Hypermagnesemia: Causes, Symptoms, Diagnosis, Treatment, Risk Factors, Complications, and Prevention of High Magnesium Levels

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 Hypermagnesemia, which is a condition characterized by abnormally high levels of magnesium in the blood. It is relatively rare and usually occurs in people with kidney failure, as the kidneys are responsible for excreting excess magnesium.



Causes

Kidney failure (most common)

Excessive magnesium intake (e.g., supplements, antacids, or laxatives)

Addison’s disease

Lithium therapy

Rhabdomyolysis (muscle breakdown)


Symptoms

Mild cases may not cause noticeable symptoms, but as levels rise, symptoms can include:

Nausea and vomiting

Muscle weakness

Low blood pressure (hypotension)

Slow heart rate (bradycardia)

Drowsiness or confusion

Respiratory depression in severe cases

Cardiac arrest (in extreme cases)


Risk Factors

Certain individuals are at higher risk of developing hypermagnesemia, including those with chronic kidney disease (CKD) or acute kidney injury, as their bodies struggle to excrete excess magnesium. Other risk factors include excessive magnesium intake, adrenal insufficiency (e.g., Addison’s disease), and medications like lithium or magnesium-containing drugs. Older adults and hospitalized patients receiving IV magnesium are also at risk.


Complications

If untreated, severe hypermagnesemia can lead to paralysis, severe hypotension, respiratory failure, and cardiac arrest. Neurological complications such as confusion, coma, and loss of deep tendon reflexes can occur. Prolonged high magnesium levels can also worsen underlying kidney disease, increasing the risk of long-term organ damage.


Diagnosis

Hypermagnesemia is diagnosed through blood tests that measure serum magnesium levels. Normal magnesium levels range between 1.7–2.2 mg/dL, and hypermagnesemia is typically diagnosed when levels exceed 2.5 mg/dL. Additional tests may include kidney function tests, ECG (electrocardiogram) to check for heart rhythm abnormalities, and electrolyte panels to assess imbalances.


Prevention

Preventing hypermagnesemia involves managing magnesium intake, especially in individuals with kidney disease. Patients at risk should avoid excessive use of magnesium-containing supplements, laxatives, and antacids. Regular kidney function monitoring and electrolyte checks can help detect imbalances early, reducing the risk of severe complications.


Treatment

Stopping magnesium intake

IV calcium gluconate to counteract effects

Diuretics (if kidney function is adequate)

Dialysis (if severe and kidneys cannot clear excess magnesium)


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