Hypomagnesemia occurs with both loop diuretics (furosemide, bumetanide, torsemide, and ethacrynic acid) and thiazide diuretics (chlorothiazide, hydrochlorothiazide, indapamide, and metolazone).
Even when people are very conscientious about their diets, they may be taking medications that can undermine healthy magnesium levels. Diuretics like furosemide (Lasix), bumetanide, chlorthalidone and hydrochlorothiazide often deplete magnesium along with potassium.
A variety of drugs including antibiotics, chemotherapeutic agents, diuretics and proton-pump inhibitors can cause magnesium loss and hypomagnesemia (see Table 1) [10,27,28,33,34,39,41,42].
Deficiencies due to poor absorption of magnesium from the gastrointestinal tract include: Diseases causing malabsorption such as celiac disease and inflammatory bowel disease. Gastric bypass surgery. Hereditary syndromes causing poor absorption of magnesium (primary intestinal hypomagnesemia).
Chronic magnesium deficiency is often associated with normal serum magnesium despite deficiency in cells and in bone; the response to oral supplementation is slow and may take up to 40 weeks to reach a steady state.
Every organ in the body, especially the heart, muscles, and kidneys, needs the mineral magnesium. It also contributes to the makeup of teeth and bones.
Magnesium deficiency can cause a wide variety of features including hypocalcaemia, hypokalaemia and cardiac and neurological manifestations. Chronic low magnesium state has been associated with a number of chronic diseases including diabetes, hypertension, coronary heart disease, and osteoporosis.
Thus, the elderly population is especially at risk of magnesium deficiency due to low intake but also increased risk for chronic diseases that predispose to magnesium deficiency (ageing also reduces magnesium absorption from the diet, ie, achlorhydria).
Diabetics or individuals with other blood sugar abnormalities, such as insulin resistance – because of increased urinary excretion, decreased dietary intake, and increased need. Individuals who consume a diet high in pastries and other junk foods – which are basically devoid of magnesium.
Statins: Cholesterol-lowering medications, such as Lipitor, are intended to lower levels of low-density lipoprotein cholesterol and triglycerides. These prescription drugs bind to fats that are necessary for mineral absorption, reducing the body's capacity to use magnesium.
One study found that very high doses of zinc from supplements (142 mg/day) can interfere with magnesium absorption and disrupt the magnesium balance in the body [17].
A magnesium blood test is used to check the level of magnesium in your blood. Levels that are too low are known as hypomagnesemia or magnesium deficiency. This is more common than levels that are too high, which is called hypermagnesemia.
Mg is essential in the metabolism of vitamin D, and taking large doses of vitamin D can induce severe depletion of Mg. Adequate magnesium supplementation should be considered as an important aspect of vitamin D therapy.
Hypokalemia and Hyperkalemia
Magnesium depletion typically occurs after diuretic use, sustained alcohol consumption, or diabetic ketoacidosis.
As noted previously, magnesium deficiency reduces cardiac Na-K-ATPase, leading to higher levels of sodium and calcium and lower levels of magnesium and potassium in the heart. This increases vasoconstriction in the coronary arteries, which can induce coronary artery spasms, myocardial infarction and arrhythmias.
Hypomagnesemia associates with inflammation and risk of diabetes and hypertension, which may contribute to kidney function decline.
A low magnesium level can be a sign of diabetes, some digestive problems, malnourishment, or long-term (chronic) alcoholism. Lower magnesium levels during pregnancy may mean preeclampsia.
Dietary deficiencies of magnesium, coupled with excess calcium and stress may cause many cases of other related symptoms including agitation, anxiety, irritability, confusion, asthenia, sleeplessness, headache, delirium, hallucinations and hyperexcitability, with each of these having been previously documented.
If symptomatic and especially if the magnesium is <0.4 mmol/L recommend urgent admission. Magnesium may be given orally in a dose of up to 24 mmol Mg2+ daily in divided doses.
You might have trouble absorbing magnesium from food if you drink too much alcohol, have kidney problems, take certain medicines, or have celiac disease or long-lasting digestive problems.
Supplementing with magnesium is shown to reverse low red blood cell magnesium and improved energy, emotional state, and pain levels in people with chronic fatigue syndrome. These changes can occur in a few as six weeks of supplementation.