Constipation, characterized by difficulty emptying the bowels and often associated with hardened feces, can be incredibly frustrating and uncomfortable, significantly affecting your overall well-being. About 16 percent of all adults and 33 percent of those over 60 experience ongoing constipation symptoms. Those who are more at risk include people who are assigned female at birth, who are pregnant, or who are seniors, or who fit into more than one of those categories. Understandably, you may be in search of relief. If you’ve been following a ketogenic diet, you might be looking for solutions to keto constipation. This article explores how magnesium, an essential mineral and electrolyte, can help alleviate constipation, especially in the context of a ketogenic diet.
Understanding Constipation and the Keto Diet
The ketogenic diet is a very low-carb, high-fat diet. It involves drastically reducing carbohydrate intake and replacing it with fat. This reduction leads to a metabolic state called ketosis, where the body starts breaking down fat for energy. While offering benefits such as weight loss, lowered blood pressure, and better blood sugar control, the keto diet can also bring about side effects, including constipation, especially in the transitional period when you make the change from your previous dietary habits to your new keto lifestyle.
Several factors contribute to constipation on a keto diet:
- Dehydration: Insufficient water intake can lead to hardened stools and difficulty in passing them.
- Electrolyte Imbalance: Ketosis can increase the flushing out of electrolytes, including magnesium, potassium, and sodium, from your system. An electrolyte imbalance can contribute to constipation as well as diarrhea, headaches, cramping, and general weakness.
- Inadequate Fiber Intake: Many people are used to getting their fiber from processed “high fiber” cereals before they go keto. Traditional keto diets often neglect alkaline foods, which become critical for optimizing pH and therefore maintaining an optimal keto diet.
- Digestive Issues: High amounts of foods that are notoriously difficult to digest, including nuts, low-starch vegetables such as crucifers, and full-fat dairy products. Sometimes food sensitivities can cause constipation in certain individuals, so if you have eliminated the five most common constipation culprits and still have difficulty, consider that you may be uniquely sensitive to something that most people have no trouble digesting. Examples that come to mind are eggs and beef.
The Role of Magnesium in Relieving Constipation
Magnesium is one of the body’s seven essential electrolytes, which help maintain fluid balance by “pulling” fluids from one area in the body to another in a process you may remember from middle school biology: osmosis. Magnesium, an essential mineral and electrolyte your body needs for over 300 daily bioactivities, can come to your aid, generally producing a bowel movement within hours. It is involved in energy production, blood sugar control, blood pressure/heart rhythm regulation (heart health), bone health, and so much more. It can even be helpful for heartburn. Magnesium is also crucial for your mental health and a healthy sleep routine. Men should aim for 400 to 420 milligrams of magnesium per day.
Magnesium works for constipation through several mechanisms:
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- Draws water into the intestines: When you ingest magnesium (whether pill, tablet, liquid, dissolved powder, or other form), your digestive tract doesn’t absorb all of it. Magnesium draws water into the intestines, but different forms of magnesium have different resulting impacts of this influx of water.
- Softens stool: Increased water can soften stool, making it easier to pass.
- Stimulates a bowel movement: The influx of water into the intestines and the softened stool can create a pressure that stimulates intestinal muscle contractions (peristalsis), which helps move poo through your digestive tract.
Types of Magnesium and Their Laxative Effects
Not all magnesium types are created equal when it comes to their laxative effects. The body absorbs some types of magnesium better than others. When too much is left in the intestines, as is the case with magnesium hydroxide, it can produce the strong urge to go, causing discomfort such as cramping. Your symptoms may require a Goldilocks approach with a magnesium that has a “just right” level of absorption, acting as a moderate laxative.
Here's a breakdown of different magnesium supplements, ranked from least absorbed (producing a strong laxative effect) to most absorbed (less likely to produce a bowel movement):
Magnesium Hydroxide (Milk of Magnesia): It is also available as a chewable tablet. Magnesium hydroxide (aka milk of magnesia) is poorly absorbed, which can be a good thing for urgent constipation relief (under six hours), as it stays in the intestines to do its osmotic work. However, it should be used sparingly because it can produce diarrhea, cramping, and electrolyte imbalance with excessive use.
Magnesium Sulfate (Epsom Salt): Also known as Epsom salts, this form of magnesium can be used in baths to relieve muscle aches. Magnesium sulfate (aka Epsom salt) is also poorly absorbed, making it highly effective for constipation when consumed orally. It can produce quick constipation relief (under six hours). As with magnesium hydroxide, magnesium sulfate should be used sparingly rather than regularly. If you buy Epsom salt, be sure it’s a form you can safely take orally, rather than one intended for the bath only, as these might contain additives, such as lavender or another essential oil that’s not meant to be ingested.
Magnesium Oxide: Magnesium oxide is another poorly absorbed form, but it’s not as fast acting (takes more than six hours) as magnesium hydroxide or sulfate. It’s ideal for overnight relief because if you take it around bedtime, you should wake up ready to go in the morning. Since it works a bit slower, magnesium oxide may reduce your risk for intense side effects, such as diarrhea or cramping. When magnesium binds with oxygen, it forms magnesium oxide. Magnesium oxide has the highest concentration of elemental magnesium per dose. Because magnesium oxide isn’t easily or quickly absorbed, most of it goes right through you. When it hits your colon, it turns into a serious laxative. Magnesium oxide shouldn’t be an everyday supplement.
Read also: Magnesium Supplements for Keto
Magnesium Citrate: Magnesium citrate has a higher absorption rate than magnesium oxide. But it’s faster acting, doing the job in less than six hours. It’s ideal for bowel prep (cleaning out the intestines) before procedures such as colonoscopy. It serves a gentler alternative to magnesium hydroxide or sulfate, but it acts faster than the also-gentle magnesium oxide. As a bonus, since more of magnesium citrate is absorbed than magnesium hydroxide, sulfate, or oxide, it is also a good choice if you have constipation issues coupled with a magnesium deficiency. Magnesium citrate is magnesium bound with citric acid. It’s the most common form of magnesium, making it widely available, affordable, and often recommended. As a supplement, magnesium citrate (magnesium with citric acid) is the form of magnesium best known for its laxative properties.
Magnesium Chloride: Magnesium chloride is well-absorbed, making it less effective for constipation relief. However, if other types produce extreme side effects, magnesium chloride might serve as a gentler option for you. But it might take longer (more than six hours) to work. It’s also useful for correcting a magnesium deficiency and to help treat certain conditions, such as migraine. Magnesium chloride flakes mixed with water, coconut oil, or shea butter create magnesium oil.
Other Magnesium Types (Glycinate, Malate, Taurate, L-Threonate, Lactate, Orotate): Additional types of magnesium include glycinate, malate, taurate, L-threonate, lactate, and orotate. These are not generally effective as laxatives since they are highly absorbed. This type combines magnesium with an amino acid called glycinate. It’s easily absorbed by the body and can contribute to regularity.
Chelated Magnesium Supplements: Chelated mineral supplements bind amino acids (the building blocks of protein) to minerals. Amino acids help your body absorb minerals before negative side effects kick in. With magnesium, amino acids provide additional health benefits and lessen its laxative effects. Chelated magnesium supplements are the most bioavailable. You’ll notice fewer side effects and may improve other areas of your health thanks to the amino acids.
Magnesium Glycinate: Magnesium Glycinate, which is magnesium bound with glycine. Glycine increases bioavailability, and it’s also a relaxing neurotransmitter.
Read also: Exploring Magnesium Citrate and Its Impact on Weight
Magnesium L-Threonate: Magnesium L-threonate binds magnesium with l-threonate, a sugar acid found in capers, huckleberries, and pecans. Magnesium L-threonate is the only type that crosses the blood-brain barrier. So magnesium L-threonate may support brain health, reduce migraine headaches, improve memory, and reduce the risk of dementia and Parkinson’s.
Magnesium Malate: Magnesium Malate is magnesium bound with malic acid, which you’ll find in oranges, apples, and pears.
Magnesium Orotate: Magnesium Orotate is magnesium bound with orotic acid.
Magnesium Taurate: Magnesium Taurate is magnesium bound with the amino acid taurine.
Magnesium Aspartate: Magnesium Aspartate is magnesium bound with aspartic acid.
Choosing the Right Magnesium Supplement
The best form of magnesium for constipation will depend on your unique situation and your desired effect. The "best" type of magnesium for addressing constipation depends on multiple factors, including individual responses. To find out which type of magnesium works best for you requires experimentation, as there is no universal “perfect” form.
- For Urgent Relief: Types that aren’t as readily absorbed (hydroxide and sulfate) will work faster but may produce intense side effects.
- For Gentler Relief: Those that have limited absorption but are longer acting (magnesium oxide) and those that are moderately absorbed but faster acting (magnesium citrate) may produce fewer or less intense side effects.
- For Regularity: This type combines magnesium with an amino acid called glycinate. It’s easily absorbed by the body and can contribute to regularity.
When taking magnesium for constipation, start with the recommended product dose. Or you may even want to try a smaller dose to see how the product affects you. Taking magnesium at this time can be beneficial because its osmotic effects will go to work for you overnight. As a bonus, some forms of magnesium may improve your sleep. By morning, you should feel the urge to go.
Addressing Keto Constipation Beyond Magnesium
While magnesium can be a helpful tool, it's essential to address other factors contributing to constipation on a keto diet:
Hydration: Staying hydrated with lots of warm/room temperature water. Drink enough water. It’s so basic, but it’s so important. If you’re dehydrated, constipation is likely going to be an issue whether you’re following a keto diet, or any other diet for that matter. To increase your hydration and encourage stool passage, you can also drink herbal tea, caffeinated teas including black and green, organic coffee in moderation and bone broth. It’s especially important to increase your water intake when you’re increasing your fiber intake because if you only add fiber and don’t add more water to your diet, you can actually make constipation worse.
Electrolyte Balance: As just mentioned, electrolytes like potassium, sodium and magnesium can be decreased faster when you go into ketosis. To make sure your sodium levels are adequate, use a high quality pink Himalayan sea salt to season your food. A great keto-friendly source of potassium is the delicious and highly nutritious avocado.
Fiber Intake: Eat plenty of fiber: Fiber has many positive effects on the gut, including bulking stool. But be sure to increase your intake slowly over time to avoid any discomfort. Too much fiber, especially in the absence of hydration, can paradoxically contribute to constipation. Move over bran flakes, it’s time to get your fiber from low-carb, nutrient-dense items that are keto-friendly like leafy green vegetables. Even though the bulk of your calorie intake will be from fats, vegetables should still be included in just about every meal you have while on the keto diet.
Probiotics: If you’re struggling with keto constipation probiotics should not be forgotten! You should include acceptable amounts of certain fermented foods in your diet on a regular basis.
Exercise: By exercising regularly, you’re not only speeding up the movement of your body; you’re also speeding up the movement of your bowels.
Improve gut-brain communication: Conditions such as IBS, which can cause chronic constipation, are often rooted in disrupted gut-brain interaction.
Manage mental health: Stress, anxiety, and inadequate sleep can all contribute to constipation.
Precautions and Considerations
While magnesium is considered safe when taken in recommended amounts, it can cause side effects when taken in excess, including diarrhea, abdominal cramping, nausea and vomiting. The most reported side effects of taking magnesium include nausea, abdominal cramping, and loose stools (diarrhea). These are signs your body may not be absorbing optimal levels of magnesium in your intestines before the laxative effect strikes in your colon. If this happens, try splitting your dose in half. Hopefully it’ll be more absorbable if your body has to work to absorb a smaller quantity. Take one half in the morning and the other at night.
Magnesium can also interact with prescription medications, including insulin, specific antibiotics, heart medications and others. Magnesium supplements may interfere with certain medications such as antibiotics, diuretics, and oral bisphosphonates.
Everyone will experience a bout of constipation from time to time as a result from a change in routine, dietary habits, activity level, medications, or other factors. In some cases, constipation can be a medical emergency.
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