Pathophysiology

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·         Calcium is an important electrolyte in the body.

·         The storage of the calcium takes place in the bones

·         Amount of calcium in the blood is tightly regulated

·         The level of calcium is controlled by Calcitonin and parathyroid hormone.

·         Calcium ions play an important role in regulation muscle contraction, enzyme activity, and blood coagulation.

·         Calcium ions are critical to the signaling when controlling a variety of cellular processes.

·         Calcium exists as a free cation, in bound state, and complexed with other ions.

·         Calcium signaling pathway indicates the role of the mineral in regulating the enzymes and proteins.

·         Calcium function as a signal transducer through the activation of ion channels.

Hpyo < 8.8 mg/dL

·         Vitamin D deficiency

·         Magnesium deficiency

·         Chronic and acute renal failure

·         Parathyroid problems

·         Certain medications

Hyper > 10.5 mg/dL

·         Hyperparathyroidism

·         Some of forms of cancers including cancer of the lung and breast

·         Hereditary factors \

·         Severe dehydration

·         Vitamin D over-supplementation

Hypo < 8.8 mg/dL

·         Hypoalbuminemia

·         Hyperphosphatemia

·         Medication effects

·         Vitamin D deficiency

Hyper > 10.5 mg/dL

·         Overactive parathyroid glands

·         20-30% cancer patients develop hypercalcemia.

·         Elevated levels of Vitamin D.

·         Hypocalcemia develops when the ECF falls below the recommended range

·         Hypercalcemia develops when there is a surge or rather an increase in the ECF calcium levels.

·         Changes in the calcium levels in the body results in an change in the total calcium in the extracellular matrix.

Hypercalcemia

·         CNS effects such as coma, confusion, lethargy

·         Renal effects such as polyuria, kidney stones, and renal failure

·         Gastrointestinal effects; constipation, anorexia, pancreatitis.

Hypocalcemia

·         Neuromuscular symptoms; dysphagia, muscle cramps, numbness

·         Neurologic symptoms; irritability, fatigue, seizures

·         Dermatologic manifestation; coarse hair, brittle nails, cataracts, poor dentition.

·         Hyperglycemia: Diagnosed using blood tests

·         Hypoglycemia: Basic Blood Tests/Metabolic Panel

Hypo

·         Vitamin D supplementation

·         Magnesium and Calcium supplementation

·         Change in the diet

Hyper

·         Reduction in dietary intake of calcium and Vitamin D

·         Giving the patient Bisphosphonates

·         Treating using denosumab (Xgeva)

Hypercalcemia

·         Osteoporosis

·         Kidney Stones

·         Kidney failure

·         Nervous system problems

·         Arrhythmia

Hypocalcemia

·         Fractures

·         Disability

·         Chronic Muscle Pain

·         Dental Problems

·         Seizures