Magnesium deficiency (medicine)
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Magnesium deficiency refers to an intake of dietary magnesium below minimal levels, which can result in numerous symptoms and diseases. These can generally be remedied by an increase of magnesium in diet or oral supplements. However intravenous supplementation is necessary for more severe cases.
"Magnesium depletion" (ICD10 code E83.4) should be distinguished from hypomagnesemia, since the first refers to a disorder of magnesium metabolism, and is much more difficult to treat. However, in the past, the terms have sometimes been used interchangeably. Magnesium deficiency can be present without hypomagnesemia, and hypomagnesemia can be present without magnesium deficiency.
Signs and symptoms
Symptoms of magnesium deficiency include: hyperexcitability, dizziness, muscle cramps, muscle weakness and fatigue. Severe magnesium deficiency can cause hypocalcemia, low serum potassium levels (hypokalemia), retention of sodium, low circulating levels of parathyroid hormone (PTH), neurological and muscular symptoms (tremor, fasciculations, muscle spasms, tetany), loss of appetite, nausea, vomiting, personality changes  and 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. Deficiency can cause irregular heart beat.
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. 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 effect 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.
- Rude RK, Shils ME. Magnesium. In: Shils ME, Shike M, Ross AC, Caballero B, Cousins RJ, eds. Modern Nutrition in Health and Disease. 10th ed. Baltimore: Lippincott Williams & Wilkins; 2006:223-247
- Health and Nutrition Secrets, Russell L. Blaylock, M.D., Health Press, 2006, page 395, ISBN 978-0-929173-48-1
- Kobrin SM and Goldfarb S. Magnesium Deficiency. Semin Nephrol 1990;10:525-35.
- Wikipedia, phytate may absorb minerals.
- Oxalates may absorb magnesium, background information indicating possibility of oxalates absorbing magnesium.
- "Nutrient Intakes Percent of population 2 years old and over with adequate intakes based on average requirement". Community Nutrition Mapping Project. 2009-07-29. Retrieved 2012-02-11.