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Magnesium is a mineral that is an essential electrolyte needed for several body functions.
The normal adult value for serum magnesium levels is:
- 1.46 to 2.68 mg/dL
- 1.5 to 2.5 mEq/L
- 0.75 to 0.95 mmol/L
Magnesium deficiency (Hypomagnesemia) is an electrolyte disturbance caused when there is a low level of serum magnesium in the blood typically less than:
- 1.46 mg/dL
- 0.75 mmol/L
A value of magnesium levels below 1.25 mg/dL is considered severely low.
Normal daily requirements of magnesium
According to the National Institutes of Health, the recommended dietary allowance (RDA):
- For people between 19 and 30 years:
- Females: 310 mg
- Males: 400 mg
- For people above 31 years:
- Females: 320 mg
- Males: 420 mg
What is magnesium?
Magnesium is a mineral found in the body as well as in the earth’s crust.
It is an essential electrolyte needed for several body functions, such as bone health, cellular functions, nerve conduction, and other needs including:
- Prevents mood swings and helps in stabilizing depressive episodes
- Proper functioning of the heart, muscles, and the nerves
- Helps control energy, blood sugar, and blood pressure levels
What foods contain magnesium?
Magnesium is naturally found in many foods, such as:
- Peanut butter
- Nuts
- Spinach
- Beans
- Whole grains
- Bananas
- Milk
- Salmon
- Magnesium-fortified breakfast cereals or bottled water
What are the symptoms of hypomagnesemia?
Symptoms from low magnesium are not evident unless they persist for a long time. However, symptoms may include:
- Poor appetite
- Nausea and vomiting
- Sleepiness
- Generalized weakness and exhaustion
- Headaches
- Pins and needles sensation
- Pronounced reflexes
- Constipation
- Facial twitches
- Extreme cases can cause muscle spasms and tremors
Magnesium deficiency also can cause hypocalcemia (decreased calcium levels) and hypokalemia (decreased potassium levels).
Magnesium affects the electrical activity of the myocardium and vascular tone making patients with hypomagnesemia at risk for cardiac arrhythmias.
What causes hypomagnesemia?
Hypomagnesemia can be attributed to:
- Chronic diseases
- Older age
- Alcohol use disorder
- Alcoholic cirrhosis
- Starvation or poor diet
- Burns that affect a large area of the body
- Malnutrition or malabsorption
- Excessive sweating
- Gastrointestinal diseases such as:
- Celiac disease
- Inflammatory bowel diseases
- Long-lasting digestive problems
- Acute diarrhea
- Chronic diarrhea due to Crohn’s disease and ulcerative colitis
- Acute pancreatitis
- Hungry bone syndrome (an increased magnesium uptake by renewing bone following parathyroidectomy or thyroidectomy)
- Laxative abuse
- Kidney problems or renal losses such as:
- Inherited tubular disorders (Gitelman syndrome, Bartter syndrome)
- Familial hypomagnesemia with hypercalciuria and nephrocalcinosis
- Rare genetic renal diseases
- Acute kidney failure
- Hyperaldosteronism (excess production of aldosterone hormone)
- Diabetes
- Thyroid issues
- Certain medications:
- Loop and thiazide diuretics
- Proton pump inhibitors
- Aminoglycoside antibiotics
- Amphotericin B
- Digitalis
- Chemotherapeutic drugs, such as cisplatin and cyclosporine
- Recent surgery
- Critically ill patients who are receiving parenteral nutrition
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How is hypomagnesemia diagnosed?
A blood test is the most common way to determine magnesium levels.
The doctor may also recommend checking the following in a patient suspected of having hypomagnesemia:
- Serum phosphate and calcium levels
- The basic metabolic panel, including serum creatinine/kidney function and glucose levels
- Electrocardiogram
Complications of hypomagnesemia
Magnesium depletion can get complicated in many ways including neuromuscular, cardiovascular manifestations, and other electrolyte abnormalities.
- Neuromuscular manifestations:
- Cardiovascular manifestations:
- Electrocardiogram changes (widening of the QRS complex, peaked T waves, prolongation of the PR interval)
- Atrial and ventricular premature systoles
- Atrial fibrillation
- Ventricular arrhythmias (torsades de pointes)
- Cardiac ischemia
- Other electrolyte and hormonal abnormalities:
- Hypocalcemia
- Hypoparathyroidism
- Hypokalemia
- Patients with hypomagnesemia should be encouraged to eat the following foods:
- Green vegetables such as spinach
- Beans
- Legumes
- Peas
- Nuts
- Seeds
- Unrefined grains
For severe cases or those with significant hypomagnesemia, a doctor may recommend a high dose of magnesium supplements or injecting magnesium into a muscle or vein for some time.