Magnesium deficiency (medicine)
Encyclopedia
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.
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, 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.
for levels of magnesium. The kidneys are very efficient at maintaining body levels, but not in cases where the diet is deficient.
, 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.
Causes of magnesium deficiency include alcohol abuse, poorly controlled diabetes, excessive or chronic vomiting and/or diarrhea. Certain drugs can also 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
.
For a more detailed discussion on the subject of magnesium metabolism
and causes of magnesium deficiency see hypomagnesemia
.
or magnesium citrate
. The citrate is the least expensive soluble (high bioavailability) oral magnesium salt available in supplements, with 100 mg and 200 mg magnesium typically contained per capsule or tablet.
Magnesium aspartate
, chloride
, lactate
, citrate
and glycinate
each have bioavailability 4 times greater than the oxide form and are equivalent to each other per amount of magnesium, though not in price.
The ligand of choice for large-scale manufacturers of multivitamins and minerals containing magnesium is the magnesium oxide
due to its compactness, high magnesium content by weight, low cost, and ease-of-use in manufacturing. However it is insoluble in water. Insoluble magnesium salts such as magnesium oxide or magnesium hydroxide (milk of magnesia) depend on stomach acid for neutralization before they can be absorbed, and thus are relatively poor oral magnesium sources, on average.
Magnesium sulfate (Epsom salts) are soluble in water, but are commonly used as a purgative, due to the poor absorption of the sulfate component. In lower doses, they may be used as an oral magnesium source, however.
Severe hypomagnesemia is often treated medically with intravenous or intramuscular magnesium sulfate solution, which is completely bioavailable, and effective.
Diet (nutrition)
In nutrition, diet is the sum of food consumed by a person or other organism. Dietary habits are the habitual decisions an individual or culture makes when choosing what foods to eat. With the word diet, it is often implied the use of specific intake of nutrition for health or weight-management...
or oral supplements. However intravenous supplementation is necessary for more severe cases.
Symptoms
Symptoms of magnesium deficiency include: hyperexcitability, dizzyness, muscle weaknessMuscle weakness
Muscle weakness or myasthenia is a lack of muscle strength. The causes are many and can be divided into conditions that have true or perceived muscle weakness...
and fatigue. Severe magnesium deficiency can cause hypocalcemia, low serum potassium levels (hypokalemia), retention of sodium, low circulating levels of parathyroid hormone
Parathyroid hormone
Parathyroid hormone , parathormone or parathyrin, is secreted by the chief cells of the parathyroid glands as a polypeptide containing 84 amino acids...
(PTH), neurological and muscular symptoms (tremor, 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.
Incidence/prevalence
61% of the US population does not meet the US RDADietary Reference Intake
The Dietary Reference Intake is a system of nutrition recommendations from the Institute of Medicine of the U.S. National Academy of Sciences. The DRI system is used by both the United States and Canada and is intended for the general public and health professionals...
for levels of magnesium. The kidneys are very efficient at maintaining body levels, but not in cases where the diet is deficient.
Terminology
"Magnesium depletion" (ICD10 code ) should be distinguished from hypomagnesemiaHypomagnesemia
Hypomagnesemia is an electrolyte disturbance in which there is an abnormally low level of magnesium in the blood. Usually a serum level less than 0.7 mmol/L is used as reference. The prefix hypo- means low . The middle 'magnes' refers to magnesium...
, since the first refers to a disorder of magnesium metabolism
Metabolism
Metabolism is the set of chemical reactions that happen in the cells of living organisms to sustain life. These processes allow organisms to grow and reproduce, maintain their structures, and respond to their environments. Metabolism is usually divided into two categories...
, 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
Hypomagnesemia
Hypomagnesemia is an electrolyte disturbance in which there is an abnormally low level of magnesium in the blood. Usually a serum level less than 0.7 mmol/L is used as reference. The prefix hypo- means low . The middle 'magnes' refers to magnesium...
, and hypomagnesemia can be present without magnesium deficiency.
Causes of magnesium deficiency include alcohol abuse, poorly controlled diabetes, excessive or chronic vomiting and/or diarrhea. Certain drugs can also deplete magnesium levels such as osmotic diuretics, cisplatin, ciclosporin, amphetamines, and possibly proton pump inhibitors. Also deficiency may occur in Bartter syndrome
Bartter syndrome
Bartter syndrome is a rare inherited defect in the thick ascending limb of the loop of Henle. It is characterized by low potassium levels , increased blood pH , and normal to low blood pressure. There are two types of Bartter syndrome: neonatal and classic...
and Gitelman syndrome
Gitelman syndrome
Gitelman syndrome is a rare inherited defect in the distal convoluted tubule of the kidneys. It causes the kidneys to pass sodium, magnesium, chloride, and potassium into the urine, rather than allowing it to be resorbed into the bloodstream....
.
For a more detailed discussion on the subject of magnesium metabolism
Metabolism
Metabolism is the set of chemical reactions that happen in the cells of living organisms to sustain life. These processes allow organisms to grow and reproduce, maintain their structures, and respond to their environments. Metabolism is usually divided into two categories...
and causes of magnesium deficiency see hypomagnesemia
Hypomagnesemia
Hypomagnesemia is an electrolyte disturbance in which there is an abnormally low level of magnesium in the blood. Usually a serum level less than 0.7 mmol/L is used as reference. The prefix hypo- means low . The middle 'magnes' refers to magnesium...
.
Treatments
Magnesium is absorbed orally at about 30% bioavailability from any water soluble salt, such as magnesium chlorideMagnesium chloride
Magnesium chloride is the name for the chemical compounds with the formulas MgCl2 and its various hydrates MgCl2x. These salts are typical ionic halides, being highly soluble in water. The hydrated magnesium chloride can be extracted from brine or sea water...
or magnesium citrate
Magnesium citrate
Magnesium citrate, a magnesium salt of citric acid, is a chemical agent used medicinally as a saline laxative and to completely empty the bowel prior to a major surgery or colonoscopy. It is available without a prescription, both as a generic brand or under the brand name Citromag or Citroma. It is...
. The citrate is the least expensive soluble (high bioavailability) oral magnesium salt available in supplements, with 100 mg and 200 mg magnesium typically contained per capsule or tablet.
Magnesium aspartate
Magnesium aspartate
Magnesium aspartate, the magnesium salt of aspartic acid, is a mineral supplement....
, chloride
Magnesium chloride
Magnesium chloride is the name for the chemical compounds with the formulas MgCl2 and its various hydrates MgCl2x. These salts are typical ionic halides, being highly soluble in water. The hydrated magnesium chloride can be extracted from brine or sea water...
, lactate
Magnesium lactate
Magnesium lactate, the magnesium salt of lactic acid, is a mineral supplement.Added to some food and beverages as an acidity regulator and labeled as E329....
, citrate
Magnesium citrate
Magnesium citrate, a magnesium salt of citric acid, is a chemical agent used medicinally as a saline laxative and to completely empty the bowel prior to a major surgery or colonoscopy. It is available without a prescription, both as a generic brand or under the brand name Citromag or Citroma. It is...
and glycinate
Glycine
Glycine is an organic compound with the formula NH2CH2COOH. Having a hydrogen substituent as its 'side chain', glycine is the smallest of the 20 amino acids commonly found in proteins. Its codons are GGU, GGC, GGA, GGG cf. the genetic code.Glycine is a colourless, sweet-tasting crystalline solid...
each have bioavailability 4 times greater than the oxide form and are equivalent to each other per amount of magnesium, though not in price.
The ligand of choice for large-scale manufacturers of multivitamins and minerals containing magnesium is the magnesium oxide
Magnesium oxide
Magnesium oxide , or magnesia, is a white hygroscopic solid mineral that occurs naturally as periclase and is a source of magnesium . It has an empirical formula of and consists of a lattice of Mg2+ ions and O2– ions held together by ionic bonds...
due to its compactness, high magnesium content by weight, low cost, and ease-of-use in manufacturing. However it is insoluble in water. Insoluble magnesium salts such as magnesium oxide or magnesium hydroxide (milk of magnesia) depend on stomach acid for neutralization before they can be absorbed, and thus are relatively poor oral magnesium sources, on average.
Magnesium sulfate (Epsom salts) are soluble in water, but are commonly used as a purgative, due to the poor absorption of the sulfate component. In lower doses, they may be used as an oral magnesium source, however.
Severe hypomagnesemia is often treated medically with intravenous or intramuscular magnesium sulfate solution, which is completely bioavailable, and effective.