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Understanding Hypocalcaemia as a Persistent Deficiency

Understanding Hypocalcaemia as a Persistent Deficiency

Max Lab

Feb 02, 2024

Hypocalcaemia, also known as calcium deficiency disease, is when one has low blood calcium levels (not counting the calcium levels in the bones). The disease may arise because of various health conditions and is often associated with abnormal parathyroid hormones or vitamin D levels. The symptoms of hypocalcaemia can range from mild to severe, depending on the degree of calcium deficiency.

Hypocalcaemia may be acute and temporary or chronic, depending on the underlying cause. Mild cases of the disease may at times even be asymptomatic, while severe calcium deficiencies may cause muscle spasms, tingling, and arrhythmia. Prompt diagnosis and treatment of hypocalcaemia is important to restore the body’s calcium balance. With proper management, acute hypocalcaemia can even be reversed, while chronic cases can be controlled.

What Is Calcium and What Does It Do?

Calcium is one of the most essential and most common minerals found in the body, a major part of which is stored in the bones to help maintain their strength. However, calcium is also needed in the blood to support nerve function, making the muscles squeeze to enable movement, and helps the blood clot and maintain heart function. It is also required for the bones to keep them strong.

Low calcium levels in the blood, or hypocalcaemia, can hinder the ability of the body to perform these vital functions. Not consuming enough calcium in the diet can lead to the body taking calcium from the bones, which in turn can weaken the bones.

Vitamin D plays a crucial role as it is needed by the body to absorb the calcium from ingested foods, while the levels of calcium in the blood and bones are controlled by the parathyroid and calcitonin hormones. Any cases of chronic calcium deficiency or an acute deficiency caused by a lack of calcium in the diet may require monitoring and proper treatment to prevent severe hypocalcaemia and restore the optimal calcium level in the body.

Who Is at Risk for Hypocalcaemia?

Hypocalcaemia can affect individuals at any age. However, the age when one develops hypocalcaemia may be indicative of a particular reason for the calcium deficiency. For instance, cases of hypocalcaemia in infants are more likely to be associated with congenital disorders that can affect calcium regulation in the body. On the other hand, in adults, the reason for calcium deficiency may be chronic kidney disease, vitamin D deficiency, or thyroid disorders that can affect the production of the hormones that control the calcium levels in the body. While hypocalcaemia may develop at any age, the probability of the aetiology may vary, based on age-specific vulnerabilities.

The Symptoms of Low Calcium Levels and Causes

People with mild hypocalcaemia are often asymptomatic and the symptoms of calcium deficiency that one displays may depend on the severity of the condition. Some of the most common symptoms that may be noticed include:

  • Muscle cramps, particularly in the back and legs.
  • Dry and scaly skin.
  • Brittle nails.
  • Coarser hair texture than usual.

If not addressed, hypocalcaemia may progress to a more severe stage, leading to one developing neurological (of the nervous system) or psychological (of the mind) symptoms over time. These may include:

  • Confusion
  • Memory loss
  • Muscle spasms
  • Hallucinations
  • Depression
  • Irritability or restlessness
  • Increased susceptibility to fractures

The Causes of Hypocalcaemia

Maintaining calcium homeostasis is a complex process involving multiple regulatory functions and factors. That is why there are several kinds of disorders and health issues that can lead to hypocalcaemia. The abnormal levels of the parathyroid hormone (PTH) and vitamin D in the body are among the most common reasons behind hypocalcaemia. On the other hand, mild transient drop in the calcium levels may also be caused by an inadequate diet. However, identifying the root cause of the condition is essential for guiding the treatment plan.

Some of the most common causes of hypocalcaemia include:


Hypoparathyroidism is a hormonal disorder that can lead to calcium deficiency disease. The parathyroid hormone, which is responsible for controlling the body’s calcium levels, is produced by the parathyroids, located near the thyroid glands. Lower than normal levels of parathyroid hormone (PTH) production by the parathyroid glands is a disorder that can be caused by a genetic disorder or the surgical removal of the parathyroid or thyroid glands. Hypoparathyroidism can lower the calcium levels in the body, leading to hypocalcaemia.

Vitamin D Deficiency

Vitamin D is required by the body to be able to properly absorb calcium, so a lack of vitamin D is another condition that can lead to hypocalcaemia. Low levels of vitamin D in the body may be caused by inadequate exposure to sunlight, not consuming enough vitamin D, or by a genetic disorder.

Kidney Failure

Renal failure or kidney failure leads to an increase in the phosphorus levels in the blood and a reduced renal production of a particular type of vitamin D, which can also lead to one developing hypocalcaemia.


Instances of hypocalcaemia in acute pancreatitis are quite common. Pancreatitis causes the levels of the serum, lipase to rise. This serum splits the fatty acids from the triglycerides, removing them from their existing hydroxyl groups. These free fatty acids then react with the calcium in the blood to form calcium soaps, which seem to look like chalky yellowish-white deposits, effectively reducing the blood calcium levels, leading to hypocalcaemia.

Diagnosing Hypocalcaemia

Mild cases of hypocalcaemia may at times be detected incidentally through routine blood tests or while undergoing testing for other conditions. In general, one is said to have hypocalcaemia if their total blood calcium concentration is less than 8.8 mg/dL. A healthcare practitioner may prescribe a calcium concentration blood test to diagnose hypocalcaemia. However, identifying the underlying cause of the condition is just as important as detecting the condition itself. For this, further testing may be prescribed, including:

  • Blood tests to measure the levels of magnesium, vitamin D, and parathyroid in the blood.
  • An electrocardiogram to check for abnormal heart rhythm.
  • Bone imaging tests to check for calcium issues in the bones.

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