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Category	Causes
Alcohol use disorder	Inadequate intake and excessive renal excretion
Gastrointestinal losses	Chronic diarrhea Steatorrhea Small-bowel bypass Chronic proton pump inhibitor use
Pregnancy-related	Pregnancy (especially third trimester; excessive renal excretion, other factors; usually physiologic) Lactation (increased magnesium requirements)
Primary renal losses	Rare disorders that cause inappropriately high magnesium excretion (eg, Gitelman syndrome)
Secondary renal losses	Loop and thiazide diuretics Hypercalcemia Removal of parathyroid tumor Diabetic ketoacidosis Hypersecretion of aldosterone, thyroid hormones, or vasopressin Nephrotoxins (eg, amphotericin B, cisplatin, cyclosporine, aminoglycosides)Nephrotoxins (eg, amphotericin B, cisplatin, cyclosporine, aminoglycosides)