Comprehensive View of Magnesium Physiology

Significant progress has been observed in recent decades, elucidating the biochemical, cellular, and molecular pathways that regulate the 10% inorganic ions, such as Na, K, Ca, HCO3, Cl, and fluid balance in both health and diseases. However, magnesium (Mg), a forgotten electrolyte, despite its critical role as the calcium antagonist found in nature with clinically relevant data on Mg disorders, was one of the least used ions till the late twentieth century. The underappreciation of the clinical importance of Mg may stem from a lack of detailed knowledge about its regulation at the subcellular and systemic levels. Recent technologies and scientific advancements in identifying Mg-specific ion channels and transporters, alongside a more profound understanding of biochemical, physiological, and hormonal mechanisms regulating Mg homeostasis, have opened new ways and renewed interest in magnesium research in human science, shedding light on its critical multidimensional role in various biological processes and offering new insight into its therapeutic potential. This comprehensive review delves into the latest advancements regarding the physiological functions of Mg, emphasising hypomagnesaemia as the most clinical manifestation of Mg imbalance. It covers key aspects, such as the physiology of Mg transporters, the renal mechanism in Mg homeostasis, and integrated regulatory systems governing its balance. Additionally, it addresses Mg deficiency, highlighting the intricate interplay between Mg, Ca, and K deficiencies, drug-induced Mg depletion, and non-pharmacological aetiologies. The review also looks at how common magnesium deficiencies are, how to diagnose them, and what they mean for patients. It also looks at how magnesium supplements can help with a number of medical conditions, giving a full picture of the important biological role of magnesium.