Intensification of Magnesium Deficiency by Calcemic and Phosphate Therapy

Abstract

The possibility that magnesium deficiency might be contributory to, or might accompany, the abnormalities that cause ostopenia, hypocalcemia, hypercalcemia, and renal and cardiovascular disease is rarely considered in initiating therapy. Refractoriness to direct attempts to correct hypocalcemia and hypokalemia are now increasingly leading to investigation of serum magnesium levels, and less frequently to other (better) means of ascertaining the body’s magnesium status. Emphasis is placed, in this chapter, on the problems that can result from treatment of either hypo- or hypercalcemia by agents that cause magnesium loss, when the primary disorder is one resulting in magnesium deficiency. Accepting the difficulties in evaluating the magnesium status, it is proposed that serum magnesium levels and 24-hour urinary magnesium outputs be made part of the routine initial diagnostic program. Since higher serum levels of magnesium are tolerable without serious hazard, except perhaps when there is hypercalcemia, it is suggested that magnesium therapy be tried before calcium loading of patients who have disorders that might make them susceptible to magnesium deficiency.