Calcium is a component of the blood that helps regulate the heartbeat, transmit nerve impulses, contract muscles, and form bones and teeth. Too much or too little can cause serious--sometimes life-threatening -- medical problems. Body parts involved include membranes of all body cells, muscles, bones, parathyroid glands, and parathyroid hormones (these regulate calcium absorption and utilization).
Appropriate health care includes: self-care after diagnosis; physician's monitoring of general condition and medications; hospitalization (sometimes) followed by self-care at home.
SIGNS & SYMPTOMSToo little calcium: muscle spasms and twitching; numbness and tingling in the arms, legs, hands, and feet; seizures; irregular heartbeat; high blood pressure.
Too much calcium: lethargy; loss of appetite; vomiting and diarrhea; dehydration and thirst; irregular heartbeat; low blood pressure; seizures or coma (worst cases only).
CAUSESToo little calcium: underactive parathyroid glands from disease or damage during neck surgery; inadequate dietary intake of calcium and vitamin D; malabsorption from the gastrointestinal tract (usually for unknown reasons); severe burns; severe infections; chronic pancreatitis; kidney failure; decreased blood levels of magnesium.
Too much calcium: overactive parathyroid glands; multiple fractures and prolonged bed rest; multiple myeloma; tumors--benign or malignant--that destroy bone.
RISK FACTORSToo 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 consumption leading to poor nutrition.
Too much calcium: improper diet, especially overconsumption of milk products or non-prescription antacids that contain calcium; repeated transfusions with citrated blood.
Either too little or too much calcium: chronic kidney disease.
PREVENTING COMPLICATIONS OR RECURRENCE
Urge your child to eat a normal, balanced diet. If your child drinks alcoholic beverages, not more than 1 or 2--if any -- should be consumed daily. Urge your child not to use non-prescription antacids on a regular basis.
MEDICAL TESTSYour own observation of symptoms; medical history and physical exam by a doctor; laboratory blood studies of calcium levels; EKG (See Glossary); X-rays of bones.
POSSIBLE COMPLICATIONSCardiac arrest; fractures of weak bones.
Unless your child's calcium imbalance is caused by cancer, most cases are curable with treatment in 1 week.
HOME CAREThe underlying cause must be corrected before your child can follow a treatment program to prevent a recurrence.
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.
After treatment, the child can resume normal activities as symptoms improve.
DIET & FLUIDSFor a mild low-calcium level, your child should take calcium supplements and vitamin D. Increase the child's intake of protein, milk, and milk products.
For a mild high-calcium level, restrict your child's consumption of dairy products and calcium-containing antacids.
OK TO GO TO SCHOOL?When appetite has returned and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of a calcium imbalance.
Symptoms recur after treatment.