From the Guidelines
Hypomagnesemia (low magnesium levels) can cause a range of symptoms, including muscle cramps, tremors, muscle weakness, fatigue, and irregular heartbeat (arrhythmias), as well as numbness and tingling in the extremities, muscle spasms, seizures, personality changes, and nausea or vomiting. These symptoms occur because magnesium is essential for proper nerve and muscle function, heart rhythm regulation, bone health, and hundreds of biochemical reactions in the body 1. According to the American Heart Association, magnesium deficiency is common and can be associated with benefit in treating torsades de pointes (TdP), a type of abnormal heart rhythm 1.
Some of the key symptoms of hypomagnesemia include:
- Muscle cramps and tremors
- Muscle weakness and fatigue
- Irregular heartbeat (arrhythmias)
- Numbness and tingling in the extremities
- Muscle spasms and seizures
- Personality changes and nausea or vomiting
In severe cases, low magnesium can lead to coronary spasms, abnormal heart rhythms, and even seizures or coma 1. The American Heart Association recommends IV magnesium 1 to 2 g of MgSO4 bolus IV push for cardiotoxicity and cardiac arrest due to hypomagnesemia (Class I, LOE C) 1.
It's essential to consult a healthcare provider if you experience these symptoms, as they can order a blood test to check your magnesium levels and determine the best course of treatment, which may include magnesium supplementation and increasing dietary intake of magnesium-rich foods like leafy greens, nuts, seeds, and whole grains 1.
From the FDA Drug Label
Early symptoms of hypomagnesemia (less than 1. 5 mEq/L) may develop as early as three to four days or within weeks. Predominant deficiency effects are neurological, e.g., muscle irritability, clonic twitching and tremors. The symptoms of hypomagnesemia (low magnesium levels) are:
- Muscle irritability
- Clonic twitching
- Tremors Hypocalcemia and hypokalemia often follow low serum levels of magnesium 2.
From the Research
Symptoms of Hypomagnesemia
The symptoms of hypomagnesemia, or low magnesium levels, can be varied and affect different systems in the body. Some of the common symptoms include:
- Neurologic symptoms such as weakness, tremors, stupor, coma, nausea, vomiting, and anorexia 3
- Neuromuscular hyperactivity, including tremor, myoclonic jerks, convulsions, Chvostek sign, Trousseau sign, spontaneous carpopedal spasm, ataxia, nystagmus, and dysphagia 4
- Psychiatric disturbances, ranging from apathy and coma to delirium 4
- Cardiac arrhythmias, including ventricular fibrillation and sudden death 4, 5
- Hypocalcemia and hypokalemia, which may not respond to treatment without magnesium therapy 4, 5
- Neuromuscular hyperexcitability, cardiac arrhythmias, and biochemical abnormalities of hypokalemia and hypocalcemia 6
Clinical Manifestations
The clinical manifestations of magnesium deficiency can be acute or chronic. Acute manifestations may include:
- Neuromuscular hyperexcitability
- Cardiac arrhythmias
- Biochemical abnormalities of hypokalemia and hypocalcemia 6 Chronic magnesium depletion may contribute to:
- Hypertension
- Atherosclerotic vascular disease
- Altered glucose homeostasis
- Metabolic bone disease 6
Diagnosis and Treatment
The diagnosis of magnesium deficiency is usually made by a low-serum magnesium concentration 7, 5. Treatment of acute manifestations usually requires parenteral magnesium administration 6, while long-term magnesium repletion may be accomplished by oral administration of magnesium 6. It is essential to repair coexisting hypomagnesemia in hypokalemic patients to avoid refractory potassium repletion 5.