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Magnesium Deficiency (Hypomagnesemia): What Is Known, What Is Not, and When to Seek Care

Magnesium deficiency: Symptoms, signs and treatment

Key Takeaways

  • Magnesium deficiency is a recognized and often underdiagnosed medical condition.
  • Verified effects involve muscle, heart rhythm, neurological, and bone health.
  • Several popular online claims lack high-quality evidence and should be approached cautiously.
  • Diagnosis and treatment should always be guided by a qualified healthcare professional.

Quick Overview

  • Magnesium deficiency (hypomagnesemia) is a recognized medical condition.
  • It can be underdiagnosed, in part because blood tests may appear normal despite low total body magnesium.
  • Verified effects involve neuromuscular, cardiovascular, neurological, and bone health.
  • Several popular questions (e.g., nightmares, tingling) do not have high-quality evidence linking them to deficiency.

What Is Magnesium Deficiency?

Magnesium deficiency—also called hypomagnesemia—occurs when the body does not have sufficient magnesium to support normal physiological functions. Importantly, total body magnesium depletion can exist even when serum magnesium levels are within the reference range, which contributes to missed diagnoses.

Evidence indicates magnesium deficiency is often difficult to detect until levels become significantly low and is frequently underdiagnosed.

What Magnesium Does in the Body

High-quality evidence confirms that magnesium:

  • Is required for the activity of over 300 enzymes
  • Plays a role in muscle contraction and relaxation
  • Is involved in nerve signaling and neurotransmitter release
  • Influences electrical activity and conduction in the heart
  • Participates in cellular energy metabolism through ATP
  • Is a major mineral component of bone
  • Interacts closely with calcium balance

Because of these roles, deficiency can affect multiple organ systems simultaneously.

Symptoms and Health Effects

Neuromuscular

  • Muscle twitching
  • Muscle cramps
  • Tremors

Cardiovascular

  • Irregular heart rhythms (arrhythmias), which are considered potentially serious

Neurological / Mental Health

  • Neurological manifestations
  • Apathy (emotional numbness or reduced emotional responsiveness)

Bone Health

  • Increased risk of osteoporosis
  • Lower blood calcium levels, which may contribute to bone weakening over time

How Common Is Magnesium Deficiency?

High-quality evidence indicates:

  • Approximately 2.5% to 15% of U.S. adults may have magnesium deficiency
  • Prevalence is higher in certain at-risk populations
  • Among hospitalized patients, prevalence has been reported at about 10%

Causes and Risk Factors

Magnesium deficiency is more common in:

  • People with diabetes
  • Individuals with chronic diarrhea
  • People with celiac disease or malabsorption
  • Individuals with alcohol use disorder
  • Diuretics, particularly loop diuretics, increase urinary magnesium loss

Diagnosis

  • Serum magnesium testing is the most commonly used diagnostic test
  • Serum levels may not reflect total body magnesium status
  • No single laboratory test reliably measures total body magnesium

These limitations explain why magnesium deficiency can be present even when blood test results appear normal.

Treatment and Management

Evidence supports that:

  • Dietary magnesium intake is important for maintaining magnesium balance
  • Magnesium supplementation may be recommended by a healthcare professional
  • Intravenous magnesium may be administered by clinicians in certain severe or emergency settings

Management depends on clinical context and professional judgment.

When to See a Doctor

Based on verified evidence, medical evaluation is appropriate if a person experiences:

  • Persistent muscle twitching, cramps, or tremors
  • Symptoms of irregular heartbeat
  • Neurological symptoms such as unexplained emotional numbness
  • Known risk factors (e.g., chronic diarrhea, diabetes, alcohol use disorder) combined with concerning symptoms

Urgent care may be required when magnesium deficiency contributes to serious cardiac rhythm disturbances.

Frequently Asked Questions

Is magnesium deficiency common?

Yes. High-quality evidence indicates magnesium deficiency is relatively common, particularly in at-risk populations.

Can magnesium deficiency cause anxiety?

There is no high-quality evidence directly proving that magnesium deficiency causes anxiety.

Can magnesium deficiency cause nightmares or vivid dreams?

There is no high-quality evidence supporting this.

Can magnesium deficiency cause tingling or burning sensations?

There is no high-quality evidence supporting this.

Can magnesium deficiency affect sleep?

There is no high-quality evidence directly linking magnesium deficiency to sleep disturbances.

What causes magnesium deficiency?

High-quality evidence supports causes such as malabsorption, chronic diarrhea, diabetes, alcohol use disorder, and increased urinary loss from diuretics.

How do you know if you are magnesium deficient?

There is no single reliable test. Blood tests are commonly used, but normal results do not always exclude deficiency.

Can magnesium help with nightmares?

There is no high-quality evidence supporting this.

Does magnesium deficiency cause burning sensations?

There is no high-quality evidence supporting this.

APA Reference List

Food and Nutrition Service, U.S. Department of Agriculture. (n.d.). Eye on Nutrition: Magnesium. WIC Works Resource System. https://wicworks.fns.usda.gov/resources/eye-nutrition-magnesium

Gragossian, A., Bashir, K., Bhutta, B. S., & Friede, R. (2023, November 30). Hypomagnesemia. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK500003/

MedlinePlus. (2025, May 19). Magnesium deficiency. National Library of Medicine. https://medlineplus.gov/ency/article/000315.htm

Merck Manual Professional Edition. (2025). Hypomagnesemia. https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/electrolyte-disorders/hypomagnesemia

Moabedi, M., Aliakbari, M., Erfanian, S., & Milajerdi, A. (2023, December 22). Magnesium supplementation beneficially affects depression in adults with depressive disorder: A systematic review and meta-analysis of randomized clinical trials. Frontiers in Psychiatry, 14, Article 1333261. https://doi.org/10.3389/fpsyt.2023.1333261

Office of Dietary Supplements, National Institutes of Health. (2022, June 2). Magnesium: Fact sheet for health professionals. https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/

Swaminathan, R. (2003). Magnesium metabolism and its disorders. Clinical Biochemist Reviews, 24(2), 47–66. https://pmc.ncbi.nlm.nih.gov/articles/PMC1855626/

U.S. Food and Drug Administration. (2022, January 10). FDA announces qualified health claim for magnesium and reduced risk of high blood pressure. https://www.fda.gov/food/hfp-constituent-updates/fda-announces-qualified-health-claim-magnesium-and-reduced-risk-high-blood-pressure