Serum magnesium: time for a standardized and evidence-based reference range.

Area of Science:

• Clinical biochemistry
• Nutritional science
• Internal medicine

Background:

• Magnesium deficiency is linked to serious health issues, including type 2 diabetes and cardiovascular diseases.
• Despite recognized importance, magnesium is underemphasized in clinical practice due to a lack of uniform, evidence-based reference ranges.
• Serum magnesium concentration has limited diagnostic value as body pools buffer low levels.

Purpose of the Study:

• To highlight the clinical significance of magnesium deficiency.
• To advocate for the inclusion of serum magnesium in routine diagnostics.
• To propose an updated, evidence-based reference range for serum magnesium.

Main Methods:

• Review of current scientific data on magnesium levels and health risks.
• Analysis of existing reference ranges for serum magnesium.
• Comparison of serum magnesium values with health outcomes.

Main Results:

• Low serum magnesium and intake are risk factors for type 2 diabetes and cardiovascular diseases.
• Current reference ranges (0.75–0.95 mmol/L) may not adequately identify deficiency.
• Serum magnesium values below 0.85 mmol/L are associated with increased health risks.

Conclusions:

• Serum magnesium testing should be routine for improved deficiency detection.
• The lower limit of the serum magnesium reference range should be raised to 0.85 mmol/L (2.07 mg/dL).
• Adjusting the reference range will enhance the identification of at-risk individuals and prompt timely intervention.