Hypocalcemia – Causes, Symptoms and Treatment

Hypocalcemia is a condition in which there is too little calcium in the blood. A common form of hypocalcemia in babies is called neonatal hypocalcemia. This condition may occur at different times with different causes, including the following:

Early hypocalcemia – occurs in the first three days of life.
Late hypocalcemia – develops between the fifth to tenth days of life, usually after several days of formula feedings. Some formulas have high levels of phosphate which can lower the blood calcium levels.

Symptoms

Symptoms of hypercalcemia can influence many organs and tissues of the body. For instance, in the skeletal system, hypercalcemia can lead to bone pain, spinal column curvature, and pathological fractures. Abnominal symptoms of hypercalcemia include nausea, vomiting, and constipation. Pschological symptoms of hypercalcemia could include depression, irritability, apathy, and dementia. In the musculoskeletal system, hypercalcemia can lead to the symptoms of weakness, muscle twitches, and muscle atrophy. Kidneys can be damaged and lead to frequent urination.

Causes

Some possible causes of hypocalcemia are:

You are not getting enough calcium or vitamin D from your diet. (Vitamin D helps your body take calcium from the food you eat and use it to build bone.)
Your intestines are not absorbing calcium.
Your parathyroid gland is not making enough parathyroid hormone, which affects calcium levels in the blood.

Treatment

Treatment is directed at the underlying cause of hypercalcemia whenever possible. In cases of hyperparathyroidism, surgery may be needed to remove the abnormal parathyroid gland and cure the hypercalcemia.
When hypercalcemia is mild and caused by primary hyperparathyroidism, patients may be followed closely by their doctor over time. A new medication named cinacalcet has been shown to lower calcium levels in the blood by reducing parathyroid hormone production.

Chronic hypocalcemia (hypoparathyroidism and so forth) is treated by administration of oral calcium and, if this is insufficient, vitamin D supplementation. The serum calcium level should be targeted to about 8.0 mg/dL. Most patients will be entirely asymptomatic at this level, and further elevation will lead to hypercalciuria because of the lack of PTH effect on the renal tubules. Chronic hypercalciuria may lead to development of nephrocalcinosis, nephrolithiasis, and renal impairment, and must be avoided.
When hypercalcemia is mild and caused by primary hyperparathyroidism, patients may be followed closely by their doctor over time. A new medication named cinacalcet has been shown to lower calcium levels in the blood by reducing parathyroid hormone production.

Treatment of hypocalcemia generally involves elucidating the cause for the inability to maintain normal levels of blood calcium, followed by correction of the problem. The most common cause of a low blood calcium is inadequate function of or damage to or surgical removal of the parathyroid glands. As most patients have 4 parathyroid glands, the function of at least 3 or more glands needs to be compromised before hypocalcemia develops. In most cases, treatment with oral calcium supplementation is effective in restoring the blood calcium to normal. In some instances, vitamin D supplements may be prescribed to enhance absorption of the calcium supplement. There are many different forms of calcium preparations, and similarly, there are several different types of vitamin D tablets.