A healthy diet alone is not enough
Muscle cramps are likely a common complaint from many of your patients. While there are plenty of easy ways to identify causes like overextension, repetitive physical work or simply tweaks from reaching or stretching, low nutrient intake may be another cause. You would think some of these minerals and vitamins, such as magnesium, vitamin B6 and zinc, would be common enough in the diet, but in reality, they are in short supply.
Magnesium: the missing mineral
Many people think they get enough magnesium and other minerals from their diets alone. But that could be a dangerous conclusion. In fact, magnesium has been depleted from soils and is often stripped from foods during processing, so it’s not as prevalent in the diet as was once thought. Some experts estimate up to 80% of Americans are deficient in magnesium — an alarming possibility, because this one mineral alone supports a strong mind and body in virtually every way.
Since magnesium intake from food alone is often not enough, supplementing with a readily absorbable form, such as a glycinate chelated magnesium, is a good way to overcome this short supply.
Promotes calm and alleviates stress
Although magnesium isn’t commonly associated with calmness, it should be. Deficiencies can make individuals more susceptible to stress and depression, and the resulting tension sends the adrenal and pituitary glands into overdrive, greatly increasing cortisol and insulin levels.
Additionally, stress and magnesium deficiency can be a vicious cycle; stress can lead to magnesium depletion and magnesium depletion then leads to greater stress levels and risk of depression.
As a result, your patients could be feeling mentally and physically exhausted and wondering why. Fortunately, case histories have shown magnesium supplementation — including with the more readily absorbed glycinate form — can speed recovery from depression symptoms in as little as seven days.1
Improves exercise and recovery, relieves pain
As important as magnesium is for the mind, it is equally critical for the body. For anyone who is active and would like to stay that way, or for patients recovering from surgery, injury or other illness, proper magnesium intake is very important.
A clinical survey in Portugal assessed the energy and nutrient intake of elite basketball, handball and volleyball players, and found magnesium levels corresponded with better scores in strength and movement tests, including trunk flexibility, rotation and jumping.2
In another clinical study of volleyball players, magnesium supplementation also improved jumping and arm swing movements and reduced lactate production following the workout.3
Because magnesium relieves post-exercise pain, reduces inflammatory markers and improves recovery (as one clinical study showed in just a week of supplementation), it’s a critical nutrient for patients with physically demanding jobs or regular workout regimens. Magnesium supplementation can help prevent muscle tightness and cramps that often follow intense activity.4-5
Additionally, magnesium blocks the N-methyl-d-aspartate (NMDA) receptor, reducing a person’s sensitivity to pain. So this also makes it a key nutrient for treating patients with fibromyalgia, acute migraines, neuropathy and leg cramps due to pregnancy.6
That last point may be incredibly good news for some of your patients. For pregnant women, leg cramps can be frustratingly difficult to treat because conventional, over-the-counter medications are not an option. However, a double-blind, placebo controlled clinical trial found that 300 mg per day of a magnesium bisglycinate chelate for four weeks significantly reduced the frequency and intensity of leg cramps — without any notable gastrointestinal side effects. In fact, one reason to choose a bisglycinate chelate form of magnesium is that it typically doesn’t cause the diarrhea or other side effects associated with other forms of this mineral.7
Vitamin B6: Partner nutrient to magnesium
Women who suffer from intense premenstrual symptoms may find magnesium helpful as well. A clinical trial found magnesium alone helped relieve symptoms, but was more effective paired with vitamin B6.8
That’s not surprising, since vitamin B6 helps magnesium absorb better and is often recommended as a partner nutrient to magnesium to relieve muscle cramps, stress and other conditions.9-13
Not all types of vitamin B6 are equally active. The most common forms, like pyridoxine, need to be converted by the liver into pyridoxal-5-phosphate (P-5-P) before they can be active in the body. That’s why starting with the P-5-P in a supplemental form — the already active, bioavailable form — is best. No conversion is needed, which is especially important for individuals who are not good converters, whether because of genetics, age or illness.
For example, vitamin B6 has been recommended for carpal tunnel and other nerve and muscle ailments for some time. Although the results with standard forms of vitamin B6 can be positive, there is a possibility of actually creating the very symptoms of nerve and muscle conditions you’re trying to treat and prevent when using high dosages.
That’s because pyridoxine can block the body’s ability to use active P-5-P. A Dutch laboratory study found pyridoxine induced neuropathy symptoms by inhibiting P-5-P dependent enzymes, essentially competing with the active form of vitamin B6. Surplus doses of pyridoxine, over time, paradoxically cause the same conditions as having a B6 deficiency.14
Nonetheless, low blood levels of the nutrient can increase risk of inflammation, and inflammation can further deplete B6, so like deficiencies of magnesium, it can be a self-creating spiral that can lead to bigger problems.15-17
Case histories and clinical work have found symptoms of carpal tunnel syndrome and other inflammatory conditions can be alleviated by vitamin B6, but it has also found dosage levels need to be carefully monitored — if pyridoxine is the form administered.16-18
Zinc: The potential to deliver more consistent results
A third nutrient for stopping muscle cramps and enhancing recovery is zinc. It seems like a common enough mineral, but it’s estimated that worldwide, about 2 billion people are deficient in zinc.19
Your patients may associate zinc with cold and flu season, but this mineral also repairs muscles, tendons and ligaments, and is critical for physical performance. In wounds or tissue stress, zinc concentration at the injured site peaks after a few days, which could mirror the length of time your patients would notice lingering pain the most.20-22
Chronic zinc deficiencies increase levels of inflammatory cytokines; and low zinc levelscan be a factor in the development and symptom severity of rheumatoid arthritis.23
Deficiencies in zinc could hamper this process and lead to reduced blood levels of glutathione as well. Glutathione protects cells from oxidative damage, which can be heavy during times of intense exercise, when the muscles require oxygen-rich red blood cells. So any depletion in zinc levels will definitely affect patients’ physical performance.24
Like magnesium, a glycinate chelated form of zinc is an excellent choice with the potential to deliver more consistent results.25-26
Whether your patients are physically active, have jobs that demand repetitive work or are simply battling occasional muscle cramps and soreness, the right nutrients can help. Recommending the proper forms of magnesium, vitamin B6 and zinc, along with performing regular chiropractic adjustments can deliver effective, safe and lasting relief.
TERRY LEMEROND is a natural health expert with more than 45 years of experience. He has owned health food stores, founded dietary supplement companies and formulated more than 400 products. Lemerond is a published author, appears on radio and television, and is a frequent guest speaker. This energy and zeal are simply part of his mission — as it has been since the beginning of his career — to improve health with the very best nature and science have to offer.
- Eby GA, Eby KL. Rapid recovery from major depression using magnesium treatment. Med Hypotheses. 2006;67(2):362-70. PubMed website. https://pubmed.ncbi.nlm.nih.gov/16542786. Accessed Sept. 18, 2023.
- Santos DA, et al. Magnesium intake is associated with strength performance in elite basketball, handball and volleyball players. Magnes Res. 2011;24(4):215-9. PubMed website. https://pubmed.ncbi.nlm.nih.gov/21983266. Accessed Sept. 18, 2023.
- Setaro L, et al. Magnesium status and the physical performance of volleyball players: effects of magnesium supplementation. J Sports Sci. 2014;32(5):438-45. PubMed website. https://pubmed.ncbi.nlm.nih.gov/24015935. Accessed Sept. 18, 2023.
- Steward CJ, et al. One week of magnesium supplementation lowers IL-6, muscle soreness and increases post-exercise blood glucose in response to downhill running. Eur J Appl Physiol. 2019;119(11-12):2617-2627. PubMed website. https://pubmed.ncbi.nlm.nih.gov/31624951. Accessed Sept. 18, 2023.
- Bilbey DL. Muscle cramps and magnesium deficiency: Case reports. Can Fam Physician. 1996;42:1348-51. PubMed website. https://pubmed.ncbi.nlm.nih.gov/8754704. Accessed Sept. 18, 2023.
- Shin HJ, Na HS, Do SH. Magnesium and Pain. Nutrients. 2020;12(8):2184. PubMed website. https://pubmed.ncbi.nlm.nih.gov/32718032. Accessed Sept. 18, 2023.
- Supakatisant C, Phupong V. Oral magnesium for relief in pregnancy-induced leg cramps: a randomised controlled trial. Matern Child Nutr. 2015;11(2):139-45. PubMed website. https://pubmed.ncbi.nlm.nih.gov/22909270. Accessed Sept. 18, 2023.
- Fathizadeh N, et al. Evaluating the effect of magnesium and magnesium plus vitamin B6 supplement on the severity of premenstrual syndrome. Iran J Nurs Midwifery Res. 2010;15(1):401–405. PubMed website. https://pubmed.ncbi.nlm.nih.gov/22069417. Accessed Sept. 18, 2023.
- Pouteau E, et al. Superiority of magnesium and vitamin B6 over magnesium alone on severe stress in healthy adults with low magnesemia: A randomized, single-blind clinical trial. PLoS One. 2018;13(12):e0208454. PubMed website. https://pubmed.ncbi.nlm.nih.gov/30562392. Accessed Sept. 18, 2023.
- Vitamin B6. In: Hendler SS, ed. PDR for Nutritional Supplements. 2nd ed. Montvale, NJ: Physician’s Desk Reference. 2008:639.
- Ellis JM, et al. Response of vitamin B-6 deficiency and the carpal tunnel syndrome to pyridoxine. Proc Natl Acad Sci USA. 1982;79(23):7494-8. PubMed website. https://pubmed.ncbi.nlm.nih.gov/6961425. Accessed Sept. 18, 2023.
- Keniston RC, et al. Vitamin B6, vitamin C, and carpal tunnel syndrome. A cross-sectional study of 441 adults. J Occup Environ Med.1997;39(10):949-59. PubMed website. https://pubmed.ncbi.nlm.nih.gov/9343760. Accessed Sept. 18, 2023.
- Ebadi M. Regulation and function of pyridoxal phosphate in CNS. Neurochem Int.1981;3(3-4):181-205. PubMed website. https://pubmed.ncbi.nlm.nih.gov/19643063. Accessed Sept. 18, 2023.
- Vrolijk MF, et al. The vitamin B6 paradox: Supplementation with high concentrations of pyridoxine leads to decreased vitamin B6 function. Toxicol In Vitro. 2017;44:206-212. PubMed website. https://pubmed.ncbi.nlm.nih.gov/28716455. Accessed Sept. 18, 2023.
- Shen J, et al. Association of vitamin B-6 status with inflammation, oxidative stress, and chronic inflammatory conditions: The Boston Puerto Rican Health Study. Am J Clin Nutr. 2010;91(2):337-42. PubMed website. https://pubmed.ncbi.nlm.nih.gov/19955400. Accessed Sept. 18, 2023.
- Chiang EP, et al. Inflammation causes tissue-specific depletion of vitamin B6. Arthritis Res Ther. 2005;7(6):R1254-62. PubMed website. https://pubmed.ncbi.nlm.nih.gov/16277678. Accessed Sept. 18, 2023.
- Ellis JM, et al. Response of vitamin B-6 deficiency and the carpal tunnel syndrome to pyridoxine. Proc Natl Acad Sci USA.1982;79(23):7494-8. PubMed website. https://pubmed.ncbi.nlm.nih.gov/6961425. Accessed Sept. 18, 2023.
- Ryan-Harshman M, Aldoori W. Carpal tunnel syndrome and vitamin B6. Can Fam Physician. 2007;53(7):1161-2. PubMed website. https://pubmed.ncbi.nlm.nih.gov/17872812. Accessed Sept. 18, 2023.
- Prasad AS. Discovery of human zinc deficiency: 50 years later. J Trace Elem Med Biol. 2012;26(2-3):66-69. PubMed website. https://pubmed.ncbi.nlm.nih.gov/22664333. Accessed Sept. 18, 2023.
- Mills BJ, et al. Effect of zinc deficiency on blood glutathione levels. J Nutr. 1981;111(6):1098-102. PubMed website. https://pubmed.ncbi.nlm.nih.gov/7241230. Accessed Sept. 18, 2023.
- Senapati A. Zinc deficiency and the prolonged accumulation of zinc in wounds. Br J Surg. 1985;72(7):583-4. https://bjssjournals.onlinelibrary.wiley.com/doi/abs/10.1002/bjs.1800720728. Accessed Sept. 18, 2023.
- Zinc. In: Hendler SS, ed. PDR for Nutritional Supplements. 2nd ed. Montvale, NJ: Physician’s Desk Reference; 2008:730-734.
- Bonaventura P, et al. Zinc and its role in immunity and inflammation. Autoimmun Rev. 2015;14(4):277-85. PubMed website. https://pubmed.ncbi.nlm.nih.gov/25462582. Accessed Sept. 18, 2023.
- Jarosz M, et al. Antioxidant and anti-inflammatory effects of zinc. Zinc-dependent NF-κB signaling. Inflammopharmacology. 2017;25(1):11-24. PubMed website. https://pubmed.ncbi.nlm.nih.gov/28083748. Accessed Sept. 18, 2023.
- DiSilvestro RA, et al. Moderately High Dose Zinc Gluconate or Zinc Glycinate: Effects on Plasma Zinc and Erythrocyte Superoxide Dismutase Activities in Young Adult Women. Biol Trace Elem Res. 2015;168(1):11-4. PubMed website. https://pubmed.ncbi.nlm.nih.gov/25877802. Accessed Sept. 18, 2023.
- Gandia P, et al. A bioavailability study comparing two oral formulations containing zinc (Zn bis-glycinate vs. Zn gluconate) after a single administration to twelve healthy female volunteers. Int J Vitam Nutr Res. 2007;77(4):243-8. PubMed website. https://pubmed.ncbi.nlm.nih.gov/18271278. Accessed Sept. 18, 2023.