Hypocalcaemia

Definition : Hypocalcemia,is a condition of low blood calcium level, occurs when

the concentration of free calcium ions in the blood falls below 4.0 mg/dL (dL =
one tenth of a liter). The normal concentration of free calcium ions in the blood
serum is 4.0-6.0 mg/dL.

Calcium is essential for :

Formation of bone and teeth
Muscle contraction
Normal functioning of many enzymes
Blood clotting
Normal heart rhythm
 Causes
Vitamin D
deficiency
High or low
magnesium
level

hypocalca
emia

Parathyroid
hormone deficiency
or malfunction
 Sign and symptoms

ECG Tendon reflexes

changes are hyperactive

Petechia which
appears as one-off Perioral tingling
spots, then later and parasthesia.
become rashes
 Diagnosis
• Hypocalcemia is often detected by routine blood tests
before symptoms become obvious. Doctors measure the
total calcium level (which includes calcium bound to
albumin) and the albumin level in blood to determine
whether the level of unbound calcium is low.
• Blood tests are done to evaluate kidney function and to
measure magnesium, phosphate, parathyroid hormone,
and vitamin D 
levels. Other substances in blood may be measured to
help determine the cause.
 Treatment
Intravenous
Oral calcium
Intravenous
Vitamin
Vitamin D
Oral calcium
calcium
D
salts –
calcium salts –
supplements
in severe cases
supplements
in severe cases

Ma
gn
esi
um
 -
po
ssi
bly
use
d if
co
ndi
tio
n is
cau
sed
by
ma
gn
esi
um
de
fici
en
cy
 Prevention
• The first, and most obvious, way to help prevent hypocalcemia is to ensure
that adequate amounts of calcium and vitamin D are consumed each day,
either in the diet or as supplements.

• Hypocalcemia that may occur with damage to the parathyroid gland or to

the kidneys cannot be prevented.

• Hypocalcemia resulting from overuse of enemas can be prevented by

reducing enema usage.

• Hypocalcemia resulting from magnesium deficiency tends to occur in

chronic alcoholics, and this type of hypocalcemia can be prevented by
reducing alcohol consumption and increasing the intake of healthful food.
 Vitamin D synthesis
• Vitamin D synthesis is the process of creating
vitamin D within the body.
• As vitamin D is uncommon in foods, the main
source is vitamin D synthesis, where the
cholesterol is transformed into the vitamin.
Diets low in cholesterol, then, can lead to
decreased levels of vitamin D.
 Inactive form of vitamin D is known as cholecalciferol is synthesized from cholestrol.

To make the biologically inactive vitamin ready for use, vitamin D synthesis must occur. First, it is
transformed to Calcidiol, in the liver.

Next, the kidneys transform the Calcidiol into the active form of vitamin D that is, Calcitriol.

When vitamin D is transformed into calcitriol, it can be used to regulate calcium levels in the blood.