Magnesium Deficiency in the Pathogenesis of Disease

Abstract

There is a large and rapidly growing body of literature on the importance of magnesium in biochemical and physiological processes. There is also much evidence that magnesium deficiency, alone and in combination with agents that interfere with its utilization, is associated with functional and structural abnormalities of membranes, cells, organs, and systems. The manifestations of the changes caused by magnesium deficiency depend upon its extent and duration and on variable factors. Among the conditions that increase the risk of magnesium deficiency are (1) metabolic factors that affect the absorption, distribution, and excretion of this mineral; (2) disease and therapy; (3) physiologic states that increase requirements for nutrients; and (4) nutritional imbalances. Excesses of nutrients that interfere with the absorption or increase the excretion of magnesium-such as fat, phosphate, sugar, and vitamin D-can contribute to long-lasting relative magnesium deficiency. All have been implicated in several of the diseases considered in this book. Whether their influence on the need for magnesium is a common denominator remains to be investigated further.Unfortunately, means of diagnosing clinical magnesium deficiency of a lesser degree than that associated with overt signs such as convulsions or cardiac arrhythmias or other electrocardiographic changes are not readily accessible. Plasma magnesium levels are unreliable as an index of its cellular inadequacy. More complicated means of evaluating the magnesium status are considered in the Appendix, as are their limitations and need for convenient determinants. Until magnesium clinical methodology is improved and made available, the importance of correcting magnesium deficiency in man's diet and of preventing intensification of a deficit when needs are increased by physiologic or pathologic processes and drugs will have to be inferential-based on experimental and epidemiologic observations. Because magnesium has pharmacologic activities that have been recognized for many years, demonstration of the correction of abnormal acute neurologic and cardiac signs (even though such signs are characteristic of acute magnesium deficiency) are not readily accepted as evidence that magnesium deficiency can contribute to diseases in which such magnesium-responsive signs are seen. With notable exceptions, there has been clinical neglect of magnesium in most medical centers and certainly in private practice. This is unfortunate because many of the pathologic changes produced by experimental magnesium deficiency or loss resemble many of those of chronic diseases that are responsible for intractable medical problems.