Magnesium deficiency

Symptoms of Magnesium deficiency 

Magnesium deficiency usually remains unnoticed for a few months as symptoms develop gradually. The early signs and symptoms may include:

• Fatigue

• Weakness

• Loss of appetite

• Nausea 

• Vomiting 

Magnesium depletion in the long run can cause: 

• Numbness

• Tingling

• Muscle contractions and cramps

• Seizures

• Abnormal heart rhythms

• Abnormal eye movements

The prolonged low level of magnesium is also associated with psychological symptoms such as:

• Apathy (the feeling of not being interested in or enthusiastic about anything)

• Confusion

• Depression

• Psychosis

The severely low levels of magnesium can also cause:

• Hypocalcemia (low levels of calcium)

• Hypoparathyroidism 

• Hypokalemia (low levels of potassium)

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Causes Of Magnesium deficiency

The possible causes of magnesium deficiency include:

• Reduced consumption of magnesium 

• Inadequate absorption from the intestine

• Excessive loss of magnesium through the kidneys (pee) or the gastrointestinal tract (stool)

These causes may be associated with many risk factors, discussed in the next section.

Risk Factors For Magnesium Deficiency

 
1. Inadequate dietary intake

It is one of the most important causes of magnesium deficiency. It can be attributed by 

• Starvation

• Dieting or highly selective eating

• Difficulty in swallowing

• Mental illnesses

• Last stage cancer

• Critically ill patients who are on total i.v. nutrition
  
  

2. Age 

The absorption of magnesium from the gut decreases with age. Older people are also more likely to have chronic diseases that can deplete magnesium levels.

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3. Gastrointestinal disorders

Poor absorption of magnesium by the gastrointestinal tract in the following conditions can also lead to magnesium deficiency:

• Celiac disease 

• Inflammatory bowel disease

• Gastric bypass surgery

• Crohn’s disease

• Chronic diarrhea

• Pancreatitis (swelling of the pancreas)
  
  

4. Excessive fluid loss

Excessive fluid loss as a result of profuse sweating or increased urination as seen in some kidney disorders also makes one more susceptible to magnesium deficiency.

5. Type 2 diabetes

Individuals with type 2 diabetes are more susceptible to magnesium deficiency due to increased excretion. It is estimated that diabetes increases the risk of magnesium deficiency by 13.5–47.7%.

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6. Long term alcohol intake

Chronic alcoholism increases the extent of magnesium deficiency to several folds. Almost 30% of people suffering from magnesium deficiency are chronic alcoholics.
 

7. Certain medications 

Magnesium deficiency is common in long-term consumption of certain medications like: 

• Loop and thiazide diuretics

• Proton pump inhibitors

• Aminoglycoside antibiotics

• Amphotericin 

• Pentamidine

• Digitalis

• Chemotherapeutic drugs, such as cisplatin and cyclosporine
  
  

8. Genetic disorders 

The following rare genetic conditions are also associated with magnesium deficiency:

• Gitelman syndrome

• Hypercalciuric hypomagnesemia

• EAST (SeSAME) syndrome
  
  

9. Burns

Burns that affect large areas of the body increase the risk of magnesium deficiency due to fluid loss through the burn wound. 

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A medical condition known as hyperaldosteronism (increased secretion of aldosterone by adrenal gland) also increases the risk of magnesium deficiency. Adrenal glands are small, triangular-shaped glands located on the top of both kidneys. They produce aldosterone hormone that helps regulate salt and water in the body.

Diagnosis Of Magnesium deficiency 

Magnesium deficiency can be diagnosed through a combination of clinical symptoms, medical history, physical examination, and laboratory tests:

1. Medical history and physical examination

Your doctor will ask about the symptoms, medical history, and any relevant factors such as diet and lifestyle. They will also perform a physical examination to check for signs associated with magnesium deficiency. Clinicians can also look for the following signs:

• Chvostek sign: It is the twitching of the upper lip.

• Trousseau sign: It involves a characteristic posture of the hand when the sphygmomanometer (an instrument used to measure blood pressure) cuff is inflated above the systolic blood pressure within 3 minutes.
  
  

2. Lab tests

Magnesium deficiency can lead to calcium and potassium deficiencies. The basic investigations through a blood test include:

• Magnesium blood test

• Calcium blood test

• Potassium blood test

• Comprehensive metabolic panel (CMP)

• Urine magnesium test
  
  

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3. Imaging tests

Imaging tests are performed to detect outcomes of the deficiency. 

• Electrocardiography: This is done to rule out irregular heartbeat.

• Bone X-rays: X-rays are done to check for any deformities in the bones.

• Renal ultrasonography: This involves the use of sound waves to detect any abnormalities in the kidneys.
  
  

4. Genetic testing

The genetic testing is done to find out the genetic cause of the deficiency. It is done in the following cases: 

• Positive family history of magnesium deficiency

• Unexplained magnesium deficiency
  
  

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Prevention Of Magnesium deficiency 

 
1. Add magnesium-rich foods to your diet

Recommended dietary allowance (RDA) is the daily intake of nutrients sufficient to meet the needs of most healthy individuals within a specific age and gender group. The RDA for magnesium for children, adults, and pregnant and lactating mothers is indicated below:
 

 For children: 

• 1-3 years: 80 mg/day

• 4-8 years: 130 mg/day

• 9-13 years: 240 mg/day
  
  

For adolescents and adults:

• Males 14-18 years: 410 mg/day

• Females 14-18 years: 360 mg/day

• Males 19-30 years: 400 mg/day

• Females 19-30 years: 310 mg/day

• Males greater than 31 years: 420 mg/day

• Females greater than 31 years: 320 mg/day
  
  

The requirement increases to 350-360 mg/day and 350-360 mg/day during pregnancy and lactation respectively.

Make sure to include good sources of magnesium in your diet like:

• Spinach

• Legumes

• Wholegrains

• Swiss chard

• Nuts (especially brazil nuts, cashew nuts, peanuts, almonds, and hazelnuts)

• Seeds (especially pumpkin seeds, sesame seeds, chia seeds)

• Avocado

• Milk

• Yogurt

• Banana

• Dark chocolates

These magnesium-rich sources are elaborately discussed in the “home care section”.

2. Consider magnesium supplements

Magnesium supplements might be most helpful in people with type 2 diabetes and low magnesium levels. For women who develop diabetes during pregnancy, taking magnesium seems to improve insulin sensitivity and reduce the levels of sugar in the blood.

3. Be cautious of alcohol and certain medications 

Excessive alcohol consumption and long-term use of certain medications can interfere with magnesium consumption. Either stop or limit alcohol consumption. Talk to your doctor about any alternatives to the medications that can cause magnesium deficiency.

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4. Support your gut health

Good gut health ensures magnesium is absorbed well. Support your gut health with a daily serving of fermented food such as

• Yogurt

• Kefir

• Kombucha 

• Sauerkraut
  
  

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5. Keep caffeinated and fizzy drinks at bay

Caffeine may increase magnesium loss from the body. Fizzy drinks contain phosphoric acid which may deplete magnesium too. Limiting the intake of caffeine and fizzy drinks can help prevent magnesium deficiency. 

Specialist To Visit

Medical professionals to consult in case of magnesium deficiency include:

• General Physician

• General medicine specialist 

• Gastroenterologist

• Nutritionist

• Geneticist

A general physician can diagnose and treat magnesium deficiency through blood tests, dietary advice, and magnesium supplementation. 

A gastroenterologist helps in managing cases where deficiency develops due to magnesium malabsorption.

A nutritionist can help with magnesium deficiency by assessing your dietary habits and developing a personalized meal plan to ensure adequate intake of this essential nutrient. 

A geneticist helps in the diagnosis of genetic causes of magnesium deficiency (inherited magnesium deficiency) 

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Treatment Of Magnesium Deficiency 

The duration and route of treatment vary depending on the underlying cause of the deficiency and the severity of the symptoms. Here are some common methods used to treat magnesium deficiency:

1. Dietary changes

If the cause of the deficiency is related to the diet, increasing your consumption of foods that are rich in magnesium can be beneficial for mild cases of deficiency.

2.  Oral magnesium supplements

For mild to moderate magnesium deficiency, oral supplements are typically prescribed in the form of tablets or capsules. 

Different types of magnesium supplements available in the market include:

• Magnesium citrate: It is the most commonly available form of magnesium supplement. It is also used to treat constipation due to its laxative effect. 

• Magnesium chloride: The oral form of this type is used to treat deficiencies. It is also available in topical preparation, in the form of lotions or oils, to support muscle and joint health.

• Magnesium glycinate: It is also one of the gentlest magnesium supplements on the stomach and usually doesn't cause stomach distress associated with some magnesium types.

• Magnesium sulfate: It is majorly used in the treatment of seizures in pregnant women with high blood pressure along with decreased magnesium levels in blood. 

• Magnesium lactate: This form is easily absorbed and is mostly used to treat deficiency in people with some digestive issues. 

• Magnesium malate: This type of magnesium is easily absorbed by the body and is also associated with decreased muscle pain. 

• Magnesium taurate: Some studies suggest its role in managing blood glucose and blood pressure. 

• Magnesium oxide: It helps relieve heartburn, indigestion, and constipation. It is not used to treat deficiency due to its poor absorption. 

• Magnesium L-threonate: This form of magnesium is potentially beneficial for brain health. It may also relieve sleeplessness, tense muscles and anxiety. 
  
  

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3. Systemic (Intravenous/I.V.) magnesium 

If the hypomagnesemia is severe, you’ll likely be admitted to the hospital and receive fluids and magnesium through a vein (I.V.)

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Topical magnesium formulations are also available in the form of oil and sprays. These preparations are mostly used to support muscle, joint health as well as sleep. However, their use as a supplement to raise magnesium levels is debatable and needs more research.

Home care For Magnesium deficiency 

To obtain the recommended intake of magnesium deficiency, it is advisable to consume a diverse selection of foods, including the following options:

1. Nonfat or low-fat Greek yogurt: Low-fat Greek yogurt is a great source of magnesium. Pair yogurt with a fiber-rich fruit for an easy, healthy breakfast.

2. Soybean: Soybean is a magnesium-rich food that also offers fiber and vitamins. Snacking half a cup of dry roasted soybeans makes you gain magnesium (106 mg) and protein (20.2 g).

3. Fatty fish: Add fatty fish such as salmon and tuna to the menu to boost your magnesium intake. These fatty fish make one closer to the magnesium intake.

4. Pumpkin seeds: An ounce of pumpkin seeds provides around 150 milligrams of magnesium. They make a nutritious snack or can be added to salads and yogurt.

5. Spinach: A cup of cooked spinach contains about 157 milligrams of magnesium. It can be incorporated into salads and omelets.

6. Almonds: A quarter cup of almonds contains approximately 97 milligrams of magnesium. They are a convenient snack or can be used as a topping for cereals and salads.

7. Avocado: A medium-sized avocado provides roughly 58 milligrams of magnesium. It can be enjoyed in salads, sandwiches, or as a standalone snack.

8. Dark chocolates: It is a very good source of magnesium. About 28g of a serving of dark chocolate of dark chocolate provides 65 mg of magnesium. It also contains the fiber that can help feed the bacteria that produce magnesium.

9. Tofu: Apart from being a good source of protein for vegetarians. It is also highly rich in magnesium. A 100-g serving contains 35 mg of magnesium.

10. Banana: It is among the most popular fruits in the world rich in several nutrients. One large banana contains approximately 37 mg of magnesium.  

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Complications of Magnesium Deficiency 

1. Fatigue and weakness

Individuals with low magnesium often experience fatigue, low energy levels, and general weakness.

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2. Muscle cramps and weakness

Inadequate magnesium levels may result in muscle cramps, weakness, and spasms.

3. Irregular heartbeat

Low magnesium can lead to irregular heart rhythms (arrhythmias) as it plays a role in regulating heart function.

4. Osteoporosis 

Prolonged deficiency might affect bone health, potentially contributing to osteoporosis.

5. Mood changes

Imbalances can impact mood stability, potentially causing anxiety, depression, or irritability.

Living With Magnesium deficiency 

Living with a magnesium deficiency requires careful management and attention to your diet and overall health:

1. Early diagnosis 

Visit a healthcare professional to confirm the deficiency and determine the severity. They may recommend further tests to identify the underlying cause of the deficiency.

2. Take supplements on time

To restore your levels, your doctor may prescribe oral or injectable magnesium supplements. Follow their dosage and frequency recommendations.

3. Monitor your diet

Maintain a food diary to track your magnesium intake and discover any inadequacies. This might assist you in identifying patterns and making appropriate adjustments.

4. Go for regular check-ups

Schedule regular appointments with your doctor to monitor your magnesium levels and overall health. They can guide you on necessary adjustments to your treatment plan.

5. Watch your symptoms

Stay vigilant for any symptoms of magnesium deficiency and report any new symptoms to your doctor as soon as possible.

6. Educate yourself

Learn about magnesium deficiency, its causes, symptoms, and management options. This knowledge will empower you to make informed decisions about your health and work effectively with your healthcare professional.

7. Be aware of the toxicity

Consuming a large amount of supplements over a short period of time can cause toxicity. The total intake, from combined dietary and supplemental sources, should not exceed as per the recommended amount.

Symptoms of magnesium toxicity usually develop after serum concentrations exceed 1.74–2.61 mmol/L. The sign of toxicity include:

• Hypotension

• Nausea

• Vomiting

• Facial flushing

• Retention of urine

• Depression

• Lethargy 

• Difficulty breathing,

• Extreme hypotension

• Irregular heartbeat

• Cardiac arrest 
  
  

The risk of toxicity is higher in individuals with impaired kidney function.