Uncommon Cold: Mental Health (pt. 2)
The science and practice of deliberate cold exposure (during midlife crisis)
MAGNESIUM FOR MENTAL HEALTH
SUMMARY
Mental health depends healthy mitochondria, and mitochondria require magnesium.
Magnesium deficiency is difficult to detect, because blood tests are ambiguous.
Oral supplementation with magnesium L-threonate has reversed both cognitive impairments and depressive disorders.
Ice baths activate brown fat, which promotes mitobiogenesis and expression of neuroprotective hormones.
Brain wave data from electroencephalography (EEG) suggests that an ice bath both spikes brain activity and puts the brain in a deep meditative state. The therapeutic possibilities of this paradox for brain health are not yet well understood.
Optimal mental health is likely achieved through two mechanisms: 1) metabolism, and 2) meaning. For many people, an ice bath practice provides both.
Magnesium deficiency and mental health
Magnesium deficiency has been demonstrated to impair brain metabolism. For example, Dr. James DiColantonio recently posted a study used magnesium supplementation to reversal of mild cognitive decline in Alzheimer's patients (Wroolie et al. 2017). After 8 weeks of supplementing patients with magnesium-L-threonate (MgT) + Vitamins C & D, the patient cohort showed measurable improvement in cognitive function. Moreover, after discontinuing the supplement, patients regressed.
Among the myriad nutritional demands of the brain, magnesium is probably the first one to target for therapeutic intervention – especially for those practicing deliberate cold exposure for their metabolism. For example, studies of people suffering from major depressive disorder reveal an association with magnesium deficiency (Jacka et al. 2009, Serefko et al. 2013).
Every metabolic function in the human body relies on magnesium, including energy production, protein synthesis (Reddy et al 2018) and Vitamin D photosynthesis (Dai et al. 2018). Magnesium is essential for functions in the brain, liver, kidneys, and repair of DNA. People who are deficient in magnesium are at greater risk of diabetes, cardiovascular disease, Alzheimer's, major depression, and a myriad of other diseases.
Magnesium is essential for mitochondrial function, and it is particularly important in activation and maintenance of brown fat. Magnesium concentrations in mitochondria are about ten times higher than elsewhere in the human cell (Gout et al. 2014) and nowhere in the body are mitochondria more densely packed than in brown fat.
That means that more cold means for demand for magnesium.
In one Russian study, exposure to -70C for only 3 minutes resulted a long-lasting 5%-10% increase in magnesium concentrations in the blood (Juravlyovaa et al. 2018). Most of that magnesium was likely released from the bones, where up to one-third of the magnesium stores are available to meet immediate metabolic needs.
Moreover, magnesium also plays a critical role in the function of insulin (Jahnen-Dechent 2012). According to Castellanos-Gutiérrez et al (2018) "several studies have reported that a lower magnesium intake is associated with an increased risk of insulin resistance," and "increased magnesium intake is associated with lower body mass index, (smaller) waist circumference and lower serum glucose."
How to measure magnesium deficiency?
Given that the effects of magnesium deficiency are so serious, insidious, and life-threatening, you'd think that everyone who is remotely concerned about their health and well-being would be anxious to understand their magnesium balance. Yet, there is still no reliable medical test for measuring magnesium levels in the body.
For most people, maintaining sufficient levels of magnesium requires a daily intake of at least 360 mg. Green, leafy plants are the most common source, but changes in agricultural and food industry practices have stripped magnesium from the foods that used to contain abundant quantities. Modern vegetables contain less than 10% of the magnesium measured in 1914 (Workinger et al 2018). As a consequence of these changes in agriculture and diet, most people in Western, industrialized countries fail to get the recommended daily allowance of magnesium in their diets (Barbagallo et al 2021).
However, studies based on blood serum concentrations of magnesium yield ambiguous results, mostly because less than 1% of bodily stores of magnesium is found in the bloodstream (Razzaque 2018). For example, in one study, 19 participants who bathed for 12 min in a hot Epsom salt bath showed small increases in blood serum magnesium, but big increases in urine concentrations. On average, magnesium concentrations in urine sampled 2hrs after just one bath doubled, compared to increases of less than 10% in the bloodstream (Waring 2015). Those results suggest that magnesium was being absorbed through the skin and either removed from the bloodstream by the kidneys or partitioned into other parts of the body for storage.
Given the deficiency in most Western diets, and the necessity of magnesium for recruiting new, mitochondria-packed brown fat cells, regular cold plungers might do well to take a regular magnesium supplement. My favorite is magnesium L-threonate, because that reaches the brain and was shown to be effective in the metabolic intervention studies that reversed cognitive decline.
However, there is another way.
The problem with oral magnesium, in either food or supplements, is that absorption is mediated by the digestive tract. For example, absorption of oral magnesium oxide into the body is poor, but has been used as an effective laxative known as as Milk of Magnesia since it was patented in 1873. By contrast, in rats magnesium-L-threonate (MgT) has been shown to elevate magnesium levels in the brain, leading to "enhancement of learning abilities, working memory, and short- and long-term memory" (Slutsky et al. 2010).
Different forms of magnesium partition into different parts of the body, depending on the chemical structures to which they’re attached. Nonetheless, Dr. Mark Sricus suggests in Transdermal Magnesium Therapy (2011) that oral supplements have complications that don't occur when dosing magnesium through the skin. Sricus points out that oral medicines must pass through the stomach and liver, whereas "transdermal application bypasses the liver, entering tissues and blood more directly." He suggests both soaking in a magnesium salt bath and applying oils infused with magnesium to the skin as effective transdermal dosage pathways.
A group of German researchers agree, writing:
Transdermal magnesium application should be the ultimate way to replenish cellular magnesium levels since every cell in the body bathes in it. It passes directly into the tissues via the skin, where it should quickly be transported to cells throughout the body. Furthermore, the transdermal absorption of magnesium in comparison to oral application is presented as being more effective on the one hand due to nearly 100% absorption, and as presenting fewer side effects on the other hand as it is bypassing the gastrointestinal tract.
- Gröber et al. 2017.
Epsom salt baths for mental health
Although some scientists are skeptical that magnesium can be absorbed directly through the skin (e.g., Gröber et al. 2017) direct laboratory measurements demonstrate that their skepticism is unwarranted. Back in 2016, researchers in Australia sought to settle the question of transdermal absorption in a series of experiments that established two facts: 1) magnesium ions penetrate human skin, and 2) hair follicles contribute about a third of total magnesium flux (Chandrasekaran et al. 2016). Wherever studies ruling out magnesium absorption through the skin are based on blood concentrations only, they cannot be accepted as definitive because magnesium can be stored in muscle and bone without being detected by a blood draw.
Studies based on hair and urine samples after soaking in an Epsom salt bath have shown better results. For example, "the measurement of magnesium levels in urine showed a rise from the control level, mean 94.81 ± 44.26 ppm/mL to 198.93 ± 97.52 ppm/mL after the first bath. Those individuals where the blood magnesium levels were not increased had correspondingly large increases in urinary magnesium showing that the magnesium ions had crossed the skin barrier and had been excreted via the kidney, presumably because the blood levels were already optimal" (Waring 2015).
Given that many Americans have an undiagnosed deficiency, adding 3-5lb of pure Espom salt to an ice bath may be a good way to help meet your bodily needs for magnesium, without risking side effects (like diarrhea) of supplements. I've dissolved as much as 18lb of Epsom salt (magnesium sulfate) in my 80-gallon ice bath tub without ill effects on the tub, the filtration, or the function of the ozone. While starting with 3-5lb is a good idea for softening ice, it is possible to add even more.
Even if you don't soak for extended periods of time, or you are concerned that the magnesium will not be absorbed through pores that are closed up tight by the cold water, you might increase absorption by postponing a shower after your ice bath. Showering before your ice bath, instead of after allows the salt to stay on your skin while rewarming, so that it has more time to enter your body through hair follicles and sweat glands as they reopen.
I have yet to conduct assays to test the efficacy of this hypothesis about carrying a residue of Epsom salt on my skin all day, so results are not assured. Nonetheless, it reminds me of being a kid at the beach, with my skin covered with ocean salt. It's not exactly the same, because the Epsom salt is much less noticeable than sea salt, but I like my skin so much that now I feel kind of funny without it.
Regardless, the mood-lifting upside of adding magnesium to your bath could be terrific, and the down-side risk is negligible, so it seems prudent to try it and see how it feels for yourself.
Magnesium as mental health therapy
The first double-blind, controlled trial of magnesium supplementation for treatment of major depression was in 2008. In a group of elderly, Type 2 diabetics who were newly diagnosed with major depression and deficient in blood serum magnesium, administration of magnesium chloride solution was just as effective for treating depression as the popular anti-depressant imipramine (Barragán-Rodríguez 2008). Since then, a number of studies have confirmed the salubrious effects of magnesium on the brain (e.g., Toffa et al. 2019, Botturi et al. 2020).
For example, a cross-over controlled study of over 120 patients in Vermont showed that magnesium chloride supplementation improved scores on a standardized questionnaire related to mental health. Subjects in both immediate and delayed treatment groups showed improvement after two to four weeks of taking magnesium, which faded 2-4 weeks after ceasing supplementation, suggesting that improvements were due to oral magnesium supplementation. Moreover, those patients already taking SSRIs were not excluded from the study. In fact, they experienced a greater positive effect.
The researchers concluded:
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