Calcium, Magnesium, and Estrogen

Here is a good clinical case to illustrate the interrelationship between these three important factors for healthy aging:

Background : A 65 year old patient in good health with family history of hypertension. She has had a complete hysterectomy 6 years ago and is on hormone replacement of synthetic estrogen (Premarin) 0.625 mg once a day.

The patient wishes to take calcium and Magnesium but is not sure how much.


Here are my thoughts:

1. She should not be on unopposed estrogen, especially Premarin (synthetic estrogen). That is a sure prescription for worsening hormonal imbalance (estrogen dominance). Though this is not your main question, you need to be careful. Consider progesterone (natural) cream to counter the effect and taper of estrogen.

2. Too high a calcium level leads to increased coagulation and increased risk of vascular accident.  Too low  a magnesium (and 80% of modern day diet is low in magnesium) will raise the ca/mg ratio, causing similar problem as too much calcium.

3. Most adults are walking around with estrogen dominance due to our diet and exposure to environmental estrogen.  Excessive estrogen reduces circulating Magnesium, leading to a relative excess of calcium. So any excessive calcium will only increase even more the already high ca/mg ratio in the presence of high estrogen. The lesions of arteries and heart caused by experimental Mg deficiency have been well documented and may contribute to human cardiovascular disease. Estrogen's enhancement of Mg utilization and uptake by soft tissues and bone may explain resistance of young women to heart disease and osteoporosis, as well as increased prevalence of these diseases when estrogen secretion ceases.


4. In summary:

a. Most of us are in an estrogen dominant environment, resulting in lowered Magnesium.

b. Most of us can easily get into a calcium dominant environment. Reason: Too little magnesium.

c. Most of us are in a magnesium deficient state.

As a result, we all end up with too much calcium.

What do you do? Simply reduce calcium intake and increase Magnesium. The ideal ratio is Ca/Mg ratio of 1 to 2 for adults. The same rule does not apply to growing children, and does not apply to those who are on whole food.

a. Obtain intracellular calcium and magnesium blood level if you want to be scientific about it.

b. Reduce calcium to 300-500 mg a day.

c. Increase magnesium to 500-1000 a day, or as tolerated (excessive amount can cause diarrhea).