Abstract: SA-PO0615
Improvement in Refractory Enteropathy-Associated Hypomagnesemia After Tirzepatide Initiation: A Case Report
Session Information
- Fluid, Electrolyte, and Acid-Base Disorders: Case Reports - 2
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Fluid, Electrolytes, and Acid-Base Disorders
- 1102 Fluid, Electrolyte, and Acid-Base Disorders: Clinical
Authors
- Shukr, Maan, West Virginia University, Morgantown, West Virginia, United States
- Diab, Anas, West Virginia University, Morgantown, West Virginia, United States
Introduction
Serum magnesium concentration is maintained through a balance between intestinal absorption and renal excretion. Chronic diarrhea and enteropathy can interfere with this balance through impaired absorption and ongoing gastrointestinal loss leading to persistent hypomagnesemia. Managing hypomagnesemia secondary to malabsorption may require intravenous replacement which is time and resource consuming.
Case Description
We report a case of a patient with symptomatic chronic hypomagnesemia who presented with muscle spasm and lower extremity weakness that resolved with intravenous magnesium replacement. The patient was evaluated for hypomagnesemia; her workup supported gastrointestinal magnesium losses as the underlying etiology. The patient was referred to nephrology for long-term management. She required daily oral magnesium supplementation and a weekly intravenous magnesium infusion. Tirzepatide, a dual Glucose-dependent insulinotropic polypeptide (GIP)/Glucagon-like peptide-1 (GLP-1) receptor agonist, was initiated by endocrinology for the management of type 2 diabetes mellitus. Following tirzepatide initiation, an improvement in serum magnesium levels was incidentally observed, along with a substantial reduction in intravenous magnesium requirement from 8 grams weekly to 4 grams every 4 weeks. This has been associated with a 30 lbs weight loss.
Discussion
This case highlights a possible association between tirzepatide initiation and improved magnesium levels in refractory enteropathy-associated hypomagnesemia, as demonstrated by a marked reduction in intravenous magnesium requirements. This could be related to the known effect of GIP/GLP-1 on slowing the gastrointestinal tract, leading to increased absorption. Further studies are needed to clarify whether GIP/GLP-1 receptor agonists influence gastrointestinal magnesium absorption or electrolyte losses.