Hypocalcemia

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is hypocalcemia?

Calcium brings important benefits to your health and vitality. Not only is it essential for bone growth and health, but it also plays a role in nerve signal conduction to the brain, cell function, and muscle contraction. Sometimes calcium levels can become abnormally low. Hypocalcemia (low calcium in the blood) occurs when blood calcium levels in your body become deficient.

There are a number of causes of hypocalcemia, including deficiencies in magnesium, renal failure, pancreatitis, or hypoparathyroidism (low parathyroid levels; the parathyroid controls the amount and density of calcium in your bones). Hypocalcemia can also occur as a result of low levels of vitamin D, which is necessary for calcium absorption.

People with hypocalcemia may exhibit no symptoms, especially in the beginning stages, but symptoms emerge as the condition becomes more severe. These symptoms include muscle cramps and twitching, arrhythmias (irregular heartbeat), overactive reflexes, and burning or tingling sensations in the hands and feet.

Newborns and infants can develop hypocalcemia, and they must be evaluated immediately because this condition could negatively affect their growth and development. Neonatal hypocalcemia includes early and late hypocalcemia. Early hypocalcemia develops in the first few days of life. Late hypocalcemia can be attributed to feeding with formulas that have high levels of phosphate and can deplete calcium levels. This type of hypocalcemia is thought to be caused by excessive phosphate levels or problems with an underactive parathyroid gland.

Any newborn displaying signs of hypocalcemia should be evaluated immediately so that treatment can begin. Seek prompt medical care if your infant is showing symptoms of irritability, tremors, muscle twitches, and difficulty feeding.

What are the symptoms of hypocalcemia?

In adults, symptoms may not appear initially, but can occur as the condition progresses. These symptoms include muscle spasms and twitching, cardiac arrhythmias (irregular heartbeat), and a pins-and-needles (prickling) sensation in the hands and feet.

Infants with hypocalcemia may seem lethargic, irritable and slow, or they may experience seizures, tremors and twitching. They may have difficulty latching or feeding and display a poor appetite. However, these symptoms may mimic other medical conditions, so it is crucial that they are evaluated by a health care professional.

Common symptoms of hypocalcemia in adults

Symptoms of hypocalcemia include:

Common symptoms of hypocalcemia in newborns

Symptoms of hypocalcemia in newborns include:

  • Difficulty with latching and feeding
  • Irritability
  • Lethargy or sluggishness
  • Loss of appetite
  • Muscle spasms
  • Seizures and tremors

Symptoms that might indicate a serious condition

All cases of hypocalcemia can indicate a serious condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have the following serious symptoms:

  • Convulsions or seizures
  • Difficulty feeding or loss of appetite in an infant
  • Muscle spasms

What causes hypocalcemia?

Low calcium levels are thought to be caused by underactivity in the parathyroid gland, which regulates the amount of calcium in your body, or high levels of phosphorous, which can lower calcium levels. Hypocalcemia can also be caused by low levels of the protein albumin, which is manufactured in the liver, and is important in fluid regulation in the cells and tissues in your body. Deficiencies in magnesium, vitamin D, or dietary calcium are also necessary to sustain proper calcium levels. Sources of dietary calcium include dairy products (milk and cheese), as well as spinach, mustard greens, broccoli, and oranges.

Hypocalcemia can also be caused by alcoholism and its complications, including pancreatitis (inflammation of the pancreas), renal failure, and liver failure.

Common causes of hypocalcemia

Common causes of hypocalcemia include:

  • Alcoholism
  • High levels of phosphorus
  • Kidney disease
  • Lack of dietary calcium
  • Low levels of albumin, a protein made in the liver that helps regulate fluid distribution
  • Low levels of magnesium
  • Low levels of vitamin D
  • Malabsorption
  • Pancreatitis
  • Parathyroid disease

What are the risk factors for hypocalcemia?

A number of factors increase the risk of developing hypocalcemia. These include:

  • Alcoholism
  • Kidney or liver disease
  • Low dietary consumption of calcium
  • Malnutrition

How is hypocalcemia treated?

Hypocalcemia is treated with infusions to restore and replenish calcium levels in the body. These infusions may be provided by supplements that can be taken orally or administered intravenously. If the hypocalcemia is due to an underlying medical condition, treatment is also directed at that specific condition.

Hypocalcemia may resolve on its own without treatment; this is more likely if no symptoms are present. Your health care provider will determine what treatment, if any, is needed. In newborns, the assessment will be based on overall health and weight; tolerance for certain foods, medications, or therapies; and parental preference for treatment

Treatment of hypocalcemia

Treatment of hypocalcemia includes the following:

  • Intravenous calcium supplementation
  • Monitoring under medical supervision
  • Oral calcium supplementation
  • Treatment of underlying causes of hypocalcemia

What are the potential complications of hypocalcemia?

Complications of untreated hypocalcemia can seriously affect the health and development of your infant. In adults, the complications can be serious as well. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of hypocalcemia include:

  • Failure to thrive
  • Impaired brain and motor function
  • Malnutrition or nourishment
  • Osteomalacia (soft, weak bones due to lack of vitamin D during the bone-building process)
  • Osteoporosis (thinning and weakening of the bones)
  • Poor growth
  • Tetany (excessive nerve activity, causing extreme pain)
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 9
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