Hypocalcemia Symptoms – Diagnosis, Causes & Treatment of Hypocalcemia

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Read information about Hypocalcemia including symptoms, causes, diagnosis, treatment methods, misdiagnosis, patient stories, prevention, videos, prognosis and forums. It is better to get proper medical advice if any Symptoms of Hypocalcemia are found and start treatment.

Half of all calcium present in the blood is bound to proteins such as serum albumin. In case of abnormal levels of blood proteins, the plasma calcium count may be inaccurate Calcium is not only a component of bones and teeth, but is an essential ingredient aiding normal blood clotting and also for normal musclo-nervous functions. Calcium ions occur in the bones in a complex form with phosphate to form crystals of calcium phosphate while in the bloodstream, calcium is found combined with proteins and various nutrients. However, in the bloodstream, calcium also occurs in a free form.

hypocalcemia symptoms - Diagnosis,Causes & Treatments of hypocalcemia

In a healthy adult, about 47% of the calcium in the blood plasma is free form, while 53% occurs in a complex forms. It is the concentration of free calcium ions which impact nervous and muscular functions. The level of total calcium in the blood serum is normally 8.5-10.5 mg/dL, while the level of free calcium is normally 4-5 mg/dL. When the serum calcium level falls in the blood stream beyond its minimal requirement it usually results in a disease called Hypocalcemia. Severe hypocalcemia occurs when serum free calcium is under 3 mg/dL.

Causes of Hypocalcemia

Hypocalcemia can be caused by a multitude of reasons, treatments and health conditions – hypoparathyroidism, low levels of plasma magnesium, or failure to consume adequate calcium or vitamin D. Hypoparathyroidism involves the failure of the parathyroid gland to make parathyroid hormone which controls and maintains plasma calcium levels. The hormone exerts its effect on the kidneys, where it triggers the synthesis of 1,25-dihydroxyvitamin D. Thus, hypocalcemia can be independently caused by damage to the parathyroid gland or to the kidneys.

Some other reasons might also include,

Eating disorders
Excessive dietary magnesium, as with supplementation.
Prolonged use of medications/laxatives containing magnesium
Absent parathyroid hormone (PTH)
Chronic renal failure
Absent active vitamin D
Decreased dietary intake
Decreased sun exposure
Defective Vitamin D metabolism
Anticonvulsant therapy

Hypocalcemia Symptoms

The prominent symptom of acute hypocalcemia is neuromuscular irritability which might show itself through numbness and tingling of the mouth, fingertips, toes, and the perioral region. Fatigue and anxiety may occur, along with muscle cramps which can be very painful and might even progress to carpal spasm or tetany. In extreme cases of hypocalcemia, bronchial or laryngeal spasm may occur. Hypocalcemia can also result in depression, memory loss, or hallucinations. Chronic and moderate hypocalcemia can result in cataracts (damage to the eyes).

Perioral tingling and parasthesia, ‘pins and needles’ sensation over the extremities of hands and feet.
Tetany, carpopedal spasm
Fatigue
Anxiety
Muscle cramps
Polymyositis
Laryngeal spasms
Bronchial spasms

Diagnosis

Hypocalcemia is diagnosed by taking a sample of blood serum and measuring the concentration of free calcium using a calcium-sensitive electrode. As Hypocalcemia might result from several causes, a full diagnosis requires assessment of the parathyroid gland, kidneys, and of plasma magnesium concentration is recommended.

Hypocalcemia Treatment Guidelines

The preferred intravenous treatment for Hypocalcemia is Calcium gluconate which contains 90 mg of elemental calcium per 10 mL and usually 1 to 2 ampules (180 mg of elemental calcium) diluted in 50 to 100 mL of 5% dextrose is infused over 10 minutes. This can be repeated until the patient’s symptoms have cleared.

For persistent hypercalcemia, administration of dilute calcium solution over longer periods of time may be necessary. The aim here is to raise serum calcium levels by 2 to 3 mg/dL with the administration of 15 mg/kg of elemental calcium in 4 to 6 hours. Calcium should be maintained in the low-normal range. If possible, oral calcium supplementation should be initiated concurrently with 1 to 2 grams of elemental calcium and if warranted, 1,25-dihydroxyvitamin D.

Patients with cardiac arrhythmias or patients on digoxin therapy need continuous ECG monitoring during calcium replacement because calcium potentiates digitalis toxicity.

As a healthy and preventive measure, ensure that adequate amounts of calcium and vitamin D are consumed each day, either in the diet or as supplements.