Low serum calcium level is termed hypocalcemia. Hypocalcemia can occur due to numerous reasons. Low thyroid hormones level (hypoparathyroidism and pseudohypoparathyroidism), low serum protein levels (hypoproteinemia), vitamin D deficiency, inflammation of the pancreas, kidney diseases, high protein diet, some drugs, and gastric surgery causes impair calcium absorption. Calcium deficiency led to the development of tetany and osteoporosis. Tetany is the syndrome characterized by hyperexcitability of the nervous system, producing cramps in the muscles. Tetany is classified into acute and chronic tetany. Acute tetany is due to surgical removal of the thyroid and parathyroid gland. Symptoms of acute tetany are irritation, confusion, paresthesia, pain, and spasm of the hands and feet. Bronchial muscle spasm can lead to dyspnea, laryngeal muscle spasm produces cyanosis, convulsions, and collapse. Gastrointestinal spasm produces dysphagia, vomiting, and pain stimulates intestinal and biliary colic. Chronic tetany is due to the low activity of the parathyroid gland. Symptoms of chronic tetany are irritation, depression, impairment of memory, changes in hair and nails, rough skin, pitted teeth, cataracts, and epileptic fits.
Osteoporosis is the loss of bone minerals. It is due to low calcium intake, deficiency or imbalance of hormones, some physical and circulatory factors. It is clinically manifested by low back pain, loss of weight, fractures of the vertebrae, neck of the femur, distal radius, ulna, and loss of teeth due to lack of bone support.
Diseases due to excessive calcium
Increased levels of calcium in the blood are known as hypercalcemia. Hypercalcemia can occur due to hyperactivity of the parathyroid gland that mobilizes calcium from bones into the blood, hypervitaminosis D, sarcoidosis, familial benign hypercalcemia, milk-alkali syndrome, destruction of bones due to cancer, and use of thiazide diuretics. Hypercalcemia is manifested as constipation, lassitude, lethargy, rapid onset of fatigue, and excessive urine. Hypercalcemia crisis produces loss of appetite, vomiting, nausea, dehydration, constipation, and severe abdominal pain related to peptic ulcer and pancreatitis.
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