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Could Low Macrominerals Be Causing Your Symptoms?

Written by Dr. Ruscio on November 14, 2022

Written by Dr. Ruscio on November 14, 2022 — Reviewed by Heidi Turner

Dr. Michael Ruscio is a DC, Naturopathic Practitioner, researcher, and clinician. He serves as an Adjunct Professor at the University of Bridgeport and has published numerous papers in scientific journals as well as the book Healthy Gut, Healthy You. He also founded the Ruscio Institute of Functional Health, where he helps patients with a wide range of GI conditions and serves as the Head of Research.

Healthy Macromineral Levels Support Important Day-to-Day Functions

• What are Macrominerals?|
• Deficiency Symptoms|
• Natural Ways to Increase Macrominerals|
• Supplemental Macrominerals|
• Supporting Macromineral Levels|

There are some essential minerals that we need to function well on a daily basis such as (but not limited to) magnesium, calcium, and sodium. If you are low in these major minerals, you may experience symptoms or illnesses such as dizziness, fatigue, and osteoporosis. 

Fortunately, there are some simple ways to improve macromineral levels through daily lifestyle changes such as decreasing processed foods, increasing whole foods of meats and veggies, and improving your gut health. Some groups of people may need additional supplementation, such as people with POTS (postural orthostatic tachycardia syndrome) or athletes with a heavy training load.     

In this article, we will take a look at which macrominerals are most often too low, what problems they might cause, and how to make sure you are getting enough of them so you can start feeling better. 

What are Macrominerals?

Macrominerals, according to the National Institutes of Health, are any essential dietary minerals we require in fairly large amounts relative to trace minerals (microminerals). The main dietary minerals we need in large amounts are calcium, phosphorus, magnesium, sodium, potassium, and chloride. These are needed in larger amounts than microminerals and trace elements such as fluoride, selenium, chromium, molybdenum, and manganese.

Why are these macrominerals so important? They are needed to support many essential functions of the body on a daily basis. 

In fact, you will recognize these macrominerals as you have probably heard of them in relation to either bone strength, heart health, or electrolyte balance. 

The most common macrominerals adults and children are deficient in are [2, 3, 3]:

• Calcium
• Potassium
• Magnesium

The standard American diet, which is high in processed foods and sugar and low in fruits and vegetables, is especially low in calcium, potassium, and magnesium [2, 3]. This makes these the most common macromineral deficiencies. Conversely, we tend to take in macrominerals like phosphorus in excess, due to its presence in baked goods, soda beverages, and red meat [4]. 

A quick note: Because the term “macros” has been everywhere in the health space recently, It is easy to confuse the terms macrominerals with macronutrients. Macronutrients are essential nutrients that we need in large amounts in order to function, rather than essential minerals. The three macronutrients are carbohydrates, protein, and fat. 

In the next section, we will talk about the symptoms you may experience in your daily life if your macromineral levels are too low. 

Symptoms of Macromineral Deficiency

Without macrominerals we simply cannot function, and low levels can greatly hinder your health. 

Probably the most common manifestation of a macromineral deficiency people know about is having an electrolyte imbalance. Electrolytes not only reflect and regulate proper hydration levels in your body but also maintain muscle and nervous system function [5]. 

The most likely reason for low electrolytes is dehydration. Dehydration occurs when you have water loss and some combination of altered potassium, chloride, magnesium, and/or sodium levels. Some common symptoms of dehydration/ an electrolyte imbalance are dizziness, fainting, shakiness, muscle fatigue, and nausea [6].

When mentioning low electrolytes, it’s helpful to say here that some people have a condition called POTS (postural orthostatic tachycardia syndrome) which often comes with chronically low sodium and other electrolytes. [7] These persistent electrolyte imbalances disrupt the fluid balance in the body causing low blood pressure, headaches, shakiness, and fatigue.

Calcium is another macromineral that is also often low, and you may not find out until you’re diagnosed with osteoporosis or low bone density. Although, many people also experience bone pain, bone fractures, muscle cramps, reduced cognition, and/or numbness and tingling.

If concerned about your macromineral levels, you can check them at home:

1. Keep track of your food and beverage intake over a typical 24-hour period [8]. (There are apps that can help with this like MyFitnessPal or ViCa Vitamin Tracker.) 
2. Once you have a list of what and how much you consumed, you can look up each item and quantity in a reliable food composition database [9], such as the USDA’s FoodData Central [10]. 
3. Then add up your macrominerals. (Or the apps will do this for you.) 
4. Lastly, compare your macromineral amounts to the recommended daily amounts in the table below.

All of your macrominerals can also be checked with a simple blood draw, and if you have any of the symptoms above, this will probably be the first thing your doctor will check.

However, I often find that electrolyte levels can appear normal in blood work, but clinically, my patients can still experience symptoms of a deficiency. This is because the body is highly efficient at regulating serum electrolyte levels but not levels inside our cells. When patients respond well to supplemental electrolytes like magnesium, their intracellular levels are likely low.

Below is a comprehensive table that covers many of the symptoms of a macromineral deficiency.

Natural Ways to Increase Macrominerals

Optimizing your macromineral status all starts with changing your diet and healing your gut. Fortunately, there is an easy way to improve your levels of these major minerals — with whole foods, particularly dairy products, fruits, and vegetables.   

As you can see from the list above, of foods rich in different macrominerals, eating a whole-food diet of a variety of foods is a good way to support your macromineral levels. While some processed foods and cereals have added minerals, eating a variety of fresh, whole foods is a more desirable option. 

At the clinic, we often start with a Paleo diet which removes inflammatory foods such as grains, gluten, and processed foods, and encourages a variety of meat, vegetables, and healthy fats.

We also look at gut health when improving macromineral levels. In particular, making sure you are not low in stomach acid is helpful because low stomach acid can impair the absorption of calcium and magnesium [19]. A common reason for low stomach acid is gastritis (inflammation of the gut) and acid-blocking medications. 
Better gut health through an improved diet and often probiotics will decrease gut inflammation and, in turn, support better absorption of macrominerals.

Should You Take Supplemental Macrominerals?

But what if diet is not enough? 

Fortunately, for most people, diet will be enough to improve macromineral levels. However, there are some times when it may not be enough to boost the amount of minerals in your body. 

In general, if you have found that your diet has a low mineral content and/or you have an increased nutrient requirement (like during pregnancy), you can also increase your macromineral levels by taking a multivitamin-multimineral supplement that contains the full spectrum of micronutrients [20, 21, 22]. 

However, if you know or suspect that you are low in only one macromineral, such as magnesium or potassium, supplementing with just that nutrient may make more sense. You are more likely to get a therapeutic dose and, especially if you eat a nutrient-dense diet, taking a multivitamin could put you over the levels needed for other vitamins and minerals. 

While this typically isn’t a problem, if you overdo it by too much for too long, you can start to experience unwanted side effects or toxicity.

If you are unable to eat foods high in calcium such as milk products (often due to lactose intolerance) or fish, and/or if you are low in vitamin D, you may want to consider supplementation that can help with calcium levels. 

In general, calcium supplementation alone is not as effective at improving bone density and reducing fractures as we think it is [23]. If you cannot eat calcium-containing foods, you may want to talk to your doctor before taking a calcium supplement. However, when truly indicated, calcium is best absorbed when combined with vitamins D and K, so a combination of supplements is probably your best option to support the calcium levels your body needs.  

Vitamin D is important in bone health because it promotes calcium absorption from the gut [24]. A large study of 10,000 older adults showed that vitamin D and calcium supplementation resulted in a 16% reduction in bone fractures [25]. When possible, the best way to support Vitamin D levels is with 15-20 minutes of sun exposure daily.

Do We Need Extra Electrolytes?

There are a few reasons why someone might use an electrolyte supplement mix. 

Athletes or those who lose a lot of electrolytes through sweating and muscle use may need additional electrolytes on heavy workout days. Regular runners, sauna users, and those who live in hot climates also fall into this category and may benefit from supplemental electrolytes. In these cases, a good electrolyte mix such as LMNT can be a great way to start to feel better. 

As previously discussed, people with POTS often need supplemental electrolytes because they tend to have low sodium levels. They too can use an electrolyte mix, but some people, with severe symptoms of POTS may have a port or PICC line (which provides direct access to larger veins) put in so they can get intravenous saline (sodium). 

For supplementation of macrominerals, especially if you are having severe symptoms, work with your doctor to get your levels checked so you know what supplementation will be best for you. 

Supporting Macromineral Levels for Better Health

Macrominerals support the daily functioning of our brain and body. When we do not have enough of them, we may struggle to get through the day with fatigue, headaches, and shakiness, or we could have more severe symptoms over time.

Because the standard American diet is low in some of our essential macrominerals like calcium and magnesium, it is important to improve the quality of your food as your first step to restoring nutrient levels.   

A varied, whole-food diet including meat, fish, and a variety of colorful vegetables is the best way to support your macromineral levels and improve any gut health issues that may be leading to poor nutrient absorption. Consider adding in some dairy (if you can tolerate it) and fish with the bone in, such as canned sardines, for calcium. Be sure to fill at least half of your plate at each meal with veggies for your other macrominerals. 

You can check the levels of macrominerals in your diet by recording what you eat and drink to get an estimated daily level. If your levels appear to be low, you can add in a multivitamin or individual supplement, which is generally safe to take long-term. To be safe, do not exceed the recommended daily limits of all nutrients, including macrominerals for an extended period of time [22].

If you have severe or chronic symptoms of low macrominerals, you should want to get your levels checked by your doctor. If you have been having a variety of symptoms and you are not sure if your macrominerals are balanced and you would like some support, we would be happy to help you at our functional health clinic.  

The Ruscio Institute has developed a range of high-quality formulations to help our patients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you.