Reduced levels of serum magnesium in the blood for less than 1.45mg/dl is considered hypomagnesemia. The levels at which it is termed as low magnesium level may differ in different gender, ages, health statuses. Magnesium is an essential element of the body that contributes to maintained brain functions like consciousness maintenance, orientation, and overall well-being. In acid and base imbalance, organ damage, poor nourishment hypomagnesemia can arise. It is treatable but may show as a serious condition symptomatically. The kidney is the leading organ to take care of the magnesium levels and hypomagnesemia may indicate kidney dysfunction.

What causes hypomagnesemia? 

• Improper diet: lack of leafy vegetable intake such as spinach. Lack of intake of dry fruits, beans, nuts, fruits, etc.
• Improper absorption: gastrointestinal complications such as Crohn’s disease, Whipple’s disease, inflammatory bowel disease, over acidity or basicity in the body.
• Decreased absorption surface: gastrectomy, intestinal malfunction, colonic insufficiency.
• Medications: tablets used to control hypertension such as loop diuretics including frusemide, torasemide, bumetanide. Others like spironolactone, metoprolol, propranolol, telmisartan, etc.
• Diabetes causes reduced magnesium levels in the blood.
• Other systemic disorders like liver disease, pancreatic disease, etc.
• Alcohol consumption and a bad lifestyle cause this condition.
• Surgeries and recent medical interventions.

How to identify hypomagnesemia and what are its symptoms?

• The patient feels lightheaded.
• The patient may develop epileptic convulsions or seizures.
• Blabbering, irrelevant speech, abnormal behavior, disorientation.
• Lack of consciousness.
• Loss of balance.
• Sweating.
• Headache and shallow breathing.
• Arhythmic heart beat and pulse rate.

Immediate management of hypomagnesemia.

• If the person feels giddy or is disoriented to the time, place, and person suddenly, one must provide water with some electrolytes like sugar and salt in it. Chocolates, dry fruits can be given immediately.
• Medical interventions are required early. A magnesium supplement is administered in the hospital intravenously. 
• In a conscious patient, oral magnesium oxide should be given with a preferable and required dose.
• Proper rest and observation should be done.

Late management of hypomagnesemia with diet.

Diet is the main source of magnesium. A properly balanced diet with the required proportion of magnesium, potassium, and other substances prevents any such complications of hypomagnesemia. Dietary management includes the following:

• Eating boiled green vegetables like spinach, palak, coriander, lettuce, mint leaves, etc. chlorophyll contains magnesium in abundance which is a good source and management method.
• Consuming lentils, beans, grams, seeds, dal, cereals, and pulses are a great source of magnesium.
• Eating dry fruits like cashew, almond, avocados, lotus seed, figs, raisins.
• Water intake should be adequate.
• Consuming fruits like banana, grapes, etc have a great difference in the serum magnesium levels.

Management of hypomagnesemia in kidney disease patients.

In kidney disorders, consumption of high magnesium and potassium diet is harmful. But in hypomagnesemia conditions, the required amount of magnesium should be administered so as to keep the patient in proper condition.

• Controlled consumption of water.
• Adequate banana smoothie, spinach salad, milk products should be given.
• Beans, nuts, dry fruits can be given with precaution to avoid overload on the kidney.
• Consult your nephrologist until your magnesium levels are back to normal.
• Magnesium gluconate administration is also done by oral means to bring the magnesium level back to normal.

Management of hypomagnesemia by correcting the underlying cause.

• Gastrointestinal disease: In these conditions, the treatment for malabsorption, villi problems, motility of this system should be treated. 
• Liver and biliary system disease: jaundice, cirrhosis, alcoholic liver disease, hepatitis, hepatomegaly should be treated and fixed. This will automatically bring magnesium level back to normal.
• Hormonal imbalance and acid base imbalance should be corrected from their root to prevent hypomagnesemia.
• Poverty and lack of nutrition: eating banana, peanuts, milk powder, ORS, or oral rehydration solution can be consumed.
• Alcohol intake should be stopped totally.

Management of physiological hypomagnesemia or pregnancy and lactation.

The requirement for magnesium increases in ladies who are pregnant or are lactating. The growing fetus demands more nutrition for its growth so the intake of electrolytes has to be increased.

• More fruits should be consumed.
• Leafy vegetables, dry fruits, and magnesium supplements should be taken if required.
• This may be associated with hypokalaemia, hyponatremia, hypoalbuminemia too. So have adequate salts, minerals, and foods like fish, eggs, curd, milk, chocolates.
• This condition should be detected early and the treated early for normal development of the embryo.

Management of conditions that arise due to hypomagnesemia.

• Seizures: epileptic attacks are serious complications associated with mg disturbance. It denotes the involvement of the brain and spinal cord. It is treated with diazepam, sodium valproate, or similar drugs to control the seizures.
• Cardiac arrest: magnesium contributes to the contraction of cardiac muscles for pumping blood. Lack of magnesium causes arrhythmias and may lead to the arrest of the heart. Immediate electrolyte balancing is essential to avoid such complications which can be life threatening. 
• Tetany in muscles: jerky movements of muscles occur. This is involuntary in nature which means uncontrolled by the person. Magnesium contributes to the neuromuscular junction functioning too. Immediate administration of magnesium gluconate may be necessary.
• Personality change: patient can become violent, suicidal, depressed, or disoriented. So, in suspected cases, it is better to be with the patient and keep the patient under close observation.

Management of hypomagnesemia by lifestyle modification.

• Alcohol is the major culprit for the abnormal absorption of magnesium. So stop the intake of alcohol and alcohol based food.
• Tobacco smoking is hazardous and leads to electrolyte imbalance by damaging kidneys and lungs and in turn, causing hypomagnesemia.
• A balanc diet is a key to having a good healthy life.
• Adequate sleep is essential for proper brain functioning.
• Avoid smoked cousins, carbonated beverages, and kinds of stuff that hinders with the acid base balance.
• Maintain mental stability and reduce stress in your life.
• Breathing control and meditation can prevent this condition.
• Regular exercise and active life will pay you well.

Management of associated conditions.

• Control hypotension.
• Reduce obesity.
• Control diabetes.
• Treat thyroid issues.
• Treat kidney complications.
• Treat sodium, potassium, and phosphorus levels to manage this condition.
• Visit your doctor immediately if such symptoms are seen in your close ones.