Electrolyte Disturbance in Acute Alcoholism: With Particular Reference to Magnesium

Abstract

Serum electrolyte determinations were made in 30 patients with acute, severe alcoholism before any therapy was given. Sixty per cent of the serum magnesium levels, 30 per cent of the serum potassium levels, and 20 per cent of the serum calcium levels were below the normal range. Approximately one-third of the patients showed hypernatremia and hyperchloremia. There was little correlation in most patients between serum magnesium levels and such clinical findings as hallucinations, tremor, and tremulous handwriting. All but one of the patients with completely illegible handwriting had low serum magnesium levels. Possible mechanisms suggested for the alterations in the serum electrolytes included poor food and electrolyte intake, poor gastrointestinal absorption, and accelerated urinary loss of electrolytes due to effects of starvation and dehydration. Water diuresis, a demonstrated effect of alcohol, might explain the occurrence of hypernatremia and hyperchloremia in some patients. The need for adequate fluid and electrolyte therapy in the treatment of the acute alcoholic was stressed in view of the deleterious effects of altered body electrolytes.