Hypophosphatemia (Low Phosphate): Symptoms, Causes, Treatment


The human body requires a delicate balance of various compounds to function properly, and maintaining this balance is crucial for good health. One condition that can disrupt this equilibrium is Hypophosphatemia, which is characterized by low levels of phosphate in the blood.

Sometimes, things go awry and the results may be disastrous.

Take phosphate.  It is a mineral essential to our well-being, being involved in myriad bodily processes such as muscle contraction, pH balance maintenance and even gene transcription.

Let’s find out more about it and how its deficiency may even be life-threatening.  

You get phosphorous/phosphate from the foods you eat. A typical nutritious diet provides 1000 to 2000 milligrams (mg) of phosphate daily. Of this, your intestines absorb about 600 mg to 1200 mg.


Phosphate helps in muscle contraction. Although it is mostly asymptomatic and thereby goes unnoticed, mild to moderate levels of hypophosphatemia presents as muscle weakness and fatigue.

As the condition becomes more severe, it results in muscle and bone pain, irritability and confusion, and weakness and may often be accompanied by seizures.

Untreated and uncontrolled hypophosphatemia may result in death or coma. It is a medical emergency and if any of the symptoms are noticed, you must rush to your nearest hospital.


Our serum phosphorus levels fluctuate between 2.5 to 4.5 mg/dL. If it falls below 2 mg/dl, it is termed hypophosphatemia which may be sudden or chronic in onset. It may also be classified as mild or severe. Certain medical conditions are associated with hypophosphatemia including the following: 

  • Recovering from diabetes-related ketoacidosis (a life-threatening complication of Type 1 diabetes).
  • In the case of chronic alcoholism and withdrawal from alcohol.
  • Injuries caused by severe burns.
  • A potentially fatal shift in fluids and electrolytes occurs when one receives food after prolonged starvation, known as refeeding syndrome.
  • Deficiency of carbon dioxide in the blood (severe respiratory alkalosis).


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    Causes of Chronic Hypophosphatemia include:

    • An increase in parathyroid hormone levels as a result of hyperparathyroidism- The parathyroid glands are pea-shaped organs located behind the thyroid gland and are responsible for maintaining the levels of serum calcium and phosphate. Overstimulation caused by hypertrophy may result in hyperparathyroidism that may alter the phosphorus balance in the blood.
    • Cushing’s syndrome- It is characterised by a hormonal imbalance of the ACTH( adreno-corticotrophic hormone)
    • Deficiency of Vitamin D – Lack of sun exposure or low absorption/ intake of Vit D-rich food.
    • Nutrient deficiency – Electrolyte imbalance characterised by hypomagnesemia(low blood magnesium levels) and hypokalemia(low blood potassium levels).
    • Theophylline overdose- a bronchodilator used in asthma.
    • CKD patients- Patients with chronic kidney disease take phosphate binders to reduce the levels of serum phosphate that might cause hypophosphatemia in the long run.

    Risk factors

    You’re more likely to get hypophosphatemia if you:

    • Genetic predilection- This means that if you have any close relatives with this ailment, you might have a chance of inheriting the condition. 
    • Sepsis- Blood infection noted in severe burn or shock patients
    • Hyperparathyroidism- Hyperactivity of the parathyroid gland
    • Anorexia/ Starvation- Malnourishment may affect phosphorus levels in the blood.
    • Alcoholism- It may lead to hypophosphatemia as it may affect the body’s ability to absorb and metabolize nutrients, including phosphorus.
    • Medications- Patients with a long-term history of steroid/diuretic use.


    Phosphorus deficiency is relatively easy to treat

    • Mild cases may be course corrected through diet and having foods rich in phosphorus
    • Moderate cases may require dietary as well as oral phosphorus supplements
    • Severe cases require hospitalisation and IV phosphorus replenishment immediately


    In conclusion, phosphate plays a major role in our bodies. While this mineral is usually readily available and rarely falls to extremely low levels, its severe deficiency may land you in an emergency room or ICU. By being aware of the symptoms and home remedies, you may tackle this condition before it becomes serious.


    Here are some FAQs to quench any lingering doubts

    Can low phosphorus cause weight gain?

    Several studies have linked low phosphorus levels to weight gain and conversely, have also linked healthy phosphorus levels to lower appetite, BMI, waist circumference and body weight.

    How can I raise my phosphorus quickly?

    The best way to increase phosphorus levels is through a diet naturally rich in phosphorus. The foods mentioned above are a great way to do so quickly. In cases of clinical hypophosphataemia, your physician may provide you with phosphate pills or even IV phosphates in case of an emergency. 


    Is low phosphate serious?

    Low phosphate is not usually serious and mild to moderate hypophosphataemia is a routine bloodwork finding. However, severe hypophosphataemia can be a life-threatening condition manifesting as fatigue, muscle and bone pain, irritability, nerve pain, seizures coma and even death.


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