Symptoms of hypermagnesemia
- Alan S L Yu, MB, BChir
Alan S L Yu, MB, BChir
- Harry Statland and Solon Summerfield Professor of Medicine
- University of Kansas Medical Center
- Aditi Gupta, MD
Aditi Gupta, MD
- Assistant Professor
- University of Kansas Medical Center
Hypermagnesemia is an uncommon problem in the absence of magnesium administration or renal failure. (See "Causes and treatment of hypermagnesemia".)
When it occurs, the elevation in the plasma magnesium concentration is usually mild (<3 meq/L, 3.6 mg/dL, or 1.5 mmol/L) and the patient is asymptomatic. However, clinical symptoms may be seen when the plasma magnesium concentration exceeds 4 meq/L (4.8 mg/dL or 2 mmol/L).
The clinical manifestations of hypermagnesemia are discussed in this topic. The regulation of magnesium balance and the causes and treatment of hypermagnesemia are presented elsewhere. (See "Regulation of magnesium balance" and "Causes and treatment of hypermagnesemia".)
OVERVIEW OF SYMPTOMS
The approximate relation between clinical manifestations and the degree of hypermagnesemia can be summarized as follows:
●Plasma magnesium concentration 4 to 6 meq/L (4.8 to 7.2 mg/dL or 2 to 3 mmol/L) – Nausea, flushing, headache, lethargy, drowsiness, and diminished deep tendon reflexes.To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
- Agus ZS, Morad M. Modulation of cardiac ion channels by magnesium. Annu Rev Physiol 1991; 53:299.
- Krendel DA. Hypermagnesemia and neuromuscular transmission. Semin Neurol 1990; 10:42.
- Rizzo MA, Fisher M, Lock JP. Hypermagnesemic pseudocoma. Arch Intern Med 1993; 153:1130.
- Celi LA, Scott DJ, Lee J, et al. Association of hypermagnesemia and blood pressure in the critically ill. J Hypertens 2013; 31:2136.
- Laurant P, Berthelot A. Influence of endothelium on Mg(2+)-induced relaxation in noradrenaline-contracted aorta from DOCA-salt hypertensive rat. Eur J Pharmacol 1994; 258:167.
- Laurant P, Touyz RM. Physiological and pathophysiological role of magnesium in the cardiovascular system: implications in hypertension. J Hypertens 2000; 18:1177.
- Schmitz C, Perraud AL, Johnson CO, et al. Regulation of vertebrate cellular Mg2+ homeostasis by TRPM7. Cell 2003; 114:191.
- Sontia B, Montezano AC, Paravicini T, et al. Downregulation of renal TRPM7 and increased inflammation and fibrosis in aldosterone-infused mice: effects of magnesium. Hypertension 2008; 51:915.
- Navarro-González JF. Magnesium in dialysis patients: serum levels and clinical implications. Clin Nephrol 1998; 49:373.
- Cholst IN, Steinberg SF, Tropper PJ, et al. The influence of hypermagnesemia on serum calcium and parathyroid hormone levels in human subjects. N Engl J Med 1984; 310:1221.
- Suzuki K, Nonaka K, Kono N, et al. Effects of the intravenous administration of magnesium sulfate on corrected serum calcium level and nephrogenous cyclic AMP excretion in normal human subjects. Calcif Tissue Int 1986; 39:304.
- Monif GR, Savory J. Iatrogenic maternal hypocalcemia following magnesium sulfate therapy. JAMA 1972; 219:1469.
- Eisenbud E, LoBue CC. Hypocalcemia after therapeutic use of magnesium sulfate. Arch Intern Med 1976; 136:688.
- Spital A, Greenwell R. Severe hyperkalemia during magnesium sulfate therapy in two pregnant drug abusers. South Med J 1991; 84:919.
- Iglesias MH, Giesbrecht EM, von Dadelszen P, Magee LA. Postpartum hyperkalemia associated with magnesium sulfate. Hypertens Pregnancy 2011; 30:481.
- Carmichael AJ, McHugh MM, Martin AM, Farrow M. Serological markers of renal itch in patients receiving long term haemodialysis. Br Med J (Clin Res Ed) 1988; 296:1575.