Novel Scale for Clinical Identification of Adverse Magnesium/Calcium Imbalances: Applications and Perspectives

Background/Objectives: Calcium (Ca) and magnesium (Mg) are mutual antagonists that interact in a majority of physiological processes. Thus, maintaining a balance between these two minerals is essential for functional homeostasis. Mg deficiency plays a role in the course and severity of a wide range of chronic health conditions. This knowledge, however, has not translated into active incorporation of serum Mg determination as a reliable diagnostic tool for physiological Mg deficit. Methods: Pioneering work by von Ehrlich and Rosanoff has prompted development of a simple algorithm and scale for using serum Ca and Mg determinations to identify subclinical (i.e., "hidden") physiological Mg deficiencies. This novel serum Mg/Ca-Ca/Mg scale uses determinations of total serum Ca and Mg and their ratios to alert clinicians to avoidable risks associated with chronic latent Mg deficiency. This review applies this scale to 10 published clinical studies reporting the serum (or plasma) ratio between Mg and Ca. Results: In all 10 studies, application of the serum Mg/Ca-Ca/Mg scale diagnosed deficit Mg status more reliably than serum Mg alone. Conclusions: This review provides both illustrations of the value of the novel scale and support for its consideration in clinical practice and Mg research.