘌呤二核苷酸。我想，大家应该明白膳食补充剂公司在标签上使用字母NADH的原因。本播客无法展现这个复杂的多步骤过程，但我们可以得出，没有镁，就无法通过糖酵解产生能量。是的，放松和睡眠离不开镁，产生能量也离不开镁。这一切都同与其发生反应的酶系统有关。镁对抗氧化应激也必不可少，因为在人体产生谷胱甘肽的基本过程中，镁也发挥着作用。
听到DNA这些字母时，大家一定会联想到遗传学，这当然没错，但大家可能不知道，DNA的产生也需要镁的参与。事实上，DNA（脱氧核糖核酸）和RNA（核糖核酸）的合成都需要镁。镁对肌肉功能也至关重要。人体最重要的肌肉显然是心肌；神经系统功能也需要镁。它对于调节心律也至关重要。有时心律失常意味着缺乏镁，但也不全是如此。在这里，我要给所有人提个醒。导致心律失常的因素有很多。因此，如果出现心律不齐的症状，请立即联系医生，不要掉以轻心，尽快去做相应检查，听听专家的意见。
那么，肌肉抽搐与何矿物质有关呢？大多数人首先想到钙。钙主导肌肉收缩，镁主导肌肉放松。通常，肌肉痉挛和肌肉抽搐是由于肌肉缺乏镁元素导致。补钙实际上可能会使事情变得更糟。我们之前讨论过血液镁检测。血清钙检测是评估钙水平的一个准确方法。但血清镁通常并不准确。我与医生们已有数十年的合作经验，他们中的许多人并不知道镁的重要性，不知道病人在特殊情况下需要补充镁，因为他们将血清镁作为唯一的衡量标准，而血清镁的检测结果通常显示正常——因为人体内的镁只有1%存在于血液中。这又回到了我在本系列节目中提出的一个问题。
当人体缺乏维生素D时，是否真的需要摄入镁补充剂？根据我的经验，他们通常需要。大家可在drnugent.com网站获取参考表格、来自美国国家科学院食品营养委员会的经销商要求，以及来自美国农业部列出的食物来源。每个年龄段都需要镁，借助本网站的参考图表，大家可以看到，某些年龄段所需的镁急剧增加：6个月以下婴儿的需求是每天30毫克，在31岁时，男性每天至少需要420毫克，女性每天需要320毫克。正如我之前提到的，一般来说，男性并非总是比女性需要更多营养物质。
怀孕哺乳期的女性需要查阅图表，因为造成差异的并非仅有这两个因素，而且还与年龄相关。关于这两个因素，我总是说，食物是获取营养的最佳途径，毕竟人体的就是这样的结构原理。然而，我们已经发现，现代饮食往往无法提供充足的营养素水平，因此我们需要补充剂。在drnugent.com网站，大家可以看到美国国立卫生研究院提供的镁营养素常见食物来源图表，然后自行调整个人饮食和选择。但如果从饮食中获得的镁含量不足，则需要立即补充镁，具体取决于你的咨询渠道。有的作家声称48%的人——有的则声称70%的人——无法单纯依靠饮食摄入足够的镁。
这些数字之所以有如此大的差异，是因为他们进行比较的方式不同，但我们可以得出，大多数人可能无法单纯通过饮食获得足够的镁。根据我在红细胞镁以及血清镁检测方面的经验来看，实际数字更接近70%，但我不想在播客中吹毛求疵。我已经向大家提供了每日最低需求和食物来源的相关信息。现在，大家要做的是，进行适当的检测。如果有任何症状（如心律不齐），一定要看医生，并得到适当的检测，不要掉以轻心。朋友们，健康最宝贵。感谢收听本期Dr. Nugent报告。下期见。请多保重，保持理性，保持客观。
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本期节目是“维生素D和镁”系列的最后一讲。大家可能记得，在本系列的第三讲中，我解释了营养缺乏和营养不足的区别。那期播客讨论了维生素D，但在本期播客中，我们将关注镁。我们先来讨论一下镁缺乏症。镁缺乏如果出现症状，说明情况已经相当严重。肾脏的功能之一是限制镁的排放量。酒精依赖人群或持续摄入高浓度酒精的人群最容易缺镁。我认为，还有一个通常被忽视的风险群体，即正在使用质子泵抑制剂的人群，我们之前也讨论过这个问题。在以前，此类药物常用来抑制胃酸，用于治疗慢性胃灼热和反酸。
这类药物会在很大程度上导致镁缺乏症。在我看来，补镁是一种审慎做法。如果患者长期使用质子泵抑制剂，开药医生对此可能不十分清楚。再次强调一下，血液中的镁含量只占总镁量的1%。如果医生只要求做血液镁检测，那么他们很可能不知道你有补充镁的需求。顺便说一下，患有二型糖尿病的人，也容易出现镁缺乏症。如果你属于其中的一类人群，建议去问一下医生，进行适当的检测，并询问有无补充镁的必要。事关健康的决定最终应该由你和医生共同作出。这时候大家可能会想，我如何知道自己是否缺乏镁？我要留意哪些症状？
再次强调，我建议大家首先去咨询医生并进行适当的检测。但是，如果一些症状已经出现，大家应当尽快去看医生。请记住，营养生物化学并不绝对，各种症状可能因人而异。如果出现众多症状中的一个，并不能证实你有缺乏症；同样，如果患有缺乏症，并不意味着所有症状都会出现。所以，在此我给大家列出一个症状清单：疲劳、虚弱、恶心、呕吐、食欲不振。这些症状在缺乏症早期阶段很常见。患缺乏症的时间越长，缺乏症就越严重。你可能会出现神经系统症状，如麻木或耳鸣，甚至在极端情况下会出现癫痫。记住，肌肉需要镁来放松，钙会导致肌肉收缩。
你可能会开始感到肌肉收缩，有人将其形容为肌肉痉挛。如果缺乏镁，可能会出现肌肉痉挛。记住，镁对大脑健康必不可少，缺镁可能会导致性格变化，特别是焦虑。再说一遍，心肌是最重要的肌肉，缺镁的话，心律失常也可能发生。我之前谈到过，导致心律失常的原因有很多。因此，如果心脏跳动节奏不正常，要咨询医生，并确保从医生那里得到适当的检测。还要记住，由于钙和钾的运输需要镁，这可能会导致低钙血症或低钾血症。最后，记住我说的，许多缺乏维生素D的人实际上需要镁补充剂。
一些胃肠道疾病会导致慢性腹泻和脂肪吸收不良，患有这些疾病的人可能缺镁。同样需要注意的是，做过胃旁路或胃切除手术的人，也容易缺镁。正如之前所说，镁是通过糖酵解产生能量的必要条件。二型糖尿病患者需要通过复杂步骤维持正常健康的血糖水平，这取决于他们所产生的胰岛素量，而对于具有胰岛素抗性的人群，他们的肾脏排出的镁高于正常值，因此会导致肾脏中葡萄糖聚积。这也会导致镁缺乏症。根据研究，随着年龄的增长，我们摄入的镁减少，从而使问题更加复杂。通常情况下，吸收的镁减少，肾脏排出的镁增加，而这些都可能是导致老年人缺镁的重要因素。
我们谈一下高血压问题。营养学界有一些人认为，镁可以降低血压。如果研究一下其中的原理，自然会认为它对血压具有积极影响。相关的医学研究也有一些。然而，它们表明，效果虽然是积极的，但却不明显。差异为什么存在？研究的好坏取决于设计。正如我之前提到，以后一定也会经常提及的一句话：胡乱摄入的结果是胡乱排出，这是大学里信息技术专业新生常听到的一句话。它也适用于科学研究。研究人员可能很出色，他们也许是统计学专家，但如果采用了有漏洞的设计，那么他们的检测方法将糟糕透顶。他们最终会获得一个糟糕透顶的结果，因为镁是一种细胞内矿物质，而血清中只含有人体镁总量的1%。
将血清镁检测作为唯一衡量标准的研究本身就缺失完整的数据，并且，我所交谈过的所有研究人员都未能意识到还有更好的检测镁含量的方法，包括我之前谈论过的红细胞镁检测。因此，每当看到有关镁吸收的研究时，我首先会留意其中的检测方法。各种形式的补充剂也很多，这些也会影响科学研究的结果。一些形式的镁补充剂不易吸收，另外一些镁补充剂则具有惊人的吸收效果。有时，如果可靠数据不足，人们便会根据相关性做出假设。例如，长期使用质子泵抑制剂治疗反酸的患者可能会缺镁。然而，我们还必须考虑到，他们也在不断衰老。
这意味着，他们的消化能力可能随着年龄的增长也在下降。因此，我们需要把年龄因素所导致的镁吸收减少，与治疗反酸药物所导致的镁吸收减少区分开来，还要考虑膳食性镁补充剂的形式带来的影响。在“镁和维生素D”系列播客的一开始，我们要对所有这些因素加以考虑。当然，我们需要谈一下骨质疏松症。对于大多数人来说，一提到骨骼健康，他们的第一反应是钙。正如我们之前所讲的，要将钙离子运输到骨骼，镁必不可少。维生素D的转换和利用也需要镁，所以，我们又回到了起点。科学研究的成本相当高昂，因此背后的研究动机要足够重大。
因此，针对药物的研究要多于对营养素的研究。也正是因为如此，针对某些营养素的研究很少。全世界的女性已经从心理上默认，她们需要更多钙质来保证骨骼健康。她们中的大多数人并不知道，她们还需要其他营养物质。关于骨骼钙的研究很多，但关于镁在骨骼健康中所起作用的研究却很少。一项针对绝经后女性的著名研究表明，与安慰剂相比，每天以柠檬酸镁螯合物的形式补充290毫克镁，可以抑制骨细胞更新。这实际意味着什么？它意味着，补充镁可以减少绝经后女性的骨质流失。顺便说一下，与其他形式的钙相比，柠檬酸钙螯合物不易吸收。因此，如果在这项研究中他们使用了不同的、更易吸收的钙形式，那么数据可能会更显著。请记住，胡乱摄入的结果是胡乱排出。
在关于镁这一主题的结尾部分，我们来谈谈过量补镁可能导致的毒性。在我的职业生涯中，我常常被问到这样的问题：我该服用什么膳食补充剂？该服用多少？多久能见效？我也经常被问到安全方面的问题。其中一个问题是：多少算是过量？如果每天补充超过5000毫克的剂量，镁会显现毒性。这是对肾功能正常的人而言。对于肾功能受损的人来说，更小的剂量就足以导致毒性症状。朋友们，关于“维生素D和镁”的系列节目到此结束。希望这些信息能帮到大家。希望大家将其应用到个人健康计划中。下期见，请多保重，保持理性，保持客观。
感谢收听本期Dr. Nugent报告。访问DrNugent.com，获取更多有关健康与营养的事实性信息。如有问题或反馈意见，可发送邮件至info@drnugent.com。请在Facebook、Twitter和Instagram上关注Dr. Nugent报告。获取事实性信息，资讯先人一步。
没有很多时间阅读？ 边走边听！ 该博客整合了 Nugent 博士广受欢迎的维生素 D 和镁播客系列，您可以在点击这里收听。