What is hypocalcimia?

Hypocalcemia is defined as a total serum calcium concentration < 8.8 mg/dL (< 2.20 mmol/L) in the presence of normal plasma protein concentrations or as a serum ionized calcium concentration < 4.7 mg/dL (< 1.17 mmol/L).

1. What causes hypocalcemia?
2. What happens when you have hypocalcemia?
3. What is the most significant symptom of hypocalcemia?
4. How do you fix hypocalcemia?
5. Is low calcium an emergency?
6. Who is most at risk for hypocalcemia?
7. How the neurologic system is affected by hypocalcemia?
8. How does hypocalcemia affect the heart?
9. What is the first line treatment for hypocalcemia?
10. What level of calcium is considered hypocalcemia?
11. What are the complications of hypocalcemia?
12. What is the difference between hypercalcemia and hypocalcemia?

What causes hypocalcemia?

Causes of hypocalcemia

Vitamin D inadequacy or vitamin D resistance. Hypoparathyroidism following surgery. Hypoparathyroidism owing to autoimmune disease or genetic causes. Renal disease or end-stage liver disease causing vitamin D inadequacy.

What happens when you have hypocalcemia?

Hypocalcemia, also known as calcium deficiency disease, occurs when the blood has low levels of calcium. A long-term calcium deficiency can lead to dental changes, cataracts, alterations in the brain, and osteoporosis, which causes the bones to become brittle. A calcium deficiency may cause no early symptoms.

What is the most significant symptom of hypocalcemia?

As hypocalcemia progresses, muscle cramps are common, and people may become confused, depressed, and forgetful and have tingling in their lips, fingers, and feet as well as stiff, achy muscles. Usually, the disorder is detected by routine blood tests. Calcium and vitamin D supplements may be used to treat hypocalcemia.

How do you fix hypocalcemia?

In patients with acute symptomatic hypocalcemia, intravenous (IV) calcium gluconate is the preferred therapy, whereas chronic hypocalcemia is treated with oral calcium and vitamin D supplements. The treatment of hypocalcemia will be reviewed here.

Is low calcium an emergency?

Severe hypocalcemia, defined by a serum calcium <1.9 mmol/L (7.6 mg/dL), is often considered an emergency because of a potential risk of life-threatening cardiac arrhythmias or seizures (6, 7, 8, 9, 10, 11).

Who is most at risk for hypocalcemia?

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.

How the neurologic system is affected by hypocalcemia?

The nerve endings in your muscle cells release calcium ions, which then bind to activator proteins which signal your muscles to contract and relax. Insufficient calcium levels lead to a condition called “neuromuscular irritability,” which is an involuntary twitching or spasming of the muscles and nerves.

How does hypocalcemia affect the heart?

THE BEST KNOWN clinical effect on the heart of hypocalcemia is prolongation of the QT interval, ie, prolongation of electrical systole. Only recently has cardiac arrhythmia been reported as a clinical manifestation of hypocalcemia.

What is the first line treatment for hypocalcemia?

In severe hypocalcemia, IV calcium is used initially, with transition to oral calcium. For mild hypocalcemia, oral calcium could be used for initial treatment. 1 gram calcium chloride (if central access) or 2-3 grams calcium gluconate (via peripheral line). Either may be infused over 10-20 minutes.

What level of calcium is considered hypocalcemia?

Concentrations of total calcium in normal serum generally range between 8.5 and 10.5 mg/dL (2.12 to 2.62 mmol/L), and levels below this are considered to be consistent with hypocalcemia. The normal range of ionized calcium is 4.65 to 5.25 mg/dL (1.16 to 1.31 mmol/L).

What are the complications of hypocalcemia?

Neurologic complications of hypocalcemia include acute seizures or tetany, basal ganglia calcification, parkinsonism, hemiballismus, and choreoathetosis. Although some patients with hypocalcemia may improve with treatment, the calcification typically is not reversible.

What is the difference between hypercalcemia and hypocalcemia?

When the calcium levels in your blood become abnormal, your body might experience harmful symptoms. Hypocalcemia denotes a lower than average amount of calcium, while hypercalcemia is an overabundance of calcium.