Risk factors for low magnesium include:
- Inadequate dietary intake (elderly, malnutrition, alcoholism)
- Poor absorption in gastrointestinal disorders (IBD)
- Excessive loss – severe prolonged diarrhoea, prolonged use of loop diuretics
- Ketoacidosis
- Accompanying hypocalcaemia or hypokalaemia
- Patients receiving TPN
- Severe burns
- Toxaemia of pregnancy
Complications of low magnesium include unexplained hypocalcaemia, refractory hypokalaemia, cardiac arrhythmias, tetany or seizures.
Risk factors for high magnesium include:
- Hypermagnesaemia is predominantly the result of renal failure
- Iatrogenic causes from excessive supplementation or over use of laxatives
- Dehydration
- Hyperparathyroidism
- Hypothyroidism
- DKA – initial presentation
Complications of high magnesium can manifest with levels above 2mmol/l. Severely increased levels can result in muscle weakness progressing to a flaccid paralysis, confusion, respiratory paralysis, complete heart block and cardiac arrest in extreme cases.