Stress and Magnesium Levels

Adrenergic control of plasma magnesium in man.
Whyte KF, Addis GJ, Whitesmith R, Reid JL

Regulation of magnesium balance is poorly understood. However, hypomagnesaemia has been reported in patients in clinical situations where circulating catecholamines are raised including myocardial infarction, cardiac surgery and insulin-induced hypoglycaemia stress tests. The effects of L-adrenaline infusions, sufficient to achieve pathophysiological levels of adrenaline, and of therapeutic intravenous infusions of salbutamol, a beta 2-agonist, on plasma magnesium, plasma potassium, plasma glucose and plasma insulin levels were studied in a placebo-controlled design in eight normal subjects. Plasma magnesium levels fell significantly during the adrenaline infusion and also during the salbutamol infusion, though more slowly. In a 1 h period of observation after cessation of the infusions no recovery of plasma magnesium levels was seen. Significant falls in plasma potassium levels were also observed during both infusions with spontaneous recovery within 30 min after the infusions. No significant changes in plasma insulin levels occurred with either salbutamol or L-adrenaline compared with control. Plasma glucose levels rose significantly during the adrenaline infusion. The study suggests that both L-adrenaline and salbutamol cause shifts in plasma magnesium which are not mediated by insulin. We propose that intracellular shifts of magnesium occur as a result of beta-adrenergic stimulation.

Publication Types: Clinical trial Randomized controlled trial

Clin Sci (Colch) 1987 Jan;72(1):135-8
PMID: 3542342, UI: 87103979

Effects of Adrenaline and Exercise on Magnesium Levels

Effects of exogenous catecholamines and exercise on plasma magnesium concentrations.
Joborn H, Akerstrom G, Ljunghall S

Catecholamines and physical exercise are known to influence the metabolism of several minerals in man, but the effects on magnesium (Mg) have been scarcely investigated. In the present study, infusion of adrenaline (5 micrograms/min for 30 min followed by 10 micrograms/min for 30 minutes) significantly reduced the plasma Mg levels in healthy males. This effect was abolished by simultaneous infusion of propranolol. Noradrenaline had no such effect. In order to stimulate endogenous catecholamine release healthy males carried out physical exercise in four different ways: ergometer bicycling at maximum load until exhaustion with and without oral beta-blockade, ergometer bicycling with stepwise increasing load until exhaustion, isokinetic maximal exercise with one leg, with blood sampling both from the venous effluent of the exercising leg and the opposite resting arm and long-term (60 min) steady state ergometer bicycling at approximately 65% of estimated maximum capacity. During short-term (less than 20 min) intense exercise (i.e. experiments 1-3) the plasma Mg concentrations were increased. This was probably due to a reduction of plasma volume and to an influx of Mg to the vascular pool. During long-term steady state exercise (experiment 4) the Mg levels were not significantly affected but decreased during the first hour of recovery. These results suggest that both the beta-adrenergic system and muscular activity by itself affect Mg homeostasis.

1 : Clin Endocrinol (Oxf) 1985 Sep;23(3):219-26
PMID: 4075536, UI: 86080100

Inherited Disorders of Renal Magnesium Handling

The genetic basis and cellular defects of a number of primary magnesium wasting diseases have been elucidated over the past decade. This review correlates the clinical pathophysiology with the primary defect and secondary changes in cellular electrolyte transport.

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Magnesium and Potassium Balance

Magnesium repletion and its effect on potassium homeostasis in critically ill adults: Results of a double-blind, randomized, controlled trial

Objectives: The aims of this study were to evaluate the safety and efficacy of magnesium replacement therapy and to determine its effect on potassium retention in hypokalemic, critically ill patients.

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Magnesium Pump

HISTORY AND ADMISSION FINDINGS:

A 28-year-old man, known to have abnormal intestinal magnesium absorption, presented with recurrent cerebral seizures. Despite daily intravenous sulphate infusions, magnesium concentration remained inadequate. Physical examination was unremarkable. INVESTIGATIONS: Serum magnesium concentration was markedly reduced to 0.48 mmol/l. The parenteral magnesium tolerance test indicated reduced enteric magnesium absorption of < 20%. Absolute magnesium concentration in 24-hour urine was normal at 6.3 mmol/24 h, but high in proportion to the hypomagnesaemia. All other laboratory data were within normal limits.

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