Since our Webinar on Magnesium, I have received several Magnesium Questions recently regarding Magnesium deficiency.  There is some evidence that calcium deficiency can not be corrected with an underlying magnesium deficiency.  This may be due to the fact that magnesium is essential to converting Vitamin D to it’s active form and more information here.  The active form of Vitamin D is needed to actively transport Calcium within the cell. This may be the confusion that calcium absorption needs magnesium.  It is not needed directly but rather indirectly via Vitamin D.

Other cofactors needed in Vitamin D metabolism are:
Zinc (high doses antagonist with Magnesium and Copper)
Boron (raises Magnesium blood levels)
Vitamin K2
Vitamin A in small amounts

Further information regarding bone health and nutrients here.

Some important facts about Magnesium are:

• It is Absorbed in the distal Jejunum and Ileum (small intestines) and to some degree the colon.
• Plays an important role in Parathyroid Hormone synthesis which is also acted upon by Vitamin D
• Vitamin D increases Magnesium absorption
• All enzymes that metabolize Vitamin D require Magnesium
• Magnesium has a positive effect on Vitamin D deficiency. 
• Magnesium and calcium are antagonist to each other on a cellular level (work against each other) They use an overlapping transport system for reabsorption within the kidneys and thereby compete with each other.  Magnesium may also bind to calcium binding sites and intracellular protein binding sites due to their similarity.
• Calcium supplements can decrease Magnesium absorption.
• It Activates digestive enzymes for protein, fat and carbohydrate metabolism.
•  Essential for protein synthesis
• Stores and moves energy acquired from digestion.
• Regulates Calcium via Vitamin D and increasing urinary excretion of calcium

Factors inhibiting Magnesium absorption: 

• PPI
• Fiber
• Phytates 
• Excessive unabsorbed fatty acids
• Calcium
• Phosphorus
• Protein

In summary, post Bariatric patients are at risk for magnesium deficiency and it plays an important role in overall health and bone health.  Our practice recommends Magnesium Glycinate as the form for supplementation in at least a 2:1 ration with calcium. An example is: Calcium 2000mg daily to Magnesium Glycinate 1000mg daily. (Supplement based on your laboratory studies) We hope that this blog has answered some of your Magnesium Questions.