Simplified: Magnesium Dosing for ADHD

According to The Linus Pauling Institute at Oregon State University, it is thought that just over half of all Americans do not meet their nutritional requirements for magnesium¹ whereas WHO suggests that approximately 75% of Americans do not meet the recommended daily intake of Magnesium.

In ADHD Children with ADHD typically run low on magnesium at baseline. The reasons are not clearly understood but are though to involve genetic and environmental factors.

Examples of genetic factors include Mitochondrial dysfunction. This condition though to play a role in the development of ADHD, and mitochondrial disorders are thought to contribute to low levels of magnesium².

Example of environmental factors that drive down magnesium levels may include stress (which causes our body to loose magnesium), eating processed foods (low in magnesium), modern farming practices (which results in nutrient depleted soils, so plants no longer contain high amounts of nutrients) and the use of magnesium wasting medications (like stimulants for ADHD, which cause our bodies to lose magnesium).

In ADHD, adequate magnesium is important as this mineral plays a vital role in the production and regulation of special brain chemicals called neurotransmitters.

The four Neurotransmitters that Magnesium is involved with are:

GABA: known for its calming effects. GABA helps us feel more relaxed. In ADHD, there is thought to be a lack of GABA³ , which may contribute to symptoms such as inattention, hyperactivity, and impulsivity. GABA essentially acts the the brain's brakes. Low GABA can cause issues with concentration and memory⁴. By increasing the production of GABA in the brain, magnesium may help reduce these symptoms in children with ADHD⁵.

Glutamate: Individuals with ADHD are found to have an excess of a brain chemical called glutamate in certain areas of the brain⁶. Glutamate is an important brain chemical important for memory, cognition and mood⁷. It is called 'excitatory' and essentially steps on the gas pedal of our brains. But when there is too much glutamate in the 'wrong' areas of the brain, as in ADHD, brain cells are overstimulated/overexcited and will eventually become damaged. The symptoms we are going to see with too much glutamate are hyperactivity and impulsivity⁸. Magnesium works by decreasing Glutamate release.

Dopamine: ADHD is thought to be caused, in part, by a dopamine deficiency⁹. Dopamine is responsible for rewards and motivation, mood and learning, amongst others. When Dopamine is low we will have problems with low self-esteem, forgetfulness, impulsiveness and issues with executive functioning¹⁰. Magnesium helps to protect the brain cells that make dopamine and reduces inflammation in the brain.

Serotonin: Is know for playing positive roles in mood, learning, memory, sleep and hunger. It is referred too as the body's 'feel good' chemical. In ADHD there is thought to be low levels of serotonin leading to issues with hyperactivity, impulsivity and inattention¹¹. Magnesium helps our bodies make serotonin by helping to create the enzymes (special proteins that help speed up chemical reactions in our bodies) that our brains need to convert Tryptophan (in the food we eat) to serotonin. Those enzymes need magnesium to do their job properly and make the serotonin¹².

Potential benefits of magnesium supplementation in ADHD¹³:

• Improved focus and attention

• Better emotional regulation

• Fewer hyperactive behaviors

• Improved sleep

• Reduced anxiety and irritability

Which type of magnesium is best?

There are many different types of magnesium supplements on the market, such as magnesium oxide, magnesium citrate, magnesium glycinate etc. Each contains magnesium bound to another molecule, and those molecules can be large. So 100mg of a magnesium salt may contain far fewer milligrams of actual magnesium. Looking at the table below, for every 100mg for magnesium citrate for example, there will only be 11g of actual elemental magnesium.

Magnesium Compound	Percent magnesium by weight
Oxide	61
Threonate	7
Citrate	11
Glycinate	14

Different forms of magnesium vary significantly in how well the body can absorb them. For example the chloride and citrate salts are absorbed about three times as well as magnesium oxide¹⁴,¹⁵,¹⁶. They also vary in how likely they are to cause digestive issues like diarrhea, which is why magnesium glycinate works well in children¹⁷.

Best forms of Magnesium for ADHD: glycinate and threonate

Magnesium glycinate and threonate are particularly beneficial for children with ADHD because they can more easily cross the blood-brain barrier and help regulate brain function. Unlike some other forms, it has few gastrointestinal side effects, making it ideal for children who may be prone to digestive discomfort.

Recommended Magnesium Dosages for Children with ADHD

A word on the Recommended Daily Allowances (RDAs) numbers.  These guidelines were established by The Institute of Medicine of the National Academies as well as the Food and Nutrition Boards. These RDA values are based on meeting the nutrient requirements of 97 to 98% of ‘healthy individuals’ without the metabolic and nutritional complexities of ADHD.  The Food and Nutrition Board acknowledges that the RDAs that they recommend are not intended for individuals with specific health conditions (like ADHD).

In addition, the RDAs are the amounts recommended from all sources, food and supplements. Children with ADHD may be getting a lot less Magnesium from food compared to their neurotypical friends due to metabolic issues and underlying genetic issues driving their levels of magnesium down.

Below is a table with the RDA amounts for healthy individuals.

Age	RDA (mg)
1–3 years	80
4–8 years	130
9–13 years	240
14–18 years	360–410
19+ years	310–420

By comparison, children with ADHD are going to require higher doses of supplementation compared to their neurotypical friends as they are likely not getting enough Magnesium from food alone. Children with ADHD may need supplementation that exceeds these RDAs. According to "The ADHD and Autism Nutritional Supplement Handbook" by D. Godbout Laake and P.J. Compart MD, the recommended magnesium dosages for children with ADHD are higher. Please see table below:

Age (years)	Dose (mg)	Frequency	Total daily dose (mg)
2 to 5	100	1 or 2 times/day	200
6 to 10	100	2 or 3 times/day	300
11 and above	100–150	2 or 3 times/day	450

Dosage tips:

Whichever magnesium supplement you choose, start with a low dose and increase slowly to minimize side effects like diarrhea. For example, if the recommended dose is two capsules per day, start with one in the evening, and monitor your child’s tolerance before increasing the dose. For liquid formulations, use a 1ml syringe to start with a small amount (e.g. 0.5 ml) and gradually increase as needed.

Ok, so how do we dose using magnesium threonate or magnesium glycinate?

Magceutics brand Magnesium Threonate 60 count, is available in 1000 mg capsules, but only 7% of that is absorbable magnesium, meaning each capsule provides about 72 mg of magnesium. It needs to be noted that the dosing for the 60 count and 120 count bottle are different. The bottle with 60 capsules (60 count) has bigger capsules, so two capsules gives 144mg. The bottle with the 120 capsules (120 count) has smaller capsules, so you need 4 capsules to give 144mg.

If you are trying to provide 200mg of magnesium use 2 capsules of the 60 count bottle to give 144mg. I do not recommend dosing higher than the 200mg shown in the table above so do not advise taking 3 capsules as this puts us at 216mg for this young age group. For 300mg use 4 capsules of the 60 count bottle to give 280mg, and for 450 mg for older children, use 6 capsules of the 60 count bottle for 420mg.

The capsules can be opened and sprinkled into a small amount of apple sauce, yogurt, etc for dessert 30 minutes before bed time. I have tried it straight out of the capsule, it's gritty with a slightly acidic taste, so making it more palpable by mixing it well with something tasty should help.

And again remember to build up to the amounts shown in the table above over weeks. If 6 capsules is your goal because you have a teenager, dont start with 6 capsules on day one. Start with one capsule for a few days, then two for a few days, then three etc, all the while looking out for any tummy upset or other side effects. If you are sticking purely with Magnesium threonate, a 120 capsule container may last you anywhere from 20-40 days depending on dosing, so approx $30/month (or $0.25 capsule).

Some formulations, such as Kiddo Calm gummies by Magtein, contain even less magnesium (24 mg of magnesium per gummy). So gummies are going to be an option for younger children if you wanting to build up very slowly and introduce it into their system conservatively, before switching to the capsules form which can be opened and sprinkled onto food (otherwise you are going to need 4-8 or more gummies to even hit the recommended dose of 100-200mg daily, which gets expensive as there are only 90 gummies in a container).

If you are going to opt for Pure Encapsulations brand, they have a magnesium glycinate liquid which can be handy for children who cannot handle capsules. The liquid is 165mg per 10ml. So doing some math, thats 16.5mg per 1ml and therefore 12.12ml would give us 200 mg and so on. The bottle is 480ml, so at the lower dosing range (200mg/day) it would last just under 40 days and at the higher dosage range (450mg) it would only last 18 days, at $46. So not terribly economical but an option when capsules are just not going to work for a younger child.

Pure Encapsulations brand Magnesium glycinate capsules contain 120mg magnesium per capsule compared with 72mg for magnesium threonate. Therefore they have just under double the amount of magnesium compared to threnoate. A bottle of 180 capsules is $45 (or $0.25 per capsule) so the same so the same per unit cost as threnoate, but you are getting more bang for your buck with each capsule.

Here is where I recommend combining glycinate with threonate to make the dosages work: For a total 200mg magnesium daily, the child would take 1 capsule of glycinate at 120mg and 1 capsule of theronate to give 190mg of magnesium total. Using 2 capsules of glycinate gives us 240mg, which is higher than the dose of 200mg for children ages 2-5. We don't go over 200mg per day for this young age group, and the range as listed in the table above is 100mg once or twice per day, so if you are shooting for once per day then just take 1 capsule of glycinate instead to give 120mg.

For children 6-10, the total daily amount in the table above is 300mg maximum (or 100mg taken 2-3 times per day). Here you could take 2 capsules of glycinate to total 240mg if you are shooting for somewhere between 200-300mg, or if you want to hit 300mg/day, then use 2 capsules of glycinate to total 240mg and add 1 capsule of threonate to give 310mg. For the highest dose range of 450mg for older children, take 3 capsules of glycinate to total 360mg and add 1 capsule of threnoate to give a grand total of 430mg, just short of the max dose of 450mg. If you are aiming for lower just take 3 capsules of glyincate to give 360mg instead which would still be appropriate for anyone 11 years and older, given the range here is 200mg at the lower range (100mg twice daily, to 450mg at the upper range (150mg three times daily). See table above. The handy cheat sheet associated with this post (click the picture above) will have a table with example dosing strategies using the compounds above.

Loop in your child's healthcare provider when considering the Magnesium supplementation so they can keep an eye on your child. Let them know if your child is experiencing any side effects, like those listed below.

Side effects to look out for: diarrhea, tummy cramping, nausea.

Toxicity: Magnesium levels in the body are controlled both by the gut (controlling how much is absorbed) and by the kidneys (controlling how much is peed out). 

Magnesium is a relatively safe supplement as long as there are no kidney issues.  In children with kidney problems the body cannot remove excess Magnesium so this could cause it build up to levels high enough to cause toxicity issues.

Signs of toxicity could show up as low blood pressure, dizziness, nausea, vomiting, facial flushing, inability to pee, painful blockage of the intestine, depression, low energy, muscle weakness, difficulty breathing, irregular heartbeat, heart attack and in very rare cases, death.

Medications your child may be taking that Magnesium interacts with²:

• Bisphosphonates such as Fosamax (used to treat brittle bones). Magnesium can decrease the levels of this medicine in the blood making it less effective.

• Antibiotics should be taken at least 2 hours before or 4–6 hours after Magnesium

• Diuretics such as furosemide (Lasix) and bumetanide (Bumex), hydrochlorothiazide (Aquazide H) and ethacrynic acid (Edecrin), can cause the body to lose Magnesium in urine.

• Long term use (more than a year) of Proton Pump Inhibitor (PPI) drugs, such as esomeprazole magnesium (Nexium) and lansoprazole (Prevacid), can cause low levels of Magnesium in the body. If taking PPIs ask your provider to check Magnesium levels throughout the year to make sure levels don't get too low.

People who should not take Magnesium without first talking to healthcare provider: People with diabetes, intestinal disease, heart disease or kidney disease. 

In the PDF here that I have attached, I have provided a Cheat Sheet for Moms with a summary of Magnesium’s characteristics discussed above, as well as a ‘cut the dotted line’ section for when it comes time to dose Magnesium under medical supervision.

This site is for general informational purposes only and does not constitute the giving of medical advice. The contents do not constitute the practice of medicine, nursing, or other professional health care services. No provider–patient relationship is formed. Please consult with your child's healthcare provider when considering supplementation for children.

¹https://lpi.oregonstate.edu/mic/micronutrient-inadequacies/overview#:~:text=Other%20nutrients%2C%20including%20vitamins%20A,and%2038.9%25%20for%20vitamin%20C.

²https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5121149/#:~:text=In%20short%2C%20this%20is%20the,of%20ADHD%20at%20cellular%20level.

³https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3970207/

⁴https://mhanational.org/what-gaba#:~:text=In%20many%20of%20these%20disorders,are%20often%20symptoms%20of%20ADHD.

⁵https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7761127/

⁶https://pubmed.ncbi.nlm.nih.gov/27973969/#:~:text=Overall%2C%20glutamate%20levels%20in%20the,avenue%20for%20future%20pharmacological%20interventions.

⁷https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8586693/#:~:text=Glutamate%20is%20an%20excitatory%20neurotransmitter,%2C%20cognition%2C%20and%20mood%20regulation.

⁸https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5545734/#:~:text=The%20glutamate%20gene%20set%20was,the%20rest%20of%20the%20genome.

⁹https://www.webmd.com/add-adhd/childhood-adhd/adhd-dopamine

¹⁰ https://my.clevelandclinic.org/health/articles/22588-dopamine-deficiency

¹¹https://pubmed.ncbi.nlm.nih.gov/25684070/#:~:text=The%20onset%20of%20attention%2Ddeficit,may%20trigger%20symptoms%20of%20ADHD.

¹²https://www.mdpi.com/2072-6643/12/12/3672#:~:text=5%2DHT%20transmission%3A%20Magnesium%20directly,%2DHT%20synthesis%20%5B90%5D.

¹³ Godbout Laake, D. & Compart, P. J. MD (2013) The ADHD and Autism Nutritional Supplement Handbook. Fair Winds Press.

¹⁴ Bioavailability and Pharmacokinetics of Magnesium After Administration of Magnesium Salts to Humans; V.V. Ranade and J.C. Somberg

¹⁵ Magnesium bioavailability from magnesium citrate and

magnesium oxide; J S Lindberga, M M Zobitza, J R Poindextera, and C Y Pak; figure four.

¹⁶ Bioavailability of US commercial magnesium preparations; M Firoz, M Graber; table two.

¹⁷Bioavailability and pharmacokinetics of magnesium after administration of magnesium salts to humans; V V Ranade, J C Somberg; table one.