David Jones

For more than a decade, Kendall Platt worked as a crime scene forensic investigator – a job she found rewarding but also intensely stressful.

The 40-year-old mother of two says she would often lie awake at night thinking about the horrific images she had seen that day. Her sleep, unsurprisingly, suffered.

‘I would have bad dreams most nights and wake up sweating,’ says Kendall, from Reading. ‘And once that happened, I’d struggle to get back to sleep.’

So when, last year, Kendall changed career to become a professional gardener – offering what she describes as horticultural therapy to women – she expected her sleep to improve.

Moreover, desperate for a better night’s rest, Kendall also cut down on the amount of sugar she consumed and stopped looking at her phone in the hour before bedtime.

However, these changes did not have the effect she had hoped.

‘I was still waking up at 3am and lying awake for hours,’ she says. ‘Then the kids would wake up at 6am and I’d be up again, meaning I was getting very little sleep.’

Then, Kendall says she found a solution: a daily 10-cent dose of the vitamin magnesium.

Experts say magnesium is one of the most important nutrients our bodies need – but around one in five Americans do not get enough.

For more than a decade, Kendall Platt worked as a crime scene forensic investigator – a job she found rewarding but also intensely stressful

And, increasingly, magnesium tablets have been touted as a sleep-boosting supplement, leading to an explosion in its popularity, with this rising interest driven primarily by social media.

However, many doctors now also recommend magnesium for patients with sleep problems – based on what they believe is growing evidence that the supplement has a profound effect on rest and energy levels.

Kendall says she first learned about the sleep benefits of magnesium through social media. As a result, two months ago, she decided to give it a go, buying effervescent magnesium tablets from her local supermarket. The tablets contain a particular form called magnesium glycinate, which is thought to be most effective at improving sleep quality.

Kendall would place one of the tablets in water and drink it an hour before going to bed.

The effect was immediate. ‘I started waking up refreshed,’ she says. ‘My sleep has been consistently good for two months now.

‘I do occasionally wake up in the night, but I can easily drop off back to sleep in a way that I could not before.

‘I have more energy in the morning when I’m getting the kids ready for school. And I’ve got way more energy at work too.’

However, not everyone agrees that magnesium is a panacea for poor sleep.

In fact, some experts believe that the supplement has no effect at all.

So, do magnesium supplements really improve sleep – and should you be taking one?

The need for more sleep remedies is clear. Studies suggest that around a third of Britons suffer from insomnia – meaning they struggle to sleep. Meanwhile a quarter of people say they feel tired most of the time, regardless of how much sleep they get.

Experts say that it is this energy level crisis that has spurred the increasing popularity of magnesium.

Magnesium is found in leafy green vegetables as well as cashew nuts, beans and wholemeal bread. It is crucial for the muscles, immune system, bone strength and blood sugar levels.

Experts say magnesium is one of the most important nutrients our bodies need – but around one in five Americans do not get enough

Magnesium’s effect was immediate. ‘I started waking up refreshed,’ Kendall says. ‘My sleep has been consistently good for two months now’

In 2021, a major review of dozens of magnesium sleep studies concluded that patients with higher levels in their blood tended to sleep for longer and have more energy – though the effect was small.

Dr Oliver Bernath, a consultant neurologist at Guy’s and St Thomas’ Hospital and the Reborne Longevity clinic, both in London, argues that magnesium’s profound effect on sleep is that it boosts levels of a chemical called gamma-aminobutyric acid, which has a calming effect on the brain.

‘I’ve seen the really positive effect that magnesium can have for my patients with sleeping issues,’ he says.

Not all scientists agree. Dr John O’Neill, a biologist at the Laboratory of Molecular Biology in Cambridge, says that the only patients likely to benefit from taking magnesium supplements are those who have markedly low levels of the nutrient.

‘Your body can only hold so much magnesium,’ he says. ‘If a patient has normal levels and they take a supplement, then that extra magnesium will just be peed out.’

Instead, Dr O’Neill claims that it is more likely that patients who find their sleep improves after taking magnesium are experiencing the placebo effect – where they believe their symptoms have improved despite the medicine having no impact.

‘Most sleep issues are down to the stresses and anxieties of life, rather than vitamin deficiencies,’ he says. ‘A placebo can often be a very powerful treatment. Magnesium is also cheap and very safe, so there are few harms in taking it.’

Kendall says she doesn’t care whether or not her magnesium tablets are a placebo.

‘The effect is clear to me – it works and other steps haven’t,’ she says. ‘So to me, it’s worth it.’

Weight-loss drugs like Ozempic, Wegovy and Zepbound have benefitted millions of consumers by helping them shed pounds and become more metabolically healthy.

But as more time passes since their explosive entry into the weight-loss market, possible adverse or downstream effects become clearer.

Groundbreaking GLP-1 drugs mimic a hormone in the body that signals to the brain when to stop eating while slowing stomach emptying. This results in fewer calories — and fewer bone-boosting nutrients — taken in during the day.

When a person loses weight by restricting calories, they lose more than just fat and muscle tissue; they also lose crucial dense bone tissue.

And as fat tissue breaks down, the body loses valuable stores of the hormone estrogen, which protects bone. Without it, bones break down faster.

Given the number of GLP-1 patients experiencing bone density issues, though, the possibility that the drugs themselves can be the cause is being considered.

One study in obese people taking a GLP-1 found a nine percent increased fracture risk compared to people not on the drug.

‘Typically, when the goal is losing weight, long-term side effects such as loss of bone mass or increasing risk of fractures are not considered,’ Dr Daniel Ivankovich, a Chicago-based orthopedic surgeon, told the Daily Mail. ‘Weight loss patients should be asking about ways to lose weight slowly and preserve bone density.’

When weight drops too fast, more than two pounds per week, the body enters starvation mode, breaking down fat, muscle, and bone. It pulls calcium from the skeleton faster than bone can rebuild (stock)

He cautioned against rapid weight loss, which can happen with GLP-1 medications.

When pounds drop too fast — more than two pounds per week — the body goes into starvation mode and begins breaking down not just fat but also muscle and bone.

Specifically, the body begins to pull calcium from the skeleton to keep vital organs functioning. This process, called bone resorption, outpaces the body’s ability to rebuild new bone.

Over time, bones become thinner, weaker and more prone to fractures. \For people taking GLP-1 medications, this is a particular concern because these drugs can cause very rapid weight loss.

Limiting weight loss to one to two pounds per week gives the skeleton time to adapt and maintain its density.

And protein is nonnegotiable, Ivankovich said. It provides the building blocks for bone tissue.

Without adequate protein, the body cannot produce enough collagen matrix, which is the flexible framework that gives bones their strength and resilience.

Spreading protein across all meals ensures a steady supply throughout the day rather than a single spike.

To keep bones strong while losing weight, experts recommend consuming 1.2 to 1.5 grams of protein per kilogram of body weight each day. For a 200-pound person, about 91 kilograms, that means roughly 110 to 135 grams of protein daily.

Spread that across three meals with roughly 30 to 45 grams per meal by including foods like eggs, Greek yogurt, chicken, fish, beans or tofu.

This steady intake gives the body the building blocks it needs to maintain bone structure even as calories are cut.

Eating too little protein signals the body to break down not just fat but also bone and muscle, which is exactly what weight-loss medication users want to avoid.

‘Loss of mobility or flexibility such as having trouble walking, bending, or squatting are signs of bone loss,’ Ivankovich said.

‘Losing strength in the hands or legs is another symptom, along with fractured or broken bones after minor falls.’

When a person loses weight on GLP-1 medications, they also lose access to critical bone-supporting nutrients, including calcium and vitamin D. 

These nutrients are the raw materials that bones need to maintain their density and structural integrity. 

Without sufficient calcium, the body begins to draw calcium from the skeleton directly to support essential functions like nerve signaling and muscle contraction, causing bone resorption.

Vitamin D deficiency further compounds the problem by limiting calcium absorption from what little food is eaten.

Over months of rapid weight loss, a person can shed pounds while silently thinning their bones, increasing fracture risk from minor falls or even everyday movements.

Most people forget that rapid weight loss can thin bones and raise fracture risk, Dr. Daniel Ivankovich, a Chicago orthopedic surgeon, told the Daily Mail

Some people on GLP-1 can benefit from supplements to prevent these deficiencies. 

Dr James Chao, a San Diego-based plastic surgeon, told the Daily Mail: ‘For bone health aim to get 1,000-1,200 milligrams of calcium per day with 1,000-2,000 [international units] of vitamin D3 per day.

‘Magnesium and vitamin K2 are important as well but I’ll let you speak with your doctor about supplementation.’

For patients taking GLP-1 medications, adding exercise is also essential. 

Not all exercise is equal when it comes to bone health, however. Weight-bearing and resistance exercises are the most effective because they force the skeleton to work against gravity, stimulating bone-forming cells called osteoblasts to build new tissue.

These can include walking, jogging, climbing stairs, or dancing – anything where the feet and legs support the body’s full weight.

High-impact activities like jumping jacks, skipping rope or running generate the strongest bone-building signal. For people who cannot do high-impact moves, brisk walking on an incline or stair climbing still provides meaningful benefit.

Resistance training adds another layer of protection by strengthening the muscles that pull on bones, which in turn triggers bone density increases.

Recommended moves include squats, lunges, deadlifts and overhead presses using free weights, resistance bands or weight machines.

Experts suggest aiming for two to three sessions per week, focusing on major muscle groups and progressively increasing the weight over time.

This graph shows bone density changes at the hip before, during and after the low-calorie diet (shaded area) and one year of treatment. The exercise + liraglutide group (blue triangle) preserved hip bone density. The liraglutide-alone group (dark blue diamond) lost significantly more hip bone density than both the exercise (yellow square) and placebo groups (gray circle)

This graph shows bone density changes in the lower spine before, during, and after the low-calorie diet (shaded area) and one year of treatment. The combination group preserved spine bone density. The liraglutide-alone group lost significantly more spine bone density than both the exercise and placebo groups

For patients on GLP-1 medications who are losing weight rapidly, combining weight-bearing cardio with strength training is particularly important. Without these mechanical stresses, the body has little incentive to preserve bone mass, and density can decline even faster than fat.

A randomized clinical trial conducted in Denmark and published in JAMA Network Open sought to answer whether exercise, the GLP-1 medication liraglutide or both together can preserve bone density during weight loss.

Researchers followed 195 adults with obesity, with an average age of 43, for the one-year study following an initial eight-week low-calorie diet. Participants were divided into four groups: exercise alone, liraglutide alone, a combination of both or placebo.

The combination group lost the most weight, dropping an average of 16.9 kilograms, or about 37lbs. The liraglutide-alone group lost 30lbs (13.7kg), the exercise-alone group lost 24.6lbs (11.2kg) and the placebo group lost 15lbs (7kg).

Despite the combination group’s larger weight loss, this group preserved bone mineral density at the hip, spine and forearm.

Meanwhile, the liraglutide-alone group showed significant reductions in hip and spine bone density compared with both the placebo and exercise-alone groups.

Exercise alone produced similar weight loss to liraglutide alone but preserved bone rather than reducing it.

The researchers concluded that combining exercise with GLP-1 treatment is the most effective strategy for losing a significant amount of weight while protecting bone health.