Hypomagnesemia (magnesium deficiency) occurs when blood magnesium levels fall below the normal range. Mild hypomagnesemia may cause nonspecific symptoms, such as fatigue, nausea, weakness, or loss of appetite, although many people have no symptoms at all.
Severe or prolonged hypomagnesemia can cause serious complications, including abnormal heart rhythms, seizures, and other potentially life-threatening problems.
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What Is Hypomagnesemia?
Doctors define hypomagnesemia as low magnesium levels in your blood. Magnesium is a mineral that’s vital for every organ in your body. You can find it in different food sources and supplements.
Magnesium is necessary for energy production, bone development, and glucose control.
Magnesium plays an important role in moving calcium and potassium through your body. A serious magnesium deficiency can also lead to low calcium and potassium levels. Because magnesium, calcium, and potassium levels are closely related, doctors often check all three when evaluating hypomagnesemia.
Your body uses magnesium for many different chemical reactions throughout your body.
It’s essential for:
- Building strong bones.
- Helping control blood pressure and blood sugar.
- Making DNA.
- Making proteins throughout your body.
- Moving other minerals into your cells.
- Regulating how your muscles and nerves work.
- Regulating your heart rate.
Usually, your body keeps magnesium levels within a healthy range. But certain health conditions or medications might lower your magnesium levels. If that happens, it can lead to other serious health issues.
Without enough magnesium, you may end up with:
- Abnormal heart rhythms.
- Breathing problems.
- High blood pressure.
- Migraine headaches.
- Osteoporosis.
You can raise your magnesium levels with diet and supplements. To raise magnesium levels quickly, you will need a doctor’s care. We can treat severe hypomagnesemia with intravenous (IV) fluids.
What are the types of hypomagnesemia?
Doctors break hypomagnesemia down into two basic types:
Mild hypomagnesemia
Doctors define mild hypomagnesemia as slightly below the normal range.
The normal range is 1.46 to 2.68 milligrams per deciliter (mg/dL). Mild hypomagnesemia is between 1.2 and 1.46 mg/dL.
Symptoms at this range are fatigue, weakness, and nausea.
Severe hypomagnesemia
Severe hypomagnesemia is a magnesium level less than 1.2 mg/dL. Your symptoms might include muscle spasms, tremors, and heart problems.
Your symptoms are likely to worsen over time if left untreated.
How common is hypomagnesemia?
Hypomagnesemia is relatively common. In the general population, up to 15% of people have magnesium deficiency.
It’s more common among people:
- In intensive care units.
- With alcohol use disorder.
- With diabetes.
What causes hypomagnesemia?
There are many reasons you may have low levels of magnesium.
Some include:
Diet
Most healthy people won’t develop magnesium deficiency from not having enough of it in their diet. But if low intake happens often, it can lead to health problems.
Medications
Certain medications can cause you to absorb less magnesium or lose too much magnesium, including:
- Certain antibiotics.
- Bisphosphonates.
- Chemotherapy drugs.
- Diuretic medicines that lower blood pressure.
- Medications that cause persistent vomiting or diarrhea may contribute to magnesium loss.
- Proton pump inhibitors that lower stomach acid.
Other health conditions
You may lose magnesium from your body if you have another illness or health condition, including:
- Alcohol use disorder.
- Celiac disease.
- Gastric bypass surgery for weight loss.
- Inflammatory bowel diseases, such as Crohn’s disease or ulcerative colitis.
- Certain kidney disorders.
- Pancreatitis.
- Uncontrolled type 2 diabetes.
If you have any of these health conditions or take these medicines, ask your doctor if you need extra magnesium.
Hypomagnesemia risk factors
Risk factors for hypomagnesemia include:
- Eating a diet low in magnesium.
- Having a disease that depletes magnesium from the body.
- Taking medications that deplete magnesium from the body.
Complications of hypomagnesemia
Low magnesium levels have been associated with several chronic health conditions, including high blood pressure, migraine headaches, osteoporosis, and type 2 diabetes. More research is needed to fully understand these relationships.
How can I reduce risks of hypomagnesemia?
You can reduce your chance of having hypomagnesemia by getting enough magnesium in your diet every day. The exact amount you need varies based on your age, sex, and health conditions.
Men older than 70 and teenage girls and boys are most likely to have low intakes of magnesium.
The recommended dietary allowances (RDAs) for magnesium are:
- Men ages 19 to 30 should get 400 mg per day.
- Men over 30 should get 420 mg per day.
- Women over 18 need 310 mg and 350 mg per day if they’re pregnant.
- Women over 30 need 320 mg per day or 360 mg per day if they’re pregnant.
Eating a magnesium-rich diet is the best way to meet these needs.
The following foods are especially rich in magnesium:
- Almonds, cashews, and peanuts.
- Brown rice.
- Chia seeds.
- Edamame.
- Kidney or black beans.
- Oats.
- Pumpkin seeds.
- Spinach.
- Whole-grain cereal and bread.
What Are the Signs and Symptoms of Hypomagnesemia?
Signs of magnesium deficiency vary, depending on how severe your condition is. A magnesium level below normal can affect nerves and muscles in your body, including your heart.
If your magnesium levels are a little bit low, you probably won’t have severe symptoms. Instead, you might just feel “off,” or maybe like you have a stomach bug.
Mild hypomagnesemia symptoms include:
- Fatigue.
- Loss of appetite.
- Nausea.
- Vomiting.
- Weakness.
Magnesium levels can quickly fall if you have severe vomiting, diarrhea, or frequent urination.
Symptoms of severe hypomagnesemia include:
- Abnormal eye movements.
- Arrhythmias (abnormal heart rhythms).
- Convulsions.
- Fatigue.
- Irregular heartbeat.
- Muscle spasms, twitches, and cramps.
- Numbness and tingling.
- Personality and mood changes, such as depression or irritability.
- Seizures.
When should I see a doctor about my hypomagnesemia symptoms?
If you have any of the symptoms above, call your doctor. Severe hypomagnesemia is dangerous. If left untreated, worsening magnesium deficiency can also lead to cardiac arrest, coma, or even death.
How Do You Diagnose Hypomagnesemia?
Your doctor will do a physical exam, review your medical history, and order laboratory testing. Additional testing, such as an electrocardiogram (EKG), may be recommended depending on your symptoms and underlying health conditions.
Tests to diagnose hypomagnesemia
The tests your doctor orders will depend on your specific symptoms and underlying health conditions.
They may include:
- Blood tests to check your magnesium level.
- Calcium blood test.
- Comprehensive metabolic panel.
- Electrocardiogram (EKG).
- Potassium blood test.
- Urine magnesium test.
Hypomagnesemia outlook
With proper treatment, doctors can restore your magnesium levels to normal. Your prognosis will depend on what other health conditions you have.
How Do You Treat Hypomagnesemia?
The goal of hypomagnesemia treatment is to get your magnesium levels back to normal. How we treat magnesium deficiency depends on the severity of the problem.
Hypomagnesemia treatment will also depend on the underlying cause. If you have alcohol use disorder or diabetes, for instance, your doctor will also want to treat that condition.
Here are some ways we treat magnesium deficiency.
Changes in your diet
You can start by focusing on what you eat. A healthy diet that includes magnesium-rich foods can help keep your magnesium levels stable. Most whole foods have some magnesium, but highly processed packaged foods are low in magnesium.
You should eat a variety of vegetables and whole grains, both of which are good sources of magnesium. Lean meats, poultry, seafood, beans, and nuts also provide magnesium.
You should limit foods and drinks high in sugar and sodium. Decreasing the number of alcoholic drinks you consume can also help.
If you play sports or do other high-intensity activities, you may lose magnesium and other minerals through sweating. Maintaining adequate hydration and replacing electrolyte losses during prolonged exercise may be helpful, although most people can meet their magnesium needs through a balanced diet.
A registered dietitian can help determine whether you’re getting enough magnesium or should take a magnesium supplement.
Supplements to treat hypomagnesemia
A magnesium supplement may be enough to treat a mild case of hypomagnesemia. Your doctor can recommend an over-the-counter (OTC) product or prescribe a stronger version.
Many multivitamins and dietary supplements contain forms of magnesium that are easy for the body to absorb.
These include:
- Magnesium aspartate
- Magnesium chloride
- Magnesium citrate
- Magnesium lactate
You may also find magnesium in some laxatives and medications used to treat indigestion.
Intravenous (IV) infusions
If your magnesium levels are dangerously low, you’ll need treatment fast. The quickest way to boost magnesium levels is to get an IV infusion of magnesium sulfate. The infusion could take several hours.
It may take more than 24 hours for IV magnesium sulfate to bring your levels up to normal. You may need more than one treatment.
Your doctor will also check your other electrolyte levels since magnesium works with them. They may order an EKG to make sure your heart rate is normal.
How effective is treatment?
Treatment for low magnesium is very effective, especially in mild cases. Dietary changes and supplements are usually enough to boost your magnesium levels.
In more severe cases, IV treatment is effective at raising your magnesium levels. But it’s important that your doctor also treats the underlying cause of your hypomagnesemia to get to the root of the problem.
How long does it take to recover after IV treatment for hypomagnesemia?
You may start feeling better soon after your IV infusion, or it may take about 24 hours.
If you have an underlying condition, you may need to stay in the hospital for a few days. Your doctor can tell you how long your recovery process will take.
You may need to keep taking magnesium supplements when you get home.
