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CALCIUM IMBALANCE

DESCRIPTION

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 & SYMPTOMS

  • Too 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).

    CAUSES

  • Too 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 FACTORS

  • 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 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.

    BASIC INFORMATION

    MEDICAL TESTS

    Your 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 COMPLICATIONS

    Cardiac arrest; fractures of weak bones.

    PROBABLE OUTCOME
    Unless your child's calcium imbalance is caused by cancer, most cases are curable with treatment in 1 week.

    TREATMENT

    HOME CARE

    The underlying cause must be corrected before your child 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, the child can resume normal activities as symptoms improve.

    DIET & FLUIDS

  • For 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. ‡
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