Hypocalcemia is low blood levels of calcium. Calcium is an electrolyte, a type of mineral that carries an electric charge when dissolved in body fluids such as blood. Most of the body's calcium is stored in bones, but some circulates in the blood.
Moderately low blood calcium levels may not cause symptoms. When hypocalcemia lasts for long periods, it can cause symptoms such as:
- Muscle cramps, often in the back and legs
- Dry scaly skin
- Brittle nails
- Coarse hair
Over time, hypocalcemia can cause:
- Confusion
- Depression
- Memory problems
- Delirium
- Hallucinations
Extremely low calcium levels may cause:
- Tingling in the lips, tongue, fingers, and feet
- Stiff, achy muscles
- Muscle spasms
- Muscle spasms in the throat can lead to difficulty breathing
- Seizures
- Abnormal heart rhythms
What Causes Hypocalcemia?
Causes of hypocalcemia (low blood calcium) include:
- Problems with the parathyroid glands
- Low levels of parathyroid hormone (hypoparathyroidism), which can occur when parathyroid glands are damaged during thyroid gland surgery
- Lack of response to normal levels of parathyroid hormone (pseudohypoparathyroidism)
- No parathyroid glands at birth (such as in DiGeorge syndrome)
- Low levels of magnesium (hypomagnesemia), which can reduce the activity of parathyroid hormone
- Diet
- Inadequate consumption of calcium
- Vitamin D deficiency
- Can be caused by inadequate sun exposure or not consuming enough vitamin D in the diet
- Kidney disorders
- This can cause more calcium to pass in urine and can cause the kidneys to be less able to activate vitamin D
- Disorders that decrease calcium absorption
- Certain drugs
- Antiseizure drugs (such as phenytoin and phenobarbital)
- Bisphosphonates (such as alendronate, ibandronate, risedronate, and zoledronic acid)
- Calcitonin
- Chloroquine
- Corticosteroids
- Plicamycin
- Rifampin
How Is Hypocalcemia Diagnosed?
Hypocalcemia is usually diagnosed with routine blood tests that measure the calcium level in the blood.
Blood tests may also be indicated to evaluate:
- Kidney function
- Levels of magnesium, phosphate, parathyroid hormone, and vitamin D
What Is the Treatment for Hypocalcemia?
Treatment for hypocalcemia includes supplementation with calcium and vitamin D. Often oral supplementation is all that is needed but, in some cases, calcium may be given intravenously (IV).
If an underlying disorder is causing low calcium levels, that disorder will need to be treated. For example, people with hypoparathyroidism may be given a synthetic form of parathyroid hormone.
If certain medications cause hypocalcemia, changing medications may help restore calcium levels. Never stop taking a prescribed medication without first talking to your doctor.
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