Skip to main content
Submitted by Dr S. Patel on 13 June 2017

This time in our Health by Numbers/Medical Tests series, Dr Shital Raval takes a look at the importance of Calcium levels in the metabolic panel.

Read the previous parts on Sodium Levels, Potassium Levels and Chloride Levels

CALCIUM:

Calcium is an important component of our bones, teeth, nerve cells and organs such as heart and kidneys. A blood calcium test is ordered if there are any symptoms of any bone or neurological disorders, kidney stones etc or can be a part of a Comprehensive Metabolic Panel.

Calcium found in the body can be in free or bound state which is usually very balanced. The calcium test indicates the amount of free calcium present in the blood. Calcium is regulated by the parathyroid hormone (PTH) which is secreted by the Parathyroid glands. Increased PTH causes more calcium to be released in the blood.

If calcium is found to be abnormal, more testing is required to diagnose the underlying condition. These tests commonly include measurement of urine calcium, phosphorus, ionised calcium, magnesium, vitamin D, parathyroid hormone(PTH) and PTH related peptide. Ionised calcium test is used for patients who have lost balance of free and bound calcium; such patients either are undergoing surgery, blood loss, blood disorders, on IV fluids etc.

Calcium monitoring is needed for patients who are on calcium or vitamin D supplements, have any kidney disorders, and suffer from cancer.

The corrected total serum calcium concentration is normally 8.5-10.2 mg/dL.

Low calcium levels:

Lower than normal levels or Hypocalcemia may be due to:

  • Insufficient calcium in the diet
  • Decreased levels of vitamin D
  • Parathyroid gland abnormality such as poor functioning(hypoparathyroidism) or resistance.
  • Magnesium deficiency
  • Increase in phosphorus levels
  • Pancreatitis
  • Kidney failure

High calcium levels :

Higher than normal levels or Hypercalcemia may be due to:

  • Excess vitamin D intake
  • Increase in parathyroid function (hyperparathyroidism)
  • Cancer especially when it has spread to the bones
  • Prolonged immobility (when bones don’t bear weight, they release calcium)
  • Certain drugs such as lithium, thiazide diuretics etc
  • Kidney transplant
  • Diseases such as TB, Sarcoidosis, AIDS etc.

Foods that contain calcium :

  • Dairy products like milk, cheese and yogurt.
  • Sardines with the bones
  • Vegetables like broccoli, bok choy, turnips etc.
  • Dark greens like spinach, kale, watercress, collard greens etc.

Read the previous parts on Sodium LevelsPotassium Levels and Chloride Levels

Changed
13/Jun/2017

Stories

  • CKD Prevention
    Chronic Kidney Disease Prevention
    Can Chronic Kidney Disease (CKD) be prevented: The following may reduce your risk of developing or worsening CKD: Stop smoking and drinking alcohol Eat a balanced diet – avoid eating high cholesterol foods Exercise regularly Avoid usage of unprescribed medicine e.g. NSAIDs (pain killers) and abuse of antibiotics Manage your diabetes well Control your blood pressure
  • CKD Stages Complications
    Stages and Complications of Chronic Kidney Disease
    Different stages of Chronic Kidney Disease(CKD) Stage 1: The eGFR (estimated GFR) shows normal kidney function but you have some pre-existing kidney damage or disease. eGFR is 90 or more ml/min/1.73m2. This is the first stage of CKD.  Stage 2: Mildly reduced kidney function and you are already known to have some kidney damage or disease. Stage 3: Moderately reduced kidney function (with or without a known kidney disease. For example, an elderly person with ageing kidneys may have reduced…
  • CKD Causes and Risks
    Causes of Chronic Kidney Disease and Risk Factors
    What causes Chronic Kidney Disease (CKD) Diabetes mellitus (an increase in blood sugar level) raises the risk of developing CKD.  Hypertension (high blood pressure), if poorly controlled, can lead to CKD. CKD can also cause high blood pressure. Diabetes and hypertension together are responsible for two-thirds of cases of CKD. Glomerulonephritis, a group of diseases that cause inflammation and damage to the kidney's filtering units. These disorders are the third most common type of kidney…
  • CKD Tests Diagnosis
    Chronic Kidney Disease Tests
    Tests for Chronic kidney disease In many CKD patients, previous renal disease or other underlying diseases are already known. A small number present with CKD of unknown cause. Assessment of GFR is the best test to measure the level of kidney function and determine the stage of kidney disease. Urinary tract ultrasound and abdominal ultrasound, in which the size of the kidneys is measured. Kidneys with CKD are usually smaller (< 9 cm) than normal kidneys, with notable exceptions such as in…
  • CKD Chronic Kidney Disease Treatments
    Treatment for Chronic Kidney Disease
    Your doctor may suggest the following treatments for CKD: Control of blood pressure Treatment of the original disease, like treatment of diabetes Angiotensin converting enzyme inhibitors (ACEIs) or angiotensin II receptor antagonists (ARBs) to control the progression of kidney disease by improving renal blood flow  Replacement of erythropoietin and calcitriol (intravenous or intramuscular iron therapy prior to treatment with erythropoietin is recommended) Phosphate binders used to control…
  • CKD Symptoms Signs
    Chronic Kidney Disease Symptoms
    Symptoms of Chronic Kidney Disease Initially there are no specific symptoms and Chronic Kidney Disease is generally only detected as an increase in serum creatinine or protein in the urine. As kidney function decreases, you may have the following symptoms of CKD: Feel more tired and have less energy Have trouble concentrating Have poor appetite Have trouble sleeping Have muscle cramping at night Have swollen feet and ankles Have puffiness around your eyes, especially in the morning Have dry,…
  • Palliative care in Kerala - lessons and answers
    With a palliative care policy formulated in 2008, Kerala has become a path-breaker and a model for the rest of the country. Professor Devi Vijay of IIM Calcutta provides some insights into this community-based aspect of health care.  1. What can the rest of the country learn from the success of the Kerala palliative care story?How can other countries and communities leverage this community-based model?  There are several elements of the Kerala palliative care movement worth examining…
  • Care for the Caregiver
    Maya Ramachandran shares her experience as a caregiver to her parents and the learnings she drew from this. Caregiving is soul-satisfying, meaningful, draining and frustrating all at the same time. I had been a caregiver for my father for almost 16 years. My mother took charge from the forefront and I was with her, supporting her to the best of my ability through this period. However, for the last two years of my father’s life, I took on the role of ‘primary caregiver’, as my mother…
  • Cancer poem
    CANCER: A friend who warns or a foe with thorns!
    A poem by Rita Banik, Founder, RACE to rein-in-cancer The never uttered word CANCER  The word that fills our heart with grief  Turns our feet cold with fear The word that haunts and shatters … How long shall we go on fearing? How long shall we keep running away? The more we run, the faster it chases  The faster you erase the quicker it re-appears! Now cancer invokes anger in me The anger that returns  Every time someone is diagnosed   Every time cancer takes a life…
  • Cancer Management
    Management of Cancer
    Food and Nutrition Cancer and cancer treatments can be harsh on the body. Lack of appetite, weight loss and muscle wasting are common during cancer and treatment. Healthy food choices that are high in calories and proteins can boost cell growth, weight gain and improve recovery. Here are some tips for good nutrition that can be followed while treatment is ongoing: Eat small  and frequent snacks Eat every few hours Include lots of leafy greens and vegetables in the diet (but make sure they…