Magnesium is one of the most abundant essential minerals in your body. It’s primarily stored in the bones of your body. A very small amount of magnesium circulates in your bloodstream.

Magnesium plays a role in over 300 metabolic reactions in your body.

These reactions impact a number of very important body processes, including:

  • protein synthesis
  • cellular energy production and storage
  • stabilization of cells
  • DNA synthesis
  • nerve signal transmission
  • bone metabolism
  • cardiac function
  • the conduction of signals between muscles and nerves
  • glucose and insulin metabolism
  • blood pressure

Symptoms of low magnesium

Early signs of low magnesium include:

  • nausea
  • vomiting
  • weakness
  • decreased appetite

As magnesium deficiency worsens, symptoms may include:

  • numbness
  • tingling
  • muscle cramps
  • seizures
  • muscle spasticity
  • personality changes
  • abnormal heart rhythms

Muscle twitches and Cramps. Twitches, tremors and muscle cramps are signs of magnesium deficiency. In worst case scenarios, deficiency may even cause seizures or convulsions. Scientists believe these symptoms are caused by a greater flow of calcium into nerve cells, which overexcites or hyperstimulates the muscle nerves.

While supplements  (for example Magnesium B6, Magnesium Diasporal, Bio Magnesium) may relieve muscle twitches and cramps in deficient individuals, one review concluded that magnesium supplements are not an effective treatment for muscle cramps in older adults. Further studies are needed in other groups.

Keep in mind that involuntary muscle twitches may have many other causes. For example, they may be caused by stress or too much caffeine. They may also be a side effect of some medications or a symptom of a neurological disease, such as neuromyotonia or motor neuron disease. While occasional twitches are normal, you should see your doctor if your symptoms persist.

Mental Disorders. Mental disorders are another possible consequence of magnesium deficiency. These include apathy, which is characterized by mental numbness or lack of emotion. Worsened deficiency may even lead to delirium and coma. Additionally, observational studies have associated low magnesium levels with an increased risk of depression. Scientists have also speculated that magnesium deficiency might promote anxiety, but direct evidence is lacking.

In short, it seems that a lack of magnesium may cause nerve dysfunction and promote mental problems in some people.

Osteoporosis. Osteoporosis is a disorder characterized by weak bones and an increased risk of bone fractures. The risk of getting osteoporosis is influenced by numerous factors. These include old age, lack of exercise and a poor intake of vitamins D and K. Interestingly, magnesium deficiency is also a risk factor for osteoporosis. Deficiency might weaken bones directly, but it also lowers the blood levels of calcium, the main building block of bones. Studies in rats confirm that dietary magnesium depletion results in reduced bone mass. Although no such experiments have been done in people, studies have associated poor magnesium intake with lower bone mineral density.

Fatigue and Muscle Weakness. Fatigue, a condition characterized by physical or mental exhaustion or weakness, is another symptom of magnesium deficiency.

Keep in mind that everyone becomes fatigued from time to time. Typically, it simply means you need to rest. However, severe or persistent fatigue may be a sign of a health problem. Since fatigue is a non-specific symptom, its cause is impossible to identify unless it is accompanied by other symptoms.

Another, more specific sign of magnesium deficiency is muscle weakness, also known as myasthenia. Scientists believe the weakness is caused by the loss of potassium in muscle cells, a condition associated with magnesium deficiency. Therefore, magnesium deficiency is one possible cause of fatigue or weakness.

High Blood Pressure. Animal studies show that magnesium deficiency may increase blood pressure and promote high blood pressure, which is a strong risk factor for heart disease. While direct evidence is lacking in humans, several observational studies suggest that low magnesium levels or poor dietary intake may raise blood pressure. The strongest evidence for the benefits of magnesium comes from controlled studies. Several reviews have concluded that magnesium supplements may lower blood pressure, especially in adults with high blood pressure.

Put simply, magnesium deficiency may increase blood pressure, which, in turn, increases the risk of heart disease.

Asthma. Magnesium deficiency is sometimes seen in patients with severe asthma. Additionally, magnesium levels tend to be lower in individuals with asthma than in healthy people. Researchers believe a lack of magnesium may cause the buildup of calcium in the muscles lining the airways of the lungs. This causes the airways to constrict, making breathing more difficult.

Interestingly, an inhaler with magnesium sulfate is sometimes given to people with severe asthma to help relax and expand the airways. For those with life-threatening symptoms, injections are the preferred route of delivery.

In short, scientists believe severe asthma may be a symptom of magnesium deficiency in some patients, but further studies are needed to investigate its role.

Irregular Heartbeat. Among the most serious symptoms of magnesium deficiency is heart arrhythmia, or irregular heartbeat. The symptoms of arrhythmia are mild in most cases. Often, it has no symptoms at all. However, in some people, it may cause heart palpitations, which are pauses between heartbeats. Other possible symptoms of arrhythmia include lightheadedness, shortness of breath, chest pain or fainting. In the most severe cases, arrhythmia may increase the risk of stroke or heart failure. Scientists believe that an imbalance of potassium levels inside and outside of heart muscle cells may be to blame, a condition associated with magnesium deficiency.

Some patients with congestive heart failure and arrhythmia have been shown to have lower magnesium levels than healthy people. Treating these patients with magnesium injections significantly improved their heart function. Magnesium supplements may also reduce symptoms in some patients with arrhythmia.

Causes of low magnesium

Low magnesium is typically due to decreased absorption of magnesium in the gut or increased excretion of magnesium in the urine. Low magnesium levels in otherwise healthy people are uncommon. This is because magnesium levels are largely controlled by the kidneys. The kidneys increase or decrease excretion (waste) of magnesium based on what the body needs.

Continually low dietary intake of magnesium, excessive loss of magnesium, or the presence of other chronic conditions can lead to hypomagnesemia.

Hypomagnesemia is also more common in people who are hospitalized. This may be due to their illness, having certain surgeries, or taking certain types of medication. Very low magnesium levels have been linked to poorer outcomes for severely ill, hospitalized patients.

Conditions that increase the risk of magnesium deficiency include gastrointestinal (GI) diseases, advanced age, type 2 diabetes, use of loop diuretics (such as Lasix), treatment with certain chemotherapies, and alcohol dependence.

GI diseases

Celiac disease, Crohn’s disease, and chronic diarrhea can impair the absorption of magnesium or result in increased magnesium loss.

Type 2 diabetes

Higher concentrations of blood glucose can cause the kidneys to excrete more urine. This also causes increased loss of magnesium.

Alcohol dependence

Alcohol dependence can lead to:

  • poor dietary intake of magnesium
  • increase in urination and fatty stools
  • liver disease
  • vomiting
  • kidney impairment
  • pancreatitis
  • other complications

All of these conditions have the potential to result in hypomagnesemia.

Older adults

Gut absorption of magnesium tends to decrease with age. Urinary output of magnesium tends to increase with age. Older adults often eat fewer magnesium-rich foods. They’re also more likely to take medication that can affect magnesium (such as diuretics). These factors can lead to hypomagnesemia in older adults.

Use of diuretics

Use of loop diuretics (such as Lasix) can sometimes lead to loss of electrolytes such as potassium, calcium, and magnesium.

Diagnosis of low magnesium

Your doctor will diagnose hypomagnesemia based on a physical exam, symptoms, medical history, and a blood test. A blood magnesium level doesn’t tell you the amount of magnesium your body has stored in your bones and muscle tissue. But it’s still helpful for indicating whether you have hypomagnesemia. Your doctor will likely also check your blood calcium and potassium levels.

A normal serum (blood) magnesium level is 1.8 to 2.2 milligrams per deciliter (mg/dL). Serum magnesium lower than 1.8 mg/dL is considered low. A magnesium level below 1.25 mg/dL is considered very severe hypomagnesemia.

Treatment of low magnesium

Hypomagnesemia is typically treated with oral magnesium supplements and increased intake of dietary magnesium.

An estimated 2 percent of the general population has hypomagnesemia. This percentage is much higher in hospitalized people. Studies estimate that nearly half of all Americans — and 70 to 80 percent of those over the age of 70 — aren’t meeting their daily recommended magnesium needs. Getting your magnesium from food is best, unless your doctor tells you otherwise.

Examples of magnesium-rich foods include:

  • spinach
  • almonds
  • cashews
  • peanuts
  • whole grain cereal
  • soymilk
  • black beans
  • whole wheat bread
  • avocado
  • banana
  • halibut
  • salmon
  • baked potato with the skin

For example, just one ounce (28.4 grams) of almonds provides 18% of the RDI for magnesium. Other great sources include flaxseeds, sunflower seeds, chia seeds, cocoa, coffee, cashew nuts, hazelnuts and oats. Magnesium is also added to many breakfast cereals and other processed foods.

If you have a health disorder that causes a loss of magnesium from the body, such as diabetes, you should make sure to eat plenty of magnesium-rich foods or take supplements.

If your hypomagnesemia is severe and includes symptoms such as seizures, you may receive magnesium intravenously, or by IV.

Complications of low magnesium

If hypomagnesemia and its underlying cause remain untreated, severely low magnesium levels can develop. Severe hypomagnesemia can have life-threatening complications such as:

  • seizures
  • cardiac arrhythmias (abnormal heart patterns)
  • coronary artery vasospasm
  • sudden death

Outlook for low magnesium

Magnesium deficiency is a widespread health problem. Some studies suggest that 75% of Americans do not meet their dietary requirements for magnesium. However, true deficiency is much less common — less than 2%, according to one estimate. The symptoms of magnesium deficiency are usually subtle unless your levels become severely low. Deficiency may cause fatigue, muscle cramps, mental problems, irregular heartbeat and osteoporosis.

Hypomagnesemia can be caused by a variety of underlying conditions. It can be treated very effectively with oral or IV magnesium. It’s important to eat a balanced diet to ensure you’re getting enough magnesium. Whatever the outcome, try to regularly eat plenty of magnesium-rich whole foods, such as nuts, seeds, grains or beans.These foods are also high in other healthy nutrients. Including them in your diet not only lowers your risk of magnesium deficiency, but it also promotes your overall health. If you have conditions such as Crohn’s disease or diabetes, or take diuretic medications, work with your doctor to ensure that you don’t develop low magnesium. If you have symptoms of low magnesium, it’s important to see your doctor to prevent the development of complications.

https://www.healthline.com/health/hypomagnesemia#causes

https://www.healthline.com/nutrition/magnesium-deficiency-symptoms#TOC_TITLE_HDR_2

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