If the level of magnesium in your blood is lower than 1.8 milligrams per deciliter, your levels are considered low. If your level is below 1.25 mg/dL, your condition is considered severe. Often, doctors may not find this condition until the levels are severely low. This is when symptoms often first appear.
Brief Summary: Hypomagnesemia is a common entity in the inpatient and outpatient setting. in previous retrospective study hypomagnesemic patients have higher mortality and longer hospitalization.
Magnesium helps maintain a normal heart rhythm and doctors sometimes administer it intravenously (IV) in the hospital to reduce the chance of atrial fibrillation and cardiac arrhythmia (irregular heartbeat).
Treat with magnesium salts when magnesium deficiency is symptomatic or persistently < 1.25 mg/dL (< 0.50 mmol/L). Give oral magnesium salts unless patients have seizures or other severe symptoms, in which case, give 2 to 4 g of magnesium sulfate IV over 5 to 10 minutes.
Magnesium, at a dose of 2 g (25–50 mg/kg in children) magnesium sulphate intravenously over one to two minutes, is used to suppress EADs in the emergency situation. In vitro studies have shown it reduces the amplitude of EADs to sub-threshold levels by blocking calcium influx.
In the heart, magnesium plays a key role in modulating neuronal excitation, intracardiac conduction, and myocardial contraction by regulating a number of ion transporters, including potassium and calcium channels.
Serum magnesium 0.4-0.75 mmol/L. ECG monitoring is not required unless treating Medical Officer determines the patient has an elevated risk of arrhythmia.
Interventions to address hypermagnesemia include administering IV calcium gluconate and diuretics. Patients who are renally impaired may require dialysis. Medications containing magnesium, such as certain antacids and laxatives, should be avoided. Magnesium causes vasodilation and increases blood flow in the tissues.
Symptoms of hypomagnesaemia? Prescribe 20mmol magnesium in 100ml or 250ml of compatible fluid IV over 3 to 4 hours. If having IV fluids can add 20mmol magnesium to 500ml or 1L bag of compatible fluid and give IV over 3 to 24 hours.
Low levels of the minerals sodium, calcium, and magnesium can alter the electrical activity of brain cells and cause seizures.
The body needs magnesium to maintain the health of muscles, including the heart. Research has found that magnesium plays an important role in heart health. A 2018 review reports that magnesium deficiency can increase a person's risk of cardiovascular problems. This is partly due to its roles on a cellular level.
Magnesium therapy
For critically ill patients with mild to moderate hypomagnesemia, empirically derived “rules of thumb” suggest that the administration of 1 g (8 mEq) of intravenous Mg will increase the serum Mg concentration by 0.15 mEq/L within 18 to 30 h [111].
Low serum magnesium levels could be associated with increased risk of ischemic stroke, in part, via effects on hypertension and diabetes. Magnesium is a natural calcium antagonist and modulates vasomotor tone, blood pressure, and peripheral blood flow.
Cognitive delays
Commonly referred to as brain fog, slow cognition or difficulty with concentration and memory can all indicate magnesium deficiency. Magnesium is an essential nutrient for the brain, so without it the brain cannot perform as well.
Symptoms of Hypomagnesium:
Muscle weakness, confusion, and decreased reflexes with severely low blood magnesium levels. You may also notice "jerky" movements, high blood pressure, and irregular heart rhythms with severely low blood magnesium levels.
Severe hypermagnesemia (levels greater than 12 mg/dL) can lead to cardiovascular complications (hypotension, and arrhythmias) and neurological disorder (confusion and lethargy). Higher values of serum magnesium (exceeding 15 mg/dL) can induce cardiorespiratory arrest and coma.
Oral magnesium therapy should be considered first-line. Most oral magnesium preparations are unlicensed. The standard dose of oral magnesium for hypomagnesaemia is 24mmol daily in divided doses, however oral magnesium salts frequently cause diarrhoea.
Additionally, in less severe cases of hypomagnesemia, gradual repletion may be achieved by administration of smaller parenteral doses over 3 to 5 days, until the serum magnesium concentration level is normal.
Symptoms of hypermagnesemia may include weakness, confusion, respiratory and cardiac distress, and coma.
The patient should be assessed for signs of toxicity (e.g., visual changes, somnolence, flushing, muscle paralysis, loss of patellar reflexes) or pulmonary edema. If these signs are observed, a physician must be notified.
Monitoring magnesium level is necessary while administering magnesium. Monitoring can be done on serum magnesium levels, as well as other electrolytes such as calcium and potassium.
Low serum magnesium was linked to a greater incidence of PVCs and a higher risk of ventricular tachycardia and torsades de pointes in obese patients with diabetes and after surgery [78,79].