Serum magnesium is the most frequently used laboratory test for evaluating clinical magnesium status. Hypomagnesemia has been associated with many chronic diseases, but currently no consensus for a normal magnesemia range exists, nationally or internationally. In addition, reports as early as 1983 showed that means of serum Mg are similar in both hospitalized and healthy subjects, but the variance of those hospitalized is wider than the healthy group. A low serum magnesium is a definite sign of magnesium deficiency; however, values within the reference range do not rule out deficiencies. A recent review and many hospital laboratories and researchers use symptomatic hypomagnesemia to define the lower range marking hypomagnesemia, but there is a large range of serum Mg above these values which are asymptomatic and yet do not denote a fully “healthy” magnesium status. Two independent groups have recently designated 0.85 – 0.95 mmol/L as a reliable serum Mg reference range, but only the lower boundary marker, i.e. 0.85 mmol/L is evidence based. A reliable, evidence-based upper limit of a health serum Mg has yet to be ascertained, and it is possible that serum Mg alone may not be adequate to designate a compromised magnesium status that is asymptomatic yet portending future development of chronic disease. According to the current data, an increase in the lower limit value for serum magnesium to 0.85 mmol/L (2.1 mg/dL) is required from a health point of view. The best way to diagnose a magnesium deficiency is based on the clinical symptoms and the presence of risk factors (anamnesis) in combination with the serum magnesium.
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