Magnesium deficiency: Difference between revisions

Jump to navigation Jump to search
mNo edit summary
No edit summary
 
(One intermediate revision by the same user not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{SI}}
{{SI}}                                                                  
{{CMG}}; {{AE}}
{{CMG}}
 
{{PleaseHelp}}
 
==Overview==
==Overview==
'''Magnesium deficiency'''  or '''hypomagnesia'''  (not to be confused with [[hypomagnesemia]]) refers to inadequate intake of [[dietary magnesium]] or impaired absorption of magnesium, which can result in numerous symptoms and diseases.<ref>{{cite web|title=Definition of Magnesium Deficiency|url=http://www.medterms.com/script/main/art.asp?articlekey=4244|publisher=MedicineNet.com|accessdate=31 May 2014}}</ref> It is generally corrected by an increase of magnesium in [[diet (nutrition)|diet]], oral supplements, and in severe cases, intravenous supplementation.


==Historical Perspective==
==Historical Perspective==
Magnesium deficiency in humans was first described in the medical literature in 1934.<ref>{{cite journal|last1=Hirschfelder|first1=A. D.|last2=Haury|first2=V. G.|title=Clinical Manifestations of High and Low Plasma Magnesium; Dangers of Epsom Salt Purgation in Nephritis|journal=Journal of the American Medical Association|date=1934|volume=102|page=1138|doi=10.1001/jama.1934.02750140024010 }}</ref>
*[Disease name] was first discovered by [scientist name], a [nationality + occupation], in [year] during/following [event].
 
*In [year], [gene] mutations were first identified in the pathogenesis of [disease name].
*In [year], the first [discovery] was developed by [scientist] to treat/diagnose [disease name].
==Classification==
==Classification==
 
*[Disease name] may be classified according to [classification method] into [number] subtypes/groups:
:*[group1]
:*[group2]
:*[group3]
*Other variants of [disease name] include [disease subtype 1], [disease subtype 2], and [disease subtype 3].
==Pathophysiology==
==Pathophysiology==
[[Magnesium]] is a co-factor in over 300 functions in the body regulating many kinds of  biochemical reactions. It is involved in [[protein synthesis]], muscle and nerve functioning, bone development, energy production, the maintenance of normal heart rhythm, and the regulation of [[glucose]] and [[blood pressure]], among other important roles.<ref name=factsheet>{{cite web|title=Magnesium: Fact Sheet for Health Professionals|url=http://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/#en3|website=nih.gov|publisher=National Institutes of Health|accessdate=8 November 2014}}</ref> Low magnesium intake over time can increase the risk of illnesses, including [[hypertension|high blood pressure]] and [[cardiovascular disease|heart disease]], [[diabetes mellitus type 2]], [[osteoporosis]], and [[migraine]]s.<ref name=factsheet>{{cite web|title=Magnesium: Fact Sheet for Health Professionals|url=http://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/#en3|website=nih.gov|publisher=National Institutes of Health|accessdate=8 November 2014}}</ref>
*The pathogenesis of [disease name] is characterized by [feature1], [feature2], and [feature3].
*The [gene name] gene/Mutation in [gene name] has been associated with the development of [disease name], involving the [molecular pathway] pathway.
*On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
*On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].


==Causes==
==Clinical Features==
Causes of magnesium deficiency include diet, alcohol abuse, chronic stress, poorly controlled diabetes, excessive or chronic vomiting and/or diarrhea. Phytate<ref name="pmid6747725">{{cite journal|last=Forbes|first=RM |author2=Parker, HM |author3=Erdman JW, Jr|title=Effects of dietary phytate, calcium and magnesium levels on zinc bioavailability to rats.|journal=The Journal of Nutrition|date=Aug 1984|volume=114|issue=8|pages=1421–5|pmid=6747725|url=http://jn.nutrition.org/content/114/8/1421.full.pdf}}</ref> or [[oxalate]]<ref name="Great Plains Labs - oxalates">[http://www.greatplainslaboratory.com/home/eng/oxalates.asp Oxalates may absorb magnesium], background information indicating possibility of oxalates absorbing magnesium.</ref> in the diet may bind magnesium causing it to be eliminated from rather than absorbed in the colon. Certain drugs can deplete magnesium levels such as [[osmotic diuretic]]s, [[cisplatin]], [[ciclosporin]], [[amphetamine]]s, and possibly [[proton pump inhibitor]]s.<ref name=fda>{{cite web|title=FDA Drug Safety Communication: Low magnesium levels can be associated with long-term use of Proton Pump Inhibitor drugs (PPIs)|url=http://www.fda.gov/drugs/drugsafety/ucm245011.htm|website=fda.gov|publisher=F.D.A. U.S. Food and Drug Administration|accessdate=8 November 2014}}</ref> Also deficiency may occur in [[Bartter syndrome]]<ref name=bartter>{{cite journal|last1=Rodríguez-Soriano|first1=Juan|title=Bartter and related syndromes: the puzzle is almost solved|journal=Pediatric Nephrology|date=May 1998|volume=12|issue=4|pages=315–327|doi=10.1007/s004670050461|url=http://link.springer.com/article/10.1007%2Fs004670050461|accessdate=8 November 2014|pmid=9655365}}</ref> and [[Gitelman syndrome]].<ref name=gitelman>{{cite journal|last1=Simon|first1=DB|last2=Nelson-Williams|first2=C|title=Gitelman's variant of Bartter's syndrome, inherited hypokalaemic alkalosis, is caused by mutations in the thiazide-sensitive Na-Cl cotransporter|journal=Nat Genet|date=January 1996|volume=12|issue=1|pages=24–30|pmid=8528245|url=http://www.ncbi.nlm.nih.gov/pubmed?term=david%20b%20simon%20gitelman%27s%20variant|accessdate=8 November 2014|doi=10.1038/ng0196-24|display-authors=etal}}</ref>
 
==Differentiating {{PAGENAME}} from Other Diseases==


==Differentiating [disease name] from other Diseases==
*[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as:
:*[Differential dx1]
:*[Differential dx2]
:*[Differential dx3]
==Epidemiology and Demographics==
==Epidemiology and Demographics==
57% of the US population does not meet the US [[Dietary Reference Intake|RDA]] for dietary intake of magnesium.<ref>{{cite web |url=http://www.ars.usda.gov/Services/docs.htm?docid=15672 |title=Nutrient Intakes Percent of population 2 years old and over with adequate intakes based on average requirement |accessdate=2012-02-11 |date=2009-07-29 |work=Community Nutrition Mapping Project}}</ref> The kidneys are very efficient at maintaining body levels, except in cases where the diet is deficient due to the use of certain medications such as [[proton-pump inhibitor]]s<ref name=fda>{{cite web|title=FDA Drug Safety Communication: Low magnesium levels can be associated with long-term use of Proton Pump Inhibitor drugs (PPIs)|url=http://www.fda.gov/drugs/drugsafety/ucm245011.htm|website=fda.gov|publisher=F.D.A. U.S. Food and Drug Administration|accessdate=8 November 2014}}</ref> or [[chronic alcoholism]].<ref name=factsheet>{{cite web|title=Magnesium: Fact Sheet for Health Professionals|url=http://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/#en3|website=nih.gov|publisher=National Institutes of Health|accessdate=8 November 2014}}</ref>
* The prevalence of [disease name] is approximately [number or range] per 100,000 individuals worldwide.
* In [year], the incidence of [disease name] was estimated to be [number or range] cases per 100,000 individuals in [location].
===Age===
*Patients of all age groups may develop [disease name].
   
*[Disease name] is more commonly observed among patients aged [age range] years old.
*[Disease name] is more commonly observed among [elderly patients/young patients/children].
===Gender===
*[Disease name] affects men and women equally.
*[Gender 1] are more commonly affected with [disease name] than [gender 2].
* The [gender 1] to [Gender 2] ratio is approximately [number > 1] to 1.
===Race===
*There is no racial predilection for [disease name].
*[Disease name] usually affects individuals of the [race 1] race.
*[Race 2] individuals are less likely to develop [disease name].


==Risk Factors==
==Risk Factors==
*Common risk factors in the development of [disease name] are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].


==Screening==
== Natural History, Complications and Prognosis==
*The majority of patients with [disease name] remain asymptomatic for [duration/years].
*Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
*If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
*Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
*Prognosis is generally [excellent/good/poor], and the [1/5/10­year mortality/survival rate] of patients with [disease name] is approximately [#%].


==Natural History, Complications, and Prognosis==
== Diagnosis ==
===Natural History===
 
===Complications===
 
===Prognosis===
 
==Diagnosis==
===Diagnostic Criteria===
===Diagnostic Criteria===
*The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
:*[criterion 1]
:*[criterion 2]
:*[criterion 3]
:*[criterion 4]
=== Symptoms ===
*[Disease name] is usually asymptomatic.
*Symptoms of [disease name] may include the following:
:*[symptom 1]
:*[symptom 2]
:*[symptom 3]
:*[symptom 4]
:*[symptom 5]
:*[symptom 6]
=== Physical Examination ===
*Patients with [disease name] usually appear [general appearance].
*Physical examination may be remarkable for:
:*[finding 1]
:*[finding 2]
:*[finding 3]
:*[finding 4]
:*[finding 5]
:*[finding 6]


===History and Symptoms===
=== Laboratory Findings ===
Symptoms of magnesium deficiency include hyperexcitability, muscular symptoms (cramps, tremor, [[fasciculation]]s, spasms, [[tetany]], [[muscle weakness|weakness]]), [[Fatigue (medical)|fatigue]], [[anorexia (symptom)|loss of appetite]], apathy, confusion, [[insomnia]], irritability, poor memory, and reduced ability to learn. Moderate to severe magnesium deficiency can cause tingling or numbness, heart changes, [[tachycardia|rapid heartbeat]], continued muscle contractions, [[nausea]], [[vomiting]], personality changes, [[delirium]], hallucinations, [[hypocalcemia|low calcium levels]], [[Hypokalemia|low serum potassium levels]], retention of sodium, low circulating levels of [[parathyroid hormone]] (PTH),<ref>Rude RK, Shils ME. Magnesium. In: Shils ME, Shike M, Ross AC, Caballero B, Cousins RJ, eds. Modern Nutrition in Health and Disease. 10th ed. Baltimore: Lippincott Williams & Wilkins; 2006:223-247</ref> and potentially death from heart failure.<ref>{{cite book|last=Blaylock|first=Russell L.|title=Health and nutrition secrets that can save your life|year=2006|publisher=Health Press|location=Albuquerque, NM|isbn=978-0-929173-48-1|page=395}}</ref> Magnesium plays an important role in carbohydrate metabolism and its deficiency may worsen [[insulin resistance]], a condition that often precedes diabetes, or may be a consequence of insulin resistance.<ref name="pmid2255809">{{cite journal|last=Kobrin|first=SM|author2=Goldfarb, S|title=Magnesium deficiency.|journal=Seminars in nephrology|date=Nov 1990|volume=10|issue=6|pages=525–35|pmid=2255809}}</ref><ref>{{MedlinePlus|002423|Magnesium in diet}}</ref>
*There are no specific laboratory findings associated with [disease name].
 
===Physical Examination===
Diagnosis of severe hypomagnesemia can be made through a standard serum magnesium test. The accuracy of the serum magnesium blood test as an indicator of overall magnesium sufficiency is disputed due to claims that the total percentage of magnesium stored freely in the blood is less than 1%.
 
===Laboratory Findings===


*A  [positive/negative] [test name] is diagnostic of [disease name].
*An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
*Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
===Imaging Findings===
===Imaging Findings===
*There are no [imaging study] findings associated with [disease name].
*[Imaging study 1] is the imaging modality of choice for [disease name].
*On [imaging study 1], [disease name] is characterized by [finding 1], [finding 2], and [finding 3].
*[Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].
=== Other Diagnostic Studies ===
*[Disease name] may also be diagnosed using [diagnostic study name].
*Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].


===Other Diagnostic Studies===
== Treatment ==
 
=== Medical Therapy ===
==Treatment==
*There is no treatment for [disease name]; the mainstay of therapy is supportive care.
===Medical Therapy===
Magnesium deficiency can often be effectively treated with an [[oral magnesium preparation]]. It can also be treated by using a nebulizer filled with magnesium sulphate or magnesium chloride dissolved in water. Nebulising has the advantage of taking effect within minutes, relieving muscle pain, tension or breathing difficulties. Nebulizers can be bought without prescription in the U.K, as can magnesium sulphate and magnesium chloride. For those that require frequent doses, a portable, battery driven nebulizer is useful although more expensive and prone to break down than older style plug in nebulizers.
*The mainstay of therapy for [disease name] is [medical therapy 1] and [medical therapy 2].
 
*[Medical therapy 1] acts by [mechanism of action 1].
[[Probiotic]] lactobacilli, and other species of endogenous digestive microflora ''may'' play a role in the bioavailability of magnesium as they may affect the breakdown of antagonists such as [[Phytic acid|phytate]] and [[oxalate]] in the diet. Other minerals in the diet, such as calcium and zinc, may interact with phytate and oxalate, reducing magnesium loss.{{citation needed|date=September 2014}}
*Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].
Severe hypomagnesemia is often treated medically with intravenous or intramuscular [[magnesium sulfate]] solution, which is completely bioavailable, and effective.
 
=== Surgery ===
===Surgery===
*Surgery is the mainstay of therapy for [disease name].
 
*[Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
===Prevention===
*[Surgical procedure] can only be performed for patients with [disease stage] [disease name].
=== Prevention ===
*There are no primary preventive measures available for [disease name].
*Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].


*Once diagnosed and successfully treated, patients with [disease name] are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].
==References==
==References==
{{reflist|2}}
{{Reflist|2}}
 
[[Category:Endocrinology]]
[[Category:Pick One of 28 Approved]]


{{WS}}
{{WH}}
{{WH}}
{{WS}}

Latest revision as of 17:13, 25 February 2019

WikiDoc Resources for Magnesium deficiency

Articles

Most recent articles on Magnesium deficiency

Most cited articles on Magnesium deficiency

Review articles on Magnesium deficiency

Articles on Magnesium deficiency in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Magnesium deficiency

Images of Magnesium deficiency

Photos of Magnesium deficiency

Podcasts & MP3s on Magnesium deficiency

Videos on Magnesium deficiency

Evidence Based Medicine

Cochrane Collaboration on Magnesium deficiency

Bandolier on Magnesium deficiency

TRIP on Magnesium deficiency

Clinical Trials

Ongoing Trials on Magnesium deficiency at Clinical Trials.gov

Trial results on Magnesium deficiency

Clinical Trials on Magnesium deficiency at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Magnesium deficiency

NICE Guidance on Magnesium deficiency

NHS PRODIGY Guidance

FDA on Magnesium deficiency

CDC on Magnesium deficiency

Books

Books on Magnesium deficiency

News

Magnesium deficiency in the news

Be alerted to news on Magnesium deficiency

News trends on Magnesium deficiency

Commentary

Blogs on Magnesium deficiency

Definitions

Definitions of Magnesium deficiency

Patient Resources / Community

Patient resources on Magnesium deficiency

Discussion groups on Magnesium deficiency

Patient Handouts on Magnesium deficiency

Directions to Hospitals Treating Magnesium deficiency

Risk calculators and risk factors for Magnesium deficiency

Healthcare Provider Resources

Symptoms of Magnesium deficiency

Causes & Risk Factors for Magnesium deficiency

Diagnostic studies for Magnesium deficiency

Treatment of Magnesium deficiency

Continuing Medical Education (CME)

CME Programs on Magnesium deficiency

International

Magnesium deficiency en Espanol

Magnesium deficiency en Francais

Business

Magnesium deficiency in the Marketplace

Patents on Magnesium deficiency

Experimental / Informatics

List of terms related to Magnesium deficiency

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Historical Perspective

  • [Disease name] was first discovered by [scientist name], a [nationality + occupation], in [year] during/following [event].
  • In [year], [gene] mutations were first identified in the pathogenesis of [disease name].
  • In [year], the first [discovery] was developed by [scientist] to treat/diagnose [disease name].

Classification

  • [Disease name] may be classified according to [classification method] into [number] subtypes/groups:
  • [group1]
  • [group2]
  • [group3]
  • Other variants of [disease name] include [disease subtype 1], [disease subtype 2], and [disease subtype 3].

Pathophysiology

  • The pathogenesis of [disease name] is characterized by [feature1], [feature2], and [feature3].
  • The [gene name] gene/Mutation in [gene name] has been associated with the development of [disease name], involving the [molecular pathway] pathway.
  • On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
  • On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].

Clinical Features

Differentiating [disease name] from other Diseases

  • [Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as:
  • [Differential dx1]
  • [Differential dx2]
  • [Differential dx3]

Epidemiology and Demographics

  • The prevalence of [disease name] is approximately [number or range] per 100,000 individuals worldwide.
  • In [year], the incidence of [disease name] was estimated to be [number or range] cases per 100,000 individuals in [location].

Age

  • Patients of all age groups may develop [disease name].
  • [Disease name] is more commonly observed among patients aged [age range] years old.
  • [Disease name] is more commonly observed among [elderly patients/young patients/children].

Gender

  • [Disease name] affects men and women equally.
  • [Gender 1] are more commonly affected with [disease name] than [gender 2].
  • The [gender 1] to [Gender 2] ratio is approximately [number > 1] to 1.

Race

  • There is no racial predilection for [disease name].
  • [Disease name] usually affects individuals of the [race 1] race.
  • [Race 2] individuals are less likely to develop [disease name].

Risk Factors

  • Common risk factors in the development of [disease name] are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].

Natural History, Complications and Prognosis

  • The majority of patients with [disease name] remain asymptomatic for [duration/years].
  • Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
  • If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
  • Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
  • Prognosis is generally [excellent/good/poor], and the [1/5/10­year mortality/survival rate] of patients with [disease name] is approximately [#%].

Diagnosis

Diagnostic Criteria

  • The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
  • [criterion 1]
  • [criterion 2]
  • [criterion 3]
  • [criterion 4]

Symptoms

  • [Disease name] is usually asymptomatic.
  • Symptoms of [disease name] may include the following:
  • [symptom 1]
  • [symptom 2]
  • [symptom 3]
  • [symptom 4]
  • [symptom 5]
  • [symptom 6]

Physical Examination

  • Patients with [disease name] usually appear [general appearance].
  • Physical examination may be remarkable for:
  • [finding 1]
  • [finding 2]
  • [finding 3]
  • [finding 4]
  • [finding 5]
  • [finding 6]

Laboratory Findings

  • There are no specific laboratory findings associated with [disease name].
  • A [positive/negative] [test name] is diagnostic of [disease name].
  • An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
  • Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

Imaging Findings

  • There are no [imaging study] findings associated with [disease name].
  • [Imaging study 1] is the imaging modality of choice for [disease name].
  • On [imaging study 1], [disease name] is characterized by [finding 1], [finding 2], and [finding 3].
  • [Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].

Other Diagnostic Studies

  • [Disease name] may also be diagnosed using [diagnostic study name].
  • Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].

Treatment

Medical Therapy

  • There is no treatment for [disease name]; the mainstay of therapy is supportive care.
  • The mainstay of therapy for [disease name] is [medical therapy 1] and [medical therapy 2].
  • [Medical therapy 1] acts by [mechanism of action 1].
  • Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].

Surgery

  • Surgery is the mainstay of therapy for [disease name].
  • [Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
  • [Surgical procedure] can only be performed for patients with [disease stage] [disease name].

Prevention

  • There are no primary preventive measures available for [disease name].
  • Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
  • Once diagnosed and successfully treated, patients with [disease name] are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].

References

Template:WS Template:WH