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Magnesium Many women with PMOS have lower serum magnesium concentrations compared with controls, particularly those who are overweight or obese.[15][16] Magnesium is the second most abundant intracellular cation in the human body and plays a vital role in glucose metabolism and insulin signaling.[17] A cross-sectional analysis of 1,000 women with PMOS found that lower serum magnesium was independently associated with greater insulin resistance and higher testosterone levels.[18] Women with PMOS also have lower dietary magnesium intake compared with women without the condition.[19] Magnesium supplementation has been shown to improve insulin resistance, and deficiency has been associated with an increased risk for type 2 diabetes.[17] A systematic review of 12 clinical trials found that magnesium supplementation reduced fasting glucose, fasting insulin, and HOMA-IR values, particularly in patients with hypomagnesemia.[17] In a randomized, double-blind, placebo-controlled trial of 60 women with PMOS, magnesium supplementation (250 mg magnesium oxide daily) for eight weeks resulted in favorable decreases in BMI and testosterone levels compared with placebo.[20] When co-supplemented with vitamin E, magnesium has also been shown to significantly reduce serum insulin, HOMA-IR, triglycerides, hirsutism scores, and hs-CRP in women with PMOS.[21][22] However, a systematic review noted that magnesium supplementation alone did not consistently improve markers of inflammation, oxidative stress, or metabolism, and that combination supplementation appeared more effective.[23] Magnesium status can be assessed with a serum magnesium level, though this reflects only extracellular stores
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