Magnesium deficiency


Generality

Magnesium deficiency can develop for various reasons, attributable to insufficient food intake, increased requirements, excessive losses, impaired intestinal absorption or prolonged intake of particular drugs (e.g. proton pump inhibitors, including omeprazole).

The resulting symptoms are very diverse and can regress after adequate oral or intravenous administration of magnesium.

In medical language, magnesium deficiency in the blood is called ipomagnesemia; in the most serious cases, this condition can be very dangerous, considering the possible onset of serious cardiac arrhythmias.

Cause

L’alcoholism chronic represents the condition most frequently associated with a secondary magnesium deficiency, both due to a reduced intake and excessive renal excretion induced by ethanol.

Magnesium deficiency due to insufficient dietary intake is common in prolonged fasting and Kwashiorkor.

Although many people in industrialized countries do not reach the recommended intake levels, this slight deficit is normally asymptomatic or paucisymptomatic.

More severe deficiencies may be due to reduced intestinal absorption, as in the presence of pancreatitis, steatorrhea, large surgical resections of the small intestine, Crohn's disease, ulcerative colitis, celiac disease and malabsorption syndromes in general.

Magnesium deficiencies can also be caused by thyroid or parathyroid diseases.

Severe magnesium losses can trigger deficiency syndromes; this is the case of protracted diarrhea and vomiting, therapy with certain drugs (such as some diuretics or laxatives), diabetic acidosis, excessive lactation, intense and prolonged sporting activity, chronic renal failure and hyperaldosteronism primitive.

Symptoms

The symptoms of magnesium deficiency are quite varied and can include: mental confusion, mood variability, osteo-tendinous hyperreflexia, muscle incoordination, tremors, paresthesias, tetany not differentiable from that present in hypocalcemia, muscle cramps, cardiac arrhythmias and hypertension arterial.

In women of childbearing age, magnesium deficiency has been associated with premenstrual syndrome.

Diagnosis

Identifying a magnesium deficiency can be difficult, especially in milder forms.

The diagnosis can be based on the dosage of magnesium in the blood, with a search for hypomagnesemia, on the reduction of the magnesium content in the erythrocytes or on the disappearance of the mineral in the urine. In this regard, intramuscular magnesium loading tests are very useful, followed by monitoring of urinary excretion: in case of depletion, a large part of the injected magnesium is retained, while when the balance is positive, most of the mineral is eliminated in the urine.

Treatment

Magnesium can be administered orally via supplements containing one or more of its compounds, such as magnesium citrate, magnesium carbonate, magnesium oxide (poorly absorbable), magnesium sulfate, magnesium aspartate, or magnesium chloride.

In general, it is preferable to use organic magnesium salts (gluconate, aspartate, pyruvate, malate, citrate, pidolate, lactate, orotate etc.), as they are better absorbed at the intestinal level.

An excess of these supplements can have a laxative effect.

If the deficiency is mild, it can easily be filled by increasing the intake of foods rich in magnesiumsuch as vegetables – especially green leafy ones – peanuts and whole grains.

In more serious cases, when supplements may be insufficient, magnesium sulphate is administered intramuscularly.


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