Definition

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.

Causes

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

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Symptoms

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

Diagnosis

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

Treatment

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.

Prevention

To help prevent low calcium levels:

• Eat a diet with enough calcium and vitamin D.
• Take calcium or vitamin D supplements—if advised by the doctor.
• Manage related conditions, such as chronic kidney disease and hypoparathyroidism.