Hypomagnesaemia is defined in terms of a lower than normal free serum ionised magnesium concentration (0.54–0.67 mmol/l), although may be confused with total body magnesium deficiency which is possible with normal serum magnesium, and can occur with normal total body magnesium. It is grossly underdiagnosed, being present in more than 10% of acute inpatients, and this increases with the severity of the illness. There is a lack of correlation in critical ill patients between albumin, serum total magnesium as usually measured and free ionised magnesium.
- Endocrine disease
- Malabsorption/No intake
- Renal disease
- Obligatory renal magnesium loss.
- Diuretic phase of acute renal failure
- Post-obstructive diuresis
- Post renal transplantation
Signs and symptoms unusual if serum magnesium > 0.5 mmol/l
- Cardiac excitability
- Treat underlying condition
- Acute symptomatic hypomagnesaemia must be treated with iv magnesium salt (monitoring may be necessary especially in renal failure)
- Chronic magnesium deficiency states may need oral magnesium gluconate as well as appropriate diet
- ↑ a b Swaminathan R. Magnesium metabolism and its disorders. The Clinical biochemist. Reviews / Australian Association of Clinical Biochemists. 2003 May; 24(2):47-66.
- ↑ Huijgen HJ, Soesan M, Sanders R, Mairuhu WM, Kesecioglu J, Sanders GT. Magnesium levels in critically ill patients. What should we measure? American journal of clinical pathology. 2000 Nov; 114(5):688-95.(Link to article – subscription may be required.)
- ↑ Shabajee N, Lamb EJ, Sturgess I, Sumathipala RW. Omeprazole and refractory hypomagnesaemia. BMJ (Clinical research ed.). 2008; 337:a425.(Epub)
- ↑ Cundy T, Dissanayake A. Severe hypomagnesaemia in long-term users of proton-pump inhibitors. Clinical endocrinology. 2008 Aug; 69(2):338-41.(Link to article – subscription may be required.)