Magnesium

Abnormal levels of magnesium are most frequently seen in conditions or diseases that cause impaired or excessive excretion of magnesium by the kidneys or that cause poor absorption in the intestines. Magnesium levels may be checked as part of an evaluation of the severity of kidney problems or of uncontrolled diabetes and may help in the diagnosis and monitoring of gastrointestinal disorders, sometimes characterised by prolonged diarrhoea.

Since a low magnesium level can, over time, cause persistently low calcium and potassium levels, it may be checked to help diagnose problems with calcium, potassium, phosphorus, and/​or parathyroid hormone (involved with calcium regulation).

Magnesium levels may be measured frequently to monitor the response to oral or intravenous (IV) magnesium supplements and may be used, along with calcium and phosphorus testing, to monitor calcium supplementation. Magnesium supplementation is also used in the treatment of pre-eclampsia in pregnancy, where supplementation is given intravenously and blood levels are then checked to ensure adequacy of treatment.

Magnesium testing may be requested as a follow-up to persistently low levels of calcium and potassium. It may also be requested if you have symptoms of an abnormally low magnesium level such as muscle weakness, twitching, cramping, confusion, cardiac arrhythmias, and seizures.

Although dietary deficiencies of magnesium are rare, your doctor may request a magnesium blood test to check for a deficiency as part of an evaluation of malabsorption, malnutrition, diarrhoea, or alcoholism. If you are taking certain drugs that can cause the kidneys to excrete magnesium, testing may also be performed. If magnesium and/​or calcium supplementation is necessary, then the level of magnesium in the blood is likely to be checked at intervals to monitor the effectiveness of treatment.

If you have a kidney disorder or uncontrolled diabetes, your doctor may request a blood test to measure magnesium to help monitor kidney function and to make sure that you are not excreting or retaining excessive amounts of magnesium.

Low levels of magnesium (hypomagnesaemia) in your blood may mean that you are: 1) you are not getting enough magnesium in your diet; 2) your intestines are not absorbing enough magnesium; or 3) your kidneys are excreting too much magnesium. Deficiencies may be due to:

• Low dietary intake (seen in the elderly or malnourished), and with alcoholism (low intake and increased excretion) 
• Gastrointestinal disorders (such as Crohn disease) 
• Uncontrolled diabetes
• Hypoparathyroidism (underactive parathyroid gland)
• Long-term use of certain drugs e.g. diuretics, proton pump inhibitors ( omepraxone, etc)
• Prolonged diarrhoea
• Surgery
• Severe burns
• Toxaemia of pregnancy

Increased levels of magnesium are rarely due excess magnesium in the diet and are usually the result of an excretion problem or excessive supplementation. Increased levels are seen in:

• Kidney failure
• Hyperparathyroidism (overactive parathyroid gland)
• Hypothyroidism
• Dehydration
• Diabetic acidosis (when first seen) 
• Addison disease
• Use of magnesium-containing antacids or laxatives

Since magnesium is an electrolyte, it may be requested with other electrolytes such as sodium, potassium, chloride, bicarbonate, calcium, and phosphorus to evaluate a patient’s overall electrolyte balance. If magnesium is low, it is not unusual for calcium and potassium also to be low.

Magnesium blood levels may be low normally in the second and third months of pregnancy.

Low magnesium levels can affect calcium level regulation. Parathyroid hormone and Vitamin D ordinarily work together along with phosphorus to regulate calcium levels. Low magnesium levels can make low calcium levels more resistant to change.