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Hypocalcemia

What is hypocalcemia?

Hypocalcemia is a condition in which there are lower-than-average levels of calcium in the liquid part of the blood, or the plasma. Calcium has many important roles in your body:

  • Calcium is key to the conduction of electricity in your body.
  • Your nervous system needs calcium to function properly. Your nerves need calcium to relay messages between your brain and the rest of your body.
  • Your muscles need calcium to move.
  • Your bones need calcium to stay strong, grow, and heal.

Hypocalcemia may be the result of low calcium production or insufficient calcium circulation in your body. A deficiency of magnesium or vitamin D is linked to most cases of hypocalcemia.

What are the symptoms of hypocalcemia?

Some people don’t have any symptoms or signs of hypocalcemia. As it affects the nervous system, babies with the condition may twitch or tremor. Adults who do have symptoms may experience:

  • muscle stiffness
  • muscle spasms
  • paresthesias, or feelings of pins and needles, in the extremities
  • changes in mood, such as anxiety, depression, or irritability
  • memory issues
  • hypotension
  • difficulty speaking or swallowing
  • fatigue
  • parkinsonism
  • papilledema, or swelling of the optic disc

The symptoms of severe hypocalcemia are:

  • seizures
  • arrhythmias
  • congestive heart failure
  • laryngospasms, or seizures of the voice box

The long-term symptoms of hypocalcemia include:

  • dry skin
  • brittle nails
  • kidney stones or other calcium deposits in the body
  • dementia
  • cataracts
  • eczema

What causes hypocalcemia?

The most common cause of hypocalcemia is hypoparathyroidism, which occurs when the body secretes a less-than-average amount of parathyroid hormone (PTH). Low PTH levels lead to low calcium levels in your body. Hypoparathyroidism can be inherited, or it can be the result of surgical removal of the thyroid gland or cancer of the head and neck.

Other causes of hypocalcemia include:

  • not enough calcium or vitamin D in your diet
  • infections
  • some medications, such as phenytoin (Dilantin), phenobarbital, and rifampin
  • stress
  • anxiety
  • intense exercise
  • irregular magnesium or phosphate levels
  • kidney disease
  • diarrhea, constipation, or other intestinal disorders that prevent your body from absorbing calcium properly
  • a phosphate or calcium infusion
  • cancer that’s spreading
  • diabetes in the mother, in the case of infants

Who is at risk for hypocalcemia?

People with a vitamin D or magnesium deficiency are at risk of hypocalcemia. Other risk factors include:

  • a history of gastrointestinal disorders
  • pancreatitis
  • kidney failure
  • liver failure
  • anxiety disorders

Newborn babies are at risk because their bodies aren’t fully developed. This is especially true for children born to diabetic mothers.

How is hypocalcemia diagnosed?

The first step in diagnosis is a blood test to determine your calcium levels. Your doctor may also use mental and physical exams to test for signs of hypocalcemia. A physical exam may include a study of your:

  • hair
  • skin
  • muscles

A mental exam may include tests for:

  • dementia
  • hallucinations
  • confusion
  • irritability
  • seizures

Your doctor may also test for Chvostek’s and Trousseau’s signs, which are both linked to hypocalcemia. Chvostek’s sign is a twitching response when a set of facial nerves is tapped. Trousseau’s sign is a spasm in the hands or feet that comes from ischemia, or a restriction in blood supply to tissues. Twitching or spasms are considered positive responses to these tests and suggest neuromuscular excitability due to hypocalcemia.

How is hypocalcemia treated?

Some cases of hypocalcemia go away without treatment. Some cases of hypocalcemia are severe and can even be life-threatening. If you have an acute case, your doctor will most likely give you calcium through your vein, or intravenously. Other treatments for hypocalcemia include:

Medications

Many hypocalcemia cases are easily treated with a dietary change. Taking calcium, vitamin D, or magnesium supplements, or eating foods with these can help treat it.

Home care

Spending time in the sun will increase your vitamin D levels. The amount of sun needed is different for everyone. Be sure to use sunscreen for protection if you’re in the sun for a long time. Your doctor may recommend a calcium-rich diet plan to help treat it as well.

What is the outlook for people with hypocalcemia?

The symptoms often go away with proper treatment. The condition is rarely life-threatening. In many cases, it goes away on its own. People with chronic hypocalcemia may need medication throughout their lives.

People with hypocalcemia are at risk of developing osteoporosis because their bones release calcium into the bloodstream, instead of using it. Other complications include:

  • kidney stones
  • kidney failure
  • abnormal heartbeats, or arrhythmia
  • nervous system issues

Maintaining healthy calcium levels in your body is key to preventing this condition. Eat calcium-rich foods and if you don’t get enough vitamin D or magnesium, you may need to add supplements of them to your diet, as well as calcium supplements.


Content licensed from:

Written by: Heaven Stubblefield
Medically reviewed on: Jul 11, 2016: Deborah Weatherspoon, PhD, RN, CRNA, COI

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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