Hypomagnesemia

Low magnesium is a serum plasma level of less than 0.7 mmol/ L or < 1.46 mg/ dL.

Symptoms most likely when levels < 0.5 mmol / L. Symptomatic hypomagnesemia is often associated with hypocalcemia and hypokalaemia. 2nd most abundant intracellular cation -imp for cellular function , nerve conduction and other needs. Emergency - usually IV replacement is needed.

anorexia nausea / vomiting CNS - confusion , apathy , depression , hallucinations , agitation weakness / lethargy paraesthesia tetany / paresthesia / tremor / muscle fasciculations / seizures cardiac arrhythmias : digitalis toxicity may be enhanced , non -specific ECG changes , tachycardia , hypertension other electrolyte abnormalities as low Ca , K , hypoparathyroidism.

Symptoms can be non- specific and attributed to low calcium and potassium Work up - Ca , ph , Us & Es , glucose , ECG 24 hr urinary Mg excretion.

Symptoms – Gastrointestinal diarrhoea , vomiting , stoma or fistula output malabsorption medications ( e,g PPIs ) GI fistulae / gastric bypass malnutrition dietary deficiency.

Metabolic-chronic alcoholism uncontrolled diabetes ketoacidosis parathyroid disorders low Vit D acute pancreatitis re-feeding syndrome acidosis.

Others -renal losses blood transfusion drugs ( e,g loop & thiazide diuretics , theophylline...