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)
-
Neck irradiation/radioiodine therapy
-
Postparathyroidectomy in dialysis patients
-
Inadvertent surgical removal (can be transient or permanent)
-
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
-
Antibiotics
-
Cinacalcet
- Proton pump inhibitors (PPIs)
- Heartburn and indigestion -Histamine-2 receptor blockers
-
Calcitonin and bisphosphonates cause chelation and end-organ inhibition
-
Ethylene glycol complexes with calcium
-
Estrogen inhibits bone resorption
-
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
- Okra
- 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:
-
- 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).
Vitamin K2
- Vitamin K2 activates the proteins required to move calcium from the blood straight into the bone and teeth.
- Sources include:
- Natto: A traditional Japanese fermented soybean dish. It is the single richest dietary source available.
- Hard Cheeses: Varieties like Gouda, Edam, and Jarlsberg. The specific starter bacteria generate high levels of K2.
- Sauerkraut: Fermented cabbage. It offers modest amounts of K2 alongside beneficial gut probiotics.
- Kefir: A fermented dairy drink. It contains minor amounts of K2 depending on the fat content
Sumas Mountain Farms
Best Animal-Based Sources (Rich in MK-4)
- Goose Liver Pate: An exceptionally dense animal source of K2.
- Beef and Chicken Liver: Organ meats contain significantly more K2 than standard muscle meat.
- Egg Yolks: The K2 is concentrated entirely in the fat of the yolk, especially in eggs from pasture-raised chickens.
- Grass-Fed Butter: Butter from cows raised on fresh green pastures contains notably higher K2 levels than grain-fed varieties.
- Dark Chicken Meat: Thighs and drumsticks contain higher concentrations of the vitamin than lean chicken breast.
- High-Fat Dairy: Whole milk, heavy cream, and full-fat yogurt from grass-fed animals
Kark
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).
- Medical News Today
Medical news and health news headlines posted throughout the day, every day.
- Medscape (Professional level)
Latest medical news and expert commentary in your specialty as well as disease information.
- Healthline
Medical Information and health advice you can trust
- EveryDay Health
Wellness inspired. Wellness enabled.
- Pharmaceutical Journal (Professional level)
The Pharmaceutical Journal covers analysis, features, opinion, learning and careers articles, providing insight and knowledge about drugs, pharmacy practice, medicines use and healthcare policy in the context of the pharmacy profession and pharmaceutical science.
- NHS
Find information and advice on health conditions, symptoms, healthy living, medicines and how to get help (British National Health Service).
- WebMD
Better Information. Better Health.
- Cleveland Clinic
Pushing the Standards of care.
- Mayo Clinic
No.1 Hospital in the Nation (America)
- Drugs.com
Know more. Be sure.
- National Organisation of Rare Diseases
NORD is dedicated to supporting education, elevating care, advancing research, and driving policy for rare diseases.
- Verywell Health
Know more. Fell better.
- Nathnac
Travel health guidance for health professionals advising travellers and for travellers going overseas from the UK.
- DR Axe
Health and fitness news. Recipes, Natural Remedies
- Better health - NHS
Healthy changes start with little changes. Whether you want to lose weight, drink less alcohol, get active or quit smoking, you have access to lots of free tools and support through Better Health. You can also find simple ways to lift your mood with Every Mind Matters.
There has never been a better time to kickstart your health. Let’s do this!