Table of contents
Recommendation on an updated standardization of serum magnesium reference ranges
European Journal of Nutrition https://doi.org/10.1007/s00394-022-02916-w
Andrea Rosanoff1© • Christina West2 • Ronald J. Elin3 • Oliver Micke4 • Shadi Baniasadi5 Mario Barbagallo6 • Emily Campbell1,7 • Fu-Chou Cheng8 • Rebecca B. Costello1 • Claudia Gamboa-Gomez9 • Fernando Guerrero-Romero10 • Nana Gletsu-Miller11 • Bodo von Ehrlich12 • Stefano lotti13 Ka Kahe14 • Dae Jung Kim15 • Klaus Kisters16,17 • Martin Kolisek18 • Anton Kraus19 • Jeanette A. Maier20 • Magdalena Maj-Zurawska21 • Lucia Merolle22 • Mihai Nechifor23 • Guitti Pourdowlat24 • Michael Shechter25,26 •
Yiqing Song27 • Yee Ping Teoh28 • Rhian M. Touyz29 • Taylor C. Wallace1,30,31 • Kuninobu Yokota32 • Federica Wolf33,34 • for the MaGNet Global Magnesium Project (MaGNet)
Purpose Serum magnesium is the most frequently used laboratory test for evaluating clinical magnesium status. Hypomagnesemia (low magnesium status), which is associated with many chronic diseases, is diagnosed using the serum magnesium reference range. Currently, no international consensus for a magnesemia normal range exists. Two independent groups designated 0.85 mmol/L (2.07 mg/dL; 1.7 mEq/L) as the low cut-off point defining hypomagnesemia. MaGNet discussions revealed differences in serum magnesium reference ranges used by members’ hospitals and laboratories, presenting an urgent need for standardization.
Methods We gathered and compared serum magnesium reference range values from our institutions, hospitals, and colleagues worldwide.
Results Serum magnesium levels designating “hypomagnesemia” differ widely.
Of 43 collected values, only 2 met 0.85 mmol/L as the low cut-off point to define hypomagnesemia.
The remainder had lower cut-off values, which may underestimate hypomagnesemia diagnosis in hospital, clinical, and research assessments. Current serum magnesium reference ranges stem from “normal” populations, which unknowingly include persons with chronic latent magnesium deficit (CLMD). Serum magnesium levels of patients with CLMD fall within widely used “normal” ranges, but their magnesium status is too low for long-term health. The lower serum magnesium reference (0.85 mmol/L) proposed specifically prevents the inclusion of patients with CLMD.
Conclusions Widely varying serum magnesium reference ranges render our use of this important medical tool imprecise, minimizing impacts of low magnesium status or hypomagnesemia as a marker of disease risk. To appropriately diagnose, increase awareness of, and manage magnesium status, it is critical to standardize lower reference values for serum magnesium at 0.85 mmol/L (2.07 mg/dL; 1.7 mEq/L).
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| Magnesium | not Magnesium | |
| Vitamin D | Magnesium or Vitamin D Aging, Amyotrophic Lateral Sclerosis, Alzheimer's Disease; Asthma, Attention Deficit Disorder, Autism, Cancer, Cerebrovascular, Chronic Fatigue, Diabetes, Hearing Loss, Heart Disease, Heart Attack, Atherosclerosis, Cardiovascular Disease, HIV, AIDS; Hypertension; Kidney Stones, Migraine Headache, Multiple Sclerosis, Obesity, Osteoporosis, Peripheral vascular disease; Pregnancy-related problems, Rheumatoid Arthritis, Sports-related problems, | Vitamin D only Acne, Allergy, Autoimmune, Bone, Breathing, Celiac, Cognition, Colds and Flu, Cystic Fibrosis, Dental, Fertility, hyperparathyroid, Immunity, Kidney, Liver, Lupus, Osteoarthritis, Pain - chronic, Parkinson, Psoriasis, Rickets, Strokes, Sarcoidosis, Thyroid, Parathyroid, Tuberculosis, Vision, Hair, Skin, Sports |
| Not Vitamin D | Magnesium only Aggressive Behavior, Alcoholism, Arrhythmia, Cerebral Palsy, Chemical Sensitivity, Cluster Headaches; Cocaine-related Stroke; Constipation, Cramps, Fluoride Toxicity, Head Injuries, Central Nervous System Injuries, Magnesium Deficiency; Menopause, Mitral Valve Prolapse, Nystagmus, Psychiatric Disorders; Repetitive Strain Injury, Sickle Cell Disease, SIDS, Stress, Stuttering, Tetanus; Tinnitus, Sound Sensitivity; TMJ; Toxic Shock; Violence | Neither ALL OTHER DISEASES |
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