A Fairy Tale…

Once upon a time there was a sad neglected little ion called Maggie (Mg2+). Everyone paid lots of
attention to Maggie’s bigger cousins Na+ and K+ but because she was little (normal serum conc. 0.75
– 0.95 mmol/l) poor Maggie got ignored. What people didn’t realise was Maggie was shy – mostly
she hid in the cells of muscle (27%) and soft tissue (19%) or the matrix of bone (53%). Maggie was
an intracellular ion and in fact the 4th most abundant cation in the body after her cousins Na+, K+
and Ca2+.

Maggie was also very important. Everyday she worked with hundreds of enzymes as a cofactor,
helping with energy metabolism, nucleic acid synthesis and shipping ions across cell membranes.
Maggie was a busy ion.

They didn’t think about it, but every time humans ate green leafy vegetables or legumes Maggie got
absorbed from the ileum or colon. Similar to her big cousin K+, the kidney controlled her serum
levels, excreting any excess.

Maggie was so neglected that sometimes, when people became ill doctors forgot to measure
Maggie. Usually if Maggie was upset she ran away and her serum concentration fell (Identify 3
causes of hypomagnesaemia). Often her cousin K+ ran away too. When Maggie ran away people
developed confusion, their muscles became weak and sometimes their heart developed abnormal
rhythms…- that was serious!

Less often, when people’s kidneys weren’t working very well, Maggie’s level would rise.

One day Maggie’s dream came true. Doctors discovered that Maggie (given intravenously) could
make people better!

 Maggie could treat ventricular arrhythmias

 Maggie could help in cases of acute severe asthma
 And Maggie was the treatment of choice in eclampsia (a major cause of maternal mortality)
and some cases of pre-eclampsia

Maggie was not a neglected little ion any more but a recognised, established, life-saving treatment.
Maggie was happy.

For those wishing a more orthodox review of Magnesium physiology:

Fawcwett, W.J.et al,(1999) Magnesium: physiology and pharmacology, British Journal of Anaesthesia
83 (2) pp302-320