Hypocalcemia

Things You Can Do For Hypocalcemia:
Make sure you take in enough calcium if your blood test results indicate hypocalcemia. The recommended intake of calcium daily, for bone health, is based on your age and race. If you are: o A man, age 25 to 65 years - take 1000 mg of calcium a day. o A man over the age of 65 years - take 1500 mg of calcium a day o A woman from age 25-50 - take 1000 - 1200 mg of calcium a day. o A woman over the age of 50 years - take 1500 mg of calcium a day. Calcium, in any form, needs vitamin D to be absorbed. Take 400-800 mg of Vitamin D with your calcium supplements per day; to ensure that the calcium you take is being absorbed. To increase your dietary intake of calcium, choose your foods wisely. o Greens (collard and kale) o sardines and salmon (with bones) o Red beans o seaweed Dairy products contain the most calcium: o 8 oz. of milk or yogurt will provide 300 mg. of calcium. o 1 oz. of cheddar cheese will provide 200 mg of calcium. o 4 oz. of Tofu will give you 250 mg. of calcium. Many cereals, orange juices, and other foods are fortified with calcium. Read the labels of your food items carefully. If you do not take in enough calcium during hypocalcemia, especially if you have taken steroids for your disease that may cause "bone thinning," you are at risk for long term complications of bone loss (osteoporosis). You may be at a higher risk for fractures, curved spine, and loss of height. Discuss with your healthcare provider if calcium replacement therapy is right for you.
Severe constipation, unrelieved by laxatives, lasting 2 to 3 days. Nausea that interferes with your ability to eat, and is unrelieved by any prescribed medications. Vomiting (vomiting more than 4-5 times in a 24 hour period). Diarrhea (4-6 episodes in a 24-hour period), unrelieved with taking anti-diarrhea medication and diet modification. Excessive sleepiness, confusion. Muscle twitching or Irritability. Increased urination. Poor appetite that does not improve.
Return to list of Blood Test Abnormalities Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice. History and Physical Assessment. Most hypocalcemia is asymptomatic, but there may be historical clues to conditions associated with hypocalcemia. For example, patients may report chronic diarrhea or inflammatory bowel disease that could interfere with vitamin D or calcium absorption, previous neck surgery that might have injured or removed the parathyroid glands, or a seizure disorder requiring anticonvulsant use. With more severe hypocalcemia, patients may manifest symptoms of neuromuscular irritability and muscle spasm, changes in mentation, seizure, palpitation, and syncope. Two well-known neuromuscular physical findings in patients with hypocalcemia are Chvostek's and Trousseau's signs. Chvostek's sign is contraction of the facial nerve muscles and upper lip in response to percussion of the ipsilateral facial nerve. Trousseau's sign is elicited after 3 minutes of inflating a blood pressure cuff on the arm to an abovenormal systolic blood pressure level (approximately 20 mm Hg above); this results in involuntary flexion of the wrist and in the metacarpophalangeal and interphalangeal joints of the extremity. In extreme hypocalcemia, mental status changes can progress from mental confusion to movement disorders (eg, hemiballism) and seizures. Patients also may develop cardiac manifestations of hypocalcemia, with a widening of the QT interval and malignant cardiac rhythm disturbances. Laboratory Assessment. Hypocalcemia is defined as a serum calcium level less than 8.8 mg/dL or less than 4.2 mg/dL of ionized calcium. In hypocalcemia caused by hypoparathyroidism, PTH levels are low or inappropriately normal. High PTH levels in hypocalcemia are indicative of PTH resistance due to chronic kidney disease or hypomagnesemia. Because PTH decreases renal tubular phosphate absorption and promotes its excretion, PTH deficiency-related hypocalcemia is associated with hyperphosphatemia. Low levels of 25(OH) vitamin D suggest dietary deficiency of vitamin D malabsorption and inadequate ultraviolet light exposure. Low levels of 1,25(OH)2 vitamin D and elevated PTH are consistent with findings in hypocalcemia caused by chronic renal disease.
Drugs That May Be Prescribed By Your Doctor For Hypocalcemia:
As with all types of electrolyte imbalance, the treatment of hypocalcemia is based on correcting the cause. If there is a dysfunction of your endocrine or hormone system, you may be referred to an endocrinologist. If it is due to medications or treatments, these may be altered or removed, if possible. For severely decreased levels a calcium infusion could be ordered. Calcium pills or supplements. Follow instructions. If you have mildly reduced blood calcium levels, increasing your dietary intake of calcium (see above) may be recommended.
When To Call Your Doctor or Health Care Provider About Hypocalcemia:
Treatment. In emergency settings, hypocalcemia is treated with calcium gluconate via intravenous (IV) infusion. If hypomagnesemia is present, it also must be corrected. The treatment must proceed with caution, including monitoring for cardiac rhythm disturbances, especially in patients who are taking digitalis, because of the potential for hypocalcemia to increase digitalis toxicity. These acute management interventions should be accompanied by a search for the etiology and initiation of long-term therapy to prevent recurrence of hypocalcemia. In hypoparathyroidism, oral calcium supplementation as calcium carbonate should be administered (typically 2 g, 3 times a day) as the transition from IV to oral therapy is made; chronic therapy is then continued as
calcium carbonate (1 g/day with meals) along with vitamin D supplementation or the use of calcitriol. In chronic renal disease, supplemental calcium along with vitamin D to suppress PTH levels and to minimize hyperphosphatemia is required. In patients with severe hyperphosphatemia and hypocalcemia, serum phosphate binders are administered before calcitriol is begun if the calcium level is less than 6 mg/dL. Long-term therapy includes monitoring urinary calcium excretion to ensure that calcium therapeutic mobilization from bone is not excessive (ie, urinary calcium greater than 250 mg/dL/day). For patients with chronic renal disease, diets high in calcium and low in phosphates should be emphasized.

Hypocalcemia

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Hypocalcemia

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Things You Can Do For Hypocalcemia:

Drugs That May Be Prescribed By Your Doctor For Hypocalcemia:

When To Call Your Doctor or Health Care Provider About Hypocalcemia:

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