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Common Causes of Hypocalcemia

If you experience unexplained tingling lips, muscle spasms, or odd heart rhythms, your body might be giving you early warning signs of a calcium disorder, namely hypocalcemia.

Here’s The Endocrine Center’s expert guide to hypocalcemia, its causes, and treatments. 

Hypocalcemia 101

Hypocalcemia means you have abnormally low levels of calcium in your blood. Unfortunately, it often goes undiagnosed. 

Calcium isn’t just the building block of strong bones; it also contributes to the health of your muscles and nerves, blood coagulation, and hormone release. Therefore, running low on calcium interferes with several bodily functions.

Hypocalcemia occurs when your total serum calcium level falls below the normal range, which typically spans between 8.5 and 10.2 milligrams per deciliter. This decrease can trigger symptoms ranging from subtle neuromuscular irritability — in the form of numbness, tingling, and muscle cramps — to pronounced alterations in mental status and cardiac function.

Beyond acute symptoms, hypocalcemia can also play the long game, paving the way for more chronic issues, such as osteoporosis, the weakening of bones over time, and rickets, a soft bone disease that typically affects children.

Root causes of hypocalcemia

Hypocalcemia stems from multiple potential pathways involving various internal and external factors. Here are some of the most common culprits.

Vitamin D deficiency 

Even in Texas, where sunshine is a constant, many Houstonians grapple with vitamin D deficiency — a pivotal player in your body’s calcium homeostasis. 

Vitamin D, often dubbed the “sunshine vitamin,” enables proper absorption of dietary calcium from your gut. Whether you lack sun time, your diet lacks vitamin D, or your metabolism fails to process vitamin D, hypocalcemia could result.

Parathyroid problems

Sometimes, surgical interventions cause collateral damage. The parathyroid glands, four small glands near your thyroid, play a crucial role in managing your body’s calcium levels. 

When these glands are damaged or removed during surgery, it can lead to hypoparathyroidism. This condition disrupts the usual regulation of calcium in your body, paving the way for hypocalcemia and its complications.

Genomic issues

Certain genetic disorders significantly contribute to the development of hypocalcemia. For instance, autoimmune polyendocrine syndrome Type 1, a condition characterized by the malfunctioning of various glands in the body, can lead to hyperparathyroidism, a direct cause of hypocalcemia. 

Genetic conditions often lead to calcium imbalances that affect the parathyroid glands’ ability to produce sufficient amounts of parathyroid hormone (PTH), which is crucial for maintaining calcium levels.

Renal and liver disease

Renal (kidney) disease impairs your body’s ability to convert 25-hydroxyvitamin D into its active form, calcitriol, so your kidneys can’t reabsorb the calcium. 

Similarly, severe liver disease can lead to a deficit in vitamin D, which is crucial for calcium absorption and regulation. 

Both conditions significantly contribute to the development and exacerbation of hypocalcemia.

Heavy metals

Heavy metals, such as copper and iron, directly affect your parathyroid glands’ ability to regulate calcium levels. These substances can accumulate, become toxic, and disrupt the glands’ function. 

Minimizing your exposure to heavy metals can help you prevent and detect hypocalcemia related to this environmental culprit.


When cancer metastasizes to the parathyroid glands, it can impair their ability to produce PTH, essential for calcium balance, revealing a critical connection between environmental exposure to toxic substances, the development of certain cancers, and the risk of developing hypocalcemia. 


Hypomagnesemia or hypermagnesemia mirrors and shadows hypocalcemia because magnesium and calcium are interdependent. Among its many responsibilities, magnesium helps you produce PTH — critical in controlling calcium. Low PTH can lead to secondary hyperparathyroidism.


Certain medications, from antibiotics to antiepileptics, impact your body’s calcium levels. Their interference with the parathyroid hormone, vitamin D metabolism, or calcium absorption mechanisms can set off the hypocalcemic alarms.

Diagnosing hypocalcemia

Diagnosing hypocalcemia isn’t as simple as checking for a fever. The Endocrine Center physicians employ a battery of tests — including serum calcium levels, PTH assessments, and imaging studies — to create a differential diagnosis. It’s about finding hypocalcemia as well as understanding why it’s occurring.

Treating hypocalcemia

Hypocalcemia treatment regimens vary, not just by cause but often by patient response. 

If hypocalcemia is your body’s response to a lack of dietary calcium or vitamin D, the solution might be as simple as a dietary change or multivitamin enhancement. 

However, when the issue emanates from underlying problems, the therapies include more comprehensive strategies that address the root cause, stabilize your calcium levels, and prevent recurrences.

If you suspect hypocalcemia, don’t ignore the signs; call The Endocrine Center in Houston, Texas, or request an appointment online.

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