by Rob Lamberts, MD
Today’s article will not focus on a disease or a specific symptom. I won’t solve any mysteries or suggest new euphemisms for bodily functions. Instead I am turning my attention to a much smaller thing. Actually, it’s about the smallest thing I could talk about: a single molecule, an element, and a substance vital for life called calcium.
Why Doctors Don’t Always Share Patient Test Results
Doctors order lots of tests on their patients, but are often reluctant to share the results with them. The reason for this is that the interpretation of lab tests is very complicated, and we don’t want to spend our time explaining what all of those letters and numbers mean. But the fact is, more people are accessing their own test results and trying to figure out what they mean. I hope this article will take a small step at reducing the confusion of patients and maybe even make those worried doctors happy.
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Why Is Calcium Important?
Calcium is an element, meaning it is a unique atom, made up of a certain number of protons and electrons. Calcium is often combined with other elements to form molecules, but often acts on its own, doing its own calcium stuff in a way that only calcium could do.
In your body, calcium is one of the most plentiful elements because of one thing: bones. Bones (and teeth) get their strength from calcium, and so most of the calcium in your body is just sitting around in bones, keeping them strong. But it does much more than that, floating around in the blood and helping the organs do what they need to do. One of its most important functions is to help muscles contract, including the heart muscle. So, the bottom line is this: without calcium you would be a dead pile of jelly.
How to Understand Calcium Levels
You have a certain level of calcium in your bloodstream, but that level is not really determined by how much calcium you eat. There are two kinds of cells in your bones that regulate your calcium level:
one that breaks down bone to release calcium into the bloodstream when your blood calcium is low, and
one that takes the calcium out of the bloodstream and deposits it in the bone when the blood levels are high.
These cells are regulated by a hormone called parathyroid hormone, which is put out (naturally) by the parathyroid glands, which are not part of the thyroid, but are surrounded by it. The parathyroid puts out more hormone in response to low calcium levels, making the bones break down and release calcium to the blood. If the level is high, the parathyroid gland lowers hormone levels and reduces breakdown of bone.
What Causes Calcium Problems?
So you see how problems can happen: if you don’t take in enough calcium, your body keeps the levels up in the blood by breaking down the bones. If this happens enough, the bones will get weak, fracturing easily. Another problem is that the parathyroid gland can get sick and put out too much hormone, breaking down the bone and raising the calcium levels too high. This is a condition known as hyperparathyroidism.
What Does a High or Low Blood Calcium Number Mean?
Low calcium is dangerous, causes significant muscle cramps, and should not be ignored.
So what does the calcium number on the blood test mean, and what does it mean if it is high or low? There are two types of calcium in the blood: inactive and active. Blood calcium level measures the total calcium in the blood, which—makes calcium levels tricky to interpret because the active calcium level is far more important.
Between a high calcium level and a low calcium level, the most dangerous is the low level. As I said earlier, calcium is important for muscle contraction. A low blood calcium can cause the muscles to painfully contract, a condition called tetany. Tetany is painful, but what is more dangerous is that the heart doesn’t function as well. That is why the parathyroid and the bones regulate calcium so carefully, and thankfully tetany is rare.
What Causes Low Calcium Levels?
The most common cause of a low calcium level is medication--specifically high phosphate containing medications, the most common of which are certain enemas and colon cleansing medications. That is especially dangerous for people with kidney problems. There are a few rare causes of low calcium which I’ll skip, but the bottom line is this: low calcium is dangerous, causes significant muscle cramps, and should not be ignored.
What Are Symptoms of High Calcium Levels?
A high calcium level is more common, but thankfully the symptoms are much less dangerous. People don’t usually have any symptoms for a mild elevation of the calcium. If the level gets high enough, it can cause some confusion, anxiety, constipation, and other nonspecific symptoms. The real danger is longer-term, as high calcium levels can cause bone thinning and easy fracture.
When Should You Get Your Calcium Levels Checked?
When should people get calcium levels checked? Fortunately, calcium is part of the most basic blood tests, so it is checked often. Problems with calcium are rare enough, however, that there is no need for routine testing.
Should You Take Calcium Supplements?
What about calcium supplements? In general, people get enough calcium in their diet to not need extra. Dairy is a main source of calcium, but you can get it from other foods--Nutrition Diva can tell you about them.
Some women should take calcium; current recommendations are that women near, in, or post menopause should take 1000mg calcium plus vitamin D every day, and those with inadequate intake should take 1500 mg. Vitamin D helps the body absorb calcium and use it properly.
There is one last issue that I need to touch on, and that is a recent study on the news suggested women taking calcium may have an increased risk of heart disease. That kind of study makes doctors very mad at scientists. It confuses our patients and makes life difficult for us. This is only one study, and there are currently many studies that tell of the benefits of calcium supplements. At the present time I do recommend taking calcium, but I’ll keep my eye on those pesky scientists and change if the evidence sways me.
Let me once again remind you that this podcast is for informational purposes only. My goal is to add to your medical knowledge and translate some of the weird medical stuff you hear, so when you do go to your doctor, your visits will be more fruitful. I don’t intend to replace your doctor; he or she is the one you should always consult about your own medical condition.
Catch you next time! Stay Healthy!