Hypocalcemia is a decrease in blood calcium levels that, in most cases, does not cause any symptoms and is usually identified in the blood test result. However, when the amount of calcium is very low, severe symptoms such as muscle spasms, mental confusion and seizures can occur.
Generally, hypocalcemia arises when the body is unable to maintain normal circulating levels of free calcium, as in hypoparathyroidism or lack of vitamin D, for example, and treatment is done according to the cause, taking into account the severity of and whether there are symptoms or not, calcium supplementation being necessary.
Calcium is an essential mineral for bone health and the body's metabolism, and its levels in the blood are regulated essentially by the parathyroid gland and vitamin D, which balance calcium absorption in food, distribution in bones and the body or their elimination by the kidneys. Check out more about the functions and the benefit of calcium for the body.
What are the causes
The main causes of hypocalcemia include:
- Hypoparathyroidism, especially when there is injury or removal of parathyroid glands, which can happen through neck surgery, such as during thyroid removal, or irradiation during cancer treatment, for example; Pseudohypoparathyroidism, when the body loses sensitivity and does not can respond to levels of PTH, which is the parathyroid hormone; Deficiencies in parathyroid development, such as DiGeorge syndrome, which affects babies; Vitamin D deficiency; Low calcium intake or malabsorption; Kidney diseases, which hinder activation vitamin D and can cause greater excretion of calcium in the urine; Side effect of certain medications, such as Asparaginase, Cisplatin, Rifampicin, Ketoconazole, anticonvulsants or bisphosphonates, for example; Changes in the levels of other minerals that interfere with calcium levels, such as excess phosphate or lack of magnesium; chronic alcoholism.
In addition, hypocalcemia can be a complication of acute pancreatitis, as the fatty acids released by the inflamed pancreas can interfere with the amount of calcium.
How to confirm
Hypocalcemia is diagnosed by measuring free calcium in the blood, called ionic calcium, which is below normal levels, which should be between 4 to 5 mg / dl and the total calcium dosage indicates that it is missing when below 8, 5 mg / dl. However, these values may vary depending on the laboratory that performs the examination. Also check out what happens when there is excess calcium in your blood.
However, the doctor may still need to do kidney tests, hormones and levels of other components in the blood, such as PTH, vitamin D, phosphorus and magnesium levels, for example, to identify the possible cause of the problem.
Main symptoms of Hypocalcemia
Although hypocalcemia does not show symptoms in the mildest cases, when calcium levels become too low or drop abruptly, signs such as:
- Muscle cramps and spasms; Tingling in the mouth, hands and feet; Convulsions; Sweating; Nausea and vomiting; Abdominal cramps; Asthma crisis.
When hypocalcemia is chronic and appears gradually, as in hypoparathyroidism, dry skin, brittle nails, hair loss and tooth erosion may also be noticed, as well as nervousness, anxiety, mental confusion, altered memory and tremors. Learn about other common symptoms of this problem.
How the treatment is done
The treatment of hypocalcemia depends on the cause, the severity of the condition and the presence or absence of symptoms. When there is severe hypocalcemia and symptoms, calcium replacement, such as calcium gluconate or calcium chloride, is required through the vein until symptoms are relieved.
In cases of mild hypocalcemia, calcium supplements and increased food intake with calcium may be indicated. See a list of foods rich in calcium.
It is also necessary to investigate the cause and resolve it, which may include magnesium replacement, vitamin D, as well as treatment of renal or parathyroid disorders, if they are the reason for hypocalcemia.
