July 2, 2019

Addressing the Challenge of Mineral Supplementation in Clinical Practice

Sponsored by Albion Minerals
CE Icon
CE Approved
CE Icon
CE Approved

In this interview Stephen Ashmead, MS, MBA, discusses mineral acid chelates and their functions. Listeners will understand the molecular characteristics and physiologic significance of chelated minerals. In addition to discussing mineral supplementation in general, Ashmead delves more deeply into the importance of magnesium and why magnesium chelate is the preferred form.

Approximate listening time: 31 minutes

Continuing Education Credits Available

This podcast interview qualifies for 0.5 general continuing education (CE) units. The Oregon Board of Naturopathic Medicine has approved this educational content for 0.5 “general” CE units for naturopathic physicians. Naturopathic physicians licensed in any U.S. state except California may obtain general CE by listening to this podcast and completing a 10-question test on the material contained within the clinical topic. Click the button below to take the test for FREE, thanks to an educational grant from Albion Minerals. Upon successful completion, you will receive an email confirming you passed. This CE approval may also qualify for the CE requirements of other practitioner types.

Take CME Test

About the Expert

Stephen Ashmead

Stephen Ashmead, MS, MBA, is a senior fellow in research and development at Balchem Corporation. He has a master of science degree from the University of Utah in Nutrition Science and an MBA from Western Governors University. His area of specialty is in mineral amino acid chelates and their functions.

About the Sponsor

Balchem is a supplier of Albion Minerals—highly effective nutritional mineral forms that can be easily absorbed by the human body. These special organic molecules are known as mineral amino acid chelates; they are used in nutraceutical supplements and food fortification to provide complete organic mineral nutrition, giving consumers the greatest chance to absorb minerals for their best biological advantage.


Karolyn Gazella: Hello, I'm Karolyn Gazella, the publisher of the Natural Medicine Journal. Today our topic is addressing the challenge of mineral supplementation in clinical practice. My guest is mineral expert, Stephen Ashmead. Before we begin, I'd like to thank the sponsor of this interview, who is Albion Minerals. Stephen, thank you so much for joining me today.

Stephen Ashmead: You're welcome. It's a pleasure to be here.

Gazella: Well, let's begin with the basics. Now why has it become so important to consider a mineral supplementation in clinical practice? Can't patients get everything they need from food alone?

Ashmead: In theory, yeah, you can get everything you need from food alone, but just our lifestyles, particularly here in the United States with our westernized diet, our agricultural practices. We typically don't consume enough of minerals and other micronutrients that we need in our diet, and so supplementation has become a way to deal with that.

Gazella: Right. So what are some of the challenges that clinicians face when it comes to mineral supplementation?

Ashmead: I think there are three main challenges that they face. The first one is just finding good formulations. There is a multitude of formulations that are out there that have micronutrients in it, and just trying to find the formulation that works the best for their patients or for their clients. That's challenge number one. Challenge number two is patient compliance. Some of the supplements, people don't want to take because it's too big. They're trying to swallow something that's too large. It causes gastric upset. They just don't feel it's working, so they just don't take it, or they have to take so many of them that it's difficult to do. I think patient compliance is challenge number two.

Then challenge number three is just impact of other nutrients. A classic example of this is iron bioavailability can be upregulated or downregulated just based upon what you do, what you consume. For example, if you take your iron supplement in the morning with your coffee or tea, you're probably not going to get as much out of it as if you took it with a glass of orange juice. I think those are three main challenges that clinicians face in trying to get minerals and mineral supplementation in with patients and their clients.

Gazella: Okay, so let's dig into these challenges. How do we overcome these challenges?

Ashmead: I think it's a multistep, multifactorial approach. The first one, in terms of finding good formulations, there are a couple of databases that are out there in the industry that can be utilized to screen and see what's out there. One is by the government with Office of Dietary Supplements, although that one probably isn't as much up to date. The other one is a new effort by the Council for Responsible Nutrition, where they are asking the members of their organization to post up their labels, and creating a database of those dietary supplements. I think that helps, trying to find and trying to screen what those are before you can recommend them to your clients. The other one is just trying to find supplements that have a history in their track record of being both efficacious as well as tolerable for your clients.

Then the third one, and probably almost as important, something that the clinicians can do themselves, is just educating their patients or clients on how to take these mineral supplements, how to incorporate them in the diet. Using our previous example, if they're prescribing an iron supplement, for whatever reason, or recommending an iron supplement for whatever reason, given them the education. Don't take this when you're drinking your coffee and your tea. You might look at what they do, and how their patients' lifestyle is, and make their recommendations based on that so they can get the most out of the supplements that they might be taking.

Gazella: Okay, that makes a lot of sense. Now I'd like to talk about... It seems like all of these things revolve around the quality of the product and the efficacy of the product. We have done a lot of articles and such on mineral chelates. I'd like to have us delve a little bit more into mineral chelates. First let's start with the research. Tell us a little bit about the research regarding the safety and efficacy of mineral chelates.

Ashmead: Sure. So there's been a lot of research that has been done both in clinical research as well as animal research, and even in agricultural research. There's been a lot of research done on how effective mineral chelates are. Albion has been doing research since 1965 on mineral chelates, and they have done safety studies. They've done tolerability studies. They've done bioavailability studies. They've done functional studies where bioavailability is a little hard to measure. They're just looking at the functional aspects on it. They've really done a lot of work just showing that these mineral chelates are safe, and an effective, and are very good sources of minerals.

Gazella: Perfect. Before we dig in a little bit further, how do you define a mineral chelate?

Ashmead: That's a good question. So a mineral chelate is a chemical structure. The chelate refers to a chemical structure, and what it is is there's a... I'm going to use a couple terms, and I'll explain what they mean. There is a term called the ligand, or ligand depending upon where you are in the country and what pronunciation you use. This is the entity that bonds to the mineral. When it bonds to the mineral it forms a ring structure. That ring structure is characterized by another term called heterocyclic. What that means is it just means that all the members of the ring, all the atoms in the ring, are not all the same. They're not all a carbon atom, or they're not all an oxygen, which makes sense. If you're trying to bind a mineral with something that's organic, then you're also going to be different than everything else anyway. It just makes sense. This is a chemical structure for a chelate, and that confers upon it some of the enhanced properties in terms of bioavailability, and safety, and tolerability.

Gazella: Right, so that's where I want to go next. What makes these mineral chelates more effective? What are some of the factors that make a nutritionally functional chelate effective?

Ashmead: That's a really good question because there are chelates out there that are very, very good chelators, but they're not really nutritionally functional. Some of our drugs are based upon chelates to be able to take metals out of the body if there's a toxic thing. They're not really designed to be bioavailable or nutritionally functional. They're designed to do something else. For a nutritionally functional chelate, I think there are a few things for consideration. First of all, in definition, is it's got to be a chelate. It's hard to have a nutritionally functional chelate if you really don't have a chelate to begin with.

Second one is it's got to be relatively small in size. What that is, there's some literature out there. Some stay it needs to be less than 800 Daltons. Some say it needs to be less than 1,000 Daltons. I don't know where that exact number is, but what it needs to be is it needs to be small enough so the body doesn't have to digest it before it can actually utilize it. If the body has to digest before it gets utilized, then you lose some of the benefits of it being chelated if you've got it digested before it can be used. I think it also needs to have stability constants that are effective. What do I mean by effective? We want it to be bound up tight enough by the chelate that it helps protect it and still has those properties. At the same time, we don't want it to be bound so tight that the body actually can't utilize the metal once it gets absorbed.

So where that is, it depends upon the ligand and the metal. It varies, but it's a real balancing act, just kind of hit a sweet spot between the two. Then the third thing, I think, is that your ligand, or the binding entity, really needs to be something that the body can use. I know that out in the literature there's a lot of talk about iron-EDTA chelates being utilized as good food fortificants, and EDTA chelates are really good chelators, but our body doesn't use EDTA. On the other side, amino acids, our body would use amino acids. It could utilize them in the energy cycle. It could use them for protein building depending upon the need of the body at that time. So that ligand, that binding entity, can also be used by the body. I think those four things are the things that really make up what a nutritionally functional chelate is.

Gazella: Can you talk a little bit more about the absorption issue? Will a practitioner know that a chelated mineral is better absorbed in the body versus a non-chelated mineral?

Ashmead: Yeah, there's certainly some research out there that would show that that is, but looking at a bottle of a mineral supplement, it's going to be really, really difficult to tell just because our labeling laws don't allow for that sort of information to be on there. There isn't enough information on those bottles to tell whether or not they've really got a chelate in there or not.

Gazella: Interesting.

Ashmead: It's interesting, yeah.

Gazella: Yeah.

Ashmead: Some of the things they need to do is, really, they need to look for a brand that has some trust and reliability built up and looking for indications that that brand in there. For example, with the Albion products, the Albion brand will be on the bottle. Companies such as ours and others who have built a brand are really protective of that brand to make sure, one, it's being used correctly, and two, that the product is actually in there.

Gazella: Right. So Albion makes chelated minerals that are ingredients that are in dietary supplements, correct?

Ashmead: Correct.

Gazella: So when the practitioner looks at the supplement that they're using, it will say that it's an Albion ingredient?

Ashmead: Yes.

Gazella: Okay, I see. So that's one way-

Ashmead: That's one way they can tell.

Gazella: Yeah, because you were talking about the fact that there are true chelates, and there are so-called chelates, and the so-called chelates are not functional. They should be avoided, basically, is what you're saying?

Ashmead: Correct.

Gazella: Okay, perfect. Is there anything else practitioners should look for other than that brand on the label? Anything else that comes to mind, or is that the primary thing to look for?

Ashmead: That's really the primary thing that they would look for because the label is going to tell them how much of the mineral is in there. It might list a source, but it doesn't have to list a source. They might be able to look at the ingredient list and see a source on there, but really looking for that brand name from an ingredient supplier who has built their reputation for an efficacious product, as Albion has done, is really the primary way that they can tell that they're getting a good product.

Gazella: Okay, great. Now before I leave the topic of chelates I have one more question. You mentioned that Albion has been doing research since 1965. Can it be assumed that a lot of the research on chelated minerals actually features the Albion chelated minerals? Is that a fair statement?

Ashmead: I would say that that is a fair statement. There is a lot of information out there. Albion has developed a lot of that information, developed a lot of the patents surrounding the chelated mineral products, not only for humans, but for animals and for plants as well. We have chelates for those entities as well.

Gazella: Okay, perfect. I think that's why looking for that brand is so important, because you don't want to buy a product that's using borrowed science, or hasn't been studied in the scientific literature. I think that's important to our practitioners. I'd like to switch gears. I'd like to talk about magnesium, because magnesium plays such a significant role in the human body. What forms of magnesium are presently on the market for practitioners to choose from?

Ashmead: Oh, goodness. There's a number of forms. Probably one of the most common ones is magnesium oxide. There's magnesium sulfate, magnesium citrate, lactate, magnesium phosphate. Albion provides a di-magnesium malate, a magnesium creatine... Excuse me, a magnesium creatine, and of course we supply amino acid chelates such as the magnesium bisglycinate chelate.

Gazella: So that's why I wanted to ask that question, because what's the preferred form of magnesium, and why do you feel it's the best form to choose? Because there are a lot of different forms, so what's preferred, and why is it best?

Ashmead: That's a loaded question because the other part of that is what is the intent? What are you trying to do with that magnesium? You're just trying to supply magnesium for supplementation? Then the next set of questions that have to be answered is, how is supplying that magnesium? Is it going to be in traditional capsule tablets? Is it going to be as a gummy? Is it going to be in a drink? I think the best magnesium that is selected depends upon some of those factors. For example, traditional capsules, tablets, they have finite volumes.

Depending upon how much that manufacturer wants to put in magnesium, that affects a little bit of what are the sources that they might use when they have to cram so much ingredient within a finite volume. You really can't expand that volume because the capsule shell is what the capsule shell is. It doesn't get any bigger, so it depends. Overall, I'm going to lean towards a magnesium bisglycinate chelate just because I believe that it's the most effective, one of the most tolerable, and certainly has a good record of safety and good record of use. So I'm going to lean towards that, but there are mitigating factors that might dictate something else.

Gazella: Okay, and you've mentioned the different delivery, capsules, tablets. Is the magnesium bisglycinate chelate... Can that be delivered across all of those vehicles, capsule, tablet, liquid, food, whatever?

Ashmead: Yes, and I'm going to qualify that just a little bit. It has certain properties in it, particularly you mentioned food. Sometimes food vehicles, depending upon the food vehicle, because that is a hugely complex area. Just think about the food that you eat each day, and how a mineral will taste in each of those foods is very, very different because they're such complex entities. So it may work in some foods. It may not work in other foods. I'm going to say yes, but I'm going to qualify it as well.

Gazella: Yeah, that sounds good. I think that's perfect. I'd like to talk a little bit about the technology associated with magnesium bisglycinate chelate. Now that technology has led to, according to what I've read, enhanced bioavailability, tolerability, and safety. Tell us more about that technology because it seems like that's pretty significant.

Ashmead: Yes, it is. So to talk a little bit about that technology, let me just back up just a little bit. When you think about your food that you consume every day, there are minerals in there and other micronutrients. For the most part, we tolerate that food extremely well. Now I'm not talking about likes and dislikes because if you want to talk about that, I really don't tolerate liver and onions really well.

Gazella: Me neither.

Ashmead: But in terms of just tolerability in terms of GI distress and things of that nature, for the most part, we tolerate our foods very well, and they have those minerals in there. Why do we tolerate it well from the foods? It's because nature packages those minerals up, typically with proteins. It might be with some nutrients, but their typically packaged up. I mean, it's not in there as salts like are commonly available, that we talked about with oxides, and sulfates, and so on of that nature. What the mineral chelates, bisglycinate chelates, and amino acid chelates do is they try to mimic how nature does it. They give the protection to the minerals to keep them from binding with other foods. They try to keep them from that binding, minimizes the amount of GI irritation. When we do that, we're mimicking a little bit what nature does. I think that's why these amino acid chelates, and in our specific example here the magnesium bisglycinate chelate, that's why it is efficacious, safe, and tolerable.

Gazella: What about the bioavailability issue? Is that correct, that it is more bioavailable?

Ashmead: Typically, yes, they are more bioavailable. Bioavailability is another complex issue that is dependent upon the body's need at the time. It may be dependent upon environmental issues such as what else is in the gut that can decrease bioavailability, and it often can depend upon genetics. If we're missing some of the necessary proteins and other enzymes to be able to handle some of our foods, then that's going to impact it. But comparing apples to apples, everything the same across the board, then yes, it provides for more bioavailability.

Gazella: So also comparing apples to apples, if I'm taking magnesium bisglycinate chelate, do I take the same amount as another form of magnesium? Is that apples to apples, or do I need to take less of the chelate?

Ashmead: That's a really good question. That's an interesting discussion. When you look at our labeling laws, it doesn't differentiate between the form. It's based upon the elemental amount of that micronutrient in there. A lot of consumers and a lot of perhaps clinicians are just looking at that number, which is totally appropriate because it's based upon RDIs that have been established by government entities, and that's totally appropriate. The question I think that's probably a little bit more appropriate is do I want to have or do I want to take a full RDI equivalency, or am I supplementing my diet, and do with less because I know I'm getting some in my diet? I think that's probably a more appropriate question versus trying to match bioavailability because, as I said before, bioavailability is such a complex issue that is very individualized. It's hard to make that general statement for the entire population.

Gazella: Yeah, that makes a lot of sense. Let's stay on the topic of tolerability just for a second. Now you mentioned GI irritation. Are there other symptoms of intolerability when it comes to magnesium, or is that the primary symptom of tolerability?

Ashmead: So magnesium has a well known reputation for causing GI distress, and it's typically manifested as diarrhea or laxation. You could also have gas, kind of a bloating feeling. Those are the principle ones for that. Some people may have an upset stomach, some nausea, with it as well. Again, particularly magnesium, some people are a little bit more sensitive than others. Why? I don't know. It's hard to look at a person and say, "Oh yes, you're magnesium sensitive," and the person sitting next to them, "No, you're not." There's no really way to look at that and tell, but the typical GI distress factors with magnesium are going to be laxation and gas.

Gazella: Yeah, that makes a lot of sense. It's good to know that the chelate form has better tolerability because I know in clinical practice our practitioners are running across that. Our practitioners are also very interested in research. I'd like to have you tell us a little bit more about the research specifically associated with magnesium bisglycinate chelate.

Ashmead: Okay, sure. Yes. Let me just describe some maybe perhaps more recent studies that have been performed on it. There was a study that was presented in 2016 at Experimental Biology meetings, and it was using an in vitro model, so they were growing cell. In this particular case, the cell model being utilized was a Caco-2 cell model, which is a human intestinal epithelial cell. It's very perfect for studying absorption. What they did in this particular study is they created a monolayer of cells. They applied various magnesium sources on what we would consider the luminal side, so the inside of the intestine, and look for magnesium coming through on the basolateral side, or coming through the cell and being exported out. They compared several different magnesium sources. They found that magnesium bisglycinate was significantly greater absorbed through those cells than magnesium oxide and magnesium citrate. So there's one study showing that we've got better absorption.

Another study that was done quite a number of years ago. Excuse me, sorry. This was done by a group out of Chicago. In this particular study, this was a human clinical trial, and they were looking at patients that had undergone ileal resection, so their intestinal system and absorption capabilities already been compromised through surgery. They were looking at whether or not the magnesium bisglycinate would help these patients out who are at risk for developing magnesium deficiency.

This study is interesting because this is one of the few ones on literature where they used isotopes of magnesium, stable isotopes of magnesium, so they could definitively determine that when they drew blood, and looking for magnesium in the blood, that it was definitely coming from the supplement that they gave them. What they found is those with the highest need, or the lowest levels of magnesium, absorb the magnesium bisglycinate much more effective than the inorganic magnesium oxide that they were comparing against. The interesting thing too is as a secondary endpoint that they were looking at in this study was tolerability, and they had very good tolerability from the magnesium bisglycinate as compared to the magnesium oxide. So there's one study.

Another study, and this one's really interesting. I like this study. I have four kids, and my wife has issues with cramping during pregnancy. There was a study that was done looking in pregnant women, and in the pregnant women, they were comparing the amount of leg cramps, particularly later in the pregnancy. They found that with the magnesium bisglycinate, not only did they have a significant reduction in the frequency of the leg cramps, but even when they did have leg cramps, and they asked them how intense those leg cramps were, there was a significant reduction in the intensity of leg cramps. So not only did they get fewer ones, but the ones they got were less intense than compared to those that were not getting the magnesium bisglycinate. Again, with that one there was really good tolerability. In fact, the patients preferred the magnesium bisglycinate over the other magnesium source because it was easier on their GI system.

Then another study just looking at tolerability. There was a study that we conducted where subjects were given a placebo, 300, 450, or 600 milligrams of magnesium. So we're going above the RDI. They were given that on a per day basis, and they were comparing GI and fecal consistency scores going across those doses. What we found there is that there really wasn't a significant difference between gastrointestinal upset of 600 milligrams of magnesium bisglycinate as compared to a placebo. Again, in terms of fecal consistency, there wasn't a decline in fecal consistency either, so we didn't have the laxation effect that you would typically see with magnesium sources. So that's some highlights and some studies.

Gazella: Yeah, I like the fact that the studies address these main issues of bioavailability and tolerability. The leg cramp study is awesome, and it's good that there's in vivo and human clinical trials. I think a lot of times our practitioners are definitely looking at those human trials when it comes to ingredients. So that's an important one as well.

Ashmead: It is. I-

Gazella: Oh, go ahead.

Ashmead: I was just going to mention too that with human clinical trials, particularly with magnesium, it's hard to find good clinical markers of magnesium. The typical gold standard right now is 24 hour urinary collection, which is really difficult to do, particularly in a clinical setting. A lot of times you're going to be looking at the functional mechanisms or functional outcomes such as was done with the pregnant women. Sometimes to get that really nitty gritty absorption data, you have to go outside of the human clinical model into an in vitro model.

Gazella: Okay. Now is there an average dosage? I know that you supply these ingredients to other manufacturers, so they determine how much they want to put in their formulation. Is the quantity of magnesium bisglycinate chelate, is it all over the board, or is there an average?

Ashmead: That's a good question, and it's difficult for me to answer that. I guess there is a little bit all over the board depending upon whether it's in a magnesium dose by itself, if it's with other ingredients, and how much of those other ingredients, what they're trying to do. I will say that from an RDA, RDI standpoint, typically what we're required and what we need is right around 400 milligrams, depending upon the country you're in. It might be a little less, might be a little more, but right around 400 milligrams a day.

Gazella: Perfect.

Ashmead: So looking for a supplement as a supplement, I'd probably recommend base upon that and try not to exceed that if you're supplementing your diet.

Gazella: Yeah, that makes a lot of sense. So as we mentioned, this is an ingredient that is found in products that are sold to healthcare professionals. Where can our listeners find the Albion chelated minerals, including this magnesium bisglycinate chelate that we've been talking about?

Ashmead: That's a good question. There are multiple dietary supplement products out there that incorporate them in. There are a couple of ways that I would recommend looking for them, trying to find them. First one is through our website at www.albionminerals.com/human-nutrition, and we have there a tab called Products and a program called Gold Medallion. In that area you will find some manufacturers that incorporate and use our minerals. Another way that you can do it that's probably as easy and maybe more appropriate to our lifestyle is go to amazon.com, and you type in Albion chelated minerals in your search term. It will bring up a variety of mineral products that incorporate Albion mineral products, including magnesium bisglycinate.

Gazella: Okay, that sounds good. I want our listeners to know that we are going to provide a link to albionminerals.com, so you can just click over and find the professional grade manufacturers who are incorporating these chelated minerals into their products. This has been a lot of great information. I would once again, of course, like to thank today's sponsor, Albion Minerals. And thank you, Stephen, for joining me and providing us with such great information today.

Ashmead: You're welcome. It's been my pleasure. It really has been.

Gazella: Great. Have a great day.

Ashmead: Okay, thank you. You, too.

Categorized Under