Calcium

Overview

Calcium is a mineral found in your body and in many foods. It keeps your bones and teeth strong, and it also helps your muscles, nerves, and heart work properly. Most of your calcium is stored in your bones, but the right amount needs to be in your blood too. When calcium levels are too high or too low, it can cause health problems.

Both low and high calcium levels are fairly common in clinical practice, especially in older people and people with certain health conditions.

It can affect anyone, but you may be more at risk if you have kidney disease, parathyroid problems, vitamin D deficiency, or take certain medications.

Symptoms

Common symptoms

• Muscle cramps or spasms
• Tingling or numbness in fingers, toes, or lips
• Fatigue or weakness
• Bone pain or fragility
• Dry skin or brittle nails
• Irregular heartbeat

Symptoms in children

• Irritability or fussiness
• Poor appetite
• Muscle twitching
• Delay in growth or teething

Symptoms in older adults

• Confusion or memory changes
• Muscle weakness that may cause falls
• Bone fractures
• Depression or low mood

Causes

Main causes

• Low levels of vitamin D
• Problems with the parathyroid glands (which control calcium)
• Chronic kidney disease
• Certain medications
• Only eating a very poor diet (rare)

Risk factors

• Being over 65
• Having thyroid or parathyroid surgery
• Using certain medicines over a long time
• Not getting enough calcium or vitamin D in your diet
• Having a family history of calcium disorders

When to see a doctor

See a doctor urgently if:

• If you have symptoms of very high or low calcium, such as severe weakness, heart palpitations, or confusion, seek medical care the same day.

Book a routine appointment if:

• If you have mild symptoms like ongoing tiredness, muscle aches, or changes in appetite, make an appointment with your doctor.

Diagnosis

A doctor can check your calcium level with a simple blood test. If it is outside the normal range, they may order more tests to find the reason.

Tests that may be done

• Blood test for calcium and albumin (a protein that helps measure calcium correctly)
• Parathyroid hormone (PTH) blood test
• Vitamin D test
• Kidney function tests
• Urine calcium test

What to expect at your appointment

Your doctor will discuss your symptoms and medical history. You may need to fast before the blood test. Results usually come back within a few days, and your doctor will explain what they mean.

Treatment

Treatment depends on whether your calcium is too high or too low, and on the underlying cause. The goal is to bring your calcium back to a safe level and treat the reason it changed.

Self-care at home

• Eat foods rich in calcium, such as dairy products, leafy greens, and fortified foods.
• Get enough vitamin D through safe sun exposure and foods like oily fish.
• Stay well hydrated.
• Do not take extra calcium or vitamin D supplements without talking to your doctor.

Medical treatments

For low calcium, doctors may recommend calcium and vitamin D supplements. For high calcium, treatment may include extra fluids through a vein, and medicines that help lower calcium levels. The exact approach depends on your personal situation and the cause.

When is surgery considered?

In some cases, if a parathyroid gland is overactive, surgery may be advised to remove the abnormal gland. Your doctor will discuss this option if it is appropriate for you.

Living with this condition

If you have a calcium imbalance, you may need regular blood tests to check your levels. Many people manage with diet changes and supplements, and they go on to live active lives.

Lifestyle tips

• Follow your doctor's plan for follow-up visits.
• Take supplements exactly as advised.
• Tell your doctor if you start any new medicines.
• Wear a medical alert bracelet if you have a condition that puts you at risk of dangerously low or high calcium.

Diet and exercise

A balanced diet with calcium-rich foods and weight-bearing exercises like walking or resistance training can help keep your bones strong.

Mental health and emotional wellbeing

Living with a chronic condition can feel worrying. It's normal to feel anxious or low. Talking to your healthcare team and trusted people can help.

Prevention

Not all calcium problems can be prevented, but you can reduce your risk by eating a balanced diet, getting enough vitamin D, staying active, and managing underlying conditions with your doctor.

Screening programmes

Routine screening is not needed for everyone. Your doctor may check calcium levels if you have symptoms or risk factors.

Complications

If left untreated

• If left untreated, very low calcium can cause seizures or heart rhythm problems.
• Very high calcium can lead to kidney stones, kidney damage, or severe confusion.
• Chronic imbalances can weaken bones and cause fractures.

Long-term outlook

With proper diagnosis and treatment, most calcium imbalances can be corrected or well controlled. Many people improve quickly once the underlying cause is treated, and they can stay healthy and active.

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