Low magnesium levels can disrupt bodily functions, contributing to hypertension, insulin resistance, Type 2 diabetes, muscle weakness, and metabolic disorders. It's essential for metabolic and cardiovascular health, supporting overall wellness
Published Apr 14, 2025 | 1:54 PM ⚊ Updated Apr 14, 2025 | 1:54 PM
Uncovering the hidden side effects of everyday medication(iStock)
Synopsis: A 45-year-old man’s unexplained muscle cramps and fatigue were initially misdiagnosed as anxiety despite normal tests. After worsening symptoms, doctors discovered his condition was caused by Hypomagnesemia, linked to long-term use of the acid reflux medication Omeprazole. Dr. Sudhir Kumar, who identified the issue, advises regular screenings for magnesium deficiency in long-term PPI users, highlighting the often overlooked condition
It began with mysterious muscle cramps and increasing fatigue. A 45-year-old healthy and active man had his life abruptly disrupted by unrelenting spasms in his arms and legs. Doctors performed all the standard tests – bloodwork, neurological exams, even psychiatric evaluations, but everything checked out as normal. It could be stress or anxiety, he was told. But nothing helped, and the symptoms only got worse, thus, it started affecting his day-to-day functions.
What doctors initially overlooked was a subtle but serious condition called Hypomagnesemia, or low magnesium levels in the blood. What caused it, was a widely used acid reflux medication – Omeprazole, that the patient had been taking for over a year. This case, which was examined by Dr Sudhir Kumar, Senior Consultant Neurologist at Apollo Hospitals, Hyderabad, not only uncovered a personal health mystery but also exposed a larger, overlooked issue that could be affecting thousands of unsuspecting long term PPI users.
According to Dr. Sudhir Kumar, a renowned neurologist, Hypomagnesemia refers to low levels of magnesium in the blood, typically below 1.7 mg/Dl. “Magnesium plays a crucial role in neuromuscular function,” says Dr. Sudhir.
“A deficiency can lead to muscle pain, cramps, spasms, and a general fatigue are the issues that can impact everyday life activities such as walking, doing household chores and exercising”, he explains. To understand the case in detail, Dr. Sudhir says, “the patient initially showed clear signs- muscle cramps, irritability and sleep disturbances- but was misdiagnosed and treated for his anxiety first.”
“While the patient’s calcium and vitamin D levels were checked and found normal, magnesium wasn’t considered until I reviewed the patient’s history and saw, he had been taking Omeprazole for several months.”
To prevent Hypomagnesemia, Dr. Sudhir suggests regular screening every six months or upon the occurrence of the symptoms, for patients on long term PPIs. He encourages patients to follow a nutrient-rich diet and consult their doctors about drug induced deficiencies. “The symptoms are common and often overlooked, which is why hypomagnesemia continues to be underdiagnosed in clinical practice,” he says.
“Magnesium is a cornerstone mineral for human health, involved in over 300 enzymatic processes,” explains Shashikant Iyengar, a certified Metabolic Health Coach (Dlife.in); Founder of Metabolic Health India.
According to him, low magnesium levels can disturb a wide range of bodily functions. It is linked to major health issues like hypertension, insulin resistance, Type 2 diabetes, reduced bone density, muscle weakness, and a host of other metabolic disorders. Magnesium deficiency compromises core metabolic and cardiovascular health, making it a vital nutrient for daily wellness.
Early signs of magnesium deficiency may often go unnoticed or be misattributed. People with low magnesium may experience muscle cramps, especially at night or in the legs, along with sleep disturbances, unexplained fatigue, anxiety, irritability, or mood swings.
In more advanced cases, they might notice tingling, numbness, or an unusually high heart rate, says Iyengar. These symptoms indicate underlying dysfunction in the body’s muscular and nervous systems, often related to an inadequate magnesium supply.
“Interestingly, serum magnesium levels can appear normal even when cellular magnesium is low,” Iyengar points out. He emphasises that RBC (erythrocyte) magnesium testing is a more accurate measure of magnesium status, as it reflects intracellular stores.
“While this test is not widely available in India, I’ve seen European clients show low erythrocyte magnesium levels despite normal serum values,” he adds. This highlights the need for more comprehensive testing methods in clinical practice.
To maintain healthy magnesium levels, Iyengar stresses the importance of food-based sources. “Include magnesium-rich foods like pumpkin seeds, almonds, spinach, avocado, and other green leafy vegetables in your daily meals,” he advises.
Additionally, for those with Type 2 diabetes or high blood pressure, magnesium supplementation, especially magnesium glycinate, known for its better absorption and gentleness on the stomach, can be beneficial. This proactive approach can help prevent long-term health issues.
“Patients on long-term PPI (Proton Pump Inhibitor) therapy should definitely be screened for magnesium deficiency,” Iyengar warns. These medications, often used for acid reflux, can impair magnesium absorption over time, especially when used for more than 12 months.
He recommends checking serum magnesium levels at baseline and repeating every 6 to 12 months. “In these cases, supplementing with magnesium glycinate is often a wise precaution,” he adds.
Iyengar believes the spike in magnesium deficiency is largely a consequence of modern dietary habits “Heavily processed foods, sugary drinks, and fast food are low in magnesium and can even accelerate its loss,” he notes. Poor intake of vegetables and real, whole foods further adds to the problem. “A high intake of refined sugar and soft drinks like cola can also increase magnesium excretion,” he warns. His solution? “Eat more home-cooked meals with diverse, unprocessed ingredients. It is the best long-term strategy.”
Iyengar highlights a significant study from the Journal of the American Heart Association (March 26,2025), which shows that long-term use of non-prescription magnesium supplements is associated with a lower risk of heart failure and major cardiovascular events in people with diabetes. “This emerging data strengthens magnesium’s role in heart health, especially among those with metabolic disorders,” he says.
“What’s truly remarkable is that magnesium is the only supplement allowed to carry a qualified health claim by the FDA for its role in reducing the risk of high blood pressure,” Iyengar shares. The FDA officially acknowledged this on 10 January, 2022, reinforcing magnesium’s powerful benefits in cardiovascular regulation.
(Edited by Ananya Rao)
