Hypocalcemia (low blood calcium)

Chest | Endocrinology and Metabolism | Hypocalcemia (low blood calcium) (Disease)


Calcium brings important benefits to the health and vitality. Not only is it essential for bone growth and health, but it also plays a role in nerve signal conduction to the brain, cell function, and muscle contraction. Sometimes calcium levels can become abnormally low. Hypocalcemia (low calcium in the blood) occurs when blood calcium levels in your body become deficient.

People with hypocalcemia may exhibit no symptoms, especially in the beginning stages, but symptoms emerge as the condition becomes more severe. These symptoms include muscle cramps and twhiching, arrhythmias (irregular heartbeat), overactive reflexes, and burning or tingling sensations in the hands and feet.

Newborns and infants can develop hypocalcemia, and they must be evaluated immediately because this condition could negatively affect their growth and development. Neonatal hypocalcemia includes early and late hypocalcemia. Early hypocalcemia develops in the first few days of life. Late hypocalcemia can be attributed to feeding with formulas that have high levels of phosphate and can deplete calcium levels. This type of hypocalcemia is thought to be caused by excessive phosphate levels or problems with an underactive parathyroid gland.

Causes and Risk factors

There are a number of causes of hypocalcemia, including deficiencies in magnesium, renal failure, pancreatitis, or hypoparathyroidism (low parathyroid levels; the parathyroid controls the amount and density of calcium in your bones). Hypocalcemia can also occur as a result of low levels of vitamin D, which is necessary for calcium absorption.

Diagnosis and Treatment

The treatment of hypocalcemia depends on the cause, the severity, the presence of symptoms, and how rapidly the hypocalcemia developed. Hypocalcemia generally results from another disease process. Awareness of the diseases that cause hypocalcemia is important so that the cause can be identified and managed early.

Most hypocalcemic emergencies are mild and require only supportive treatment and further laboratory evaluation. On occasion, severe hypocalcemia may result in seizures, tetany, refractory hypotension, or arrhythmias that require a more aggressive approach.

In the emergency department, magnesium and calcium (in their many different forms) are the only medications necessary to treat hypocalcemic emergencies. The consulting endocrinologist may choose to prescribe any of the various vitamin D supplements depending on laboratory workup findings, and oral calcium supplementation for outpatient therapy. ...

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