Hypomagnesemia: Causes, Symptoms, Diagnosis, Treatment, and Monitoring for Optimal Magnesium Balance and Health

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Definition 


Hypomagnesemia, which is a condition characterized by low magnesium levels in the blood (serum magnesium <1.7 mg/dL or <0.7 mmol/L). Magnesium is essential for muscle and nerve function, energy production, and maintaining normal heart rhythm.


Causes of Hypomagnesemia

1. Gastrointestinal Losses


Chronic diarrhea

Malabsorption syndromes (e.g., Crohn’s disease, celiac disease)

Prolonged nasogastric suctioning

Excessive use of proton pump inhibitors (PPIs)


2. Renal Losses


Diuretics (loop & thiazide)

Alcohol abuse

Uncontrolled diabetes (osmotic diuresis)

Tubular disorders (e.g., Gitelman syndrome, Bartter syndrome)

3. Other Causes of Hypomagnesemia


Poor dietary intake

Chronic alcoholism

Severe burns

Hyperaldosteronism

Pancreatitis

Symptoms of Hypomagnesemia


Muscle cramps, weakness, or tremors

Neuromuscular hyperexcitability (tetany, Chvostek’s & Trousseau’s signs)

Seizures

Cardiac arrhythmias (torsades de pointes, prolonged QT interval)

Fatigue and irritability

Hypocalcemia or hypokalemia (often coexisting)

Diagnosis


Serum magnesium levels

Electrolyte panel (calcium, potassium)

ECG (to check for arrhythmias)

Urinary magnesium (to differentiate between renal and GI losses)


Treatment


Mild Cases: Oral magnesium supplements (e.g., magnesium oxide, magnesium citrate).

Severe Cases: IV magnesium sulfate, especially if there are cardiac arrhythmias or severe neuromuscular symptoms.

Address Underlying Cause: Treat gastrointestinal or renal issues, discontinue offending drugs, improve dietary intake (e.g., nuts, leafy greens, whole grains).

Monitor Levels: Regularly check serum magnesium and other electrolytes to ensure proper correction and prevent recurrence.


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