Magnesium's Surprising Role In Preventing Strokes

Magnesium is the fourth most abundant mineral in the body and is responsible for a host of functions, including blood pressure, insulin metabolism, muscular contraction, nerve transmission, and neuromuscular conduction. A stroke occurs when the supply of blood to the brain is interrupted, leading to the death of brain cells. Given magnesium's role in neuromuscular function, there may be a connection between stroke recovery and magnesium.

Studies analyzing the link between stroke risk and magnesium levels have shown mixed results. On the one hand, low magnesium levels have been linked to higher mortality rates in patients after a new ischemic stroke, implying that magnesium offers a neuroprotective effect against ischemic strokes. However, more studies are needed to confirm this connection.

While there is little evidence supporting the use of magnesium oil for stroke recovery, some people believe that applying magnesium oil to the affected muscles can help improve mobility after a stroke. This could be due to the stimulation from massaging the affected muscles or the placebo effect.

A large-scale clinical trial called FAST-MAG found that administering intravenous magnesium to stroke patients within an hour of symptom onset did not improve stroke outcomes. However, the trial did demonstrate the feasibility of administering intravenous medications to stroke victims within the golden hour, during which they have the best chance of survival and avoiding long-term neurological damage.

Magnesium-rich foods can lower stroke risk

Magnesium is the fourth most abundant mineral in the body and is responsible for a host of different functions like blood pressure, insulin metabolism, muscular contraction, nerve transmission, and neuromuscular conduction. A stroke occurs when the supply of blood to the brain is interrupted, leading to the death of brain cells. This interruption is usually caused by a blocked or burst artery.

A review of seven international studies found that people who eat plenty of magnesium-rich foods – leafy greens, beans, lentils, nuts and whole grains – are significantly less likely to have a stroke. For every extra 100 milligrams of magnesium consumed each day above the average intake, the risk of having any type of stroke fell by 8%. A higher magnesium intake prevented ischemic stroke but did not significantly lower the risk of hemorrhagic stroke.

However, studies analyzing the link between stroke risk and magnesium levels have shown mixed results. On the one hand, low magnesium levels have been linked to higher mortality rates in patients after a new ischemic stroke. This would imply that magnesium offers a neuroprotective effect against ischemic strokes. On the other hand, a Phase 3 clinical trial called FAST-MAG found that giving stroke patients intravenous magnesium within an hour of the onset of symptoms does not improve stroke outcomes.

Prospective data on the relation of magnesium, potassium, and calcium intakes with stroke risk are inconsistent, and a combined mineral diet score has not been examined until recently. A recent study examined associations between intakes of magnesium, potassium, and calcium and the risk of incident stroke in 86,149 women in the Nurses' Health Study (NHS) I and 94,715 women in the NHS II. During follow-up, a total of 3780 incident stroke cases were documented. Pooled multivariate RRs of total stroke for women in the highest compared to the lowest quintiles were 0.87 for total magnesium, 0.89 for total potassium, and 0.97 for total calcium intake.

In conclusion, magnesium-rich food consumption should be recommended in dietary guidelines for high-risk individuals.

Magnesium's role in neuromuscular function and its potential to aid stroke recovery

Magnesium is an essential mineral that plays a critical role in neuromuscular function and has the potential to aid stroke recovery. Magnesium is involved in over 800 enzymatic reactions, including those involved in glucose metabolism, protein production, and nucleic acid synthesis.

Magnesium is a critical cofactor for hundreds of enzymes and plays a vital role in maintaining healthy blood pressure and regulating blood sugar by influencing the release and activity of insulin. It also helps to maintain low cytosolic calcium in order to limit the inhibition of ATP synthesis within the mitochondria, ultimately reducing the chances of cell death caused by mitochondrial calcification.

Magnesium's role in neuromuscular function is due to its interaction with the N-methyl-d-aspartate (NMDA) receptor. It serves as a blockade to the calcium channel in the NMDA receptor and must be removed for glutamatergic excitatory signaling to occur. Low magnesium levels may potentiate glutamatergic neurotransmission, leading to a supportive environment for excitotoxicity, which can cause neuronal cell death.

Magnesium also plays a protective role against excessive excitation that can lead to neuronal cell death (excitotoxicity). It has been implicated in multiple neurological disorders, including migraine, chronic pain, epilepsy, Alzheimer's, Parkinson's, and stroke, as well as the commonly comorbid conditions of anxiety and depression.

Magnesium has been shown to have a strong inverse association with total stroke and ischemic stroke, and a mild but not significant inverse association with hemorrhagic stroke, subarachnoid hemorrhage, and intracerebral hemorrhage.

Magnesium consumption may be recommended as an optimization for stroke prevention or management.

Magnesium's neuroprotective effect against ischemic strokes

Magnesium is a natural calcium antagonist that can be used to treat cerebral ischemic diseases. It can be administered in various ways, including intraperitoneal, intravenous, arterial, and intracranial magnesium supplementation.

Intraperitoneal magnesium supplementation

Intraperitoneal magnesium supplementation has been shown to reduce infarct volume in cerebral ischemic animals. It can also improve nerve damage caused by neonatal ischemia and improve prognosis in brain injury patients with relatively high serum magnesium levels.

Intravenous magnesium supplementation

Intravenous magnesium supplementation is widely used in the clinical treatment of eclampsia, pre-eclampsia, and neuroprotection of premature infants. However, large clinical trials have failed to show that intravenous magnesium supplementation improves the prognosis of ischemic patients.

Arterial magnesium supplementation

Arterial magnesium supplementation has been shown to improve cerebral blood flow and reduce infarct volume in cerebral ischemic animals.

Intracranial magnesium supplementation

Intracranial magnesium supplementation has been shown to improve neurological outcomes in cerebral ischemic animals.

Potential influencing factors of magnesium intervention in cerebral ischemia injury

• Magnesium dosage and route of administration
• Time of magnesium administration
• Post-ischemic hypothermia

Future research directions

• Magnesium supplementation into the circulatory system combined with magnesium supplementation in the lateral ventricle
• Magnesium supplementation in the lateral ventricle combined with hypothermia therapy
• Lateral ventricle magnesium supplementation combined with intracarotid magnesium supplementation combined with selective hypothermia

Magnesium's ability to dilate blood vessels in the brain

Magnesium is a well-known neuroprotective and vasodilatory agent with various experimental and clinical profiles. It is the second most predominant intracellular cation and can influence the cardiovascular system through vascular tone, blood pressure, endothelial function, platelet aggregation and coagulation, cardiac arrhythmias, and glucose and insulin metabolism.

Magnesium has similar properties to calcium antagonists and is considered a physiological calcium blocker. It is thought that magnesium's main action on vascular smooth muscle is to decrease intracellular calcium through the inhibition of calcium influx and the blockage of calcium release from the sarcoplasmic reticulum. The main effect of decreased intracellular calcium would be the inactivation of calmodulin-dependent myosin light chain kinase activity and decreased vascular contraction, inducing arterial relaxation.

Magnesium-induced vasodilation is partially dependent on KCa channels of smooth muscle cells but is not endothelium-dependent. This means that the dilation of the blood vessels is not reliant on the endothelium layer.

Magnesium also has anticoagulant and antiplatelet properties. It is considered to be nature's calcium blocker as it suppresses many of the physiological actions of calcium. For example, calcium promotes blood coagulation, whereas magnesium suppresses blood clotting and thrombus formation and reduces platelet aggregation, the synthesis of platelet agonist thromboxane A2, von Willebrand factor binding to collagen, and thrombin-stimulated calcium influx. Antithrombotic effects may lead to a reduction in the risk of both cardioembolic and large artery stroke.

Magnesium is also needed to maintain healthy blood pressure. A 2006 review of 12 randomised trials showed that magnesium supplementation lowered elevated blood pressure.

Magnesium's potential to reduce the risk of hemorrhagic stroke

A 2019 meta-analysis of 15 studies found that while magnesium intake was associated with a reduced risk of total stroke and ischemic stroke, there was no significant association with hemorrhagic stroke. However, the study did find a non-significant inverse association between magnesium intake and hemorrhagic stroke, meaning that while there was no proven link, there was also no proven lack of one.

Another study, published in 2012, reviewed seven international studies and found that people who consumed plenty of magnesium-rich foods were less likely to have a stroke. However, it did not specify whether this applied to hemorrhagic strokes.

A 2015 study that examined the association between mineral intake and stroke risk in two cohorts of US women found that high intakes of magnesium were associated with a reduced risk of stroke in women. Again, it is unclear whether this applies specifically to hemorrhagic stroke.

On the other hand, a 2018 mendelian randomization study found no association between genetically predicted serum magnesium concentrations and ischemic stroke or its subtypes, except for cardioembolic stroke.

Additionally, a 2024 clinical trial called FAST-MAG found that administering intravenous magnesium to stroke patients within an hour of symptom onset did not improve stroke outcomes. However, the study did find that intravenous medications can be safely administered by paramedics in the field within the "golden hour," improving patients' chances of survival and reducing long-term neurological damage.

While the existing research suggests that magnesium may play a role in reducing the risk of certain types of stroke, more studies are needed to confirm its specific impact on hemorrhagic stroke.

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