Serum Magnesium

Also known as: Mg2+, Serum Mg

Magnesium is involved in over 300 enzymatic reactions including ATP production, muscle contraction, and nerve signalling. Deficiency is extremely common but often missed because serum magnesium can remain normal while intracellular stores are depleted.

Specimen

Venous blood (serum separator tube)

Turnaround

2–4 hours

Fasting

Not required

Category

Metabolic Panel

Reference Ranges

MeasurementReference RangeUnit
Normal1.7 – 2.2mg/dL

Reference ranges are typical adult values. Your laboratory may use slightly different intervals — always use your lab's reported reference.

What This Test Measures

Magnesium is the fourth most abundant cation in the body and the second most abundant intracellular cation (after potassium). Only about 1% is in the serum — the rest is in bone (60%) and inside cells (39%). Serum magnesium reflects the tightly regulated extracellular pool, not the far larger intracellular stores. This means serum magnesium can look normal while tissues are depleted.

When Is This Test Ordered?

  • Investigating hypokalaemia (low potassium) — often coexists; cannot correct potassium without replacing magnesium
  • Cardiac arrhythmia evaluation
  • Alcohol use disorder assessment
  • Malabsorption syndromes and inflammatory bowel disease
  • Monitoring patients on proton pump inhibitors (long-term PPIs cause hypomagnesaemia)
  • Pre-eclampsia treatment monitoring

When Results Are High

Hypermagnesaemia (above 2.5 mg/dL) is almost always from renal failure (kidneys cannot excrete magnesium) or excessive antacid/laxative use. Above 5 mg/dL causes neuromuscular depression; above 7–10 mg/dL risks cardiac arrest.

When Results Are Low

Hypomagnesaemia causes muscle cramps, tremor, cardiac arrhythmias, and seizures. It also makes hypokalaemia and hypocalcaemia treatment-resistant — magnesium depletion must be corrected first. A serum level below 1.5 mg/dL warrants repletion; symptoms can occur at borderline levels (1.5–1.7 mg/dL) when intracellular stores are exhausted.

Factors That Can Affect Your Result

  • Long-term proton pump inhibitors (omeprazole, pantoprazole) impair intestinal magnesium absorption
  • Alcohol is the most common cause of hypomagnesaemia — increases renal excretion
  • Diuretics (loop and thiazide) increase renal magnesium wasting
  • Diabetic ketoacidosis causes significant magnesium loss
  • Aminoglycoside antibiotics cause renal magnesium wasting

Tracking This Test Over Time

If you have persistent low potassium that does not correct with supplementation, always check and correct magnesium. The kidney cannot conserve potassium in the setting of magnesium deficiency — this is one of the most commonly missed mineral interactions in clinical medicine.

Track your Magnesium in Looms

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Medical disclaimer

This page is for educational purposes only and does not constitute medical advice. Reference ranges vary between laboratories, and results must be interpreted in the context of your symptoms, history, and other tests. Always discuss your results with your healthcare provider. Content reviewed by the Looms medical team, 2026-06-01.