Hypocalcemia Cause and Treatment

Hypocalcemia occurs when the level of calcium in your blood, not your bones, is very low. Hypocalcemia can cause many different health conditions. Symptoms of hypocalcemia depend on how mild or severe it is.

It is a treatable disease that can last for a short period or be chronic depending on the cause. Here we will learn about all that information about this disease.

What is Calcium? What Does It Do?

Calcium is one of the most important and common minerals in the body. Most of the calcium in your body is stored in your bones, but calcium is needed in the blood, too.

The calcium in your blood helps your nerves function, helps force and squeeze your muscles together so you can move, helps blood clot if you’re bleeding and helps your heart work properly. Therfore, a low blood calcium level, i.e. hypocalcemia, can impair your body’s ability to perform these important functions, you also need calcium in your bones to make them strong.

If you don’t get enough calcium in your diet, your body takes calcium from your bones to use in your blood, which can weaken your bones. Hypocalcemia occurs when there are low levels of calcium in your blood and not in your bones, so we are talking about hypocalcemia here.

Calcium levels in the blood and bones are controlled by two hormones, parathyroid hormone and calcitonin. Vitamin D also plays an important role in maintaining calcium levels because it is necessary for your body to absorb calcium. When you maintain an appropriate level of this vitamin, calcium will be stored in the body.

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What is Hypocalcemia

To study this disease we first need to know what it means to have a calcium deficiency:

Hypocalcemia is a medical condition characterized by low levels of calcium in the blood serum, where the normal range of calcium in the blood is usually between 2.1 – 2.6 mmol/L (8.8 – 10.7 mg/dL) while levels less than 2.1 mmol/L are defined as It is hypocalcemia.

Who Suffers from Hypocalcemia?

Is it true that calcium deficiency is associated with aging?

This information is completely wrong, and the fact is that hypocalcemia can affect people of all ages, including children.

The age at which someone can develop hypocalcemia usually depends on the cause, for example if an infant has hypocalcemia it is usually due to a genetic disorder.

Hypocalcemia Symptoms

People with mild hypocalcemia often do not show any symptoms, that is, they are asymptomatic. Symptoms of hypocalcemia depend on whether they are mild or severe, but there are simple signs that you can recognize when you have mild hypocalcemia.

Symptoms of mild hypocalcaemia include:

It often appears as muscle spasms, especially in your back and legs.
Dry, scaly skin
Sometimes brittle nails.
Coarser hair than is normal for you.

If left untreated, hypocalcemia over time can cause neurological symptoms affecting the nervous system, or psychological symptoms affecting the mind, including these:

Confusion.
Memory problems
Irritability or anxiety
Depression.
Hallucination.

Severe hypocalcemia, when there are very low levels of calcium in your blood, can cause the following symptoms:

Tingling in the lips, tongue, fingers or toes.
Muscle pain.
Muscle spasms in your throat that make breathing difficult (Laryngospasm).
Stiffness and spasms of your muscles (tetany).
Seizures.
Arrhythmia.
Congestive heart failure.

Hypocalcemia Causes

There are a number of causes of hypocalcaemia, so let’s get to know them in turn:

Hypoparathyroidism.
Pseudohypoparathyroidism.
Kidney disease.
Vitamin D deficiency.

Hypoparathyroidism

The parathyroid glands are four small, pea-sized glands located behind the thyroid gland in the neck.

Hypoparathyroidism occurs when these glands do not produce enough parathyroid hormone. Low levels of parathyroid hormone lead to low levels of calcium in the body.

You could have hypoparathyroidism as a result of a genetic disorder or from having your thyroid gland surgically removed.

Hypoparathyroidism causes hypocalcemia and hyperphosphatemia and often causes chronic tetany.

Transient hypoparathyroidism is common after thyroidectomy, but permanent hypoparathyroidism occurs after 3% of thyroidectomies.

Symptoms of hypocalcemia usually begin about 24 to 48 hours after surgery but may occur months or years later.

Hypothyroidism is more common after radical thyroidectomy for cancer or as a result of surgery on the parathyroid glands (thyroidectomy).

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Pseudohypoparathyroidism

Pseudohypoparathyroidism is an uncommon group of disorders characterized not by hormone deficiency, but by target organ resistance to the hormone produced by the parathyroid glands.

Patients usually present with hypocalcemia and hyperphosphatemia.

Malformations may occur due to hypocalcemia-induced pseudohypoparathyroidism which include malformations associated with short stature, round face, intellectual disability with calcification of the basal ganglia, short metatarsals, mild hypothyroidism and other endocrine abnormalities.

It has two main types. Type 1 pseudohypoparathyroidism is caused by a protein mutation, and is less common. Affected patients have hypocalcemia, hyperphosphatemia, and secondary hyperparathyroidism, but do not have the other associated abnormalities.

Vitamin D Deficiency

Vitamin D helps your body absorb calcium properly. So a lack of vitamin D in the body can cause low levels of calcium in the blood (hypocalcemia). Vitamin D deficiency can be caused by a genetic disorder, not getting enough sunlight, or not getting enough vitamin D.

Kidney Failure

Hypocalcemia in chronic renal failure is caused by an increased level of phosphorus in the blood and decreased production by the kidneys of a certain type of vitamin D.

Other Causes

Other causes of hypocalcaemia include:

Acute pancreatitis.
Medications including seizure medications such as phenytoin, phenobarbital, and rifampin that alter vitamin D metabolism, and medications generally used to treat hypercalcemia.
Hungry bone syndrome: This syndrome appears after parathyroidectomy, after kidney transplantation, and rarely in patients with renal disease.
Hyperphosphatemia.
Hypoproteinemia: The protein-binding fraction reduces calcium in the blood. Hypocalcemia due to decreased protein binding is asymptomatic because the ionized calcium remains unchanged. This entity is called factitious hypocalcaemia.
Magnesium depletion: It can cause a relative deficiency of parathyroid hormone and end-organ resistance to the action of parathyroid hormone, usually when serum magnesium concentrations are less than 1.0 mg/dl. Magnesium concentration increases parathyroid hormone concentrations and improves renal calcium preservation.

Although excessive calcitonin secretion would be expected to cause hypocalcemia, the effect of calcitonin on serum calcium is small. For example, low serum calcium concentrations rarely occur in patients with large amounts of circulating calcitonin due to medullary parathyroid carcinoma.

Hypocalcemia Diagnosis

It is important to know the concentration of calcium in your blood. Generally, you will have hypocalcemia if your blood calcium concentration is less than 8.8 mg/dL. Your health care provider may detect hypocalcemia incidentally from routine blood tests or through other blood tests.

Tests to Diagnose Hypocalcemia Cause

Health care providers use a blood calcium concentration test to diagnose hypocalcemia. Finding and diagnosing the cause of hypocalcemia is just as important as diagnosing hypocalcemia itself.

Your healthcare provider may perform the following tests or procedures to try to determine the cause of your hypocalcemia or to make sure your hypocalcemia isn’t affecting other parts of your body:

Other blood tests: Your healthcare provider may do more blood tests.
Vitamin D to check levels of magnesium, phosphorous, and parathyroid hormone (PTH).
Electrocardiogram (EKG), which is a procedure that uses electrodes attached to your chest to measure your heart’s rhythm. Where hypocalcemia can cause an irregular heartbeat.
Bone imaging tests: Bone imaging tests may be used to see if you have problems with calcium in your bones, such as osteomalacia or rickets.

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Hypocalcemia Treatment

If you miss your daily dose of calcium, you won’t become deficient overnight. But it’s important to get your daily requirement because the body uses it quickly.

Women need to take calcium supplements during pregnancy and lactation to avoid deficient levels during these periods. It should also be taken with menopause, as the chances of osteoporosis increase during this period. Because the decrease in estrogen may lead to a woman’s bones thinning faster.

In general, the treatment of calcium deficiency depends mainly on compensating it through diet and nutritional supplements. In the absence of any pathological problem affecting its absorption through the intestine.

Natural sources of calcium include:

Dairy products such as milk, yoghurt, cheese.
Some fish like sardines and salmon.
Beans.
Figs.
Broccoli
Tofu.
Spinach.
Avocado.
Calcium-fortified breakfast cereals and juices.
Nuts and seeds, including almonds and sesame seeds.

A doctor may recommend nutritional supplements in the form of tablets to swallow or chew, or in the form of injections if there is a problem with the absorption of calcium through the intestines, or if the deficiency is severe.

Calcium supplements should not be taken without consulting a doctor. Too much calcium may lead to a condition known as hypercalcemia, which increases the risk of cardiovascular disease, kidney stones, and other health problems.

If calcium deficiency is caused by a disease, then its treatment depends mainly on getting rid of the cause behind it. Treat the cause before treating calcium deficiency with nutritional supplements and other foods.

You should not stop taking medications that may affect calcium absorption without consulting a doctor, who usually recommends suitable alternatives.

Commonly recommended calcium supplements include:

Calcium carbonate, which is the least expensive.
Calcium citrate, which is the easiest to absorb, is therefore usually recommended in cases of bariatric surgery that affects absorption.
Calcium phosphate, which is easily absorbed and does not cause constipation.

You can expect to see results within the first few weeks of treatment, if the deficiency is severe, a follow-up of one to three months is required.

The recommended dose of calcium depends mainly on age, as children, for example, need more calcium, because their skeletal structures are still in the growth stage. And women in the menopausal stage need to increase the level of calcium because they are more vulnerable to fragility. The doctor will determine the dose according to the condition and age .

Hypocalcemia Risk Factors

Risk factors for developing hypocalcaemia can include:

Vitamin D deficiency.
Parathyroid gland disorder or surgery.
Thyroidectomy is the removal of the thyroid gland.
A family history of genetic conditions such as certain genetic mutations, a genetic vitamin D disorder or DiGeorge syndrome.

Can I Prevent Hypocalcemia?

Unfortunately, there is nothing you can do to prevent hypocalcemia. Although it may seem that eating and drinking more calcium can prevent hypocalcemia. However, a lack of calcium in your diet usually does not affect the amount of calcium in your blood. However, maintaining an adequate amount of calcium in the blood is important for bone health, and for preventing some diseases related to hypocalcemia.

Hypocalcemia Prognosis

Hypocalcemia is a treatable condition. Symptoms of hypocalcemia usually disappear once calcium levels return to normal. If left untreated, severe hypocalcemia can cause life-threatening complications such as seizures and congestive heart failure.

Be sure, my dear, to contact your health care provider if you have symptoms and go to the nearest hospital if you have severe symptoms. You must follow the symptoms that may affect you when you are in a state of calcium deficiency in the blood.

How Long Will I Suffer from Hypocalcemia?

Depending on the cause, you could have temporary or chronic (lifelong) hypocalcemia. It depends on what type of deficiency is in your body. You need to ask your health care provider how long you can expect to have hypocalcemia and how long you should take the treatmen. And when the treatment ends, your suffering will end.

Can I Die from Hypocalcemia?

Hypocalcemia can be potentially life threatening if not diagnosed and treated in a timely manner. Be sure to contact your healthcare provider if you are experiencing symptoms. You can get the right treatment.

My dear, would you allow me to summarize for you the most important lines mentioned in this article, in order to increase the benefit:

Hypocalcemia is considered a hidden disease, which may present with symptoms that are far from the patient’s expectations. These symptoms may range from invisible to mild or serious life-threatening, including but not limited to: fainting, heart failure, chest pain, numbness of sensations around the mouth, hands, and feet, difficulty swallowing, voice changes due to laryngospasm, and many more. Calcium deficiency can have serious consequences such as osteoporosis and rickets.

Therefore, it is necessary to conduct tests before taking supplements and medicines. And this should be done under medical supervision, because calcium has an important role in regulating the heartbeat, and in the transport functions between the membranes, as its deficiency leads to involuntary contractions, which are known as muscle tetany.

After menopause, maintaining acceptable levels of calcium in the body after menopause works to maintain bone health.

And since calcium reaches through the food that reaches the digestive system, we must eat all the foods that contain it, so an pound of prevention is better than a pound of cure. We hope you liked the article. Stay safe.