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)

Are you finding it difficult to fall asleep? It might be a symptom 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 or the gastrointestinal tract

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

1. Inadequate dietary intake
   It is one of the most important causes of magnesium deficiency. Contributing factors include:
   • Starvation
   • Dieting or highly selective eating
   • Difficulty in swallowing
   • Mental illnesses
   • Last stage cancer
   • Critically ill patients who are on total intravenous nutrition
2. Age
   The absorption of magnesium from the gut decreases with age. Older individuals are also more likely to have chronic diseases that can deplete magnesium levels.
3. Gastrointestinal disorders
   Poor absorption of magnesium by the gastrointestinal tract in the following conditions can 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 due to profuse sweating or increased urination, as seen in some kidney disorders, increases susceptibility 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%.
6. Long term alcohol intake
   Chronic alcoholism significantly increases the risk of magnesium deficiency. Approximately 30% of individuals with magnesium deficiency are chronic alcoholics.
7. Certain medications
   Magnesium deficiency is common with the long-term use of certain medications, including:
   • 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 associated with magnesium deficiency:
   • Gitelman syndrome
   • Hypercalciuric hypomagnesemia
   • EAST (SeSAME) syndrome
9. Burns
   Burns affecting large areas of the body increase the risk of magnesium deficiency due to fluid loss through the burn wound.

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

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 inquire about symptoms, medical history, and relevant factors such as diet and lifestyle. A physical examination will be performed to check for signs associated with magnesium deficiency. Clinicians can also look for the following signs:
   • Chvostek sign: Twitching of the upper lip.
   • Trousseau sign: Characteristic posture of the hand when the sphygmomanometer cuff is inflated above the systolic blood pressure within 3 minutes.
2. Lab tests
   Magnesium deficiency can lead to calcium and potassium deficiencies. Basic investigations through blood tests include:
   • Magnesium blood test
   • Calcium blood test
   • Potassium blood test
   • Comprehensive metabolic panel (CMP)
   • Urine magnesium test
   The impaired function of the kidneys can also be a cause of persistent magnesium deficiency. Get the function of your kidneys tested from the comfort of your home.
3. Imaging tests
   Imaging tests are performed to detect outcomes of the deficiency:
   • Electrocardiography: Done to rule out irregular heartbeat.
   • Bone X-rays: Conducted to check for any deformities in the bones.
   • Renal ultrasonography: Uses sound waves to detect abnormalities in the kidneys.
4. Genetic testing
   Genetic testing is performed to identify the genetic cause of the deficiency in the following cases:
   • Positive family history of magnesium deficiency
   • Unexplained magnesium deficiency
   Looking for a trusted lab to get your tests done? Get tested with Tata 1mg labs for accurate and timely results.

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 during pregnancy and lactation.

Include good sources of magnesium in your diet such as:

• Spinach
• Legumes
• Whole grains
• 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 chocolate

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

2. Consider magnesium supplements

Magnesium supplements might be particularly beneficial for individuals with type 2 diabetes and low magnesium levels. For women who develop diabetes during pregnancy, taking magnesium appears to improve insulin sensitivity and reduce blood sugar levels.

3. Be cautious of alcohol and certain medications

Excessive alcohol consumption and long-term use of specific medications can interfere with magnesium absorption. Consider stopping or limiting alcohol intake. Discuss alternatives to medications that can cause magnesium deficiency with your doctor.

4. Support your gut health

Good gut health ensures effective magnesium absorption. Support your gut health with a daily serving of fermented foods such as:

• Yogurt
• Kefir
• Kombucha
• Sauerkraut

Explore our wide range of supplements that help maintain gut health.

5. Keep caffeinated and fizzy drinks at bay

Caffeine may increase magnesium loss from the body. Fizzy drinks contain phosphoric acid, which may also deplete magnesium. Limiting caffeine and fizzy drink intake can help prevent 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:

• 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.
• 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 and 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 preparations, in the form of lotions or oils, to support muscle and joint health.
• Magnesium glycinate: This is one of the gentlest magnesium supplements on the stomach and usually does not cause the stomach distress associated with some magnesium types.
• Magnesium sulfate: It is primarily used in the treatment of seizures in pregnant women with high blood pressure and decreased magnesium levels in the 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 is easily absorbed by the body and is 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 but is not used to treat deficiency due to its poor absorption.
• Magnesium L-threonate: This form of magnesium is potentially beneficial for brain health and may relieve sleeplessness, tense muscles, and anxiety.
• Systemic (Intravenous/I.V.) magnesium: If the hypomagnesemia is severe, you will likely be admitted to the hospital and receive fluids and magnesium through a vein (I.V.).

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

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

• 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.
• Soybean: Soybean is a magnesium-rich food that also offers fiber and vitamins. Snacking on half a cup of dry roasted soybeans provides approximately 106 mg of magnesium and 20.2 g of protein.
• Fatty fish: Add fatty fish such as salmon and tuna to your menu to boost magnesium intake.
• 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.
• Spinach: A cup of cooked spinach contains about 157 milligrams of magnesium and can be incorporated into salads and omelets.
• 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.
• Avocado: A medium-sized avocado provides roughly 58 milligrams of magnesium and can be enjoyed in salads, sandwiches, or as a standalone snack.
• Dark chocolate: A very good source of magnesium, about 28 g of dark chocolate provides 65 mg of magnesium and contains fiber that can help support beneficial gut bacteria.
• Tofu: Apart from being a good source of protein for vegetarians, tofu is also rich in magnesium. A 100 g serving contains 35 mg of magnesium.
• Banana: One large banana contains approximately 37 mg of magnesium and is among the most popular fruits in the world, rich in several nutrients.

Complications of Magnesium Deficiency

• Fatigue and weakness: Individuals with low magnesium often experience fatigue, low energy levels, and general weakness. Learn about more mineral deficiencies that can make you feel tired.
• Muscle cramps and weakness: Inadequate magnesium levels may result in muscle cramps, weakness, and spasms.
• Irregular heartbeat: Low magnesium can lead to irregular heart rhythms (arrhythmias) as it plays a role in regulating heart function.
• Osteoporosis: Prolonged deficiency might affect bone health, potentially contributing to osteoporosis.
• Mood changes: Imbalances can impact mood stability, potentially causing anxiety, depression, or irritability.

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 its severity. They may recommend further tests to identify the underlying cause.
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 identify any inadequacies. This may assist you in recognizing 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 collaborate effectively with your healthcare professional.
7. Be aware of the toxicity: Consuming a large amount of supplements over a short period can lead to toxicity. The total intake, from combined dietary and supplemental sources, should not exceed the recommended amount.

Symptoms of magnesium toxicity usually develop after serum concentrations exceed 1.74–2.61 mmol/L. Signs 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.