Calcium has a vital role in neuromuscular function. Total calcium levels are determined during a general admissions panel of blood work. The levels normally range from 8.9 to 10.3 mg/dL (2.23 to 2.57 mmol/L). In certain situations, ionized calcium levels, which should be between 4.65 and 5.28 mg/dL (adults), provide a better picture of whether or not adequate levels of calcium are present. This is particularly true when a protein deficiency exist because 50 percent of the calcium found in the body is bound to protein.
HYPOCALCEMIA
Low calcium levels, that is, levels of 8.4 mg/dL (2.0 mmol/L) or less, are commonly caused by low protein levels, especially low albumin, which is often present with malnutrition, particularly in alcoholics. In addition, low calcium levels can result from
• Decreased parathyroid gland function (i.e., hypoparathyroidism)
• Decreased dietary intake of calcium
• Decreased levels of vitamin D
• Magnesium defi ciency
• Elevated phosphorus
• Acute infl ammation of the pancreas
• Chronic renal failure
• Calcium ions becoming bound to protein (alkalosis)
• Bone disease
• Malnutrition
• Alcoholism
Low ionized calcium levels (serum calcium not bound to protein) have the same causes as low levels of chloride, except low protein, in which case the ionized calcium will be normal.
The following signs of hypocalcemia:
• Nervousness
• Excitability
• Tetany
HYPERCALCEMIA
Elevated serum calcium levels, that is, levels of 10.6 mg/dL (2.8 mmol/L) or higher, result most commonly from increased parathyroid function often owing to a tumor or from cancer in the bones that releases calcium into the bloodstream. Additional
causes of hypercalcemia include
• Hyperthyroidism
• Bone breakage with inactivity
• Sarcoidosis
• Tuberculosis
• Vitamin D excess
• Kidney transplant
Urine calcium levels will indicate the amount of calcium being excreted in the urine. Additionally, an ionized calcium test may be performed to measure the amount of calcium that is not bound to protein in the blood. The level of ionized calcium in the blood is not affected by the amount of protein in the blood.
Symptoms with hypercalcemia include
• Anorexia
• Nausea
• Vomiting
• Somnolence
• Coma
HYPOCALCEMIA
Low calcium levels, that is, levels of 8.4 mg/dL (2.0 mmol/L) or less, are commonly caused by low protein levels, especially low albumin, which is often present with malnutrition, particularly in alcoholics. In addition, low calcium levels can result from
• Decreased parathyroid gland function (i.e., hypoparathyroidism)
• Decreased dietary intake of calcium
• Decreased levels of vitamin D
• Magnesium defi ciency
• Elevated phosphorus
• Acute infl ammation of the pancreas
• Chronic renal failure
• Calcium ions becoming bound to protein (alkalosis)
• Bone disease
• Malnutrition
• Alcoholism
Low ionized calcium levels (serum calcium not bound to protein) have the same causes as low levels of chloride, except low protein, in which case the ionized calcium will be normal.
The following signs of hypocalcemia:
• Nervousness
• Excitability
• Tetany
Elevated serum calcium levels, that is, levels of 10.6 mg/dL (2.8 mmol/L) or higher, result most commonly from increased parathyroid function often owing to a tumor or from cancer in the bones that releases calcium into the bloodstream. Additional
causes of hypercalcemia include
• Hyperthyroidism
• Bone breakage with inactivity
• Sarcoidosis
• Tuberculosis
• Vitamin D excess
• Kidney transplant
Urine calcium levels will indicate the amount of calcium being excreted in the urine. Additionally, an ionized calcium test may be performed to measure the amount of calcium that is not bound to protein in the blood. The level of ionized calcium in the blood is not affected by the amount of protein in the blood.
Symptoms with hypercalcemia include
• Anorexia
• Nausea
• Vomiting
• Somnolence
• Coma
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Unknown - Tuesday, 9 August 2011
