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Saturday, April 20, 2024
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| Article / Health / Diseases and Conditions | Post Comments |
Hypocalcemia - Low calcium levels in the body |
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| By : Dr. Sunitha , NJ, USA 17.8.2010 1 Comments Phone:- Fax:- Mail Now | |
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The normal level of calcium is 9-11 mg/dl. Calcium is necessary for bone strength, nerve conduction, muscle contraction, maintenance of heart rate and rhythm, and blood clotting. Hypocalcemia is an electrolyte imbalance indicated by a low level of calcium in the blood. It refers to the condition where calcium levels fall below 9 mg/dl. Hypocalcemia can vary from just a biochemical abnormality producing no symptoms to severe, life-threatening situations. The symptoms depend on the levels of calcium, duration of Hypocalcemia, and speed with which it develops. Causes Hypocalcemia can be caused by increased loss of calcium from the body and decreased entry of calcium into the circulation. 1. Increased loss of calcium a. Increased phosphate levels: when phosphate is expelled from the body, calcium travels with it in conditions such as : i. Renal failure ii. Muscle destruction iii. Tumor lysis iv. Phosphate administration b. Acute pancreatitis c. Wide-spread bone metastasis in prostate and breast cancer 2. Decreased entry of calcium into the circulation a. Hypoparathyroidism b. Magnesium deficiency c. Severe hypermagnesemia d. Vitamin D deficiency 3. Other causes a. Sepsis b. Surgery c. Chemotherapy Hypoparathyroidism is the most common cause. Acute pancreatitis causes calcium to deposit in the abdomen as soap. Signs and Symptoms Chronic and moderate Hypocalcemia can be asymptomatic. Acute severe Hypocalcemia can affect multiple systems such as: · CNS effects: o Irritability o Parasthesias or numbness of the fingertips o Twitching of the muscles of the face and eyes o Muscle cramps o Severe prolonged contraction of the respiratory muscles, causing stridor and even cyanosis o Seizures o Memory loss, confusion, depression and dementia o Extra pyramidal signs · Cardiovascular system o Ekg changes o Low blood pressure o Congestive heart failure · Autonomic nervous system o Smooth muscle spasm leading to biliary colic and bronchospasm o Sweating · Other o Cataracts o Dry skin o Eczema o Hyper pigmentation o Steatorrhea or frothy stools Diagnosis: - History: including that of surgery, renal insufficiency, and acute pancreatitis - Physical examination - Serum calcium levels- less than 8.2 mEq/L - 25 OH Vitamin D levels Treatment: Acute symptoms are seen when the level is below 7 mEq/L and IV calcium is recommended in a hospital setting. One hundred to 200 mg of elemental calcium is recommended in 10-20 minutes. Faster administration can cause cardiac problems, including cardiac arrest. Co-existing hypomagnesemia should also be corrected. Two milligrams of magnesium sulfate in 10-15 minutes is recommended. Acute hypophosphatemia may also have to be addressed. Chronic Hypocalcemia can be corrected by oral calcium and vitamin D supplements. Calcium carbonate 650mg Calcium gluconate 1000mg Calcium citrate 950mg Calcium lactate 300mg Normal daily dietary requirements of calcium is 1500 mg. Sources rich in calcium are milk, milk products- such as cheese and yogurt, sardines, salmon, spinach, tofu, turnip, kale and Chinese cabbage. |
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