Magnesium deficiency in human subjects—a personal historical perspective.

Abstract

Over the past 30 years human magnesium (Mg) deficiency has become an accepted fact in most medical circles. Our index patient had striking neurological manifestations including generalized tremulousness, grimaces and fibrillary twitches of facial muscles, athetoid and choreiform movements of upper extremities, dysphagia, inability to speak, repeated convulsions, and confusion. She had received glucose in water and saline intravenously for several months. A patient with chronic alcoholism was noted to have almost identical symptoms and signs as the index patient. He also responded dramatically to MgSO4 injections. This resulted in a series of studies on patients with chronic alcoholism. The evidence of Mg deficiency in alcoholism includes the following: significant hypomagnesemia, strongly positive Mg balance during recovery, significant decrease in muscle Mg, a deficit of total exchangeable 28Mg quantitatively similar to deficit by balance studies, often a dramatic response of symptoms to therapy with Mg, and diuresis of Mg produced by ingestion of alcohol. Lipolysis with high levels of long-chain free fatty acids (FFA) occurs in withdrawal of alcohol in chronic alcoholism, withdrawal of certain addictive drugs, after trauma, surgery, administration of adrenergic compounds or theophylline, exposure to cold, and an adverse environment as in grass staggers. Concentrations of Mg fall when FFA increase in all of the above circumstances. This phenomenon has wide implications in health and disease. Better awareness of Mg deficiency in a wide variety of clinical conditions will result in life-saving treatment and less morbidity of other patients.

Magnesium deficiency and alcohol intake: mechanisms, clinical significance and possible relation to cancer development (a review).

“…Such samples have gen erally been obtained from individuals having various op erative procedures. In a series of twenty chronic alcoholic patients, the mean Mg concentration in skeletal muscle was 11 mEq/kg less than that in normal controls [23]. As shown in Table 4, deficits in sodium (Na), K and phos phorous (P) concentrations were also noted, but Ca con centrations were unaffected.…”

Inhibitory effects of zinc on magnesium balance and magnesium absorption in man.

“…A great deal of information is available on various aspects of Zn metabolism [13][14][15] as well as on Mg metab olism in man [16][17][18][19][20][21] but, to our knowledge, there is no information on the effect of Zn on Mg metabolism in humans. Studies in animals reported on this interaction and the effect of Zn on Mg in bacteria has been reported [22].…”

Hypomagnesemia and Smooth Muscle Contractility:Diffuse Esophageal Spasm in anOld Female Patient

“…The metabolic abnormalities observed may be potential contributors of the cardiovascular and neurologic toxicity of theophylline [69]. The deleterious effect of theophylline overdose on Mg concentration is linked, as hypothesized by Flink [70], with the fact that the drug is an adrenergic compound and provokes a catecholamineinduced lipolysis with production of high levels of longchain FFA (which bind Mg) and intracellular precipitation of insoluble Mg-FFA soaps.…”

“…Symptoms often reported in hypomagnesemic patients are irritability, neuromuscular hyperactivity (including tremor, myoclonic jerks, Chvostek sign, rarely Trousseau sign, and spontaneous carpopedal spasm), ataxia, nystagmus, dysphagia, and depression or personality changes simulating psychiatric disorders [24,25,70,73].…”

“…At present, only a short report (a letter) is available on motor disorder of the esophagus with deglutition discomfort (due to a low Mg plasma level and responsive to parenteral Mg) concerning an old woman [88], even if dysphagia is certainly included in the symptomatological pattern of hypomagnesemia [24,25,70,73]. It is worthy to note that both in our case and in that of Ward [88], esophageal disorders affected aged female patients (79 and 97 years, respectively).…”