Why might serum magnesium blood tests not reveal the full extent of a severe deficiency initially?

Answer

Most magnesium is stored in tissues and bone

While a blood test checking serum magnesium levels is the standard method for confirming low levels, this measurement has limitations in capturing the total body deficit. The primary reason for this discrepancy is that the vast majority of the body's magnesium—a significant reserve pool—is not circulating freely in the blood plasma but is instead sequestered and stored within tissues and bone matrices. Consequently, even when tissue stores are severely depleted, the body can often maintain a near-normal level in the blood temporarily by mobilizing these reserves. This means a seemingly normal serum reading might mask a profound, underlying systemic deficiency that requires more comprehensive clinical assessment and treatment.

Why might serum magnesium blood tests not reveal the full extent of a severe deficiency initially?

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