Hypomagnesaemia, PPIs and Diuretics

  • What is Hypomagnesaemia?

    Hypomagnesaemia is an electrolyte imbalance involving a lower than normal blood level of the mineral magnesium.  

    Who is at risk?

    If you are taking a PPI medication and a diuretic be aware that you may be at an increased risk for hypomagnesaemia.  In recent research up to 43% of elderly patients who were taking both a PPI and diuretic were at an increased risk of this problem (1). 

    Hypomagnesaemia can also occur from inadequate intake, malabsorption, chronic diarrhea, alcoholism, chronic stress or other medications.

    What are the symptoms?

    Symptoms of hypomagnesaemia can include weakness, muscle cramps, cardiac arrhythmias, issues with the nervous system including tremors, hypertension, confusions, hallucinations, depression and even epileptic fits.

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    How is hypomagnesaemia diagnosed?

    Diagnosis is most often found by doing a serum blood level.  Anything below 0.7 mmol/l is considered to be deficient.  Some doctors may also do an electrocardiogram.  Long QT syndrome can also be seen in hypomagnesaemia.

    How is the deficiency treated?

    Treatment involves replenishing the magnesium that is missing.  This can be done by oral supplementation or through intravenous (IV) replacement.  In people with a lot of clinical symptoms or severe deficiency it is more likely to be replaced through IV.

    How to prevent hypomagnesaemia

    Discuss with your physician if you are on medications that increase your risk for magnesium deficiency.  If you will be on these medications long term your doctor may suggest a supplement or frequent lab tests to check your overall magnesium levels.  

    It can also help to eat foods rich in magnesium.  Some magnesium rich foods include: dark leafy greens, nuts and seeds, fish, beans and lentils, whole grains, avocado and low fat dairy.  Aiming to get 400mg of magnesium per day from your diet can help to reduce the risk for deficiency later on.

Published On: October 31, 2014