Hypocalcemia: Causes, Symptoms, and Treatment
Neonatal hypocalcemia occurs in infants soon after birth. Most cases of neonatal hypocalcemia occur within the first two days after birth. But late onset hypocalcemia can occur three days after birth, or later.
Risk factors for infants include being small for their age and maternal diabetes. Late onset hypocalcemia is most often caused by drinking cow’s milk or formula with too much phosphate.
Symptoms of neonatal hypocalcemia include:
apnea, or slowed breathing
tachycardia, or a faster than normal heartbeat
Diagnosis is made by testing an infant’s blood for the total calcium level or ionized calcium level. The infant’s glucose level will also be tested to rule out hypoglycemia.
Treatment typically involves giving intravenous calcium gluconate followed by several days of oral calcium supplements.
How’s hypocalcemia treated?
Calcium deficiency is usually easy to treat. It typically involves adding more calcium to your diet.
Do not self-treat by taking a lot of calcium supplements. Taking more than the recommended dose without your doctor’s approval can lead to serious issues like kidney stones.
Commonly recommended calcium supplements include:
calcium carbonate, which is the least expensive and has the most elemental calcium
calcium citrate, which is the most easily absorbed
calcium phosphate, which is also easily absorbed and doesn’t cause constipation
Calcium supplements are available in liquid, tablet, and chewable forms.
Shop for calcium supplements.
It’s important to note that some medications could interact negatively with calcium supplements. These medications include:
blood pressure beta-blockers like atenolol, which may decrease calcium absorption if taken within two hours of taking calcium supplements
antacids containing aluminum, which may increase blood levels of aluminum
cholesterol-lowering bile acid sequestrants such as colestipol, which may decrease calcium absorption and increase the loss of calcium in the urine
estrogen medications, which can contribute to an increase in calcium blood levels
digoxin, as high calcium levels can increase digoxin toxicity
diuretics, which can either increase calcium levels (hydrochlorothiazide) or decrease calcium levels in the blood (furosemide)
certain antibiotics such as fluoroquinolones and tetracyclines, whose absorption can be decreased by calcium supplements
Sometimes diet changes and supplements aren’t enough to treat a calcium deficiency. In this case, your doctor may want to regulate your calcium levels by giving you regular calcium injections.
You can expect to see results within the first few weeks of treatment. Severe cases of calcium deficiency disease will be monitored at one- to three-month intervals.
What are the possible complications of hypocalcemia?
Complications from calcium deficiency disease include eye damage, an abnormal heartbeat, and osteoporosis.
Complications from osteoporosis include:
spinal fractures or other bone fractures
If left untreated, calcium deficiency disease could eventually be fatal.
How can hypocalcemia be prevented?
You can prevent calcium deficiency disease by including calcium in your diet every day.
Be aware that foods high in calcium, such as dairy products, can also be high in saturated fat and trans fat. Choose low-fat or fat-free options to reduce your risk of developing high cholesterol and heart disease.
While meeting your calcium requirement is very important, you also want to make sure you’re not getting too much. According to the Mayo Clinic, upper limits of calcium intake in milligrams (mg) for adults are:
2,000 mg per day for men and women 51 years of age and up
2,500 mg per day for men and women 19 to 50 years of age
You might want to supplement your diet by taking a multivitamin. Or your doctor may recommend supplements if you’re at high risk for developing a calcium deficiency.
Multivitamins may not contain all of the calcium you need, so be sure to eat a well-rounded diet. If you’re pregnant, take a prenatal vitamin.
Vitamin D is important because it increases the rate calcium is absorbed into your blood. Ask your doctor how much vitamin D you need.
To increase your calcium intake, you can add food rich in vitamin D to your diet. These include:
fatty fish like salmon and tuna
fortified orange juice
As with calcium-rich dairy products, some vitamin D-rich dairy products can also be high in saturated fat.
Sunlight triggers your body to make vitamin D, so getting regular exposure to the sun can also help boost your vitamin D levels.