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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.
In a healthy physiology, extracellular calcium levels are maintained within a tight range through the actions of parathyroid hormone, vitamin D and the calcium sensing receptor. [1] Disorders in calcium metabolism can lead to hypocalcemia, decreased plasma levels of calcium or hypercalcemia, elevated plasma calcium levels.
Hypocalcemia is a medical condition characterized by low calcium levels in the blood serum. [5] The normal range of blood calcium is typically between 2.1–2.6 mmol/L (8.8–10.7 mg/dL, 4.3–5.2 mEq/L), while levels less than 2.1 mmol/L are defined as hypocalcemic. [1] [3] [6] Mildly low levels that develop slowly often have no symptoms.
Older adults with calcium and magnesium deficiencies also had poorer cognitive performance compared to peers with adequate micronutrient levels, a recent study has found.
glucocorticoids increase urinary calcium excretion and decrease intestinal calcium absorption no effect on calcium level in normal or primary hyperparathyroidism; effective in hypercalcemia due to malignancy with elevated vitamin D levels (many types of malignancies raise the vitamin D level). [22] also effective in hypervitaminosis D and ...
Calcium is a common constituent of multivitamin dietary supplements, [8] but the composition of calcium complexes in supplements may affect its bioavailability which varies by solubility of the salt involved: calcium citrate, malate, and lactate are highly bioavailable, while the oxalate is less.
Vitamin D increases absorption of calcium and phosphate in the intestinal tract, leading to elevated levels of plasma calcium, [4] and thus lower bone resorption. Calcitriol (1,25-dihydroxycholecalciferol) is the active form of vitamin D 3. [10] It has numerous functions involved in blood calcium levels.
However, excessive ingestion of calcium of more than 10-15 g per day has been reported to cause calcium levels too high for renal calcitriol suppression to control, resulting in net calcium absorption that ultimately causes hypercalcemia. [3] [10] Hypercalcemia affects the kidneys in multiple ways that altogether contributes to hypovolemia.