What is hypomagnesemia - Definition of hypomagnesemia

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What is hypomagnesemia?
Hypomagnesemia is defined as a deficiency of ionized magnesium in the blood serum wherein the levels fall below 1.8 mg/dL (below 0.74 mmol/L).
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The normal range for blood serum magnesium in a healthy person is between 0.74 mmol/L and 0.94 mmol/L (1.8 mg/dL and 2.3 mg/dL). The most common reason for the low levels is chronic inadequate magnesium intake.

Hypomagnesemia may also develop when there is increase in elimination of magnesium by the gastrointestinal tract or kidneys. Gastrointestinal disorders can cause poor absorption of the mineral. In certain adverse health conditions hypomagnesemia arises when ionic magnesium present in the extracellular spaces is redistributed to intracellular spaces.

The kidney is one of the major regulators of the extracellular fluid electrolytes like calcium, potassium, magnesium, sodium and chloride. Several inherited or acquired renal disorders result in magnesium wasting. Hypomagnesemia often contributes to other serum electrolyte balance disorders, such as hypocalcemia and/or hypokalemia.

Hypomagnesemia with secondary hypocalcemia (HSH) is an autosomal recessive genetic disorder. The disorder affects intestinal magnesium absorption.
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The affected infants, if left untreated may suffer from convulsions, muscle spasms, tetany, seizures, mental retardation and die at an early age.

Hypomagnesemia web definition

Definition by merriam-webster.com: "deficiency of magnesium in the blood."
Definition by en.wiktionary.org: "The condition of having an abnormally low concentration of magnesium ions in the blood."
Definition by medterms.com: "Low magnesium in the blood, which can occur due to inadequate intake or impaired intestinal absorption of magnesium."

The factors responsible for low serum magnesium levels are many. , malabsorption, increased gastrointestinal loss, excessive intercellular binding, excessive intracellular protein binding, genetic or acquired renal disorders, use of diuretics, certain medicines and chemicals are the contributing factors. Alcoholism and chronic diarrhea are known to contribute to this condition.

What are the symptoms of hypomagnesemia?

Mild low serum magnesium levels may go unnoticed. The signs of mild deficiency are weakness and muscle pain.
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In case of severe deficiency symptoms like, muscle cramps, hypokalaemia, hypoparathyroidism, hypocalcemia, bronchodilation, irritability, hyperreflexia, nystagmus, hypertension, cardiac arrhythmia, tachycardia, osteoporosis and nephrolithiasis may be encountered. Very severe condition may result in pulmonary arrest, cardiac arrest and death.

In case of mild to moderate deficiency, and supplements are given.
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If the patient suffers from gastrointestinal disorders, intravenous magnesium sulfate is administered at a slow phase to bring back and establish the normal serum levels. If the magnesium wasting is due some acquired factor, simultaneous diagnosis and treatment of the trigger is necessary to control the loss.
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References:
1.Assadi F. Hypomagnesemia: an evidence-based approach to clinical cases. Iran J Kidney Dis. 2010 Jan;4(1):13-9.
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