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Steps in performing serum magnesium measurements
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Actor123
medicine forum beginner


Joined: 29 Jun 2005
Posts: 9

PostPosted: Wed Jul 05, 2006 12:29 am    Post subject: Steps in performing serum magnesium measurements Reply with quote

Hi all.

This is going to sounds like a weird inquiry, but here goes. I have
been diagnosed with chronic magnesium deficiency. We have tried
numerous therapies with varying success, but at this point it looks
like it is going to be a lifelong struggle. I think its beatable, but
its beatable in the way diabetes is, namely watching very closely my
blood levels and making adjustments accordingly.

Unfortunately, the current laboratory testing system is not set up for
someone like me. It typically takes several days to two weeks to
obtain serum magensium results from a lab, and they won't send results
directly to me, but through my doctor first, meaning that oftentimes by
the time I find out my results, 3 weeks have passed and the opportunity
for fine tune adjustment of dosages has passed. Its also not very cost
effective, running $100 in lab fees for the test itself, not to mention
office visits at the doctor.

As such, I was looking into the possibility of getting some lab
equipment at my home and learning to perform the test myself. I know
it sounds like an icky "experimenting on yourself" thing, but I view it
much in the same way as diabetics view glucose testing - I just wish
there was a home magnesium test like there is for glucose testing.

I'm pretty scientifically able, not afraid of jabbing myself with a
needle, and financially well off enough to make the costs of obtaining
such equipment not really an issue (not to mention in the long run it
may actually save me money).

I've managed to piece together the basic steps involved in such
testing, but am not too sure of the details. i was wondering if maybe
someone familiar with the process might take me through it step by
step. Basically, the steps as I understand them are: (1) collect the
blood in a test tube (2) centrifuge the tube to separatre out the serum
(3) extract(?) the serum from the test tube and put in another test
tube with a pipette (4) add magnesium-specific reagant to the serum (5)
place the serum in the analyzer (I've got a bead on a few different
ones I can use)

Any help from a lab technician would be greatly appreciated.
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John Gentile
medicine forum beginner


Joined: 30 Apr 2005
Posts: 40

PostPosted: Wed Jul 05, 2006 1:50 am    Post subject: Re: Steps in performing serum magnesium measurements Reply with quote

On 2006-07-04 20:29:15 -0400, "Actor123" <actr123@aol.com> said:

Quote:
Hi all.


I've managed to piece together the basic steps involved in such
testing, but am not too sure of the details. i was wondering if maybe
someone familiar with the process might take me through it step by
step. Basically, the steps as I understand them are: (1) collect the
blood in a test tube (2) centrifuge the tube to separatre out the serum
(3) extract(?) the serum from the test tube and put in another test
tube with a pipette (4) add magnesium-specific reagant to the serum (5)
place the serum in the analyzer (I've got a bead on a few different
ones I can use)

Any help from a lab technician would be greatly appreciated.

Well, what we do in our clinical lab is pretty much as you describe. We
collect the blood in serum separator tubes (SST) and centrifuge to
separate the serum. The SST allow us to test without pouring off the
serum. Then we place it in our $75,000 analyzer and print out the
results.

Of course that can only be accurate if the proper maintenance is
performed, the instrument is properly quality controlled with know
controls, calibrated to the exact specifications. We also run unknown
samples from the College of American Pathology to prove that we are
accurate. We also run patient samples on duplicate instruments to prove
that there is little instrument to instrument variation.

But I'm thinking that you are probably looking for a much simpler
instrument like a spectrophotometer. Then you should know that the
instrument read out will only be a meaningless number that compares
your sample to a blank and then you have to chart the reactions to
compare your test value with the known values. However I know that
there are moves to make more POCT tests available and there may be
something out there for this - as long as you adhere to a strict
protocol of QC, calibrations and maintenance.

Your best bet would be to have your doc write an order for you to
receive the Mg levels from the lab directly. If the lab that draws the
blood and runs it at the same place should be able to give it to you
within a couple of hours.

--
John Gentile
Editor
Rhode Island Apple Group
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JEDilworth
medicine forum addict


Joined: 06 May 2005
Posts: 87

PostPosted: Wed Jul 05, 2006 1:45 pm    Post subject: Re: Steps in performing serum magnesium measurements Reply with quote

Are you going to the lab to have your blood drawn, or are you having it
drawn at your doc's office? In the latter case, they have to spine down the
blood (hopefully in the office), package up the specimen, have the courier
pick it up and take it to the lab, and then have the lab do the test. If
you're in an extremely rural area, this can take a lot of time.

Find out where the lab is and go to their on-site drawing station, if
possible. If it's a hospital lab, go right to the hospital and have your
blood drawn there. Make SURE you have something from your doctor saying they
can release the results directly to you. If you can provide them with a fax
number so much the better, as they can fax you the results directly. They
can place a "fax to" in the original order (our lab does this every day) and
they can fax the results, upon release, directly to you and/or your doc's
office. Of course, someone at the office has to pull stuff off of the fax
machine regularly, then DO something with the results. That is probably
where your problem is. If the lab give you a hassle about getting your own
results, make sure you speak with the head of chemistry/lab manager, or
their client service department (depending on how large the place is).
Again, the lab cannot release to you on your say-so only; doc must approve
of this arrangement in writing. It's all about liability here.

There is a handheld instrument called the I-Stat that they use in many ER's.
I found one page that had their test menu, but magnesium was not one of the
capabilities. I didn't have time to search further. If anyone knows if
I-Stat can perform Magnesium testing, please post here Smile.

I find it difficult to believe that it takes 2-3 weeks to obtain a result.
This testing is done same day, unless your lab is so incredibly tiny that
they're sending it out because you live in some extremely remote area or
something. Your doctor's office must be dropping the ball as far as getting
results back to you. They should be getting the results next day in most
cases IF your magnesium is done on-site at your laboratory. Again, if your
specimen is traveling to a large reference lab via the doc's office and a
small intermediary lab, this can take time, but 2-3 weeks is ridiculous. No
reference lab could take that long to do a magnesium - they'd be out of
business!!! [I used to be a reference lab marketing rep twenty years ago.]

Sit down with your doc or a representative person at his/her office and
explain the problem. Ask how you can expedite this. You can get a standing
order written for your local laboratory that will last a year, so you can go
into the lab [draw station] whenever you need to (or however often the order
specifies) and get your blood drawn. Home magnesium testing is probably not
the way to go, as it's pretty complicated.

Hope this helps.

Judy Dilworth, M.T. (ASCP)
Microbiology (but used to do chemistry and lab marketing)

"Actor123" <actr123@aol.com> wrote in message
news:1152059355.538895.220620@b68g2000cwa.googlegroups.com...
Quote:

As such, I was looking into the possibility of getting some lab
equipment at my home and learning to perform the test myself.
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JEDilworth
medicine forum addict


Joined: 06 May 2005
Posts: 87

PostPosted: Wed Jul 05, 2006 1:48 pm    Post subject: Re: Steps in performing serum magnesium measurements Reply with quote

That was supposed to say "spin down the blood." Quick centrifugation for
chemistry testing is essential. The doc's office should be separating the
serum/plasma from the cells shortly after your blood is drawn (if you are
indeed having the test drawn there). The draw station will be doing this
automatically, so don't fret about that.

JED

"JEDilworth" <bactitech@nospamhortonsbay.com> wrote in message
news:99qdnR4rIb0cXzbZnZ2dnUVZ_ridnZ2d@buckeye-express.com...

Quote:
Are you going to the lab to have your blood drawn, or are you having it
drawn at your doc's office? In the latter case, they have to spine down
the blood (hopefully in the office),
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Manky Badger
medicine forum Guru Wannabe


Joined: 01 May 2005
Posts: 158

PostPosted: Wed Jul 05, 2006 10:22 pm    Post subject: Re: Steps in performing serum magnesium measurements Reply with quote

"Actor123" <actr123@aol.com> wrote in message
news:1152059355.538895.220620@b68g2000cwa.googlegroups.com...


Quote:
Unfortunately, the current laboratory testing system is not set up for
someone like me. It typically takes several days to two weeks to
obtain serum magensium results from a lab, and they won't send results
directly to me, but through my doctor first, meaning that oftentimes by
the time I find out my results, 3 weeks have passed and the opportunity
for fine tune adjustment of dosages has passed.

I have heard this SO many times - the doctors make out that the patient has
got some absolutely amazingly rare condition and also pretend that the lab
is SO hopelessly inefficient so patients come to think that every lab test
takes weeks.

The fact of the matter is that the vast majority of tests are done and
reported the same day, often within a couple of hours - serum magnesium
levels certainly are.
The cause for delay is that the doctor doesn't have a free appointment for
the patient for several weeks, but rather than admitting it, the onus is
passed on to some faceless laboratory.
As for sending you the results directly, where we are in the UK, that's
standard practice, but patients can phone for results.



--
Posted via a free Usenet account from http://www.teranews.com
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Actor123
medicine forum beginner


Joined: 29 Jun 2005
Posts: 9

PostPosted: Thu Jul 06, 2006 11:40 pm    Post subject: Re: Steps in performing serum magnesium measurements Reply with quote

Thanks for all the responses so far. I do go directly to the lab for
the draws, and they usually post the results online within 48 hours
(viewable by the doc). The porblem with the 3 weeks isn't so much Dr's
appointment lag time, as much as quantity of testing desired. While
I'm trying different protocols to raise my levels I would really like a
significant amount of testing to determine trends, etc. We're talking
daily or even mutlti-daily testing for at least a little while. While
I may be able to schedule a Dr's appointment for 3 days after my draw,
I can't very well schedule a Dr's appointment every day.

The getting the results directly idea may be helpful, although I
imagine I'd get a lot of resistance. I'd still have to wait the 48
hours until they are posted. There is also the additional issue that
I'd like to get some samples done at nighttime since I'm of the belief
that there are diurnal variations in the numbers that I'd like to be
able to track, especially considering that my nighttime dose/digestion
may vary from the daytime.

I'm an electrical engineer by trade, so I'm well familiar with the
proper calibration and maintenance of sensitive electronic instruments.
What I'm unfamiliar with is the hemotological aspect of this - the
drawing of the blood, test tubes, reagant, etc. So these separator
tubes, after they've been centrifuged are there like different
compartments in the tube storing the different elements of the blood,
or is it simply that the lightest material is at the top and the
heaviest at the bottom, in which case how does this differ from a
normal test tube?


Manky Badger wrote:
Quote:
"Actor123" <actr123@aol.com> wrote in message
news:1152059355.538895.220620@b68g2000cwa.googlegroups.com...


Unfortunately, the current laboratory testing system is not set up for
someone like me. It typically takes several days to two weeks to
obtain serum magensium results from a lab, and they won't send results
directly to me, but through my doctor first, meaning that oftentimes by
the time I find out my results, 3 weeks have passed and the opportunity
for fine tune adjustment of dosages has passed.

I have heard this SO many times - the doctors make out that the patient has
got some absolutely amazingly rare condition and also pretend that the lab
is SO hopelessly inefficient so patients come to think that every lab test
takes weeks.

The fact of the matter is that the vast majority of tests are done and
reported the same day, often within a couple of hours - serum magnesium
levels certainly are.
The cause for delay is that the doctor doesn't have a free appointment for
the patient for several weeks, but rather than admitting it, the onus is
passed on to some faceless laboratory.
As for sending you the results directly, where we are in the UK, that's
standard practice, but patients can phone for results.



--
Posted via a free Usenet account from http://www.teranews.com
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John Gentile
medicine forum beginner


Joined: 30 Apr 2005
Posts: 40

PostPosted: Fri Jul 07, 2006 2:05 am    Post subject: Re: Steps in performing serum magnesium measurements Reply with quote

On 2006-07-06 19:40:14 -0400, "Actor123" <actr123@aol.com> said:

Quote:
What I'm unfamiliar with is the hemotological aspect of this - the
drawing of the blood, test tubes, reagant, etc. So these separator
tubes, after they've been centrifuged are there like different
compartments in the tube storing the different elements of the blood,
or is it simply that the lightest material is at the top and the
heaviest at the bottom, in which case how does this differ from a
normal test tube?

Yes, they are special tubes with a gel in the bottom. When blood clots
it separates and the gel is lighter than the red cells and clot so that
when centrifuged it acts as a barrier between the clot and the serum.
Of course a point of care test would be better if it used blood from a
finger stick.

What instruments are you thinking about? I checked on the ISTAT and Mg
is not offered as far as I can tell. I did a google search and could
not find a specific instrument that can measure Mg in a POCT type
tester.
--
John Gentile, MS M(ASCP)
Laboratory Information Manager
Providence, VAMC
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JEDilworth
medicine forum addict


Joined: 06 May 2005
Posts: 87

PostPosted: Fri Jul 07, 2006 3:52 am    Post subject: Re: Steps in performing serum magnesium measurements Reply with quote

You're talking a lot of blood if you plan on doing this at home multiple
times a day. If you're using a spec, you probably can't use micro methods.
You're going to be anemic in no time. Who's going to draw your blood????
Where are you going to centrifuge it? Lots of questions here. Perhaps you
can find somewhere that's doing metabolic research.....

If you need multiple sticks, perhaps someone can insert some sort of line in
your arm and sample off that. If you're paying cash, perhaps the lab can
give you a price per magnesium if you pay up front. Depends on what lab
you're working with. I'd have a talk with the chem supervisor or lab
manager.

John, I also looked for magnesium with I-Stat and couldn't find that
analyte. I don't think it's a test that ER's need right away, so it's not on
their panel.

Good luck, actr123.

Judy Dilworth, M.T. (ASCP)
Microbiology
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Robert CLS, MT(ASCP)
medicine forum beginner


Joined: 14 May 2006
Posts: 7

PostPosted: Fri Jul 07, 2006 6:06 pm    Post subject: Re: Steps in performing serum magnesium measurements Reply with quote

JEDilworth wrote:
Quote:
You're talking a lot of blood if you plan on doing this at home multiple
times a day. If you're using a spec, you probably can't use micro methods.
You're going to be anemic in no time. Who's going to draw your blood????
Where are you going to centrifuge it? Lots of questions here. Perhaps you
can find somewhere that's doing metabolic research.....

If you need multiple sticks, perhaps someone can insert some sort of line in
your arm and sample off that. If you're paying cash, perhaps the lab can
give you a price per magnesium if you pay up front. Depends on what lab
you're working with. I'd have a talk with the chem supervisor or lab
manager.

John, I also looked for magnesium with I-Stat and couldn't find that
analyte. I don't think it's a test that ER's need right away, so it's not on
their panel.

Good luck, actr123.

Judy Dilworth, M.T. (ASCP)
Microbiology

There is really no need for a daily MG in a non-acute hospital setting.
Like calcium the total mg level is effected by carrier proteins and by
the action of PTH. Serum levels are a rough guide to total
intracellular body stores. In certain circumstances ionized magnesium
levels are more helpful than total mg.

The source or cause of the low mg levels should be looked into and if
there is diarrhea and such then those causes should be treated.
Hypocalcemia does not respond to calcium supplements without first
correcting the low magnesium levels because of the PTH connection, low
mgs suppress PTH secretion.

He needs to work with his doctor or find another rather than going at
it on his own.
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Actor123
medicine forum beginner


Joined: 29 Jun 2005
Posts: 9

PostPosted: Sun Jul 09, 2006 1:00 am    Post subject: Re: Steps in performing serum magnesium measurements Reply with quote

Oh, I'm definitely not going at it on my own, but there are simply
limitations in the amount of testing standard medical procedure will
follow - not for safety or effacy issues, but for cost concerns. Oddly
enough, offering to pay out of pocket for additional testing above and
beyong that standard level of care simply doesn't work. Anyone who has
been through a detailed medical procedure where they wish they could be
tested more often knows what I mean. People who haven't encountered it
simply don't realize it.

Take for example glucose testing. A friend who is a diebetic receives
50 test strips a month, the standard prescription. While that may be
fine for someone who has his diebetes well under control, knows what he
can and can't eat and when, it is more beneficial to have more testing
done. Heck, as much as humanly possible would be the ideal, but of
course on the other end there are practicality issues. But
nevertheless, he is able to go in and on his own purchase a lot more
test strips if he chooses, test it at night, test it every hour if he
wants. Now that may be overkill, it may not, especially when he is
still learning the effects of certain food combinations.

I'm basically looking for the same level of freedom in magnesium
testing. I'd love it if there was a glucose-like magnesium tester, but
I don't think there is. The next best thing unfortunately is a huge
leap up, namely full fledged lab equipment. I don't recall the actual
product names off the top of my head (I have my list at home), but they
ranged from $500 to $2000, absent the accessories (tubes, pipettes,
reagant, etc.). That is well within my budget for this endeavor. Once
again, i know it may seem excessive to some, but at the risk of
sounding egotistical I have a bit of money and I can't think of
anything better to spend it on than my health. The symptoms of this
deficiency have cost me far more than that anyway in lost productivity.


Serum Mg can be somewhat of a poor indicator as a screening test for
magnesium deficiency, but it is actually quite good at measuring the
effect of the absorption of various types of magnesium supplementation,
which is mainly what I'd be using it for.

Thanks again for all the input. Its been most helpful. If anyone else
has additional comments, keep them coming!

Robert wrote:
Quote:
JEDilworth wrote:
You're talking a lot of blood if you plan on doing this at home multiple
times a day. If you're using a spec, you probably can't use micro methods.
You're going to be anemic in no time. Who's going to draw your blood????
Where are you going to centrifuge it? Lots of questions here. Perhaps you
can find somewhere that's doing metabolic research.....

If you need multiple sticks, perhaps someone can insert some sort of line in
your arm and sample off that. If you're paying cash, perhaps the lab can
give you a price per magnesium if you pay up front. Depends on what lab
you're working with. I'd have a talk with the chem supervisor or lab
manager.

John, I also looked for magnesium with I-Stat and couldn't find that
analyte. I don't think it's a test that ER's need right away, so it's not on
their panel.

Good luck, actr123.

Judy Dilworth, M.T. (ASCP)
Microbiology

There is really no need for a daily MG in a non-acute hospital setting.
Like calcium the total mg level is effected by carrier proteins and by
the action of PTH. Serum levels are a rough guide to total
intracellular body stores. In certain circumstances ionized magnesium
levels are more helpful than total mg.

The source or cause of the low mg levels should be looked into and if
there is diarrhea and such then those causes should be treated.
Hypocalcemia does not respond to calcium supplements without first
correcting the low magnesium levels because of the PTH connection, low
mgs suppress PTH secretion.

He needs to work with his doctor or find another rather than going at
it on his own.
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Actor123
medicine forum beginner


Joined: 29 Jun 2005
Posts: 9

PostPosted: Sun Jul 09, 2006 1:00 am    Post subject: Re: Steps in performing serum magnesium measurements Reply with quote

Oh, I'm definitely not going at it on my own, but there are simply
limitations in the amount of testing standard medical procedure will
follow - not for safety or effacy issues, but for cost concerns. Oddly
enough, offering to pay out of pocket for additional testing above and
beyong that standard level of care simply doesn't work. Anyone who has
been through a detailed medical procedure where they wish they could be
tested more often knows what I mean. People who haven't encountered it
simply don't realize it.

Take for example glucose testing. A friend who is a diebetic receives
50 test strips a month, the standard prescription. While that may be
fine for someone who has his diebetes well under control, knows what he
can and can't eat and when, it is more beneficial to have more testing
done. Heck, as much as humanly possible would be the ideal, but of
course on the other end there are practicality issues. But
nevertheless, he is able to go in and on his own purchase a lot more
test strips if he chooses, test it at night, test it every hour if he
wants. Now that may be overkill, it may not, especially when he is
still learning the effects of certain food combinations.

I'm basically looking for the same level of freedom in magnesium
testing. I'd love it if there was a glucose-like magnesium tester, but
I don't think there is. The next best thing unfortunately is a huge
leap up, namely full fledged lab equipment. I don't recall the actual
product names off the top of my head (I have my list at home), but they
ranged from $500 to $2000, absent the accessories (tubes, pipettes,
reagant, etc.). That is well within my budget for this endeavor. Once
again, i know it may seem excessive to some, but at the risk of
sounding egotistical I have a bit of money and I can't think of
anything better to spend it on than my health. The symptoms of this
deficiency have cost me far more than that anyway in lost productivity.


Serum Mg can be somewhat of a poor indicator as a screening test for
magnesium deficiency, but it is actually quite good at measuring the
effect of the absorption of various types of magnesium supplementation,
which is mainly what I'd be using it for.

Thanks again for all the input. Its been most helpful. If anyone else
has additional comments, keep them coming!

Robert wrote:
Quote:
JEDilworth wrote:
You're talking a lot of blood if you plan on doing this at home multiple
times a day. If you're using a spec, you probably can't use micro methods.
You're going to be anemic in no time. Who's going to draw your blood????
Where are you going to centrifuge it? Lots of questions here. Perhaps you
can find somewhere that's doing metabolic research.....

If you need multiple sticks, perhaps someone can insert some sort of line in
your arm and sample off that. If you're paying cash, perhaps the lab can
give you a price per magnesium if you pay up front. Depends on what lab
you're working with. I'd have a talk with the chem supervisor or lab
manager.

John, I also looked for magnesium with I-Stat and couldn't find that
analyte. I don't think it's a test that ER's need right away, so it's not on
their panel.

Good luck, actr123.

Judy Dilworth, M.T. (ASCP)
Microbiology

There is really no need for a daily MG in a non-acute hospital setting.
Like calcium the total mg level is effected by carrier proteins and by
the action of PTH. Serum levels are a rough guide to total
intracellular body stores. In certain circumstances ionized magnesium
levels are more helpful than total mg.

The source or cause of the low mg levels should be looked into and if
there is diarrhea and such then those causes should be treated.
Hypocalcemia does not respond to calcium supplements without first
correcting the low magnesium levels because of the PTH connection, low
mgs suppress PTH secretion.

He needs to work with his doctor or find another rather than going at
it on his own.
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harrison6723@rogers.com
medicine forum beginner


Joined: 22 Mar 2006
Posts: 2

PostPosted: Tue Jul 18, 2006 2:43 am    Post subject: Re: Steps in performing serum magnesium measurements Reply with quote

Actor123 wrote:
<SNIP>
You might want to look at the Kodak dt-60. It's a bench top, slide
based (dry chemistry)
analyser. You can probably get one fotr < $5k. I'm not sure if mg is
one of the offered
tests, but you could look into it. It uses small (~10 ul) sample sizes,
so you could use cappillary (finger prick) samples that have been spun
down, and I think the cost per slide is about $1
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