In hypocalcemia, the calcium level in blood is too low.
A low calcium level may result from a problem with the parathyroid glands, as well as from diet, kidney disorders, or certain medications.
As hypocalcemia progresses, muscle cramps are common, and people may become confused, depressed, and forgetful and have tingling in their lips, fingers, and feet as well as stiff, achy muscles.
Usually, the disorder is detected by routine blood tests.
Calcium and vitamin D supplements may be used to treat hypocalcemia.
(See also Overview of Electrolytes and Overview of Calcium's Role in the Body.)
Calcium is one of the body's electrolytes, which are minerals that carry an electric charge when dissolved in body fluids such as blood (but most of the body's calcium is uncharged). Although most of the body's calcium is stored in bones, some circulates in the blood.
About 40% of the calcium in blood is attached (bound) to proteins in blood, mainly albumin. Protein-bound calcium acts as a reserve source of calcium for the cells but has no active function in the body. Only unbound calcium affects the body’s functions. Thus, hypocalcemia causes problems only when the level of unbound calcium is low.
Unbound calcium has an electrical (ionic) charge, so it is also called ionized calcium.
Causes of Hypocalcemia
Hypocalcemia most commonly results when too much calcium is lost in urine or when not enough calcium is moved from bones into the blood. Causes of hypocalcemia include the following:
A low level of parathyroid hormone (hypoparathyroidism), as can occur when the parathyroid glands are damaged during thyroid gland surgery
Lack of response to a normal level of parathyroid hormone (pseudohypoparathyroidism)
No parathyroid glands at birth (for example, in DiGeorge syndrome)
A low level of magnesium (hypomagnesemia), which reduces the activity of parathyroid hormone
(due to inadequate consumption or inadequate exposure to sunlight)
Kidney dysfunction, which results in more calcium excreted in urine and makes the kidneys less able to activate vitamin D
Inadequate consumption of calcium
Disorders that decrease calcium absorption
Pancreatitis
Symptoms of Hypocalcemia
The calcium level in blood can be moderately low without causing any symptoms.
If levels of calcium are low for long periods, people may develop dry scaly skin, brittle nails, and coarse hair. Muscle cramps involving the back and legs are common. Over time, hypocalcemia can affect the brain and cause neurologic or psychologic symptoms, such as confusion, memory loss, delirium, depression, and hallucinations. These symptoms disappear if the calcium level is restored.
An extremely low calcium level may cause tingling (often in the lips, tongue, fingers, and feet), muscle aches, spasms of the muscles in the throat (leading to difficulty breathing), stiffening and spasms of muscles (tetany), seizures, and abnormal heart rhythms.
Diagnosis of Hypocalcemia
Hypocalcemia is often detected by routine blood tests before symptoms become obvious. Doctors measure the total calcium level (which includes calcium bound to albumin) and the albumin level in blood to determine whether the level of unbound calcium is low.
Blood tests are done to evaluate kidney function and to measure magnesium, phosphate, parathyroid hormone, and vitamin D levels. Other substances in blood may be measured to help determine the cause.
Treatment of Hypocalcemia
Calcium supplements, given by mouth, are often all that is needed to treat hypocalcemia. If a cause is identified, treating the disorder causing hypocalcemia or changing medications may restore the calcium level.
calcium from the digestive tract.
Sometimes people with hypoparathyroidism are given a synthetic form of parathyroid hormone.
FAQs
Severe hypocalcemia (serum calcium < 7 mg/dL [< 1.75 mmol/L]) may cause hyperreflexia, tetany (paresthesias of the lips, tongue, fingers, and feet, carpopedal and/or facial spasms, muscle aches), or generalized seizures.
What does hypocalcemia or low blood calcium levels cause? ›
Over time, hypocalcemia can affect the brain and cause neurologic or psychologic symptoms, such as confusion, memory loss, delirium, depression, and hallucinations. These symptoms disappear if the calcium level is restored.
What are the two classic signs for hypocalcemia? ›
Symptoms of hypocalcemia most commonly include paresthesia, muscle spasms, cramps, tetany, circumoral numbness, and seizures.
What hormone is responsible for low calcium levels? ›
parathyroid hormone (PTH) is key to regulating and maintaining a balance of two minerals in the body — calcium and phosphorus.
How do you treat low calcium levels? ›
Thus, the management of hypocalcemia depends upon the severity of symptoms. In patients with acute symptomatic hypocalcemia, intravenous (IV) calcium gluconate is the preferred therapy, whereas chronic hypocalcemia is treated with oral calcium and vitamin D supplements.
What critical illness causes hypocalcemia? ›
Gram-negative sepsis in particular is known to be associated with hypocalcemia and vitamin D deficiency in the critically ill.
What 2 signs are indicative of low blood calcium level? ›
Symptoms of low calcium include:
- painful muscle spasms and cramps.
- twitching of muscles.
- numbness or tingling in feet and hands.
- numbness or tingling around the mouth.
Calcium deficiencies can affect all parts of the body, resulting in weak nails, slower hair growth, and fragile, thin skin. Calcium also plays an important role in both neurotransmitter release and muscle contractions. So, calcium deficiencies can bring on seizures in otherwise healthy people.
What is an alarming calcium level? ›
These tests allow healthcare providers to detect abnormally high calcium levels early. The following blood calcium levels indicate different levels of diagnosis and severity of hypercalcemia: Mild hypercalcemia: 10.5 to 11.9 milligrams per deciliter (mg/dL). Moderate hypercalcemia: 12.0 to 13.9 mg/dL.
What cancers cause low calcium? ›
Hypocalcemia is associated with several types of cancer, but is more frequent in hematological, colorectal, lung, and thyroid cancers.
You might notice improvement within a few weeks. The condition is rarely life-threatening. If hypocalcemia has caused more serious damage like kidney problems, you might need more treatment. Your doctor might also want to monitor you more to check on your health.
How long does hypocalcemia last? ›
Transient hypocalcemia, often observed after the operation, generally responds favourably to replacement therapy within a few days or weeks 1. Hypocalcemia is considered permanent when it does not return to normal within 6 months (1.3-3% of cases) 2.
Is hypocalcemia life threatening? ›
Though hypocalcemia is not encountered as frequently as hypercalcemia, it can be life-threatening if not appropriately recognized and promptly treated. The cause of hypocalcemia varies greatly and is highly dependent on the interaction among parathyroid hormone, phosphorus metabolism, vitamin D, and bone metabolism.
How can I raise my calcium level quickly? ›
Good sources of calcium include dairy foods like milk, yoghurt and cheese, calcium fortified foods (such as soy products) and, to a lesser degree, some leafy green vegetables and nuts and seeds. If you don't have enough calcium in your diet, you may be at increased risk of developing osteoporosis.
What drugs cause low calcium? ›
Drugs like rifampin (an antibiotic), and phenytoin and phenobarbital (anti-seizure drugs) can cause this. Additionally, medicines that fight bone cancers and other bone issues are also linked with hypocalcemia. These drugs include alendronate, ibandronate, risedronate, and zoledronic acid.
Which of the following are signs and symptoms of hypocalcemia? ›
Severe hypocalcemia (very low levels of calcium in your blood) can cause the following symptoms:
- Tingling in your lips, tongue, fingers and/or feet.
- Muscle aches.
- Muscle spasms in your throat that make it difficult to breathe (laryngospasm).
- Stiffening and spasms of your muscles (tetany).
- Seizures.
Hypocalcaemia symptoms
Paraesthesia (usually fingers, toes and around mouth). Tetany. Carpopedal spasm (wrist flexion and fingers drawn together). Muscle cramps.
What are the chief complaints of hypocalcemia patients? ›
The hallmark of acute hypocalcemia is neuromuscular irritability. Patients often complain of numbness and tingling in their fingertips, toes, and the perioral region. Paresthesias of the extremities may occur, along with fatigue and anxiety. Muscle cramps can be very painful and progress to carpal spasm or tetany.
