Hypercalcemia vs Hypocalcemia

Calcium is an element that plays an important role in various functions of the body. Calcium contributes to the strength of bones and teeth while also playing a role in muscle contractions and regulating a normal heart rhythm. Studies have shown that most of the calcium is stored in teeth and bones while the remaining calcium circulates through the bloodstream, with its levels regulated via the parathyroid gland, the hormone calcitonin, and the absorption of vitamin D. When calcium levels are not in balance, it can have severe repercussions on biological processes and one’s health.

 

Calcium-Regulating Hormones

 

Calcium levels in the body are regulated by parathyroid hormones. These hormones are secreted from the parathyroid gland, which is situated behind the thyroid gland as a small rice grain-like gland. The parathyroid hormones regulate the rate at which calcium should be released from the bones into the bloodstream and determine calcium reabsorption via the kidneys. Another hormone that helps to regulate calcium levels in the body is calcitonin. This hormone is secreted from the thyroid gland and regulates calcium levels via two pathways.

The first method is by inhibiting the work of osteoclasts in bones. Osteoclasts are cells that break down bone to form new bone. When osteoclasts break down bone, calcium is released into the bloodstream; thus, calcitonin reduces the amount of calcium in the bloodstream by inhibiting this process.

The second method that calcitonin uses is to decrease the reabsorption of calcium from the kidneys into the bloodstream, also causing a decrease in calcium levels in the body. Vitamin D is another crucial factor for calcium absorption. In cases of insufficient vitamin D, dietary calcium’s absorption rate drops by about a quarter compared to when there is sufficient vitamin D. Vitamin D ensures optimal calcium absorption, helping to maintain normal calcium levels and ensuring the body functions properly.

 

Hypercalcaemia

 

Causes

Hypercalcaemia refers to an increased rate at which calcium is absorbed or released, resulting in higher-than-normal levels of calcium in the body. This condition is most often caused by hyperparathyroidism, which is when the parathyroid is overactive. Primary hyperparathyroidism occurs when the parathyroid produces excessive amounts of parathyroid hormones, creating an increase in calcium levels in the body, which can have serious health repercussions.

Secondary hyperparathyroidism is due to another condition that initially caused lower calcium levels, leading the parathyroid to enlarge as it tries to compensate. This often occurs due to kidney-related problems. Various cancers and medications, such as excessive vitamin D intake and thiazide diuretics, can also cause hypercalcaemia.

 

Signs and Symptoms

Hypercalcaemia usually affects females aged 50 years and older, especially post-menopause. Patients typically present with symptoms such as muscle weakness, constipation, abdominal pain, frequent urination, and increased thirst.

 

Diagnosis and Treatment

Hypercalcaemia is usually diagnosed via a blood test that measures calcium levels. To confirm the diagnosis, a parathyroid hormone blood test and a vitamin D blood test may also be requested, along with imaging scans of the parathyroid gland. In severe cases where hyperparathyroidism is the cause, surgery may be considered to remove the overactive glands. In milder cases, patients may be advised to drink more water, stop taking calcium supplements, and consult their doctor to switch from thiazide diuretics to a non-thiazide alternative.

 

Hypocalcaemia

 

Causes

Hypocalcaemia is defined by lower-than-normal levels of calcium in the body. Although this condition is less common than hypercalcaemia, it can be life-threatening if left untreated. Hypocalcaemia is most often caused by hypoparathyroidism, where the parathyroid glands do not produce enough parathyroid hormones, leading to insufficient calcium production and release from bones into the bloodstream. Another common cause is abnormally low levels of vitamin D, which impairs calcium absorption.

Kidney failure can also be a primary factor. Certain medications, such as bisphosphonates used to increase bone density, can also cause hypocalcaemia. Low magnesium levels indirectly cause low calcium levels, as the parathyroid gland requires magnesium to produce parathyroid hormone. In some cases, a genetic disorder can cause hypocalcaemia, particularly in infants. Hypocalcaemia can affect individuals of any age, from infancy to old age.

 

Signs and Symptoms

Hypocalcaemia can present with various life-threatening symptoms, such as severe muscle cramps, abnormal heart rhythms, seizures, and laryngospasm, which causes difficulty breathing.

 

Diagnosis and Treatment

Hypocalcaemia is diagnosed through blood tests that analyse calcium, parathyroid hormone, magnesium, and vitamin D levels. In some cases, a bone imaging test or an ECG may be required to check heart rhythms. Treatment typically involves calcium and vitamin D supplements, along with dietary adjustments to improve calcium levels. If the parathyroid gland is the cause, a synthetic hormone may be administered. In severe cases, intravenous calcium gluconate can be given to restore calcium balance.

You May Also Be Interested In.

What Is Hypo- And Hyperthyroidism?

When the thyroid is not functioning properly, it can lead to conditions such as hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid). These conditions can cause a range of symptoms and affect various bodily functions. Understanding these conditions is essential for diagnosis and treatment, as both hypothyroidism and hyperthyroidism can have significant impacts on overall health. […]

Read More

How Do Stress Affect Digestion?

Stress can affect your digestive system as the brain and gut are connected and constantly in communication. The gut is partly controlled by the central nervous system in the brain and spinal cord, and it also has its own network of neurons in the lining of the gastrointestinal system. The enteric nervous system regulates digestive […]

Read More

Impact Of Diet On Leaky Gut Syndrome

The concept of “leaky gut,” also known as increased intestinal permeability, has gained significant traction in recent years. It is described as “leaks” in the intestinal wall, where undesired food particles, bacteria, and harmful substances can enter the bloodstream. While research on its definitive role in various health conditions is ongoing, there is growing evidence […]

Read More

What is IBS Brain Fog?

Irritable Bowel Syndrome (IBS) is a digestive disorder of unknown origin that can cause a variety of unpleasant symptoms without leading to physical damage. If you have IBS, you’re likely familiar with digestive issues such as constipation, gas, bloating, or diarrhoea. However, IBS can also lead to brain fog, an impaired ability to concentrate. Although […]

Read More

What is Earthing?

Earthing, also known as grounding, is a practice that involves connecting our bodies with the Earth and utilising its natural electric charges to stabilise us. This is achieved by walking barefoot outdoors or using indoor grounding systems while sleeping or sitting. Although earthing differs from practices used in mental health treatment, it can have a […]

Read More
AdeaHealth Writing
Team.
Dr. Suzaan Jansen

BDS University of Western Cape; Dentist

Dané Kleynhnas

Bachelor of Pharmacy (B. Pharm & PCDT)

Cosette Greyling

Bachelor of Pharmacy
(BPharm & MPharm)

Salomé Jacobs

B.Pharm

AdeaHealth Video