• Katie Mednick

Should People with Ehlers-Danlos Syndrome Take a Magnesium Supplement?|Answered by a Dietitian

Updated: Jun 2

In this post, we'll cover

Can people with EDS benefit from a magnesium supplement?

Chances are that you’ve seen ads for magnesium supplements that make it sound like it’s capable of miracles. First of all, it’s flashy marketing. Second, there’s a reason why the touted benefits seem to range all over, including supporting bone, brain, metabolism, mood, muscle, cardiovascular health, etc. Magnesium is an essential mineral that plays a crucial role in over 300 biochemical reactions. This means that it’s involved in almost every metabolic pathway in the body, including those related to collagen synthesis and turnover. Besides assisting in biochemical reactions, magnesium plays several other roles in the body as well.


People with EDS tend to have a variety of symptoms and conditions in addition to joint hypermobility. Other common symptoms include extreme muscle soreness, chronic muscle and joint pain, GI discomfort, chronic constipation, chronic headaches, fatigue, nausea, poor appetite, low blood pressure, and mental health concerns like anxiety and depression. Could a magnesium supplement provide relief?


Maybe.


Let’s dive into the scenarios where people with EDS may benefit from taking a magnesium supplement.


Disclaimer: You should always get your doctor’s approval before beginning any supplement, including magnesium. Supplements may have unintended side effects when taken with prescription medications and some foods. It is your doctor’s responsibility to evaluate your current healthcare plan and determine if a magnesium supplement is safe for you. As such, this article is for informational use only.


Magnesium Deficiency:

Research suggests that about 65% of the US population does consume enough magnesium. Luckily, developing a severe magnesium deficiency is rare since the body has a mechanism in place to conserve magnesium when intake is low. However slight deficiencies can still occur and may be more common than once believed. Magnesium deficiency symptoms may go unnoticed or can be attributed to other health conditions that have similar symptoms. People at higher risk for developing magnesium deficiency include those on “magnesium wasting” medications, eating few plant-based foods, eating a very limited diet, having chronic diarrhea, or in their elder years.


Symptoms of magnesium deficiency can include

  • Anxiety, agitation, irritability, headache, poor appetite, nausea

  • Muscle spasms

  • Migraine, depression, poor memory, low stress tolerance, tremors

  • High blood pressure, higher risk for arrhythmias, arterial stiffness and calcification

  • Sodium retention, low serum potassium, low serum calcium

  • Insulin resistance (which can lead to higher than normal blood sugars), increased risk of Type II diabetes and Metabolic Syndrome, osteoporosis

  • Constipation


Symptoms of magnesium deficiency

Are you surprised to see that some of these symptoms overlap with symptoms that people EDS often experience? While research in this area is lacking, it is possible that magnesium deficiency may exacerbate existing EDS symptoms or cause additional symptoms. The good news is that there may be some relief from symptoms in either scenario when magnesium levels are repleted and maintained through magnesium supplementation and diet modification.


While it is possible to check magnesium levels in blood work, this test is not always the most accurate reflection of whether or not you have a deficiency and need to take a magnesium supplement. Assessing your bloodwork, what symptoms you experience, how much magnesium you get through your diet on a regular basis, what medications you take, and if you have a medical condition that leads to higher magnesium losses should all be taken into account together when determining magnesium status. Hint: working with your doctor and a dietitian is key!


If your care team agrees that you may be experiencing a magnesium deficiency, they will likely recommend you take a magnesium supplement.


In short, people with EDS who have a magnesium deficiency will benefit from taking a magnesium supplement, and may see symptom improvement after healthy levels are achieved.


Constipation:

Constipation is another scenario where a patient with EDS may benefit from taking a magnesium supplement.


Constipation can occur for a variety of reasons. Common causes of constipation include dehydration, low fiber intake or excessive fiber intake, and a sedentary lifestyle. While not very common in other patient populations, patients with EDS may have a higher prevalence of slow gut motility. Slow gut motility may lead to less frequent and uncomfortable bowel movements.


In a 2013 study, 43% of the 134 EDS patients surveyed reported experiencing constipation on a regular basis. Many of my patients struggle with constipation and it really can negatively impact their quality of life until it's resolved through diet, behavior, and occasionally medication changes.


Some forms of magnesium supplements can provide relief from constipation symptoms (more about this below!). Certain magnesium supplements can help retain water inside the intestines during the last phases of digestion which keeps stool bulkier and softer so it’s easier to pass. Of course, overdoing magnesium could lead to excess water in the intestines, resulting in uncomfortable diarrhea. Finding the right dose is key!


While chronic constipation should mainly be addressed by adjusting lifestyle factors, it can be helpful to use a magnesium supplement as an additional tool.


People with EDS who struggle with constipation may find symptom relief when using a magnesium supplement in addition to following their doctor or dietitian’s advice to increase hydration, movement, and fiber intake.

Anxiety and Depression:

Several studies have shown that the EDS patient population has significantly higher rates of anxiety and related mental health conditions relative to the general public. While we do not know why exactly this is, chronic pain and histories of poor care likely play a significant role.


Can patients with EDS and anxiety benefit from taking a magnesium supplement?


To date, there are no studies to date examining EDS patients with anxiety and magnesium supplementation. However, in a 2017 study, researchers found that study subjects with depression and anxiety who took an over the counter magnesium supplement for 6 weeks had clinically significant improvements in their symptoms. More research in this area is needed not only to study magnesium’s effects on the mental well-being of EDS patients, but also to validate the findings described here.


While it is possible that patients with EDS and anxiety or depression may benefit from taking a magnesium supplement, the body of research on magnesium and its impact on mental well-being is not strong enough yet to consider this an evidence-based practice.


Muscle Soreness:

One of the biggest obstacles I face as an EDS patient is extreme post-exercise muscle soreness – and I know I am not alone! Can magnesium supplementation help us get relief?


While there are dozens of articles on the web that suggest magnesium plays a significant role in muscle recovery and decreasing muscle soreness, there is actually minimal scientific evidence that this is true. More research is needed to confirm or disprove magnesium supplementation’s effects on post-exercise muscle soreness and recovery. Of course, research projects that analyze magnesium supplementation’s effects on muscle soreness in the EDS patient population would be even more informative.


As of now, research does not indicate that magnesium supplementation can provide substantial relief from post-exercise muscle soreness.


Hydration:

It’s estimated that 41-100% of patients with joint hypermobility and/or EDS have orthostatic intolerance symptoms on a regular basis. One of the more common orthostatic intolerance conditions in the EDS population is Postural Orthostatic Tachycardia Syndrome (POTS), an autonomic disorder that can cause a variety of symptoms like dizziness, nausea, stomach pain upon eating, and fatigue.


POTS patients are often encouraged to maintain optimum hydration to decrease symptoms associated with the condition. Electrolytes from both food and supplement sources along with adequate water consumption can help achieve and maintain good hydration.


Sodium and potassium are the two most important electrolytes when it comes to hydration. However, calcium and magnesium are considered electrolytes as well and should be consumed in healthy amounts to assist with normal body functions, including hydration.


Another reason to consider magnesium when it comes to hydration is that there may be increased magnesium losses in situations where we are becoming dehydrated. Our bodies tend to have increased losses of many nutrients, including magnesium, during vomiting, excessive sweating, and diarrhea. If you reach for an electrolyte supplement to restore hydration for these reasons, choosing one that also includes magnesium could be a good idea.


While magnesium supplementation is not the most important consideration when it comes to good hydration, it is worth talking to your doctor or dietitian about if you have frequent bouts of vomiting, excessive sweating, and diarrhea.


Migraines and Headaches:

Ehlers-Danlos Syndrome patients often suffer from headaches and migraines. While muscle tension is a common trigger for some, other patients and their practitioners have a difficult time pinpointing their exact cause. Interestingly, magnesium may play a role in decreasing muscle tension related headaches and unexplained migraines.


A review article published in 2020 summarizes the current evidence on magnesium supplementation and its effects on multiple patient populations with headaches and migraines. In the article, the research team shared multiple studies that show a strong relationship between magnesium deficiency and headaches and migraines, which show improvement after magnesium supplementation. Plus, the article cites a promising study that found a certain form of supplemental magnesium called magnesium pidolate significantly reduced the frequency of tension related headaches in young and adolescent patients.


EDS patients who suffer from chronic headaches and migraines may benefit from beginning a magnesium supplement. Be sure to keep reading to see which forms of magnesium supplements are best for specific conditions, including headaches and migraines.



Which magnesium supplement may be right for you?

If you’ve ever shopped for a magnesium supplement, chances are that you looked at the shelf and realized that there are multiple forms of magnesium. This can be confusing, especially since form does matter when it comes to magnesium. I created the guide below to help you and your practitioner choose which magnesium supplement is best for you based on your current symptoms.


Magnesium supplements for magnesium deficiency:

These forms of magnesium are highly bioavailable, meaning that they are well absorbed in the body when ingested orally.

  • Magnesium L-threonate

  • Magnesium glycinate

  • Magnesium malate

  • Magnesium lactate

  • Magnesium citrate


Magnesium supplements for constipation:

These forms of magnesium draw water into the intestines which can have a laxative effect. Work with your practitioner to find a dose that works best for you.

  • Magnesium oxide

  • Magnesium citrate

  • Magnesium chloride


Magnesium supplements for anxiety and depression:

Please talk to your practitioner about your mental health symptoms - a supplement alone is not enough to provide the relief that you need. However, it can be used to support the other therapies you are pursuing with your healthcare team.

  • Magnesium glycinate

  • Magnesium L-threonate


Note on magnesium supplements when it comes to muscle soreness:

Topical magnesium supplements that contain magnesium chloride may be marketed as products that can assist with muscle soreness. It is generally safe to try them and see if they help relieve your symptoms, but know that there is little evidence that topical products are effective or increase magnesium levels in the body. If you have a magnesium deficiency, do not rely on topical magnesium products.


Note on magnesium supplements when it comes to hydration:

If you have diarrhea, vomiting, or profuse sweating and suspect you are currently dehydrated, do not take magnesium supplements that aid in relieving constipation. Their laxative effects may worsen your diarrhea symptoms and hydration status. If you notice that your electrolyte supplement contains one of these forms of magnesium, do not worry as the dosage is likely too small to cause any issues.


Magnesium supplements for headaches and migraines:

These forms of magnesium show some evidence for relieving headaches and migraines. Talk to your practitioner about using one of these as an addition to your current care plan.

  • Magnesium glycinate

  • Magnesium pidolate - for tension headaches specifically

  • Magnesium citrate


Magnesium supplements for magnesium deficiency, constipation, anxiety, depression, headaches, and migraines

How much magnesium do people with EDS need?

It’s important to talk to your dietitian or doctor about what dose of magnesium may be best for you based on your current symptoms and how much magnesium you get from food on a regular basis.


Generally speaking, most individuals can follow the Recommended Dietary Allowances (RDA) for magnesium, unless your practitioner has informed you otherwise. The RDA should encompass what you consume from food alone or from food and supplements together. Consuming more magnesium than the RDA from food alone is not a concern since our bodies are equipped to get rid of the excess. However, consuming excess magnesium from supplements can cause us to absorb too much magnesium or decrease our ability to absorb other minerals. Only consume more than the RDA via supplements if you have been instructed to by your healthcare team.


Recommended Dietary Allowances for Magnesium

  • Children between the ages of 9 and 13 years old need about 240 mg daily

  • Children between the ages of 14 and 18 need about 360-410 mg daily

  • Adults need about 320-420 mg daily


Currently, there is no evidence to suggest that people with Ehlers-Danlos Syndrome need more magnesium than other patient populations.


Are there ways for people with EDS to include more magnesium in their diets?

Absolutely! People with EDS can easily increase their magnesium intake by choosing magnesium rich foods. Foods that are good sources of magnesium include dark leafy green vegetables, nuts, seeds, beans and soy products, whole grains, and cocoa powder.

Examples of magnesium-rich foods include

  • Pumpkin seeds, 1 ounce, 168 mg

  • Raw swiss chard, 88 mg

  • Raw cashews, 1 ounce, 83 mg

  • Raw almonds, 1 ounce, 77 mg

  • Raw spinach, 3 cups, 70 mg

  • Soy milk, 1 cup, 61 mg

  • Black beans, ½ cup, 60 mg

  • Peanut butter, 2 tbsp, 54 mg

  • Edamame, ½ cup, 50 mg

  • Whole wheat bread, 2 slices, 44 mg

  • Brown rice, 1/2 cup, 42 mg

  • Cocoa powder, 1 tbsp, 27 mg


Magnesium rich foods, food sources of magnesium

People with a magnesium deficiency may need a supplement in addition to choosing magnesium rich foods to reach healthy magnesium levels in a timely manner. However, everyone, including those without a magnesium deficiency, can benefit from choosing magnesium rich foods more often.


How do I ask my doctor if it’s safe for me to begin a magnesium supplement?

After learning about how magnesium might provide relief from one or more of your symptoms, you may want to try out taking a magnesium supplement. As a dietitian who believes in keeping patients safe, I am here to encourage you to reach out to your doctor before beginning any supplement, including magnesium. Here is a script you can use to communicate with your care team:


 

Hi [Name],

I’ve been learning more about magnesium supplements, and I think [form of magnesium] may help my [symptom]. Does this supplement have any interactions with my medications or other supplements that I should know about? Do you think it’s safe for me to try this supplement? If so, what dose do you recommend?


Thanks,

[Name]

 

Summary

While more research is needed, magnesium supplements may be warranted for people with Ehlers-Danlos Syndrome if they have a magnesium deficiency, struggle with constipation, have anxiety or depression, or have headaches and migraines. There is currently not enough scientific evidence behind using magnesium to relieve muscle soreness, and it does not appear that topical magnesium supplements are helpful in increasing magnesium levels in the body. It is not known whether people with EDS have higher needs for magnesium, so EDS patients should stick to following the RDA unless their physician or dietitian instructs them otherwise.


If you found this blog post helpful or have another topic in mind that you would like me to write about, leave me a comment below.


Looking for personalized help for EDS symptoms like frequent stomachaches, bloating, constipation, acid reflux, and fatigue? I help patients just like you! Learn more here.