Abnormal Calcium Levels – More Than Just a Bone Weakness
We’ve all seen educational ads of products claiming to be rich in calcium for strengthening our bones, helping children grow faster and for women with osteoporosis. Besides its effect on bones, calcium does much more for our bodies than it is generally known for. Calcium is the most abundant mineral in our body and constitutes 1-2% of the adult body weight alone – that is one mighty mineral!
The many functions of calcium
It’s true that the primary function of calcium is making healthy bones and teeth. Around 99% of our total body calcium content is present in the bones. Perhaps this explains the secondary functions of this mineral are lesser known. Calcium is also required for normal muscle structure and function, sending and receiving nerve impulses, maintaining a steady heartbeat and keeping our mental status in check.
Your doctor can order a simple blood test to measure the calcium level in the blood. In adults the reference range for total calcium is 8.9 to 10.1 mg/dL. You can see from this narrow range that our body generally keeps the blood level of calcium tightly controlled through the parathyroid hormone effect on the bones. It is important that you keep the calcium level in check as you will see why.
What happens when calcium levels are disturbed?
An imbalance in blood calcium levels can have mild or catastrophic consequences. Depending upon the severity of the imbalance, the symptoms experienced can vary.
When calcium levels are low:
When serum calcium levels drop below the normal range, the condition is called ‘hypocalcemia’. Low calcium levels may result from nutritional deficiency of either calcium or vitamin D (important for calcium homeostasis) in a chronic case. The commonest cause if parathyroid hormone underactivity (such as after resection during a thyroid surgery). Other underlying diseases that may result in low calcium levels include kidney disease, pancreatitis, malignancy (usually breast cancer) and hungry bone syndrome.
An acute fall in the calcium levels is usually a result of an accidental removal of the parathyroid glands during a thyroidectomy procedure. The parathyroid glands are important in maintaining serum calcium levels through the parathyroid hormone they produce.
The signs and symptoms of hypocalcemia include:
• Painful muscle spasms (tetany)
• Neuropsychiatric problems (seizures, dementia, anxiety, depression)
• Congestive heart failure
• Low blood pressure
• Pain in the abdomen
• Increased sweating
• Dermatitis, eczema, hyperpigmentation
When calcium levels are high:
Increased calcium in the blood (hypercalcemia) can have deterring effects on the body as well. The primary cause of hypercalcemia in most patients is an overactive parathyroid tissue or the entire gland. High calcium levels may also come about as a result of excess of calcium and vitamin D intake, genetic disorders (for example familial hypocalciuric hypercalcemia) and cancerous conditions.
The clinical manifestations of high blood calcium levels are:
• Nausea, vomiting, constipation
• Loss of appetite
• Osteopenia or osteoporosis (weakening of bones)
• Frequent urination
• Excessive thirst
• Irregular heartbeat (arrhythmia)
Correcting Calcium Levels through Diet
The recommended daily dose of calcium for an adult male and female is 1000 mg/day.
If hypocalcemic, calcium-rich foods can be introduced in the diet to meet the daily requirement. Sources rich in calcium include all kinds of dairy products, green vegetables, oats, green beans and calcium-fortified cereals.
Although dairy products have the highest percentage of calcium to offer, too much dairy is not recommended for pregnant women and people who are lactose intolerant. In these individuals, non-dairy sources are recommended.
Beyond calcium, an increase in magnesium and vitamin D intake can also help balance low calcium levels. Good sources of magnesium include nuts and whole grains whereas adequate exposure to the sun produces vitamin D for your body.
If hypercalcemic, calcium-rich food have to be limited but not completely cut out from the diet. Normal amounts of calcium should be included in the diet along with copious amount of fluid intake. We’re talking 8-10 glasses a day to help flush out the excess calcium from your blood. If the hypercalcemia needs medical treatment there are certain medications that your doctor can use.
Including a diet rich in phytic acid (grains and legumes) will hinder the absorption of calcium into the intestine and hence help to bring calcium levels down, but this diet also cause zinc and iron deficiency so please consult your doctor, and keep tracking your calcium biomarker to stay healthy.
Calcium is very important to our body not just for bone and teeth health. We may be hyper- or hypocalcemic and not have any symptoms, so a routine blood test or metabolic panel can include this biomarker for this very reason. And unbalanced calcium can have serious consequences.
You need to see your doctor if any symptoms or signs suggest calcium imbalance. The doctor will investigate the cause of the imbalance, manage the underlying disease and the calcium level if necessary, and investigate any potential health complications arising from the disease and/or the calcium abnormality. During all this process of screening, investigating, treatment and follow up, you will be tracking the calcium levels.
If you’re interested in learning more about calcium and to maintain healthy levels of it, read on more about it in our biomarker post here!