Are you low on magnesium? Let's talk about hypomagnesemia!

Do you sometimes feel like you're just not feeling well, your limbs are shaking, or your mind is having a hard time concentrating? Perhaps the reason for this is that you're low in the essential nutrient magnesium. Today, we're going to talk about this condition called hypomagnesemia, or magnesium deficiency.

What is Hypomagnesemia?

Simply put, hypomagnesemia is when you have less magnesium in your blood than you should. This can be a mild deficiency, or it can be a more serious deficiency.

Now you may be wondering what magnesium is and why it is important to us . Magnesium is a very important electrolyte in our body. This means that magnesium helps our cells function properly and helps our nervous system function properly. Magnesium is essential for your brain, heart, and muscles to function properly.

Another thing is that when this magnesium decreases, it directly affects the balance of other important electrolytes in our body, such as sodium, calcium, and potassium. Often, when magnesium decreases, calcium deficiency (hypocalcemia) and potassium deficiency (hypokalemia) can be seen at the same time.

Although most of the magnesium in our bodies is stored in our bones, our cells and organs can only use the magnesium dissolved in our blood. This is what we call the magnesium in the extracellular fluid.

The magnesium levels in our body are controlled primarily by three organs:

• Our small and large intestines: This is where we absorb magnesium from the foods we eat.
• Bones: This is the main place where magnesium is stored.
• Kidneys: Excess magnesium is excreted from the body through the kidneys.

So, if there is a problem somewhere in this process, you can develop hypomagnesemia.

Who is more likely to develop hypomagnesemia?

Magnesium deficiency can happen to anyone of any age, but it is more likely to occur in people with certain medical conditions or in certain situations. For example:

• This condition can be seen in about 2% of the general population .
• This can occur in between 10% and 20% of people who are hospitalized .
• This affects a large percentage of people in the intensive care unit (ICU), between 50% and 60% .
• Between 30% and 80% of people addicted to alcohol .
• About 25% of people with poorly controlled diabetes (Diabetes Mellitus) ...

When you see these percentages, you probably realize that this is not something to be taken lightly.

What are the symptoms of this hypomagnesemia condition?

Magnesium deficiency can manifest itself in a variety of symptoms. But it mainly affects your nervous system and heart . Some people may not have any symptoms at all. That is, they may be ``asymptomatic``.

For example, if your magnesium levels are slightly low (mild hypomagnesemia) , you may experience symptoms like these:

• Tremors (tremors).
• Things like muscle twitching, stiffness, and numbness in the limbs (tetany).
• Abnormal movements of the eyes (nystagmus).
• Feeling tired and lifeless all the time .

However, if magnesium levels are significantly, or seriously, low (severe hypomagnesemia) , symptoms can be more severe:

• Generalized tonic-clonic seizures (``Generalized tonic-clonic seizures``).
• Delirium ( mental confusion, confusion of mind ).
• Heartbeat abnormalities, that is, changes in the rhythm of the heart (arrhythmia).

If you have symptoms like these, it is very important to definitely seek medical advice.

Why is this magnesium deficiency? What are the causes?

There are three main reasons why magnesium deficiency can occur:

• Not getting enough magnesium.
• Excess magnesium is excreted from the body, either through the kidneys (with urine) or the gastrointestinal system (with feces).
• The magnesium in our blood goes to places where it can't be used so easily by cells (this is a bit lacking).

Let's look at each of these in a little more detail.

1. Not getting enough magnesium in the body

This may be due to:

• Fasting means going without food and drink.
• Being addicted to alcohol and not eating a nutritious diet. Just imagine, some people drink alcohol from morning until night and don't give their bodies any nutrition. Then, not only magnesium, but many other things become deficient in the body.
• People who are seriously ill, unable to eat by mouth, and are receiving only intravenous fluids (IV). Sometimes, magnesium deficiency can occur if the nutrition given in this way is not sufficient.

Also, if the body is unable to properly absorb magnesium from the foods we eat, that can also be a cause of magnesium deficiency. Examples:

• Some medical conditions can cause malabsorption, such as celiac disease and inflammatory bowel disease.
• Stomach surgeries such as gastric bypass surgery. Magnesium levels may decrease after these surgeries because the amount of food absorbed is reduced.
• Hereditary conditions that cause magnesium to be poorly absorbed (e.g., primary intestinal hypomagnesemia)
• Some medications can interfere with magnesium absorption. For example, long-term use of proton pump inhibitors, such as omeprazole, which is used to treat gastritis.

2. Excess magnesium is excreted from the body

This can happen in two main ways.

Excess magnesium excreted from the kidneys in the urine:

• Alcohol use.
• Uncontrolled diabetes (Diabetes Mellitus) . When blood sugar levels increase, the kidneys may excrete more magnesium.
• " Hereditary conditions involving the renal tubules , for example, Gitelman syndrome."
• Some diuretic medications, which are medications that remove water from the body. Examples: Hydrochlorothiazide, Chlorthalidone, Furosemide, Bumetanide.
• Aminoglycoside antibiotics. Examples: Gentamicin, Tobramycin, Amikacin.
• Some chemotherapy drugs used for cancer . Example: Cisplatin.
• Anti-rejection drugs are drugs given to prevent rejection after an organ transplant . Examples: Cyclosporine, Tacrolimus."
• Some other medications, such as Digoxin.

Excess magnesium is excreted from the gastrointestinal system with feces:

• Severe or prolonged diarrhea. You can imagine how much valuable nutrients are wasted when you keep going hungry. Magnesium is one of them.

3. Magnesium in the blood goes to places where it is difficult to use

This is a bit rare, but it can happen in situations like this:

• For people with acute pancreatitis.
• A condition called "Hungry bone disorder" can occur after the parathyroid glands are surgically removed.

How do doctors diagnose this condition of hypomagnesemia?

If you think you have symptoms of hypomagnesemia, your doctor will first examine you and ask about your symptoms and your medical history.

Then, you will likely be asked to take a blood test to check the level of magnesium in your blood. A healthy person's magnesium level should be between 1.46 and 2.68 milligrams per deciliter (mg/dL).

Not only that, you can also do other tests like this:

• A calcium blood test is a test that checks the level of calcium in the blood . As we said before, when magnesium is low, calcium can also be low.
• A comprehensive metabolic panel can check a number of other important chemicals in the body.
• A test that checks the level of potassium in the blood .
• A urine magnesium test is a test that measures the level of magnesium in the urine . This can give an idea of ​​whether the kidneys are excreting magnesium properly or excessively.
• Electrocardiogram (EKG) test to check the functioning of the heart.

Once your doctor has confirmed that you have hypomagnesemia, they can usually determine the underlying cause by reviewing your medical history and test results. However, sometimes further testing may be needed to determine the cause.

What are the treatments for this?

The treatment for hypomagnesemia depends on how severe it is, that is, how low the magnesium level is, and what the underlying cause is.

If your magnesium deficiency is not severe (mild hypomagnesemia) , your doctor will likely prescribe magnesium tablets to take by mouth.

However, if your magnesium deficiency is severe (severe hypomagnesemia) , you may be hospitalized and given fluids and IV magnesium. This can quickly restore your magnesium levels.

Also, the doctor will treat the underlying cause of this magnesium deficiency. For example, if the magnesium deficiency is due to diabetes, the necessary treatment will be provided to control the diabetes. Otherwise, if the underlying cause is not treated, magnesium deficiency may occur again, right?

Can we prevent this condition of hypomagnesemia?

Properly treating and/or controlling underlying medical conditions that can contribute to magnesium deficiency can help prevent this condition from occurring.

For example, if you have celiac disease, following a strict gluten-free diet can help prevent malabsorption, which can lead to magnesium deficiency.

However, in some cases, hypomagnesemia may not be preventable, especially when there are factors such as hereditary factors.

So, what will happen in this situation going forward? (Prognosis)

The prognosis of hypomagnesemia depends on the underlying cause. If the cause of magnesium deficiency is identifiable and treated properly, there is a good chance of a full recovery.

But remember, if magnesium levels become dangerously low, it can cause fatal cardiac arrhythmias. That's why it's important to seek medical advice immediately if you have symptoms.

When should we see a doctor about this?

If you have symptoms of hypomagnesemia (things we talked about earlier, like tremors, muscle twitching, and fatigue), be sure to see your doctor.

If you suddenly have a seizure, or if your heart beats strangely, rapidly, or feels like it's constricting, in other words, if you develop severe symptoms, call 911 immediately or go to the nearest hospital. Do not stay home alone at such times.

If you have a chronic condition like Crohn's disease or a hereditary kidney disease (which can cause magnesium deficiency), it's important to see your medical team regularly to make sure you're being treated properly and your magnesium levels are at a healthy level.

Finally, the most important things for you to remember (Take-Home Message)

Hypomagnesemia, or magnesium deficiency, is a condition that can be a bit complicated. But the best part is, it's a treatable condition.

If you have these symptoms, please don't panic. See a doctor and get the necessary tests done. Once your magnesium levels return to normal, most of the time the symptoms will go away.

Don't be afraid to ask your doctor or nurse any questions you have about hypomagnesemia or its management. The most important thing is to stay informed about your health.

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