Is your body low in calcium? Let's talk about hypocalcemia!

Have you ever heard of low calcium in the body? You may be affected by this condition without even knowing it. We all know how important calcium is for our bones. But calcium is essential for many other things in our body. So, today we will talk about this condition of low calcium levels in the blood, which is called hypocalcemia . Don't worry, this is a condition that can often be treated and cured.

What is calcium? Why is it so important to us?

Simply put, calcium is a very important and common mineral in our bodies. It helps with more than you might think.

• Strengthens bones and teeth: This is the most important thing we all know. The majority of calcium in our body is stored in our bones.
• Calcium is also needed in the blood: Not only in the bones, but also in our blood, there must be a certain amount of calcium. The calcium in this blood is:
• Helps our nervous system function .
• It helps our muscles contract and relax (which means we move).
• It helps blood clot when we get injured.
• It helps our heart work properly .

Imagine, if the calcium level in our blood decreases (hypocalcemia), our body will have difficulty performing these important processes properly.

Importantly, if we don't get enough calcium from our diet, our bodies will take the calcium from our bones and add it to our blood. This can weaken our bones. However, `Hypocalcemia` is a decrease in calcium in the blood, not just a decrease in calcium in the bones.

The level of calcium in our blood and bones is controlled by two main hormones: Parathyroid Hormone (PTH) and Calcitonin . Vitamin D is also very important for maintaining calcium levels. Vitamin D is essential for the body to absorb the calcium we eat.

Who can develop hypocalcemia?

This condition of low calcium can occur in anyone of any age, even very young babies. The age at which it occurs is usually determined by the cause. For example, if this condition occurs in a young baby, it is most likely due to a genetic disorder.

It's hard to say exactly how common this is, as it's often a side effect of another condition. However, it's common to see this condition after surgery to remove the thyroid gland (thyroidectomy) . Some studies suggest that between 7% and 49% of people may experience temporary hypocalcemia after thyroid surgery.

What are the symptoms of this calcium deficiency?

Some people have a small amount of calcium in their body but do not show any symptoms. The symptoms depend on the degree of calcium deficiency - that is, whether the condition is `mild` or `severe`.

Symptoms of mild calcium deficiency:

• Muscle cramps: Especially in the back and legs. Imagine that you're sleeping at night and suddenly your leg feels like it's going numb, that's what it feels like.
• Dry, scaly skin.
• Brittle nails.
• Hair becoming coarser than usual.

If this mild condition is not treated properly, over time, symptoms that affect the nervous system (`neurologic`) or mental health (`psychologic`) can develop. These include:

• Confusion.
• Memory problems.
• Frequent irritability or restlessness.
• Depression.
• Hallucinations: This means seeing things that are not really there.

Symptoms of severe hypocalcemia:

This is a dangerous condition that occurs when the calcium level in the blood drops too low.

• Tingling of the lips, tongue, fingers and/or feet.
• Muscle aches.
• Difficulty breathing due to tightening of the throat muscles (laryngospasm). This is a bit dangerous.
• Muscle stiffness and twitching (Tetany).
• Seizures.
• Heartbeat abnormalities (Arrhythmia).
• Congestive heart failure.

If you have any of these severe symptoms, it is very important to seek medical advice immediately.

Why does calcium in our body decrease? What are the reasons?

Our bodies have a complex process of maintaining stable levels of calcium in the blood. Therefore, hypocalcemia can be caused by a variety of health conditions and diseases.

Most of the time, the main cause of this is a problem with your parathyroid hormone (PTH) levels or vitamin D levels . This is because PTH helps control calcium in the blood, and vitamin D helps the body absorb calcium.

The three most common reasons are:

1. Hypoparathyroidism: This occurs when the parathyroid glands (four small glands located behind the thyroid gland) in your neck do not produce enough PTH. When PTH levels are low, calcium levels in your body also drop. This can be due to genetics, surgery to remove one or more parathyroid glands, or the thyroid gland.

2. Vitamin D deficiency: If you don't have enough vitamin D, your body can't absorb calcium properly. This causes low blood calcium levels. Vitamin D deficiency can be caused by genetics, not getting enough sunlight, or not getting enough vitamin D from your diet.

3. Kidney failure / Renal failure: People with chronic kidney disease may develop hypocalcemia. This is due to increased phosphorus levels in the blood and a decrease in a special type of vitamin D produced by the kidneys.

There are other reasons too:

• Certain medications: For example, certain medications such as `Bisphosphonates`, `Corticosteroids`, `Rifampin`, `Calcitonin` can cause calcium deficiency. Talk to your doctor about the medications you are taking.
• Pseudohypoparathyroidism: This is a genetic condition. What happens here is that, although the body has normal levels of the hormone PTH, the body does not respond to it properly.
• Hypomagnesemia: This is a low level of magnesium in the blood. The parathyroid glands need magnesium to make and release the hormone PTH. If magnesium is low, less PTH is produced, which in turn causes calcium levels to drop.
• Pancreatitis: Between 15% and 88% of people with acute pancreatitis may develop hypocalcemia.
• Rare genetic diseases: This condition can also be caused by certain genetic mutations, such as `DiGeorge syndrome`.

How do I find out if I have this condition?

If your total serum calcium concentration is less than 8.8 mg/dL, you may have hypocalcemia. Sometimes, mild hypocalcemia is discovered incidentally when a blood test is done for something else.

It is very important to find out that this condition exists, as well as to find out what causes it.

Your doctor may order tests like these to find the cause of the condition and to see if it is affecting other parts of the body:

• Other blood tests: Check your magnesium, phosphorus, PTH hormone and/or vitamin D levels.
• ECG (Electrocardiogram): This measures your heart rate by placing electrodes on your chest. Hypocalcemia can cause irregular heartbeats.
• Bone imaging tests: These can be used to see if you have calcium problems in your bones (such as osteomalacia or rickets).

How is calcium deficiency treated?

Oral calcium supplements are often given as a treatment for this. It is also essential to find out what is causing the low calcium and treat it. Imagine that the low calcium is due to a medication you are taking, and then the doctor may change the medication or increase or decrease the dosage.

What are the medications and treatments used for this?

• Calcium tablets: These are given to normalize the calcium level in the blood.
• Vitamin D supplement: People with chronic calcium deficiency are often given vitamin D supplements along with calcium pills. This is how the body can properly absorb calcium.
• Synthetic PTH: If you have low calcium levels due to hypoparathyroidism, your doctor may give you synthetic PTH.
• Intravenous calcium gluconate (IV calcium gluconate): If your calcium levels are very low and you have severe symptoms such as muscle twitching (tetany), you may be given a calcium gluconate solution given intravenously in a hospital.
• Other medications: Depending on the cause of low calcium, you may need to take other medications to treat/manage that cause.

What are the risk factors for developing hypocalcemia?

People who are more likely to develop this condition are:

• For those with vitamin D deficiency .
• For those who have had parathyroid gland disease or parathyroid gland surgery .
• For those who have had surgery to remove the thyroid gland (`thyroidectomy`) .
• If anyone in the family has genetic conditions (such as certain gene mutations, genetic vitamin D diseases, DiGeorge syndrome).

Is there a way to prevent this?

Unfortunately, there is nothing you can do to prevent hypocalcemia. While it may seem like you can prevent it by eating foods high in calcium, the amount of calcium you eat doesn't directly affect your blood calcium levels. However, getting enough calcium is important for bone health.

What is the outlook for this condition? (Prognosis)

The good news is that hypocalcemia is a treatable condition. Once your calcium levels return to normal, the symptoms will go away.

However, if left untreated, severe hypocalcemia can be life-threatening due to complications such as seizures and congestive heart failure. Therefore, see a doctor if you have symptoms. If your symptoms are severe, go to the nearest hospital.

How long this condition lasts varies depending on the cause. It may be temporary or lifelong (`chronic`). Ask your doctor how long this will last and how long you will need to take medication.

If left untreated, hypocalcemia can be fatal, so be aware of the symptoms.

When should you see a doctor?

If you have symptoms of hypocalcemia , be sure to see a doctor. If you have chronic hypocalcemia, it's important to see your doctor regularly to make sure your calcium levels are normal and that your treatment is working properly.

What questions should I ask the doctor if I have this condition?

Once you know you have hypocalcemia, it may be helpful to ask your doctor or nurse these questions:

• Why did I develop this hypocalcemia?
• How long will I have this condition?
• How long will I have to take medication for this?
• How long does it take for the symptoms to go away after starting the medication?
• Are my children or other family members at risk of developing this condition?

It's normal to feel scared when you learn that you have a condition. But remember, hypocalcemia is treatable. With treatment, your calcium levels will return to normal and your symptoms will go away. Don't be afraid to ask your medical team questions about your condition and the treatment you're receiving.

Take-Home Message

So, hypocalcemia, or low blood calcium, is something we should be concerned about, but it is not something to be afraid of. It can often be treated and improved. The most important thing is to seek medical advice without wasting time if you experience symptoms. If you follow the treatment your doctor recommends, you can recover quickly. Stay healthy!

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