Understanding Hypocalcemia: Causes, Symptoms, Diagnosis, Treatment, and Its Impact on Health and Well-being

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   Definition

       Hypocalcemia refers to a condition in which there is an abnormally low level of calcium in the blood. Calcium is crucial for many body functions, including bone health, muscle contraction, nerve function, and blood clotting.


Causes of Hypocalcemia:


1. Vitamin D Deficiency (common cause)

2. Hypoparathyroidism (low parathyroid hormone levels)

3. Chronic Kidney Disease

4. Magnesium Deficiency (affects parathyroid hormone secretion)

5. Pancreatitis

6. Critical Illnesses (e.g., sepsis or burns)

7. Medications (e.g., bisphosphonates, certain anticonvulsants)

8. Pseudohypoparathyroidism (tissue resistance to parathyroid hormone)

9. Malabsorption Syndromes (e.g., celiac disease)

10. Blood Transfusions (due to citrate binding calcium)

11. Alkalosis (increased pH reduces ionized calcium levels)


Symptoms:


Mild hypocalcemia may be asymptomatic, but more severe cases can include:

Neuromuscular symptoms:

Muscle cramps or spasms

Tetany (involuntary muscle contractions)

Paresthesia (tingling or numbness, especially in fingers and toes)


CNS Symptoms:

Irritability

Fatigue

Anxiety

Seizures


Cardiac Symptoms:

Prolonged QT interval on ECG

Arrhythmias

Heart failure in severe cases


Others:

Brittle nails

Dry skin

Hair thinning or alopecia


Diagnosis:


Serum Calcium: Total calcium and ionized calcium levels

Parathyroid Hormone (PTH) levels

Vitamin D levels

Magnesium and Phosphate levels

Kidney function tests and ECG (to detect QT prolongation)


Treatment:


1. Acute/Symptomatic Hypocalcemia:

IV calcium gluconate or calcium chloride

Monitor ECG during treatment


2. Chronic Hypocalcemia:

Oral calcium supplements (e.g., calcium carbonate or calcium citrate)

Vitamin D supplementation (cholecalciferol or calcitriol)

Treat underlying causes (e.g., hypoparathyroidism or vitamin D deficiency)


3. Dietary Adjustments:

Include calcium-rich foods like dairy products, green leafy vegetables, nuts, and fortified cereals.


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