What is it?
Hypocalcaemia (low levels of calcium in the blood)
- Defined as a total serum calcium concentration < 8.8 mg/dL (< 2.20 mmol/L) in the presence of normal plasma protein concentrations or as a serum ionized calcium concentration < 4.7 mg/dL (< 1.17 mmol/L).
- Reference ranges for serum calcium vary by age and sex
Diagnosis Tests
- Test include:
- Trousseau sign and chvostek sign to check tetany muscle contraction (not 100% conclusive)
- Osteoporosis
- Hypocalcaemia (low levels of calcium in the blood)
- Osteopenia
Disease causing deficiency
Vitamins, herbals and minerals
Syndromes
- Surgical effects i.e.
- Bowel resection
- Pancreatectomy
- Parathyroidectomy
- High calcitonin levels
- Trauma patients with massive transfusion
- Disorders of the parathyroid hormone gland and related hormones (hypoparathyroidism – where not enough parathyroid hormone gland is produced or Pseudohypoparathyroidism when there is resistance shown by the end – organs to the parathyroid hormone)
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Neck irradiation/radioiodine therapy
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Postparathyroidectomy in dialysis patients
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Inadvertent surgical removal (can be transient or permanent)
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Infiltrative disease i.e.
Syndromes
Parathyroid hormone gland helps to:
- Move calcium from the bones to the blood
- Make the kidney remove less calcium from the body
- Digest more calcium
- Tell the kidney to produce more vitamin D to absorb more calcium
Syndromes
Medication
- Chemotherapy drugs
- Bisacodyl (laxative)
- Phenytoin
- Phenobarbital
- Rifampin
- Corticosteroids
-
Radiocontrast
-
Hormonal supplements i.e.
-
Contraceptives
-
HRT
- Oestrogen supplements
-
-
-
Calcium supplements
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Antibiotics
-
Cinacalcet
- Proton pump inhibitors (PPIs)
- Heartburn and indigestion -Histamine-2 receptor blockers
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Calcitonin and bisphosphonates cause chelation and end-organ inhibition
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Ethylene glycol complexes with calcium
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Estrogen inhibits bone resorption
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Aluminum (decrease parathyroid hormone activity)
- Alcohol (decrease parathyroid hormone activity)
Medication to treat high calcium levels i.e.
- Cisplatin
- Foscarnet
- Denosumab
- Sodium phosphate
- Infusion of phosphate, citrate, or calcium-free albumin
Signs and symptoms of deficiency
- Aching, painful muscles, muscle cramps/spasms/stiffness
- Muscle twitching (Twitching one’s eyes and/or nose and/or face and arms and/or legs)
- Jerky movements (irregular movements which aren’t rhythmic or repetitive)
- Numbness and tingling around the mouth
- Jaw pain and/or difficulty chewing, swallowing, talking and/or slurred speech and/or difficulty in opening the mouth and /or difficult to eat
- Constant hiccups
- Pain, numbness, burning and tingling (pins and needles) sensation in one’s hands and fingers (thumb and/or index finger and/or middle finger and/or ring finger and/or small finger)
- Pain and/or numbness and/or tingling sensation in one or both legs and/or foot area
- Brittle, soft weak bones, dental problems and/or prone to fractures or curved/bone legs and/or curved spine and/or arching back
- Bone pain
- Joint pain and stiffness
- Lifeless hair and/or coarse hair
- Balance and dizziness
- Voice changes and/or a hoarse voice and/or a deep voice (due to laryngospasm)
- Short of breath and/or breathing difficulties (whether after exercise or not) and/or wheezing
- General discomfort (muscle weakness), uneasiness or ill feeling (malaise) and/or fatigue (tiredness)
- Confusion
- Low mood and Depression
- Dry skin and scaly skin
- Skin very itchy
Nail changes:
Complications /Information to beware of/General tips:
Medical Emergency Condition
And/or do not wait, phone for an ambulance if have or develop:
This condition can lead to:
Severe low levels of calcium can cause:
Good sources of calcium
- One can get 1/4 to 1/3 of your RDA of calcium in a single serving of some milks and yogurts.
- Collard greens (cooked)
- Broccoli (cooked)
- Figs (dried)
- Edamame (frozen) beans
- White beans
- Fortified tofu (regular, not firm)
- Sardines (in oil)
- Salmon (pink, canned, with bones)
Calcium doses
- While meeting your calcium requirement is very important, you also want to make sure you’re not getting too much.
- According to the Mayo Clinic, upper limits of calcium intake in milligrams (mg) for adults are:
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- 2,000 mg per day for men and women 51 years of age and up
- 2,500 mg per day for men and women 19 to 50 years of age
- You might want to supplement your diet by taking a multivitamin. Or your doctor may recommend supplements if you’re at high risk for developing a calcium deficiency.
- Multivitamins may not contain all of the calcium you need, so be sure to eat a well-rounded diet. If you’re pregnant, take a prenatal vitamin.
Vitamin D
- Vitamin D is important because it increases the rate calcium is absorbed into your blood. Ask your doctor how much vitamin D you need.
- To increase your calcium intake, you can add food rich in vitamin D to your diet.
These include:
- fatty fish like salmon and tuna
- fortified orange juice
- fortified milk
- portobello mushrooms
- eggs
- As with calcium-rich dairy products (some vitamin D-rich dairy products can also be high in saturated fat).
- Sunlight triggers your body to make vitamin D, (getting regular exposure to the sun can also help boost your vitamin D levels).
Lifestyle changes
In addition to maintaining healthy calcium and vitamin D levels, there are certain lifestyle changes you can make to promote bone health. These include:
- maintaining a healthy body weight
- exercising regularly
- restricting tobacco use and alcohol intake
Healthline
Please talk to your healthcare professional (i.e. Medical Doctor/Pharmacist) for further advice
Detailed Information
Please copy and paste any key words from the title: Calcium Deficiency in the following respective 'Medtick References and/or Sources' to find out more about the disease (this also may include diagnosis tests and generic medical treatments).
- NHS
Find information and advice on health conditions, symptoms, healthy living, medicines and how to get help (British National Health Service).
- Medscape
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- Pharmaceutical Journal
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- Healthline
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- Medical News Today
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- WebMD
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- Cleveland Clinic
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- Mayo Clinic
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- Drugs.com
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- National Organisation of Rare Diseases
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- Verywell Health
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