Magnesium homeostasis
Kupetsky A. Erine in Magnesium, 2019
Hypomagnesemia can be classified as mild (1.4–1.7 mEq/L), moderate (1.0–1.3 mEq/L), and severe (<0.9 mEq/L). Manifestations of hypomagnesemia are varied, depending on the level. Mild-to-moderate hypomagnesemia causes mild hypokalemia and hypocalcemia and is commonly asymptomatic, but some patients can have neuromuscular irritability, numbness, paresthesias, weakness, or cramps. Severe drops in serum magnesium to <1 mEq/L can lead to tetany, seizures, and arrhythmias, especially torsades de pointes. Some patients will have positive Chvostek and Trousseau signs on examination. Hypomagnesemia effects are exacerbated by concomitant hypocalcemia and hypokalemia.6 The causes of hypomagnesemia are varied, ranging from poor dietary ingestion to intestinal or renal losses.
Electrolyte and Acid-Base Disturbances
John K. DiBaise, Carol Rees Parrish, Jon S. Thompson in Short Bowel Syndrome Practical Approach to Management, 2017
Similar to the clinical manifestations of hypocalcemia, patients with hypomagnesemia may present with neuromuscular symptoms such as weakness, tremor, tetany, or hyperreflexia. In some cases, magnesium depletion can present with disorientation, psychosis, stupor, or coma. Hypomagnesemia may also precipitate hypocalcemia as the release of parathyroid hormone is partially regulated and affected by serum magnesium. Since the GI tract accounts for up to two-thirds of the daily magnesium loss, patients with SBS are at increased risk for developing hypomagnesemia. Specifically, a significant amount of magnesium is lost in the jejunal and ileal effluent in patients with severe GI fluid loss. SBS patients without a colon are at the highest risk for developing chronic hypomagnesemia [13]. Hypermagnesemia is uncommon in patients with SBS unless an excessive amount of magnesium is inadvertently administered in IV fluid or parenteral nutrition solutions.
Consequences of Cardiovascular Drug-Induced Nutrient Depletion
Stephen T. Sinatra, Mark C. Houston in Nutritional and Integrative Strategies in Cardiovascular Medicine, 2015
In clinical practice, when patients are prescribed thiazide diuretics for hypertension typically only potassium depletion is addressed, with patients being advised to drink orange juice or eat a banana, which are rich sources of potassium. Often, no education in medical schools or allied health curriculums is given regarding the potential for magnesium depletion, despite the fact that many of the listed side effects of thiazide diuretics are also signs and symptoms of magnesium depletion. While this topic may be controversial in the literature,88 enough studies have reported a magnesium-depleting effect from thiazides (one report in 2000 suggested that 20% of thiazide patients have hypomagnesemia28) to at least justify a screening for magnesium depletion symptoms among thiazide users.30,89 This is especially true when it is considered that the clinical manifestations of hypomagnesemia can be so severe.
The absolute bioavailability and the effect of food on a new magnesium lactate dihydrate extended-release caplet in healthy subjects
Published in Drug Development and Industrial Pharmacy, 2018
Peter Dogterom, ChauHwei Fu, Thomas Legg, Yi-Jin Chiou, Steve Brandon
Hypomagnesemia occurs when the body has lost between 1 and 2 mEq/kg magnesium [4]. Prevalence of hypomagnesemia is common in patients of congestive heart failure (up to 37%) [5], diabetes mellitus (25%) [6], migraine headache (50%) [7,8], in general (up to 12%), and special (up to 20%) hospital settings. Hypomagnesemia can cause abnormalities in other electrolytes such as hypokalemia, hyponatremia, hypocalcemia, and hypophosphatemia [9]. Hypokalemia associated with hypomagnesemia can be refractory to potassium repletion [10–12] and needs concurrent magnesium administration [13]. Signs and symptoms associated with hypomagnesemia may vary from weakness, fatigue, and loss of appetite in mild to moderate deficiency to psychosis, seizures, and paroxysmal atrial and ventricular dysrhythmias such as torsade de pointes and ventricular fibrillation in severe deficiency.
Hypomagnesemia and hypermagnesemia
Published in Acta Clinica Belgica, 2019
Steven Van Laecke
A common cause of mostly mild hypomagnesemia is diabetes mellitus in which magnesium deficiency inversely correlates with glycemic control [17]. Increasing serum magnesium concentrations can be seen upon initiation of most antidiabetic drugs including sodium/glucose cotransporter-2 inhibitors. The mechanism behind this common finding is the decreased activation by insulin of TRPM6 expression in the DCT which might explain renal magnesium wasting in type 2 diabetes [18]. Improvement of insulin sensitivity by excessive weight loss after bariatric surgery not only improved glycemic control but also increased serum magnesium concentration [19]. The relationship between magnesium and glucose metabolism is bidirectional as both hypomagnesemia and single nucleotide polymorphisms in genes involved in cellular magnesium physiology which influence serum magnesium concentration predict the development of diabetes or prediabetes in the general population [18]. The same bi-directionality has been observed for the relationship between magnesium deficiency and oxidative stress [2]. Of note, strenuous exercise programs and sport activities which improve insulin sensitivity may offset correction of hypomagnesemia by enhanced magnesium losses through sweating and increased urinary excretion [20].
Association of Calcium, Magnesium, Zinc, and Copper Intakes with Diabetic Retinopathy in Diabetics: National Health and Nutrition Examination Survey, 2007–2018
Published in Current Eye Research, 2023
Han Xu, Xinxin Dong, Jin Wang, Xiaowei Cheng, Shifang Qu, Tingting Jia, Jun Liu, Zhiyao Li, Yan Yao
Previous studies have shown that hypomagnesemia is closely related to T2DM. Magnesium is an important cofactor involved in glucose metabolism.33 Hypomagnesemia leads to increased insulin resistance and induces hyperglycemia, meanwhile, insulin resistance in turn aggravates hypomagnesemia.34,35 Studies have shown that hypomagnesemia is also related to hypertension, diabetes retinopathy, neuropathy, and kidney disease.36,37 Pratyush Kumar et al. found a significant difference between evaluating serum magnesium and retinopathy,38 and suggested that DM patients increase their consumption of major food sources of magnesium to prevent and reduce the occurrence of DM complications. The latest research results confirmed that the increase in dietary magnesium intake is related to the reduction of DR incidence, and adequate magnesium intake is beneficial to DR prevention,39 which is consistent with our results.
Related Knowledge Centers
- Alcoholism
- Cardiac Arrest
- Hypokalemia
- Magnesium
- Nystagmus
- Torsades De Pointes
- Tremor
- Diarrhea
- Electrolyte Imbalance
- Seizure