Hypermagnesemia is an increase in plasma concentration of magnesium. The kidneys are normally effective at the excretion of excess magnesium unless there is renal disease present. Rare – occurs in up to 15% of those hospitalized with renal failure.
Aetiology:
Mostly occurs in people with acute or chronic kidney disease.
Some laxatives and antacids contain magnesium and may lead to increased serum values of magnesium.
May occur with lithium therapy; in hypothyroidism; Addison’s disease
Clinical Features:
Confusion; weakness; slower breathing rate; decreased reflexes (reflexes reduced early); nausea and vomiting; hypotension; reduced blood calcium; abnormal heart rhythms; dizziness; drowsiness; flushing; headache.
Eventually: coma and cardiac arrest.
Diagnosis is by measurement of serum magnesium concentration – >2.6 mg/dL (> 1.05 mmol/L).
Treatment:
If mild, no treatment generally except reduction of magnesium intake in diet or medications.
IV administration of calcium gluconate (directly antagonizes the neuromuscular and cardiovascular effects of magnesium).
IV furosemide (may help excretion of magnesium).
Haemodialysis if severe.
Magnesium rich foods include: pumpkin seeds, chia seeds, almonds, cashews, peanuts, soymilk, avocado, brown rice, milk.
Relevance to Podiatry:
Consider in possibilities of a differential diagnosis for reduced lower limb reflexes.
Related Topics:
Magnesium (Blood and Urine Chemistry) | Magnesium Supplements for Verrucae | Magnesium (Vitamin, Mineral and Essential Fatty Acid Deficiency & Toxicity) | Magnesium Metabolism (Water, Electrolyte, Mineral, Acid-base Disorders)
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