The other area I want to kind of dive into, and I find very interesting with respect to where magnesium plays a role in physiology, is the stress response. So the stress response that your body experiences involves the production of hormones, stress hormones like adrenaline, cortisol. Those stress hormones can potentially lead to a reduction or depletion of magnesium levels in the body. So these hormones are released during times of stress. And then subsequently, your body uses up more magnesium to try to help manage the stress reactions. So what ends up happening is this can reduce overall amounts of magnesium available for other functions of the body.

So to better understand how stress hormones like adrenaline can lead to magnesium deficiency or lower magnesium levels and its clinical implications, there was a study by White et al. that looked at how adrenaline, which is a well-known stress hormone, affects our magnesium levels. And what they found—I personally thought it was an interesting study—was that when adrenaline was infused into people, it didn't just temporarily lower magnesium levels; these levels stayed significantly reduced even an hour after stopping the adrenaline infusion without showing any immediate signs of bouncing back. So in other words, the adrenaline immediately lowered magnesium levels, and those levels stayed low for quite some time.

There have been a range of studies that have found that stress exposure, things that are stressful and are known to increase cortisol, adrenaline, can influence magnesium levels, both in blood and urine. So for example, young adults undergoing persistent or even intermittent stress, such as anticipating a military conflict, experienced substantial decreases in their overall and plasma magnesium concentrations over 3 months. And there were similar results or outcomes found when the impact of short-term— so this is a 1-day— and also a long-term, which would be like a month, of sleep deprivation on magnesium levels was examined. So this was done in healthy men, and both short-term and long-term sleep deprivation caused reductions in red blood cell magnesium.

Long-term sleep deprivation had the most robust impact. Another study found an increase in anxiety levels and a corresponding rise in urinary magnesium excretion in university students during exam time. So that would indicate, if you're excreting more magnesium in your urine, that you are not absorbing it and using it in your body. In another related study conducted over 4 weeks after exams, researchers found a significant reduction in the concentration of magnesium in red blood cells among college students. Yet again, sort of solidifying how the stress response will lower magnesium levels. So yet another study confirmed this. This was done in people that were impacted— they were affected by noise exposure.

So they had been subjected to noise exposure, and their magnesium levels went down after the noise exposure, and their urinary excretion peaked after a few hours and it continued for up to 2 days. So it seemed like there was some sort of long-term effect with respect to excreting more magnesium through urine, which is something I mentioned that alcohol also does, just from that stress response from the very loud noise exposure. It's interesting how our body magnesium levels respond not only to mental stress, but also physical stress like exercise. So acute or short-term stress can lead to a brief spike in our blood magnesium levels. This phenomenon is known as transient hypermagnesemia.

This has been observed in the aftermath of like short, intense exercise sessions lasting around 20 minutes. But after pushing your body hard, it appears it rallies the magnesium resources, probably to aid in energy production, you know, and other vital functions. But when you start to engage in a more prolonged, let's say 1-hour session, that initial elevation in magnesium is not found. And it seems like there's a threshold after which your body does not respond in that way. And magnesium levels then have been noted to go below what your baseline resting levels are. So exercise does deplete magnesium. But let's talk briefly about why mental and physical stress can decrease magnesium.

So the body's neuroendocrine system responds to stress through a process that many will recognize as the fight or flight response. So this is primarily activated by the adrenal glands. The hormones adrenaline and cortisol rapidly increase during this response. They're responsible for preparing the body for action. Now, part of this preparation involves the mobilization of magnesium, which is a crucial cofactor for enzymes that drive energy production and utilization in the form of ATP. So during this stress response, the body rapidly pulls magnesium from cells, causing a temporary surge in serum magnesium levels, but the catch is this mobilization of magnesium is not an infinite resource.

So as the stress continues, it's mobilizing magnesium and then expelling it through urination, which then gradually depletes our overall body store of magnesium. And then there's the role of cortisol, which is often considered the body's primary stress hormone. So when cortisol levels rise, it signals to the kidneys that they need to kick into turbo mode and start expelling more magnesium out of the body. This action further reduces our body's total magnesium supply. And then on top of all this, stress also triggers certain hormones that can affect the balancing act of magnesium in our body, especially in organs like the gut, kidneys, and the bones. So these hormones can result in less magnesium getting absorbed in the intestines, more getting expelled from the kidneys, as I just mentioned, leading to this downward spiral in magnesium levels if we don't replenish it properly.