Of the body's magnesium, 54% is in the bone, 45% in the soft tissues and 1% in extracellular fluid.
All Mg2+ that is not protein-bound is filtered through the kidney's glomerulus. Following filtration, 30% is reabsorbed in the proximal tubule. Another 65% is paracellularly reabsorbed in the thick ascending loop of Henle, controlled by the voltage differential generated by active Na/Cl/K absorption. A further 5% is reabsorbed in the distal tubules. Magnesium handling is directly influenced by sensors which measure plasma magnesium ions.
PTH and calcitonin increase paracellular reabsorption, possibly by influencing tight junction permeability.
Booth loop diuretics and thiazides increase magnesium excretion.
Signs of magnesium toxicity include:
Calcium IV is the antidote.