Hypocalcemia, Its Causes and Management

Introduction

Parathyroid glands are four small glands included in the endocrine system that regulate the processing and the presence of calcium in the body. The glands are situated in the neck behind the thyroid gland and always monitor and regulate the levels of calcium in blood, bones, and the entire body (“Parathyroid gland introduction,” 2018). The glands produce the Parathyroid Hormone (PTH) that is necessary to regulate calcium levels and contribute to its efficient metabolism. The element is the most important in the body because it is imperative for controlling many systems of organs, which is why it should be regulated more consistently compared to others. Therefore, exploring the role and function of the Parathyroid gland is crucial for understanding its impact on the regulatory processes in the body.

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Main body

PTH is secreted from four parathyroid glands and is necessary to regulate the levels of calcium in the blood, predominantly by increasing them in cases when they are too low. The management of calcium deficiency or excess in the body is possible through the actions of the kidneys, bones, and intestine. When it comes to the function of the bones, PTH initiates the release of calcium that is stored in the bones into the bloodstream.

However, this decreases the strength of the bones and limits the ability of new bone development. PTH is also vital for the functioning of kidneys because it reduces the loss of calcium in urine while also stimulating the production of active vitamin D in the organ. In addition, PTH is necessary to increase the absorption of calcium from good in the intestine through its effects on vitamin D metabolism. When it comes to the control of PTH, the hormone is being managed with the help of negative feedback of calcium levels in the blood by the parathyroid glands. The secretion of PTH is stimulated with the identification of low calcium levels in the blood. When the calcium levels in the blood are too high, the release of the PTH is prevented.

The efficient regulation of calcium is needed because the element implements several essential functioning in the body. First, a sufficient level of calcium is necessary to provide electrical energy for the nervous system. Calcium provides the nutrients to facilitate electrical impulses for traveling along nerves, which means that element represents the key for the nervous system to conduct electricity.

This explains why the most common signs of high calcium levels and parathyroid disease include tiredness, weakness, and depression. Another vital role of calcium is the supply of electrical energy to the muscular system. The changes in calcium levels in the muscles provide energy for their contraction. When the levels of calcium are not correct, people are highly likely to feel week in their muscles and experience cramps (Stöppler, 2019).

Finally, calcium is needed to ensure the strength of the skeletal system. Since bones act as storage systems for the supply of calcium, the lack of the element weakens them. The effective production and regulation of PTH are thus imperative to ensure the sufficient amount of calcium in the body to facilitate the proper functioning of the nervous, muscular, and skeletal systems.

Calcium metabolism is the process involving movement and regulation of calcium through the gut and out through the gut and kidneys of the body as well as between body compartments, such as bone, the blood plasma, as well as intracellular fluids. Plasma calcium homeostasis represents an important aspect of calcium metabolism because of the need to regulate calcium ions in blood plasma. PTH and calcitonin regulate the level of calcium in plasma, with the hormone being released by the main cells of the glands when the calcium levels in the blood plasma fall below the normal range to raise them. In order to lower the presence of calcium in blood plasma, the parafollicular thyroid gland cells release calcitonin.

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Hypocalcemia is a widespread biochemical condition that can vary in the extent and impact from not showing symptoms in mild cases to causing acute life-threatening situations. In its essence, the condition implies low calcium levels in the blood serum. It is important to note that the normal range of calcium is between 2.1 to 2.6 mmol/L, which means that the levels below 2.1 are indicative of hypocalcemia. The usual range of calcium is regulated by PTH, calcitonin, and vitamin D through their specific influence on the functioning of the bowel, kidneys, and skeleton (Fong & Khan, 2012).

The most common reason for hypocalcemia development is the inadequacy in vitamin D supply or resistance to PTH (Fong & Khan, 2012). While the condition may occur without any symptoms, the widespread clinical manifestations of hypocalcemia include paresthesia (abnormal dermal sensation without any physical cause), spasms in muscle, seizures, cramps, circumoral numbness, and tetany (involuntary muscle contraction) (Fong & Khan, 2012).

More severe instances of the condition can present with such symptoms as cognitive impairment, personality disorders and disturbances, neuromuscular irritability, changes in the electrocardiography that mimic myocardial infarction, and heart failure (Fong & Khan, 2012). Therefore, when unaddressed, the deficiency in calcium can present significant complications for the quality of individuals’ lives.

When it comes to the management of the condition, several considerations should be mentioned. In acute cases, patients are given intravenous calcium when the levels of the element fall below 1.9 mmol/L, or the levels of ionized calcium are lower than 1mmol/L, or if patients show significant symptoms of low calcium (Fong & Khan, 2012). It is important to mention that the rapid correction of hypocalcemia can be a possible contributor to the occurrence of cardiac arrhythmia. Because of this, cardiac monitoring during the intravenous supplementation of calcium, especially among patients undergoing digoxin therapy.

Conclusion

In the case of long-term calcium deficiency management, the intake of oral calcium and vitamin D, as well as the latter’s metabolites is recommended besides hypomagnesemia (Murphy & Williams, 2009). Both calcium citrate and calcium carbonate have the most significant proportion of elemental calcium, 28%, and 40%, respectively (Murphy & Williams, 2009). The two substances are easily absorbed by the body, which is why they are seen as the most likely supplements to be prescribed to patients with hypoglycemia (Murphy & Williams, 2009).

Dietary modifications are also necessary to prevent the reoccurrence of hypocalcemia in the population. Apart from taking medicines as prescribed, it is recommended to eat foods rich in calcium, such as dairy products, dark green vegetables, eggs, and fatty fish. In addition, an active lifestyle is among the recommended management methods of calcium regulation due to the need to keep bones and muscles as healthy as possible.

References

Fong, J., & Khan, A. (2012). Hypocalcemia: Updates in diagnosis and management for primary care. Canadian Family Physician, 58(2), 158-162.

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Murphy, E., & Williams, G. (2009). Hypocalcemia. Medicine, 37(9):465-468.

Parathyroid gland introduction. (2018). Web.

Stöppler, M. (2019). Hypocalcemia: Symptoms & signs. Web.

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