Understanding Calcium Deficiency: Symptoms, Causes, and Management -Dr Harika Uppalapati

Calcium is a crucial mineral required for bone health, muscle movements, and heart regulation. A lack of calcium in the body can lead to numerous symptoms and health issues. Understanding calcium deficiency is crucial for prevention and early intervention.

Symptoms of Calcium Deficiency

A deficiency of calcium can show itself in a range of symptoms:

• Confusion and Memory Loss: Calcium is essential for functionalities of the brain, and a deficiency can disrupt cognitive abilities, resulting in confusion and forgetfulness.
• Muscle Spasms and Tetany: Low levels of calcium may produce muscle spasms or tetany (involuntary and painful contraction of muscles).
• Numbness & Tingling: A deficiency can cause tingling or numbness, typically in the hands, feet, or face.
• Depression: Calcium is used to regulate mood, and low levels can result in depression or anxiety.
• Malnutrition: If the diet is inadequate in critical nutrients, it may also lead to calcium deficiency.
• Seizures: Neuromuscular transmission and muscle contraction may be impaired due to severe deficiency, leading to seizures.
• Muscle Cramps: It is also a common symptom of low calcium that you can experience muscle cramps, especially in legs or feet.
• Pain-Free Bone Fractures: Calcium is essential for bone density. A lack of this vitamin causes weak bones that are more prone to breaking.
• Weak, Brittle Nails And Hair: Calcium helps maintain healthy nails and hair, and a deficiency can lead to brittle and thinning hair and nails.

Causes of Calcium Deficiency

Several factors contribute to calcium deficiency, including:

1. Inadequate Intake: Chronic low calcium intake, especially during childhood or adolescence, can result in deficiency.

2. Medications: Some medicines can decrease calcium absorption, such as anticonvulsants (e.g., phenytoin), corticosteroids and diuretics.

3. Dairy Intolerances: People who are lactose intolerant or allergic to dairy may not have adequate calcium in their diet. This is more frequent in women, as menopause hormonal changes drive lower calcium absorption.

4. Medical Disorders: Disorders that cause malabsorption, kidney disease, pancreatitis and low levels of magnesium can affect calcium in the body.

5. Familial Traits: Certain genetic issues also lead to calcium absorption or metabolism problems.

Additional factors include vitamin D deficiency (as it hinders calcium absorption) and severe malnutrition resulting in deficits of numerous nutrients including calcium.

Other contributing factors include vitamin D deficiency, which impairs calcium absorption, and severe malnutrition that leads to deficiencies in multiple nutrients, including calcium.

How to Assess Calcium Deficiency

To diagnose calcium deficiency, doctors usually perform several tests:

1. Serum Calcium and Phosphate Levels: Test for Serum Levels of Calcium and Phosphate: These are blood tests to measure calcium and phosphate levels to show deficiency.

2. Parathyroid Hormone (PTH): When calcium drops, the parathyroid gland secretes more of a hormone called parathyroid hormone (PTH) to help control calcium balance. High PTH may mean there is not enough calcium.

3. Vitamin D Levels: Because vitamin D is necessary for absorbing calcium, if vitamin D is deficient in an individual, it affects their calcium status.

4. Magnesium levels: Magnesium works in tandem with calcium, and a lack of magnesium can worsen calcium deficiency.

5. ECG: Low calcium can have effects on heart function, commonly prolonging the QT interval seen on ECG and usually required cardiac monitoring.

Other screening tests may involve serum urea, electrolytes, and signs of latent tetany (e.g., Chvostek’s sign [facial twitching] or Trousseau’s sign [muscle spasms when a blood pressure cuff is inflated]).

Managing Calcium Deficiency

The treatment of calcium deficiency involves addressing the root cause and replenishing calcium levels:

• Dietary Changes: Increasing calcium intake through food is the first step. Dairy products, leafy greens, fortified plant-based milk, and fish with bones (like sardines) are excellent sources of calcium.
• Calcium Supplements:  If diet is insufficient, calcium supplements can replenish normal levels.
• Vitamin D: Without adequate vitamin D, calcium cannot be absorbed. Increasing the absorption of calcium through sunlight (or vitamin D-rich foods) or supplementation can increase the uptake of calcium.
• Medications: If underlying health conditions or medications are leading to the deficiency, treatment adjustments or management of underlying health conditions may be necessary.

Long-term follow-up and treatment may be warranted if chronic calcium deficiency occurs.

Symptoms of either physical or mental health issues can be caused by calcium deficiency. Catching the problem early — with diet, supplements or medical help — is important to prevent complications such as osteoporosis and fractures.

If you have any symptoms of calcium deficiency, it’s critical that you see a healthcare provider for appropriate diagnosis and treatment. With proper maintenance, getting calcium at adequate levels is possible and is an important aspect of bone health, muscle performance, and general health.