Hypermagnesemia a is rare and occurs when too much magnesium circulates in the blood.

Signs and Symptoms

Nausea

Drowsiness

Tingling sensation in the face (facial paresthesia)

Progressive loss of deep tendon reflexes (earliest sign)

Coma

Muscular paralysis

Respiratory failure

Cardiac arrest

Causes

Renal failure

Kidneys unable to efficiency excrete magnesium (most common cause)

Excessive intake

Ingesting larger amounts of magnesium than the kidneys are able to excrete (supplements or
medication e.g., magnesium hydroxide, often used for heartburn or constipation.

Excessive IV administration (e.g., treatment of preeclampsia)

Cellular breakdown (excessive release)

Tumor lysis syndrome, rhabdomyolysis

Management

Treatment of severe magnesium toxicity consists of circulatory and respiratory support and
administration of 10% calcium gluconate 10 to 20 mL IV. Calcium gluconate may reverse many
of the magnesium-induced changes, including respiratory depression.

Administration of IV furosemide can increase magnesium excretion when renal function is

adequate; volume status should be maintained.

Identify and stop the source of excessive intake

- If normal renal function, with relevant history or possible iatrogenic cause, cessation of
excessive intake sufficient treatment.

Hemodialysis

- In severe cases magnesium can be externally filtered the blood.

Hypermagnesemia means higher than normal magnesium levels in the blood. And symptoms typically develop at
levels over 4 ml equivalents per liter an average adult have about 25 grams of magnesium in their body about half is
stored in the bones. And most of the other half is found within cells in fact magnesium is a really common positively
charged ion found within the cell. Second only to potassium a very tiny fraction roughly one percent of the total
magnesium in the body is in the extracellular space, which includes both the intravascular space the blood vessels
and lymphatic vessels, and the interstitial space the space between cells