Magnesium Deficiency and Anxiety: How Nutrition Affects Mental Health.

According to Vox: By May 2024, Ebony Dupas realized she had a problem. At first, she felt a slight anxiety about her direction in life, but within a few months, this morphed into paranoia that she couldn’t overcome or explain.

On her doctor’s recommendation, Dupas began consulting with various psychiatrists, most of whom tried to diagnose her with generalized anxiety disorder, bipolar disorder, or schizophrenia. They suggested immediate medication. However, one psychiatrist initially proposed blood tests to uncover possible other causes. “I was mainly depleted in magnesium,” Dupas says.

Typically, people undergoing treatment for mental illnesses like anxiety or depression use only a combination of two strategies: medication (usually SSRIs) and psychotherapy. But there is growing interest in the connection between diet and the brain, specifically how nutrition can affect psychiatric conditions. Researchers have found that deficiencies in certain micronutrients, such as magnesium and choline, are associated with anxiety and depression.

How supplements might ease certain symptoms is less clear. As of now, there is no reliable clinical research showing how micronutrients affect mental health, and the role of supplements in this sphere remains uncertain. Most supplements do not require FDA approval to be marketed, leading to a plethora of different options, most of which have not been adequately studied.

Although researchers have long acknowledged the importance of nutrition for brain health, many individuals view their diet not as a means to improve mental health. Doctors also do not always consider the connection between mental health and dietary habits. “The connection between food and the brain is ignored by most people,” says Uma Naidoo, director of nutrition and lifestyle psychiatry at Massachusetts General Hospital and author of the 2023 book Calm Your Mind With Food. Further research clarifying the relationship between micronutrients—through food or supplements—and mental health outcomes could help elevate the importance of this issue.

What Role Does Nutrition Play in Mental Health?

The connection between diet and the brain may seem illogical, but it is based on fundamental biology. “The same environment where food is digested is also the environment where neurotransmitters are produced,” says Naidoo. The gut produces the majority of serotonin in the body, along with a significant amount of the neurotransmitter GABA. Medications that alter serotonin levels are often used to treat depression and anxiety. The most common group is selective serotonin reuptake inhibitors (SSRIs).

One of the most straightforward connections between nutrition and mental health concerns the impact of food on gut microbiota. Researchers have long known that gut inflammation and changes in gut microbiota are linked to mental disorders such as anxiety and depression. However, there is also a growing interest in how specific vitamins and minerals affect the brain.

“The brain and mental health are no longer just 'above the neck' issues.”

Uma Naidoo, Director of Nutrition and Lifestyle Psychiatry at Mass General

Deficiencies in several micronutrients, including magnesium, B vitamins, vitamin D, omega-3s, choline, and L-theanine, have been linked to mental health conditions. For example, researchers can induce anxiety in mice by altering magnesium levels. Nonetheless, the degree to which supplements impact human mental health is less clear.

Research is still quite limited and contentious. A 2024 review found that “magnesium supplements are likely helpful in treating mild anxiety and insomnia,” especially in individuals with low magnesium levels. But the results of studies demonstrating how magnesium supplements can benefit individuals with mental illnesses like anxiety or depression are often contradictory due to the variety of forms these supplements take.

Magnesium, for instance, can come in various forms such as magnesium citrate, magnesium malate, magnesium glycinate, magnesium oxide, magnesium chloride, and others. Which form of magnesium is most effectively absorbed by the body and delivered to the brain remains to be researched, notes Alexander Rojji, a psychiatrist in Long Island, New York, and senior author of the article. Similar questions also apply to other micronutrients.

As is known, consuming a variety of foods rich in certain vitamins and minerals is critical since your body cannot create them on its own. Studies show that most Americans do not get enough of the necessary micronutrients. Preliminary data from national surveys suggest that up to 94 percent of the U.S. population does not get adequate daily amounts of vitamin D, 52 percent do not get enough magnesium, and 92 percent do not get enough choline.

The importance of nutrition for brain health is beyond dispute. However, while the connection between diet and brain health is evident, gaps in scientific knowledge complicate precise definitions of the role that supplements should play in treating mental illnesses. Ideally, further research will help better understand how dietary micronutrients impact brain function and which supplements are best absorbed by the body and brain. Moreover, we still do not completely understand the mechanisms that lead to most mental disorders.

What Role Should Nutrition Play in Protecting Mental Health?

When the results of her blood tests came back, Dupas' psychiatrist prescribed her a course of supplements: magnesium, L-theanine, B vitamins, and omega-3s, along with a small dose of SSRIs. But Dupas did not stay on medication for long. Within a few weeks, “I felt clarity again,” she says. “I was able to focus again and didn’t feel paranoid that someone was following me.”

Dupas might have been an exception. Studies suggest that most people with mental health issues do not experience significant improvement in their symptoms from supplements alone. Nevertheless, she is grateful to have found a doctor who actually ordered tests to uncover possible hidden factors worsening her symptoms and hopes that other patients receive similar care.

Doctors should order tests for patients, especially if they have multiple health conditions or are taking medications that might affect their condition, notes Rojji. If deficiencies are found, they should certainly be taken into account. However, test results do not always provide an accurate picture. For instance, serum magnesium tests often show normal levels even when magnesium stores in the body are low.

Despite this, Rojji uses supplements as “part of a comprehensive approach” in treating his patients. The amount of supplements needed can vary from person to person, and they should not be seen as a replacement for other treatments, including medications like SSRIs or benzodiazepines. “If you expect magnesium to replace benzodiazepines for anxiety, you will be very disappointed,” he adds.

Not all psychiatrists are trained to assess nutrition issues when evaluating patients or looking for dietary deficiencies, Naidoo from Mass General also notes. This can lead to missing simple interventions that could significantly change the situation. Additionally, an overemphasis on supplements can pose its risks. If you follow a healthy and balanced diet, you are likely getting more than enough vitamins and minerals that you need.

“There is practically always” an opportunity to use nutrition to enhance mental health, as nobody actually has a perfect diet, says Naidoo. If you want to especially boost certain micronutrients in your diet, she recommends consuming more leafy greens, nuts, and legumes for magnesium. Dairy, eggs, and whole grains are good sources of B vitamins; eggs, beans, and cruciferous vegetables are good sources of choline; fatty fish and eggs are excellent sources of vitamin D; and L-theanine can be obtained from green tea.

Nutrition is an important tool for supporting our bodies. We now understand better that what food means for the body includes benefits for the brain. “The brain and mental health are no longer just 'above the neck' issues,” says Naidoo.