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The plasma total calcium concentration is in the range of 2.2–2.6 mmol/L (9–10.5 mg/dL), and the normal ionized calcium is 1.3–1.5 mmol/L (4.5–5.6 mg/dL). [4] The amount of total calcium in the blood varies with the level of plasma albumin, the most abundant protein in plasma, and therefore the main carrier of protein-bound calcium in the blood.
The amount of biologically active calcium varies with the level of serum albumin, a protein to which calcium is bound, and therefore levels of ionized calcium are better measures than a total calcium; however, one can correct a total calcium if the albumin level is known. [citation needed]
Physiologically, blood calcium is tightly regulated within a narrow range for proper cellular processes. Calcium in the blood exists in three primary states: bound to proteins (mainly albumin), bound to anions such as phosphate and citrate, and as free (unbound) ionized calcium. Only the unbound ionized calcium is physiologically active. Normal ...
Diagnosis should generally include either a calculation of corrected calcium or direct measurement of ionized calcium level and be confirmed after a week. [1] This is because either high or low serum albumin levels does not show the true levels of ionised calcium. [ 15 ]
To calculate a corrected calcium in mmol/L one takes the total calcium in mmol/L and adds it to ((40 minus the serum albumin in g/L) multiplied by 0.02). [33] There is, however, controversy around the usefulness of corrected calcium as it may be no better than total calcium. [34] It may be more useful to correct total calcium for both albumin ...
Total body water in healthy adults is about 50–60% (range 45 to 75%) of total body weight; [1] women and the obese typically have a lower percentage than lean men. [2] Extracellular fluid makes up about one-third of body fluid, the remaining two-thirds is intracellular fluid within cells. [3]
Though calcium is the most plentiful electrolyte in the body, a large percentage of it is used to form the bones. [14] It is mainly absorbed and excreted through the GI system. [14] The majority of calcium resides extracellularly, and it is crucial for the function of neurons, muscle cells, function of enzymes, and coagulation. [14]
To prevent low bone density it is recommended to have sufficient calcium and vitamin D. [17] [18] Sufficient calcium is defined as 1,000 mg per day, increasing to 1,200 mg for women above 50 and men above 70. [18] Sufficient vitamin D is defined as 600 IUs per day for adults 19 to 70, increasing to 800 IUs per day for those over 71. [18]