Methods of treatment and symptoms of hypermagnesemia. Excess magnesium in the body in women and men. Diseases and symptoms Hypermagnesemia - the main symptoms

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Hypermagnesemia is a pathological syndrome in which the amount of magnesium in the blood plasma rises above the norm of 2.2 mmol / l. Magnesium balance is controlled by almost the same systems that determine the level of calcium, since magnesium is closely associated with bone calcium and potassium.

The main cause of hypermagnesemia is renal failure. In addition, it can be the result of an overdose of magnesium preparations, the use of laxatives or antacids containing magnesium. Especially often hypermagnesemia develops in old age.

Symptoms of hypermagnesemia

With a sharp increase in the content of magnesium in the blood, neurological symptoms appear - severe weakness, paralysis, imbalance, impaired consciousness,. There may be symptoms - nausea with vomiting, from the side of the cardiovascular system, vasodilation occurs, as a result, blood pressure decreases and respiratory functions are disturbed. Severe hypermagnesemia: when the concentration of magnesium in the blood is above 6 mmol / l, loss of consciousness may occur, bradycardia develops, cardiac arrest.

Diagnostics

The basis of diagnosis is an indication of treatment with magnesium preparations, kidney problems, clinical symptoms. In addition, ECG data indicate an increase in magnesium levels - they show signs of conduction disturbance, atrioventricular blockade and asystole.

Treatment of hypermagnesemia

The basis of therapy for increasing magnesium in the blood is the antagonistic properties of calcium and magnesium. In addition, it is necessary to remove magnesium from the serum and exclude its additional intake into the body. Until the amount of magnesium is normalized, it is necessary to control the work of the heart and blood vessels. To prevent severe, it is necessary to introduce a solution of calcium chloride.

In a hospital in severe conditions, hemodialysis is carried out, and before it begins, forced diuresis can be resorted to if the kidneys work adequately. In parallel with the removal of magnesium, correction of the level of other electrolytes is necessary.

Hypermagnesemia develops when there is an excess amount of magnesium in the blood. This is a rare condition and is usually caused by kidney failure or poor kidney function.

Magnesiumis a mineral that the body uses as an electrolyte, meaning it carries electrical charges in the blood. Magnesium plays an important role in bone and cardiovascular health.

Healthy people have very little magnesium in their blood. The gastrointestinal tract and kidneys regulate and control how much magnesium the body absorbs from food and how much is excreted in the urine. Normal magnesium levels are 1.7 to 2.3 milligrams per deciliter (mg/dL).

In most cases, hypermagnesemia develops in people with kidney failure. When the kidneys are not working properly, they are unable to get rid of excess magnesium and this leads to an increase in magnesium levels in the blood.

Causes of hypermagnesemia

Some treatments for chronic kidney disease, including proton pump inhibitors, may increase the risk of hypermagnesemia. Malnutrition and alcoholism are additional risk factors for people with chronic kidney disease.

Other causes of hypermagnesemia include:

1. Taking drugs containing lithium;
2. Hypothyroidism;
3. Addison's disease;
4. Milk-alkaline syndrome;
5. Medicines containing magnesium, some laxatives and antacids;
6. Familial hypercalcemia.

Women taking magnesium as a treatment for preeclampsia may be at risk if the dose is too high.

Symptoms of hypermagnesemia

Symptoms of hypermagnesemia include:

1. nausea;
2. vomiting;
3. neurological disorders;
4. low blood pressure (hypotension);
5. headache.

Particularly high levels of magnesium in the blood can lead to heart problems, breathing difficulties, and shock. In severe cases, coma occurs.

Diagnosis of hypermagnesemia

Hypermagnesemia is diagnosed with a blood test. The level of magnesium in the blood indicates the severity of the condition. Normal magnesium levels are 1.7 to 2.3 mg/dL. Approximately 7 mg/dl can lead to nausea and headache.

Magnesium levels of 7-12 mg/dl can affect the heart and lungs and lead to weakness and low blood pressure.

Levels above 12 mg/dl can lead to muscle paralysis and hyperventilation. When levels are above 15.6 mg/dl, coma occurs.

Treatment of hypermagnesemia

The first step in treating hypermagnesemia is to identify and stop supplemental magnesium.

Intravenous calcium may reduce symptoms such as respiratory distress, arrhythmia, hypotension, and neurological conditions. Therefore, intravenous administration of calcium, diuretics can help the body get rid of excess magnesium. People with impaired kidney function or severe magnesium overdoses may need dialysis.

If diagnosed early, hypermagnesemia is usually treatable. If kidney function is normal, then excess magnesium is excreted quickly once a source is found. Elderly people with kidney dysfunction are at high risk of developing serious complications.

Literature

1. Blaine J., Chonchol M., Levi M. Renal control of calcium, phosphate, and magnesium homeostasis // Clinical Journal of the American Society of Nephrology. - 2014. - S. CJN. 09750913.
2. Cheungpasitporn W., Thongprayoon C., Qian Q. Dysmagnesemia in hospitalized patients: prevalence and prognostic importance // Mayo Clinic Proceedings. – Elsevier, 2015. – T. 90. – no. 8. - S. 1001-1010.
3. Floridis J., Abeyaratne A., Majoni S. W. Prevalence and clinical impact of magnesium disorders in end-stage renal disease: a protocol for a systematic review //Systematic reviews. - 2015. - T. 4. - No. 1. - S. 76.
4. Haider D. G. et al. Hypermagnesemia is a strong independent risk factor for mortality in critically ill patients: results from a cross-sectional study //European journal of internal medicine. - 2015. - T. 26. - No. 7. - S. 504-507.
5. Jhang W. K. et al. Severe hypermagnesemia presenting with abnormal electrocardiographic findings similar to those of hyperkalemia in a child undergoing peritoneal dialysis //Korean journal of pediatrics. - 2013. - T. 56. - No. 7. - S. 308-311.

An increase in magnesium in the body is called a state of hypermagnesemia, the symptoms of which are different. These include breathing problems, as well as complete cardiac arrest. The diagnosis is based on determining the amount of magnesium in the blood. If the indicator exceeds the mark of 2.1 units, then such a diagnosis is made. Basically one reason is kidney failure.

Pathogenesis of hypermagnesemia

In the formed organism, the amount of magnesium is equal to 2000 units. About half of these cations are involved in bone tissue; they do not take part in the main metabolism. Experts have found that in ELC, the magnesium content is equal to 1% of the total mass. The rest is inside the cells.

The average total magnesium for an adult can range from 1.4 to 2.1 units. Elevated levels of magnesium in the blood are called hypermagnesemia.

The level of this indicator depends on:

1. Nutrition.
2. Intestinal delay.
3. Renal delay.

If you put a person on an anti-magnesium diet, the duration of which is a week, then this indicator will fall in the body by one unit per day.

The kidneys filter magnesium. About 70% of these cations pass through them. When a failure occurs, magnesium in the blood drops dramatically, which leads to a disease such as hypomagnesemia. In such a situation, a drug that increases this indicator is needed.

Many enzymes depend on magnesium. This includes ATP, nucleic acid metabolism, and more. The metabolism of potassium with calcium can also be associated with the content of this indicator, but scientists have not yet confirmed this fact through experiments.

In renal failure, this diagnosis is very often made. Hypermagnesemia is also observed in those patientspeople who have been using magnesium-based medicines or laxatives for a long time.

Hypermagnesemia: symptoms, diagnosis

In medical practice, the most common emerging symptoms include:

• change in indicators on the electrocardiogram;
• significant tendon reflexes;
• hypotension;
• anesthesia;
• erratic breathing;
• cardiac arrest.

The diagnosis of hypermagnesemia is made if the level of magnesium concentration in the blood, according to the results of the tests, is more than 2.1 units.

With such results, you should contact either an endocrinologist or a nutritionist. These specialists apply those methods of treatment that are suitable for a particular patient.

The most common:

1. Artificial ventilation of the lungs and intravenous injections of calcium gluconate. This drug is able to reverse many disorders associated with magnesium.
2. With normal functioning of the kidneys, the patient is prescribed an injection of furosemide.
3. The most effective means is hemodialysis.
4. If hemodialysis is contraindicated, peritoneal dialysis is performed.

If the magnesium index is high, it is very easy to notice pathologies in the body. The nervous system is mainly affected.

Signs of hypermagnesemia are as follows:

• increased drowsiness;
• constant fatigue;
• the occurrence of paralysis;
• sometimes loss of consciousness;
• clouded thoughts;
• fall on level ground.

During the period of the disease, the digestive system also suffers. This is evidenced by such signs as aversion to food, the occurrence of nausea, vomiting.

From the side of the cardiovascular system, vasodilation occurs. Because of this, blood pressure drops sharply, the pulse and heart contractions slow down. The patient may lose consciousness. If qualified assistance is not provided in time, the person will die.

The kidneys can excrete excess magnesium on their own, but this process can be accelerated. To do this, doctors inject fluid into the patient's vein and prescribe a course of loop diuretics. If a form of severe hypermagnesemia with impaired renal function is detected, then dialysis is required. But hemodialysis will help to cope with the disease faster.

If hypermagnesemia is detected in a newborn baby, then an exchange transfusion is prescribed. During this period, it is necessary to monitor the state of the cardiovascular system of the child. It also requires control of electrolyte metabolism.

In the most extreme cases, patients are injected with calcium gluconate into a vein, the dose of which is 100 mg per 1 kilogram. The condition will improve for a while, then the necessary therapy should be carried out.

HYPERMAGNESIA

Hypermagnesemia - an increase in the concentration of magnesium in the serum above normal - higher 2.2 mEq/l. Magnesium balance is determined by almost all of the same regulatory systems that control calcium balance. Magnesium metabolism is closely related to the metabolism of both calcium and potassium.

Causes of hypermagnesemia. The most common cause is kidney failure. Hypermagnesemia can also be iatrogenic (an overdose of magnesium preparations) or develop after the use of laxatives and antacids containing magnesium (an important cause of pathology in the elderly).

Diagnostics

Clinical signs of hypermagnesemia: neurological symptoms in hypermagnesemia are muscle weakness, paralysis, ataxia, drowsiness and impaired consciousness; gastrointestinal disorders - nausea and vomiting; cardiovascular system - moderate hypermagnesemia may be accompanied by vasodilation, and severe hypotension

!!! at extremely high concentrations of magnesium, depression of consciousness, bradycardia, hypoventilation, circulatory and respiratory arrest are observed

Diagnosis is based on:
a history that suggests hypermagnesemia
clinical picture
ECG data - the following signs appear: prolongation of the PR (Q) and QT interval; expansion of the QRS complex; varying degrees of P-wave voltage reduction; more or less pronounced sharpening of the T wave; complete AB blockade, asystole

Treatment

Any approach to therapy hypermagnesemias are based on antagonism of magnesium and calcium. This also includes methods for removing magnesium from the serum and eliminating the source of additional intake of magnesium in the body. In the period until the concentration of magnesium drops to normal, it may be necessary to monitor the activity of the cardiovascular system. Lethal arrhythmias can often be prevented or controlled by administration of a calcium chloride solution (5–10 mEq/l intravenously).

Treatment in a hospital includes hemodialysis. Before dialysis, if renal function is preserved and the state of the cardiovascular system is satisfactory, forced diuresis can be resorted to. Intravenous administration of a solution of sodium chloride (1 mEq / kg) and furosemide accelerates the excretion of magnesium. however, it should be noted that forced diuresis can simultaneously remove a significant amount of calcium from the body. the development of hypocalcemia sharply aggravates the situation caused by an excess of magnesium. During the period of correction of the electrolyte balance, the patient may need treatment for cardiovascular disorders.

HYPOMAGNESIA

Clear signs of hypomagnesemia. Hypomagnesemia is characterized by a serum magnesium level below 1.3 mEq/l and usually results from a malabsorption of the element or increased excretion through the kidneys or through the intestines (diarrhea). Hypomagnesemia may be accompanied by disorders associated with the production of parathyroid hormone, the use of certain drugs (diuretics, etc.), and the effects of alcohol. increased risk of hypomagnesaemia in women during lactation.

Causes of hypomagnesemia:
losses through the gastrointestinal tract: bowel resection ("short bowel syndrome"), pancreatitis, diarrhea
renal pathology
starvation
drug action: diuretics, gentamicin, digoxin
alcohol
hypothermia
hypercalcemia
diabetic ketoacidosis
hyperthyroidism or hypothyroidism
phosphorus deficiency
burns
sepsis
lactation

Diagnostics

Hypomagnesemia is manifested mainly by neurological symptoms. Hypomagnesemia interferes with the effects of parathyroid hormone, resulting in hypocalcemia. at the same time, hypokalemia can be observed.

A decrease in serum magnesium concentration is manifested:
muscle tremors and fasciculations
nystagmus
tetany
disorders of consciousness

Other possible symptoms include ataxia, dizziness, convulsions and dysphagia.

Diagnosis is based on:
a history that suggests hypomagnesemia
clinical picture
ECG data: prolongation of the Q-T interval and PR(Q); depression of the ST segment; T wave inversion; flattening or inversion of the P wave in the precordial leads; expansion of the QRS complex; pirouette (polymorphic) ventricular tachycardia; therapy-resistant ventricular fibrillation (and other arrhythmias); deepening the toxic effects of cardiac glycosides

Treatment

Therapeutic tactics for hypomagnesemia depends on the severity of the patient's condition.:
with clinically significant hypomagnesemia intravenously administered 1.0 - 2.0 g of magnesium sulfate in 15 minutes
with the development of arrhythmia by the type of pirouette (polymorphic) ventricular tachycardia intravenously administered 2.0 g of magnesium sulfate for 1 - 2 minutes
with convulsive syndrome 2.0 g of magnesium sulfate is administered intravenously over 10 minutes

As a rule, simultaneously with magnesium sulfate is prescribed calcium gluconate(1.0 g), since most patients with hypomagnesemia also have hypocalcemia. Diuretic-induced hypokalemia can sometimes be corrected only by the additional administration of magnesium preparations.

Magnesium preparations are prescribed for the following conditions without confirmation of hypomagnesemia:
eclampsia (effectiveness proven)
arrhythmias
leg muscle cramps

!!! replenishment of magnesium deficiency in patients with renal insufficiency should be carried out very carefully, since in this case there is a real threat to cause dangerous hypermagnesemia

Hypermagnesemia is a pathological condition that manifests itself with an increase in the concentration of magnesium in the bloodstream (above the established norm of 2.2 mmol per liter). The level of magnesium in the human body is controlled by the same mechanisms as calcium, since this element is also closely associated with bone and cartilage structures. This pathological condition can manifest itself in people from different age categories, including young children.

Reasons for development

Signs of hypermagnesemia usually appear in a person with progression in him. But, besides this, the introduction of increased doses of drugs with this microelement can provoke an increase in the concentration of magnesium in the bloodstream. Also, the intake of laxatives and antacids, which contain this substance, can also increase the level. It should be noted that hypermagnesemia is most often diagnosed in elderly patients.

Predisposing factors:

• the presence in the anamnesis of a person of pathologies of the kidneys and the entire urinary system as a whole;
• the presence of pathologies of the cardiovascular system, which can provoke kidney failure, thereby causing symptoms of hypermagnesemia;
• decrease in the reactivity of the body's immune system;
• the presence of bad habits, such as smoking, drinking alcohol;
• taking drugs with magnesium without the appointment of a qualified specialist in an arbitrary dosage.

Symptoms

If the concentration of magnesium in the bloodstream increases rapidly, then the symptoms of the pathology manifest themselves most clearly. Usually, signs of damage to the nervous system come to the fore:

• drowsiness;
• severe weakness;
• paralysis;
• disturbance of consciousness;
• imbalance.

With hypermagnesemia, damage to the organs of the digestive system can also be observed, which is accompanied by symptoms such as nausea and vomiting. The cardiovascular system also suffers from this disease - the vessels gradually expand, which causes a decrease in blood pressure and impaired respiratory function in humans. Separately, it is worth highlighting a severe form of hypermagnesemia, which is characterized by an intense manifestation of symptoms. This form of the disease develops if the concentration of magnesium exceeds six mmol per liter. The patient develops, he loses consciousness, and if medical assistance is not provided in a timely manner, then cardiac arrest will occur.

Diagnostics

The basis of the diagnostic process is to find out if the patient has kidney problems, whether he has used drugs with a high content of magnesium, and the intensity of the symptoms manifested is also assessed. An increase in the concentration of magnesium in the circulatory system can also be indicated by changes in the ECG. When conducting this instrumental examination, the doctor will be able to detect the first signs of conduction disturbance, asystole, as well as atrioventricular blockade.

Therapeutic measures

The basis of the therapy of this disease is the use of the antagonistic properties of magnesium and calcium for the purpose of treatment. In addition, it is required to purify the blood serum from the increased content of magnesium in it, so the patient is prescribed infusion therapy. You should also stop the intake of the mineral in the body. As a calcium chloride solution is introduced.

If a severe form of hypermagnesemia develops, then forced diuresis is indicated, after which hemodialysis is prescribed. It is important while treating hypermagnesemia to adjust the levels of other electrolytes in the blood.

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