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Adv Nutr. 2016 Nov 15;7(6):977-993. doi: 10.3945/an.116.012765. Print 2016 Nov.

Perspective: The Case for an Evidence-Based Reference Interval for Serum Magnesium: The Time Has Come.

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Center for Magnesium Education and Research, Pahoa, Hawaii;
Department of Pathology and Laboratory Medicine, University of Louisville, KY.
Center for Magnesium Education and Research, Pahoa, Hawaii.
Department of Nutrition and Food Studies, George Mason University, Fairfax, VA.
Biomedical Research Unit, Mexican Social Security Institute, Durango, Mexico.
Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA.
School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.
Grand Forks Human Nutrition Research Center, Grand Forks, ND.
Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN; and.
Division of Nutrition, Department of Preventive Medicine, Northwestern University, Chicago, IL.


The 2015 Dietary Guidelines Advisory Committee indicated that magnesium was a shortfall nutrient that was underconsumed relative to the Estimated Average Requirement (EAR) for many Americans. Approximately 50% of Americans consume less than the EAR for magnesium, and some age groups consume substantially less. A growing body of literature from animal, epidemiologic, and clinical studies has demonstrated a varied pathologic role for magnesium deficiency that includes electrolyte, neurologic, musculoskeletal, and inflammatory disorders; osteoporosis; hypertension; cardiovascular diseases; metabolic syndrome; and diabetes. Studies have also demonstrated that magnesium deficiency is associated with several chronic diseases and that a reduced risk of these diseases is observed with higher magnesium intake or supplementation. Subclinical magnesium deficiency can exist despite the presentation of a normal status as defined within the current serum magnesium reference interval of 0.75-0.95 mmol/L. This reference interval was derived from data from NHANES I (1974), which was based on the distribution of serum magnesium in a normal population rather than clinical outcomes. What is needed is an evidenced-based serum magnesium reference interval that reflects optimal health and the current food environment and population. We present herein data from an array of scientific studies to support the perspective that subclinical deficiencies in magnesium exist, that they contribute to several chronic diseases, and that adopting a revised serum magnesium reference interval would improve clinical care and public health.


chronic disease; magnesium deficiency; plasma magnesium; reference interval; serum magnesium

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