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Hypocalcemia

Hi-po-cal-see-me-uh

Definition

Calcium is a mineral needed for bone health, muscle movement, and nerve function. Hypocalcemia means the level of calcium in the blood is lower than normal.

Causes    TOP

Vitamin D helps to absorb calcium from food or supplements. Once in your body, calcium may be stored in the bones or exist in the blood. It may also be excreted through the kidneys. Levels of calcium in the blood are normally regulated by hormones from the parathyroid gland. Hypocalcemia may occur if an illness or medication interferes with this process. The most common cause of hypocalcemia is kidney failure. Other causes include a diet that is too low in vitamin D or pancreatitis.

Kidney Damage

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Risk Factors    TOP

Factors that may interfere with hormones, which can lead to hypocalcemia:

  • Parathyroid problems
  • Previous thyroid surgery
  • Autoimmune diseases
  • Certain types of brain cancer
  • Genetic disorders

Factors that may decrease calcium intake:

  • Lack of vitamin D in the diet or through sunlight exposure
  • Lack of magnesium in the diet
  • Digestive problems such as inflammatory bowel disease
  • Certain medications such as diuretics or laxatives

Other factors that may increase the chances of hypocalcemia:

  • Inflammation of the pancreas—pancreatitis
  • Kidney disease or failure—too much calcium excreted
  • Certain medications such as bisphosphonates—move calcium to the bones

Symptoms    TOP

Early hypocalcemia may not have any symptoms. When symptoms do occur, they may include:

  • Fatigue
  • Muscle spasms
  • Tingling and numbness
  • Irregular heartbeat
  • Skin changes such as dry, scaly skin
  • Coarse hair that easily breaks
  • Difficulty breathing in newborns

Diagnosis    TOP

You will be asked about your symptoms and medical history. A physical exam will be done.

Testing may include:

  • Blood tests, possibly including genetic testing
  • Urine tests
  • X-rays
  • ECG to test the electrical activity of the heart

Treatment    TOP

Talk with your doctor about the best treatment plan for you. Options include:

Medications

Supplements may be given through an IV or with pills. Supplements may include:

  • Calcium
  • Vitamin D
  • Magnesium

Medications may also be given to control the condition causing the problem or to increase the amount of calcium in the blood. Medication options may include:

  • Thiazide diuretics to decrease the amount of calcium lost through urination
  • Parathyroid hormone to treat chronic hypoparathyroidism

Your current medications may be changed if they are the cause of your hypocalcemia.

Other Supportive Steps

Your doctor may advise you to increase your intake of calcium and vitamin D. You may be referred to a dietitian.

Prevention    TOP

To help reduce the chances of hypocalcemia:

  • Eat a diet that contains enough calcium and vitamin D. This is especially important during pregnancy.
  • Take calcium or vitamin D supplements if advised by your doctor.
  • Manage conditions, such as chronic kidney disease and hypoparathyroidism.

RESOURCES:

Family Doctor—American Academy of Family Physicians
https://www.familydoctor.org
The American Association of Clinical Endocrinologists
https://www.aace.com

CANADIAN RESOURCES:

The Canadian Society of Endocrinology and Metabolism
http://www.endo-metab.ca

References:

Cooper M, Gittoes N. Diagnosis and management of hypocalcaemia. BMJ. 2008;336(7656):1298-1302.
Hypocalcemia. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115897/Hypocalcemia. Updated June 27, 2017. Accessed March 26, 2018.
Hypocalcaemia. Patient website. Available at: https://patient.info/doctor/hypocalcaemia. Updated December 23, 2015. Accessed March 26, 2018.
Last reviewed March 2018 by EBSCO Medical Review Board Marcin Chwistek, MD
Last Updated: 2/12/2014

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