CALCIUM IMBALANCE

General Information

DEFINITION--Calcium is a mineral component of blood that helps regulate the heartbeat, transmit nerve impulses, contract muscles and form bone and teeth. Too much calcium (hypercalcemia) or too little calcium (hypocalcemia) can cause serious, sometimes life-threatening medical problems.

BODY PARTS INVOLVED--Membranes of all body cells; muscles; bones; parathyroid glands and parathyroid hormones (these regulate calcium absorption and utilization).

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

Too little calcium:

• Muscle spasms, twitching or cramps.
• Numbness and tingling in the arms, legs, hands and feet.
• Seizures.
• Irregular heartbeat.
• High blood pressure.

Too much calcium:

• Lethargy.
• Appetite loss.
• Vomiting and diarrhea.
• Dehydration and thirst.
• Irregular heartbeat.
• Low blood pressure.
• Depression, delirium, confusion.
• Seizures or coma (worst cases only).

CAUSES

Too little calcium:

• Underactive parathyroid glands from disease or damage during neck surgery.
• Inadequate intake of calcium and vitamin D.
• Malabsorption from the gastrointestinal tract (usually for unknown reasons).
• Severe burns or infections.
• Pancreatitis.
• Kidney failure.
• Decreased blood levels of magnesium.

Too much calcium:

• Overactive parathyroid glands.
• Multiple fractures and prolonged bed rest; multiple myeloma.
• Tumors that destroy bone.

RISK INCREASES WITH

Too little calcium:

• Use of certain drugs, including thiazide diuretics and calcium-channel blockers.
• Injury, cancer or surgery of the thyroid gland or parathyroid glands.
• Excess alcohol leading to poor nutrition.

Too much calcium:

• Improper diet, especially overconsumption of milk products or antacids containing calcium.
• Repeated transfusions with citrated blood.
• Chronic kidney disease.
• Inactivity or prolonged bed rest.

> Don't drink more than 1 or 2 alcoholic drinks--if any--

a day.

• Don't use non-prescription antacids on a regular basis.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and exam by a doctor.
• Laboratory blood studies of calcium levels.
• ECG (See Glossary), x-rays of bones.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Hospitalization.
• Self-care after hospitalization.

POSSIBLE COMPLICATIONS

• Cardiac arrest.
• Fractures of weak bones.
• Kidney stones (high calcium).
• Peptic ulcer (high calcium).

PROBABLE OUTCOME--Most cases are curable with treatment in 1 week, unless the calcium imbalance is caused by cancer.

How To Treat

GENERAL MEASURES----The underlying cause must be corrected before you can follow a treatment program to prevent a recurrence.

MEDICATION--Your doctor may prescribe:

• Intravenous calcium gluconate or calcium carbonate for too little calcium.
• Intravenous saline solution and loop diuretics (furosemide and ethacrynic acid) for too much calcium.

ACTIVITY--After treatment, resume your normal activities as symptoms improve.

DIET--

• For a mild, low calcium level, take calcium supplements and vitamin D. Increase your intake of protein, milk and milk products.
• For a mild, high calcium level, restrict consumption of dairy products and calcium-containing antacids.

Call Your Doctor If

• You have symptoms of a calcium imbalance.
• Symptoms recur after treatment.