Hypocalcemia is when there is not enough calcium in the blood. Calcium is a mineral needed for healthy bones, muscles, and nerves.

This condition can be mild to life-threatening.


Hypocalcemia is caused by problems in how the body absorbs, balances, or keeps calcium. Calcium levels are affected by many things such as:

  • Vitamin D levels
  • Kidney function
  • Certain hormones

Risk Factors

Low calcium levels are more common in those who are very ill. It is also more common in newborn babies who are premature. Other things that raise the risk are:

  • Problems that interfere with hormones, such as:
    • Parathyroid problems and surgery
    • Previous thyroid surgery
    • Immune system problems
    • Certain types of brain cancer
    • Certain inherited disorders
  • Things that make it hard to get enough calcium, such as:
    • 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 medicines such as diuretics or laxatives
  • Inflammation of the pancreas—pancreatitis
  • Kidney disease or failure
  • Medicines such as bisphosphonates—move calcium to bone

Kidney Damage

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Early hypocalcemia may not have symptoms. When symptoms happen, they may be:

  • Muscle spasms
  • Tingling and numbness
  • Uneven heartbeats
  • Tiredness
  • Skin changes such as dry, scaly skin
  • Coarse hair that easily breaks
  • Problems breathing
  • Problems with emotions or thinking


The doctor will ask about symptoms and past health. A physical exam will be done. Blood tests will show the level of calcium.

The doctor may do other tests to look for causes or problems. They may be:

  • Urine tests
  • X-rays
  • ECG—to test the electrical activity of the heart


The goal of treatment is to get calcium back to normal levels. Underlying causes may need to be treated first.

Supplements may be given by mouth or IV. They may be:

  • Calcium
  • Vitamin D
  • Magnesium

The doctor or dietitian may advise diet changes.


To help prevent low calcium levels:


Family Doctor—American Academy of Family Physicians
The American Association of Clinical Endocrinologists


The Canadian Society of Endocrinology and Metabolism


Catalano A, Chilà D, et al. Incidence of hypocalcemia and hypercalcemia in hospitalized patients: Is it changing? J Clin Transl Endocrinol. 2018;13:9-13.
Hypocalcemia. Children's Hospital of Philadelphia website. Available at: https://www.chop.edu/conditions-diseases/hypocalcemia. Accessed August 5, 2021.
Hypocalcemia. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hypocalcemia. Accessed July 30, 2021.
Hypocalcemia. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/electrolyte-disorders/hypocalcemia. Accessed August 5, 2021.
Last reviewed July 2021 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD
Last Updated: 7/30/2021

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