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Magnesium Deficiency – Symptoms, Signs, Causes, Treatment

What is Magnesium Deficiency?

Magnesium deficiency is the occurrence of low dietary magnesium intake that causes the occurrence of manifestations of low magnesium in the body. Magnesium deficiency is different from hypomagnesemia, or low magnesium levels in the blood. Hypomagnesemia can occur even without magnesium deficiency, and magnesium deficiency may or may not lead to hypomagnesemia. Magnesium deficiency causes an overall lack of magnesium for the body’s use, and not only in the blood.
Magnesium is effectively regulated by the kidneys, the dietary deficiency of which may not be able to be compensated by the nephrons. Magnesium deficiency is easily treated with magnesium supplementation.

Symptoms, Signs of Magnesium Deficiency

Symptoms of magnesium deficiency include:

Hyperexcitability – Magnesium is responsible for the regulation of nerve transmission by inhibiting the release of acetylcholine. With low magnesium levels, the nerve impulses are not inhibited; therefore, there is hyperexcitability of cells.

Dizziness, fatigue and muscle weakness – The presence of hyperexcitabilty leads to overstimulation that eventually leads to fatigue and weakness.

Hypocalcemia – Hypocalcemia is caused by the inhibition of the parathyroid hormone caused by magnesium deficiency. Hypocalcemia manifests as spasms of the muscles, such as facial twitching and carpopedal spasms.

Hypokalemia – Magnesium is also responsible for the regulation of the sodium-potassium pump. Without magnesium, there is a problem on the movement of potassium in the blood from the cells leading to hypokalemia. Hypokalemia manifests with heart irregularities, weakness and cramps.

Hypoglycemia – Low magnesium levels cause insulin resistance, thereby elevating the blood glucose levels.

Loss of appetite – Hypomagnesemia or the low magnesium levels in the blood also affects the appetite leading to anorexia.

Nausea and vomiting – Nausea and vomiting may also be experienced because of the affectation of the normal digestive function.

Personality changes – Hyperexcitability often leads to overstimulation of the central nervous system, which leads to mood changes.

Heart irregularities – Hypokalemia as a result of low magnesium in the body causes changes in the ECG tracing with Peaked T waves, widened QRS complex and flat P wave. Arrhythmia may also occur, which is often life-threatening because of possible heart block.

Tetany – Tetany is the occurrence of low calcium levels in the blood that causes severe muscle spasm sand twitching.

Tremors – Tremors occur because of low blood glucose. It can also be caused by rapid firing of nerve impulse transmissions in the motor cortex.

Constipation – Magnesium is also responsible in effective bowel elimination, the absence or lack of which may lead to constipation.

Osteoporosis – With low calcium levels because of inhibition of parathyroid activity, the bones do not store adequate calcium leading to fragile bones.

What Causes Magnesium Deficiency?

A lot of factors contribute to magnesium deficiency such as:

Alcohol abuse – Alcohol abuse causes decreased production of enzymes in the intestines that are essential for magnesium absorption from foods.

Uncontrolled diabetes – High blood sugar levels cause poor absorption of magnesium in the body, as well as enhancing the secretion of magnesium in the urine.

Chronic diarrhea and vomiting – Diarrhea and vomiting cause the escape of magnesium from the gastrointestinal system.

Medications – Medications that lead to enhanced excretion of magnesium include osmotic diuretics, cytotoxic medications such as cyclosporine and cisplatin, proton pump inhibitors, and amphetamines.

Poor dietary intake – Lack of magnesium in the diet directly causes magnesium deficiency because magnesium comes solely from food.

Diseases – Gitelman syndrome, Bartter syndrome, diabetes and hypoaldosteronism also deregulate the magnesium levels in the body.

Testing of Magnesium Deficiency

Diagnostic tests for magnesium deficiency vary. The diagnosis of magnesium deficiency is made by confirming a low magnesium level in the body. Tests include:

Serum testing of magnesium levels

Low blood magnesium levels of less than 1.7 mg/dL is the initial diagnostic test for magnesium deficiency, which indicates hypomagnesemia. Hypomagnesemia is only a superficial diagnosis because the blood only contains 0.3% of the total magnesium in the body. Other tests are needed to check intracellular and bone magnesium levels.

RBC magnesium determination – Low levels of RBC magnesium indicate a chronic intracellular magnesium deficiency.

Urinary magnesium determination – Low levels of urinary magnesium of less than 100 mg per day may indicate magnesium deficiency because the kidneys are conserving magnesium due to lack of it in the body. Urinary magnesium is determined following a magnesium loading test or the administration of magnesium prior to urine collection. When the magnesium level is low, the kidneys try to conserve the loaded magnesium.

Treatment of Magnesium Deficiency

The treatment of magnesium is focused on the administration or replacement of magnesium in the body as well as managing its symptoms. Treatments include:

Magnesium administration

The administration of magnesium is the most effective treatment of magnesium deficiency because of direct increase in the magnesium levels in the body to be used for various processes. Magnesium is usually combined with water soluble salt. Magnesium supplements include magnesium citrate, magnesium chloride, magnesium lactate, magnesium aspartate, and magnesium glycinate. Poor oral sources of magnesium include milk of magnesia (magnesium hydroxide) and magnesium oxide because they are insoluble in water and thereby more difficult to absorb.

Magnesium sulfate is also available, but it is commonly used as a purgative because of poor absorption of the sulfate component. Severe cases of magnesium deficiency are treated with intramuscular or intravenous magnesium preparations. The dosing of both oral and parenteral magnesium depends on the severity of the condition.

Monitoring of blood magnesium levels is required when under parenteral therapy to prevent sudden increase of magnesium to excessive levels, which will also cause side-effects such as hypotension, loss of tendon reflexes, respiratory paralysis and loss of consciousness.

Diet modification

Aside from supplements, diet is an important treatment to regain normal magnesium levels. These include eating green leafy vegetables, avoiding processed foods and consuming fermented drinks and foods. Green leafy vegetables contain chlorophyll, which has high amounts of magnesium. Fermented foods contain probiotics that will enhance the absorption of magnesium in the gut. Processed and refined foods often do not contain magnesium because it has been removed through the processing. Try to include vegetables, yogurt, and milk in your every day diet to get the most out of the magnesium in them.
Symptoms of magnesium deficiency are also managed to prevent life-threatening complications such as the development of heart failure and collapse.

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