HYPOMAGNESEMIA

SYMPTOMS

The symptoms of hypomagnesemia can vary depending on the severity and duration of magnesium deficiency, as well as individual factors such as age, comorbidities, and magnesium levels. Common symptoms may include:

• Muscle Weakness: Weakness, fatigue, and muscle cramps are common symptoms of hypomagnesemia, reflecting the role of magnesium in muscle function and neuromuscular transmission.
• Tremors and Twitching: Involuntary muscle contractions, tremors, twitching, and fasciculations may occur due to disturbances in nerve and muscle function.
• Cardiac Arrhythmias: Hypomagnesemia can predispose individuals to cardiac arrhythmias such as atrial fibrillation, ventricular tachycardia, or torsades de pointes, particularly in severe cases.
• Neurological Symptoms: Neurological manifestations of hypomagnesemia may include confusion, irritability, agitation, seizures, hallucinations, and altered mental status.
• Hypocalcemia: Hypomagnesemia can impair parathyroid hormone (PTH) secretion and calcium regulation, leading to hypocalcemia and associated symptoms such as tetany, paresthesias, and muscle spasms.

DIAGNOSIS

Diagnosing hypomagnesemia involves a combination of clinical evaluation, laboratory tests, and assessment of magnesium levels. Diagnostic steps may include:

• Serum Magnesium Levels: Measurement of serum magnesium levels is the primary diagnostic test for hypomagnesemia. Normal serum magnesium levels typically range from 1.7 to 2.2 mg/dL (0.7 to 0.9 mmol/L).
• Electrolyte Panel: A comprehensive electrolyte panel, including measurements of calcium, potassium, and phosphorus levels, may be performed to assess for associated electrolyte imbalances.
• Renal Function Tests: Assessment of renal function, including serum creatinine, blood urea nitrogen (BUN), and estimated glomerular filtration rate (eGFR), can help identify underlying renal causes of hypomagnesemia.
• Additional Investigations: Additional tests such as urine magnesium levels, urinary calcium-to-creatinine ratio, and imaging studies (e.g., renal ultrasound) may be performed to evaluate for underlying etiologies or complications of hypomagnesemia.

TREATMENT

Treatment of hypomagnesemia aims to correct magnesium deficiency, alleviate symptoms, and address underlying causes. Treatment options may include:

• Magnesium Supplementation: Oral or intravenous (IV) magnesium supplementation is the mainstay of treatment for hypomagnesemia, with dosing and route of administration determined based on the severity of deficiency, symptoms, and underlying etiology.
• Dietary Modifications: Encouraging magnesium-rich foods in the diet, such as leafy green vegetables, nuts, seeds, whole grains, and legumes, can help prevent magnesium deficiency and support overall health.
• Medication Management: Adjusting or discontinuing medications that contribute to magnesium loss or malabsorption, such as diuretics or proton pump inhibitors, may be necessary in some cases.
• Treatment of Underlying Conditions: Addressing underlying medical conditions such as gastrointestinal disorders, renal dysfunction, or hormonal imbalances is essential for long-term management of hypomagnesemia.