Calcium deficiency (hypocalcemia) is a worldwide problem, most commonly linked with aging. Calcium is one of the essential micronutrients required to maintain bone health (98%) and muscle contraction.
The main factors regulating your body’s calcium level are parathyroid harmony (PTH), fibroblast growth factors (FGF23), vitamin D, and calcitonin. The concentration of calcium level is maintained in a narrow range. Disorders of hypocalcemia are encountered frequently in medical and surgical services. It should be treated properly because it can be life-threatening if it remains neglected in the long run.
According to the study, it is estimated that half of the world’s population has poor access to calcium, and its prevalence is increasing day by day. The current prevalence of calcium deficiency is about 27.72 %. The normal calcium level in your body is about 9-10.3 mg/dl. Hypocalcemia occurs when calcium levels fall below 8.8 mg/dl or below.
Causes of Calcium Deficiency:
Multiple factors are involved in calcium deficiency in your body, like hormonal problems, infectious diseases, and medicine-induced hypocalcemia.
1-Hormonal and Metabolic Causes:
The following are hormonal and metabolic causes of hypocalcemia or low calcium levels.
- Hypoparathyroidism
It can be post-operative, in which parathyroid glands are damaged irreversibly, or it can be due to an autoimmune disease that destroys the parathyroid gland.
- Vitamin D deficiency
Vitamin D is an important mineral that regulates the calcium level in your body. Vitamin D deficiency impairs the absorption and regulation of calcium in your body and causes calcium deficiency.
- Hyperphosphatemia
Hyperphosphatemia decreases the production of vitamin D and interferes with normal PTH functioning, resulting in calcium deficiency.
- Hypoparathyroidism
It decreases calcium turnover due to hypofunction of the gland.
Also read: Hypoparathyroidism: Symptoms, Treatment, causes
- Hypomagnesemia/hypermagnesemia
- Pregnancy
2-Genetic causes
- Pseudohypoparathyroidism
- Agenesis of the abnormal parathyroid gland (Digeorge syndrome).
3-Infectious Diseases:
- Malnutrition
- Metabolic alkalosis
- Chronic kidney disease
- Liver cirrhosis
- Acute kidney injury (AKI)
- Sepsis
- Pancreatitis
- Proton pump inhibitors therapy
4-Medicine-induced hypocalcemia:
- Use of long-term steroids therapy
- Antiepileptic drugs
- Aminoglycosides
- Bisphosphonates
- Cisplatin
- Large transfusions in traumatic hemorrhage also cause hypocalcemia due to chelation products and citrate.
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Calcium Deficiency Symptoms:
Most patients remain asymptomatic in the early stages of calcium deficiency, but symptoms develop as the disease progresses.
Symptomatology of calcium deficiency is :
Bones problems:
- Osteopenia (low bone density)
- Osteoporosis (A silent disease that weakens your bones)
Muscle problems:
- Muscle weakness
- Muscular spasms
- Muscle cramps
- Tetany
- Neuromuscular irritability
- Pain during walking or moving
- Tingling sensation in hands, arms, and feet.
- Extreme fatigability
Skin problems
- Dry skin
- Brittle nails
- Alopecia
- Psoriasis
Dental problems:
- Weaken roots
- Gums problems
- Tooth decay
- Brittle teeth
Gynecological problems
- premenstrual syndrome
Psychiatric and neurological problems:
- Depression and anxiety
- Emotional instability
- Psychosis
- Disoriented
- Memory loss
- EEG changes
- Dystonic spasm
- Increase intracranial pressure
- Dystonic spasm
Ophthalmic problems:
- Cataract
- Papilledema
Cardiac problems
- Arrhythmias ( ECG changes )
- Cardiomyopathy
- Congestive heart failure
Also Read: Magnesium For Leg Cramps What You Can Eat n Drink
Calcium deficiency diseases:
The most common calcium deficiency diseases are :
1- Osteoporosis l:
Osteoporosis is a condition in which bone density is decreased due to the alteration of bone microstructure. It weakens bone health and decreases the quality of life. It most commonly occurs in women after menopause. It occurs due to low calcium levels in your body that cause demineralization of bone.
2- Osteopenia ( low bone mineral density). Osteopenia increases the chance of getting osteoporosis.
3-Rickets (due to vitamin D deficiency in children.)
4-Cardiac arrhythmias (a life-threatening condition caused by calcium deficiency because calcium plays a vital role in the heart’s contraction.)
5-Tetany (involuntary muscle contractions due to low blood calcium levels)
How To Treat Calcium Deficiency?
Treatment of calcium deficiency depends upon the severity of the disease.
Intravenous calcium is given if the calcium level falls below 1.9mmol/l. Cardiac monitoring should be done during intravenous calcium infusion because rapid correction can cause arrhythmia.
Moreover, carefully monitor calcium levels because high calcium levels increase the risk of renal stones and cardiovascular diseases.
Oral calcium and vitamin D tablets are also available to manage calcium deficiency.
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Dietary advice:
Some foods are rich in calcium and should be used to overcome calcium deficiency. These foods include:
- Broccoli
- Soy milk
- Spinach
- Cereals
- Beans
- Nuts
- Dairy products like milk, yogurt, and cheese.
When to see a doctor?
Book your appointment with your doctor when you have symptoms like muscle aches, weakness, spasms, irritability, and confusion. Your doctor will ask you for a test and check your calcium level.
What is The Recommended Dose of Calcium:
The recommended dose of calcium is about 1000 mg/day for adults (19-50 years of age). And it is about 1200 mg/ per day for older people.
Summary!
Calcium deficiency is the most common problem worldwide. Multiple biological, chemical and genetic factors cause calcium deficiency. It requires prompt treatment after diagnosis. Otherwise, it can cause life-threatening cardiac and neurological problems. People who receive proper treatment get better results in a few weeks.
References:
- Catalano A, Chilà D, Bellone F, Nicosia G, Martino G, Loddo I, et al. Incidence of hypocalcemia and hypercalcemia in hospitalized patients: Is it changing? Journal of Clinical & Translational Endocrinology [Internet] 2018 [cited 2022 Sep 15];13:9–13. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6047106
- Fong J, Khan A. Hypocalcemia: updates in diagnosis and management for primary care. Can Fam Physician. 2012 Feb;58(2):158-62. PMID: 22439169; PMCID: PMC3279267.
- Barhum L. What happens when calcium levels are low? [Internet]. Medical news today.com2020 [cited 2022 Sep 15];Available from: https://www.medicalnewstoday.com/articles/321865#consulting-a-doctor
- Shlisky J, Mandlik R, Askari S, Abrams S, Belizan JM, Bourassa MW, Cormick G, Driller-Colangelo A, Gomes F, Khadilkar A, Owino V, Pettifor JM, Rana ZH, Roth DE, Weaver C. Calcium deficiency worldwide: prevalence of inadequate intakes and associated health outcomes. Ann N Y Acad Sci. 2022 Jun;1512(1):10-28. doi: 10.1111/nyas.14758. Epub 2022 Mar 5. PMID: 35247225; PMCID: PMC9311836.
- Goyal A, Anastasopoulou C, Ngu M, et al. Hypocalcemia. [Updated 2022 Jul 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430912/
- Shlisky J, Mandlik R, Askari S, Abrams S, Belizan JM, Bourassa MW, Cormick G, Driller-Colangelo A, Gomes F, Khadilkar A, Owino V, Pettifor JM, Rana ZH, Roth DE, Weaver C. Calcium deficiency worldwide: prevalence of inadequate intakes and associated health outcomes. Ann N Y Acad Sci. 2022 Jun;1512(1):10-28. doi: 10.1111/nyas.14758. Epub 2022 Mar 5. PMID: 35247225; PMCID: PMC9311836.
