Consider Magnesium Homeostasis: II: Staging of Magnesium Deficiencies*

Abstract

ABSTRACT

Magnesium (Mg) deficiency (MgD) lends itself to staging because of significant information about new tests to evaluate minimal disease. Type I, normomagnesemia MgD, has at least two stages based on red blood cell Mg (rbcMg) levels. In Stage 1, Occult MgD, both serum Mg (sMg) and rbcMg are normal. Initial mild episodic migraine fits this picture. Stage 2, subclinical MgD, with normal sMg and a decreased rbcMg level, is a more insidious form. Early, not earliest, periodic premenstrual syndrome (PMS) is an example. It probably takes several cycles before anyone considers the diagnosis of PMS. It is likely that a Mg load test will show retentions of Mg over the normal patient in both Stages 1 and 2. Type I MgD is much more common than Type II. In Type II, hypomagnesemia MgD, Stage 3, acute MgD is seen in patients with acute myocardial infarction where, on admission and for up to 24 hours, the sMg is normal. However, the next day, the sMg is decreased but the rbcMg remains normal. Stage 4, chronic MgD, occurs in alcoholics and both sMg and rbcMg are decreased. This latter stage is the result of continuous negative Mg balance (NMgB) over a period of months. Any disease associated with untreated NMgB is likely to progress to Stage 4.