Magnesium deficiency (medicine)
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Magnesium deficiency or hypomagnesia (not to be confused with hypomagnesemia) refers to inadequate intake of dietary magnesium or impaired absorption of magnesium, which can result in numerous symptoms and diseases. It is generally corrected by an increase of magnesium in diet, oral supplements, and in severe cases, intravenous supplementation.
"Magnesium deficiency" (or "depletion") should be distinguished from hypomagnesemia. Magnesium deficiency encompasses a broader scope, and includes disorders of magnesium metabolism and low intracellular storage. Hypomagnesemia refers only to low serum (blood) levels of magnesium. Therefore, magnesium deficiency can be present without hypomagnesemia, and hypomagnesemia can be present without magnesium deficiency. As a disorder of metabolism, magnesium deficiency can be much harder to treat than hypomagnesemia.
Signs and symptoms
Symptoms of magnesium deficiency include hyperexcitability, muscular symptoms (cramps, tremor, fasciculations, spasms, tetany, weakness), fatigue, loss of appetite, apathy, confusion, insomnia, irritability, poor memory, and reduced ability to learn. Moderate to severe magnesium deficiency can cause tingling or numbness, heart changes, rapid heartbeat, continued muscle contractions, nausea, vomiting, personality changes, delirium, hallucinations, low calcium levels, low serum potassium levels, retention of sodium, low circulating levels of parathyroid hormone (PTH), and potentially death from heart failure. Magnesium plays an important role in carbohydrate metabolism and its deficiency may worsen insulin resistance, a condition that often precedes diabetes, or may be a consequence of insulin resistance.
Causes of magnesium deficiency include diet, alcohol abuse, poorly controlled diabetes, excessive or chronic vomiting and/or diarrhea. Phytate or oxalate in the diet may bind magnesium causing it to be eliminated from rather than absorbed in the colon. Certain drugs can deplete magnesium levels such as osmotic diuretics, cisplatin, ciclosporin, amphetamines, and possibly proton pump inhibitors http://www.fda.gov/drugs/drugsafety/ucm245011.htm. Also deficiency may occur in Bartter syndrome and Gitelman syndrome.
Diagnosis of severe hypomagnesia can be made through a standard serum magnesium test.
The accuracy of the serum magnesium blood test as an indicator of overall magnesium sufficiency is disputed due to claims that the total percentage of magnesium stored freely in the blood is less than 1%.
Magnesium deficiency can often be effectively treated with an oral magnesium preparation.
Probiotic lactobacilli, and other species of endogenous digestive microflora may play a role in the bioavailability of magnesium as they may affect the breakdown of antagonists such as phytate and oxalate in the diet. Other minerals in the diet, such as calcium and zinc, may interact with phytate and oxalate, reducing magnesium loss.
Severe hypomagnesemia is often treated medically with intravenous or intramuscular magnesium sulfate solution, which is completely bioavailable, and effective.
Food sources of magnesium
Food sources of magnesium include leafy green vegetables and soybeans, raw nuts and fruit.
57% of the US population does not meet the US RDA for dietary intake of magnesium. The kidneys are very efficient at maintaining body levels, but not in cases where the diet is deficient.
Magnesium deficiency in humans was first described in the medical literature in 1934.
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