hipomagnesemia

Hypomagnesemia, also spelled hypomagnesaemia, is a medical condition defined by abnormally low magnesium levels in the blood. Magnesium is an essential mineral required for many biochemical processes, including nerve and muscle function, heart rhythm, and enzymatic reactions. Symptoms may be absent or nonspecific until levels fall markedly.

Causes include inadequate intake or absorption (malnutrition, chronic alcoholism, gastrointestinal losses from vomiting or diarrhea, malabsorption syndromes), increased losses (urinary wasting from loop diuretics, certain renal tubular disorders), and shifts of magnesium into cells (refeeding syndrome, insulin administration). Long-term use of proton pump inhibitors may contribute.

Clinical features range from mild complaints such as fatigue or irritability to neuromuscular manifestations including muscle cramps, tremor, numbness, tetany, seizures, and arrhythmias. Severe deficiency can produce life-threatening cardiac arrhythmias and respiratory compromise.

Diagnosis is based on serum magnesium concentration, with values below the lower limit of normal (typically around 1.7 mg/dL or 0.70 mmol/L). Because total body magnesium may be depleted even when serum levels are near normal, clinicians consider signs, electrolyte abnormalities (calcium, potassium), and the clinical context.

Management involves treating the underlying cause and repleting magnesium. Mild cases may use oral magnesium preparations; moderate to severe deficits typically require intravenous magnesium sulfate, with careful monitoring of serum levels and renal function to avoid hypermagnesemia. Dose is adjusted for kidney function.

Prognosis depends on timely treatment and the correction of underlying problems. Recurrent deficiencies may occur if risk factors persist, so addressing chronic diseases, nutrition, and medication exposure is important for prevention.