Ionized calcium increased to 1.33, what to do. Ionized calcium research
Since childhood, we have been told to eat more dairy products because they are rich in bone-healthy calcium. But this element is necessary not only for our skeleton, but also for blood, muscles, and nerve fibers. There are 2 forms of calcium: ionized and bound. Ionized calcium is not bound to proteins, so it circulates freely in the blood. A blood test for calcium plays a significant role in diagnosing the condition of the body. Thanks to its informative content, you can choose the correct dosage of medications. Based on its data, one can judge the metabolism minerals in organism.
Protein-bound calcium does not have such a significant effect on the body. This is the state of Ca at the time of transport.
What is calcium needed for?
Calcium is one of the essential elements human body. It influences the course of metabolic processes. Blood contains two fractions of this element - ionized and bound. The bound substance may include plasma proteins, citrates, and phosphates. This form of calcium makes up 55% of the total volume in the blood plasma. 40% of them are associated with protein, 15% are phosphorus and citrate.
It turns out that 45% of the blood plasma remains for active ionized calcium. In this state, calcium is capable of many things. Here is the list useful functions which it does:
Promotes growth and development of bone tissue;
Stimulates neurotransmitter secretion, thereby improving conductivity nerve fibers, since without this substance the transmission of neural impulses throughout the body is impossible;
It is one of the elements involved in the process of blood clotting;
Stabilizes the enzyme activity of the body;
Affects the intensity of muscle and heart contractions;
Reduces the permeability of the walls of blood vessels, thereby protecting them from exposure harmful substances.
The level of ionized calcium in the blood is important for the body. This is where he tries to send him first. Therefore, if a person’s teeth begin to hurt or bones become brittle, this is a clear signal of mineral deficiency. By the way, calcium also plays important role in regulation blood pressure. Another of its functions is to strengthen the immune system and activate most hormones and enzymes.
The bound form is less productive. Experts believe that deviations up or down are not always a symptom of a malfunction in the metabolic process.
A person should consume 850-1300 mg of calcium per day. The main thing is not to overdo it, because upper limit– 2500 mg. However, there are cases when increased consumption of this element is justified. For example, in the blood of pregnant women, or during lactation. The body's need for calcium also increases in athletes.
What to do to provide the body with this essential microelement? You should add the following foods to your diet:
From cereals - this is buckwheat;
From fruits - oranges;
Dairy products;
Legumes;
Vitamin D helps absorb calcium. It is often prescribed by pediatricians for newborns and older children.
There are also foods that interfere with the absorption of ionized calcium. These include:
Palm oil. It is found in the composition different products where you need to replace milk natural fat for various cheap ersatz;
Some types of animal fats;
Sweets that have an alkaline reaction. For example, some candies.
Norms for different age groups
Norm of ionized mineral for each age group its. The table below shows the numbers that an analysis for ionized calcium should show. Otherwise, the obtained value is considered a deviation from the norm.
In a child, ionized Ca is increased when compared with the adult category. This phenomenon is explained by the intensive growth of bones, which shows the body’s high need for this element. This situation lasts for children until they reach the age of 16.
During pregnancy;
During lactation;
When taking contraceptives.
Who should undergo the procedure?
Most often, know the level total calcium in the blood is enough to evaluate the process of mineral metabolism, since the ratio of free (45%) and bound (55%) forms is constant. But any rule has its exceptions, and for some people this ratio is violated. Therefore, it is advisable to conduct another type of study - an analysis of ionized calcium.
Significant fluctuations in the content of calcium ions have certain symptoms:
Unstable heart rhythm. She either speeds up or slows down her pace;
Muscle spasms;
Impaired consciousness.
The following conditions may serve as indications for donating blood for testing:
Cancerous tumors;
Preparation before surgery;
Gastrointestinal diseases;
Convulsions;
Pathology of the kidneys and urinary tract;
Changes in the cardiovascular system;
Pain in muscles and bones;
Low levels of proteins in the blood (hypoproteinemia).
So if you fall into one of these categories, then do not delay the study, as it will help you choose the right dosage of the required medication and make the course of therapy more effective.
Preparing and conducting analysis
In order for the result of the analysis of calcium levels to be normal and undistorted by various factors, it is necessary to prepare for it. Here is a small list of rules to follow:
Biomaterial is given on an empty stomach. The last meal should be 12 hours ago;
You can smoke 1 hour before visiting the laboratory;
Excluded and heavy loads before taking the analysis;
Many medications can help raise or lower calcium levels in the body. Therefore, 14 days before the test, you should refrain from taking them. Naturally, you should first consult with your doctor on this issue. If the doctor does not allow you to interrupt the course of treatment, then the study form will indicate the medications taken and their dosage.
Venous blood will be taken for the analysis. Currently in medical practice Two methods are used to determine the level of free calcium:
- For total calcium;
- Directly to the ionized form.
The first method is less expensive and therefore available in almost any government laboratory. It is financed by the compulsory medical insurance policy. The second method is more informative. It allows you not only to install accurate diagnosis, but also to develop an individual course of treatment.
Very an important condition is to conduct the study within 2 days after blood sampling. Otherwise, prolonged exposure to air may distort the results, increasing the reference value of calcium ions. So you will receive a form with the analysis results after 3 days.
The time of day when the biomaterial is taken for analysis also plays an important role. It is preferable to do the fence in the morning. If the biomaterial is taken in the evening, active calcium will most likely be higher than normal.
Reduced rate
If a patient’s level of calcium ions is low, the following symptoms indicate this:
With these symptoms, hypocalcemia is diagnosed. The reasons that caused this condition are different in nature:
Vitamin D deficiency;
Extensive burn injuries;
Lack of magnesium in the blood;
The period after surgery;
The intestines absorb calcium poorly;
Metabolic alkalosis (acid-base imbalance).
You should know that such a condition with an indicator of less than 0.7 mmol/l is critical and faces the possibility of death.
Increased rate. Hypercalcemia
Hypercalcemia is a disease in which there is elevated calcium in the blood. The test results in this case are more than 2.6 mmol/l. At this concentration, a calcium deposit forms in the vessels, liver and renal tissue, which makes them brittle. There is a high risk of developing heart failure. Hypercalcemia on early stage characterized by the following symptoms:
Nausea;
Lack of appetite;
Intensive kidney work;
Calcium is one of the most important elements that plays an extremely important role in our body. It helps muscles contract, takes part in metabolic reactions, participates in the synthesis of hormones, cell division and reproduction, strengthens bone tissue and is involved in a variety of other functions. physiological processes. And ionized calcium (Ca++) takes part in all these processes. It is also called free calcium, since it is not bound by proteins and is completely freely transported throughout the body. The amount of free calcium can reach 50% of the total calcium found in the body. At the same time, the concentration of free calcium reaches its maximum at approximately 3 a.m., while it reaches its minimum at approximately 8 p.m. The level of free calcium in the body can be influenced by various factors - the amount of protein, acid-base balance, magnesium, parathyroid hormone and vitamin D3 levels.
Calcium ionized norm. Explanation of the result (table)
Determining the level of ionized calcium in the blood can be important in order to monitor the progress of treatment with calcium preparations, heparin, magnesium, bicarbonate, especially in those patients who are undergoing recovery after surgery. At the same time, the concentration of ionized free calcium provides much more information to specialists than the level of total blood calcium. It allows you to identify possible hypercalcemia in a timely manner. This can be important for patients undergoing blood hemodialysis, as well as for those patients who have been diagnosed with various oncological diseases.
Typically, free calcium is in direct relation to total blood calcium levels. However, some diseases upset this balance, and then it is almost impossible to determine the level of free calcium by the level of total calcium. In these cases, the doctor prescribes a blood test to determine ionized calcium. It is very important to monitor fluctuations in this indicator when various diseases heart and blood vessels. An ionized calcium test is also prescribed for chronic renal failure, simultaneously with a test for parathyroid hormone levels. And when the patient has to constantly administer blood substitutes and intravenous saline solutions.
Frequent urination, attacks of vomiting, constant thirst, fatigue, lack of appetite - these are signs possible increase calcium level, which is also a sufficient basis for prescribing such an analysis, as well as suspicions of its decrease - muscle twitching, tremors of the fingers, muscle spasms and numbness of the skin of the runes and the area around the mouth.
Blood is drawn from a vein, on an empty stomach, in the morning.
Please note that during the second and third trimester of pregnancy, the concentration of free ionized calcium may decrease slightly. In fetuses and newborns this figure is usually slightly higher than in adults.
If ionized calcium is elevated – what does this mean?
An increase in the level of ionized calcium in the blood is always a very serious and alarming signal. Theoretically, there are three main reasons for this: primary hyperparathyroidism, bone tissue breakdown and the development of tumors of neuroendocrine origin.
Primary hyperparathyroidism is a disease in which one or more special glands located near thyroid gland tumors arise - benign adenomas. Such glands are commonly called parathyroid glands. These glands maintain normal levels of ionized calcium in the blood. If an adenoma appears in them, then the work of these glands is disrupted, the hormones they produce begin to release calcium from the bone tissue and send it into the blood. With primary hyperparathyroidism, there is not only a high level of calcium in the blood, but also a high concentration of the hormone parathyroid glands or, as it should be correctly called, parathyroid hormone.
Primary hyperparathyroidism entails calcium deficiency in bone tissue, increased fragility and fragility of bones, deformation, and slowed growth. On the other hand, excess calcium, which is in the blood, is deposited in the walls of blood vessels and in the clans of the heart muscle, which ultimately leads to stroke, myocardial infarction or thrombosis of veins and blood vessels.
Bone breakdown, which is the second most common cause of elevated ionized calcium levels in the blood, usually occurs due to the development of malignant tumor or metastases getting here. Unlike primary hyperparathyroidism, in this case, the level of parathyroid hormone remains within normal limits.
Finally, the third reason is tumors, which are called neuroendocrine. As a rule, they begin their development in the lungs, although they can affect any other organ. A distinctive feature of such tumors is that the amino acids they produce are very similar in properties to the already mentioned parathyroid hormone. Therefore, it also causes an increase in the level of ionized calcium in the blood.
Excessive intake of vitamin D, especially its active form, vitamin D3, can have the same result.
If ionized calcium is low - what does this mean?
If there is a lack of ionized free calcium in the blood, then the following symptoms gradually develop:
- rachiocampsis,
- osteoporosis,
- muscle spasms,
- deterioration of dental condition,
- brittle hair and nails.
Besides reduced content calcium in the body leads to nervous conditions, cardiac arrhythmia, increased blood pressure, and deterioration of memory. Therefore, calcium deficiency in the blood is also a very unpleasant symptom. It may occur due to the following reasons:
hypoparathyroidism – reduced function parathyroid glands caused by surgery, tumor processes, autoimmune diseases and so on. In any case, the production of parathyroid hormone decreases, which leads to a decrease in the level of calcium in the blood,
- alkalosis,
- blood transfusion containing citrate,
- pancreatitis,
- vitamin D deficiency,
- magnesium deficiency,
- extensive burns,
- sepsis,
- change acid-base balance,
- postoperative conditions.
Please note that a decrease in blood calcium levels to less than 0.7 mmol/l is critical and threatens not only health, but also human life.
When a disease is detected, sometimes it is not enough to determine total calcium (Ca), as a result, doctors prescribe a test for ionized calcium to find out its level in the blood.
Some people are confused by the specialist’s offer, as they believe that it is the same thing. Therefore, it is worth understanding what the difference is between them.
Ca- essential macronutrient, entering human body from food. The bulk of the mineral is concentrated in bone tissue and tooth enamel, and only one percent circulates in the blood.
There are three forms of calcium:
- associated with proteins;
- complexed with anions.
The first fraction makes up approximately 46% of the total and differs from the rest in that Ca ions are not associated with other elements, as a result of which it moves freely through the blood. It is this active part that is the main indicator of ongoing laboratory research, since free calcium performs many physiological functions.
Usually in people the balance between total and ionized Ca is stable, but sometimes some diseases disturb this balance, and the concentration of total Ca does not serve as a guide for the entire calcium metabolism. Therefore, testing for Calcium free is advisable to detect pathologies in the body.
Ionized Ca occupies an important place in metabolic processes. Among his tasks:
- Regulating the rhythm of the heart muscle and ensuring muscle contraction.
- Along with phosphorus, it takes care of the health of bones, teeth, nails and hair.
- Resists the formation of blood clots.
- Regulates iron saturation in the blood and enzyme activity.
- Assistant in the creation of hormones.
- Affects the functioning of some endocrine glands.
- Contributes to the fight against allergic reactions.
- Helps strengthen the immune and nervous systems.
Calcium enters the body with food and is excreted through small intestine and kidneys.
Normal blood calcium levels
depends on age and gender. Even in the womb, in the third trimester of pregnancy, the fetus begins to accumulate calcium.
And this continues until about 30-35 years. Slow bone loss then occurs.
The process usually accelerates during menopause. At this time, there is a danger of osteoporosis.
After examining the patient and based on his complaints, the doctor suggests that he take biochemical analysis blood from a vein to find out the calcium concentration in the body.
The concentration of free calcium is not constant. The greatest saturation of plasma occurs in the morning, the least in the evening.
In a child, ionized Ca is usually elevated, as this is associated with bone growth. In women, this situation is explained by: pregnancy, period breastfeeding, as well as taking contraceptives.
The average level of total calcium in the blood is 2.1-2.8 mmol/l. Ionized is half as much - 1-1.32. Each indicator is individual, as it depends on many circumstances. The amount of Ca ions is determined in millimoles per liter of quantitative composition.
The concentration of total Ca in the blood is usually determined in public health institutions. To get tested for ionized calcium, you should contact a paid laboratory.
Reasons for the increase in Ca ions
An increase in the substance in the blood leads to hypercalcemia.
The disease is characterized by sedimentation of the mineral on the walls of blood vessels, in the liver and kidneys.
Subsequently develops urolithiasis disease, the work of the heart is disrupted, destructive processes in the biliary tract and the largest gland of the human body are activated.
Other signs of pathology:
- high levels of vitamin D;
- Williams syndrome in newborns;
- malignant tumors and metastases affecting bones;
- adrenal insufficiency;
- hereditary excess calcium;
- blood diseases;
- increase in the number of thyroid hormones;
- dehydration of the body;
- progressive joint degeneration;
- dystrophic changes in all parts of the small intestine;
- chronic inflammatory process in the lungs.
Transplantation of one of the paired urinary organs also increases Calcium free. The level of the mineral also increases from the action hormonal drugs, antacids, drugs containing lithium salts and excessive consumption of foods that contain calcium.
Often the coefficient is higher than normal due to an incorrectly performed blood sample test. The results may be affected by contact of the biomaterial with open air.
Symptoms
With a high level of macronutrient content, it is characteristic increased fatigue, weakness throughout the body, convulsions are possible. Gradually subsides physical activity, the rhythm of the heart is disturbed. Hypercalcemia is accompanied by nausea and thirst.
Therapy
If an increased level of calcium ions is detected, the diet is adjusted. Coffee, cocoa, animal proteins, and salt are removed from the menu.
When a person's kidneys are functioning normally, but there are other signs of disease, then medical worker prescribes a drinking regime.
Water rids the body of excess calcium, while protecting it from dehydration.
In some situations, fluid is administered intravenously. If the method does not help, then the doctor prescribes a dialysis session.
The treatment for elevated Ca depends on specific disease.In the case of tumor formations, therapy is not carried out. If there are problems with the parathyroid glands, surgery is often performed to remove them.
Reasons for the decrease in Ca ions
The main factor is a disruption in the functioning of the intestines, due to which the substance is slowly absorbed.
Accordingly, deficiency leads to insufficient bone mineralization and disruption of the acid-base balance.
Hypocalcemia is caused severe burns, recovery period after major surgery, childhood rickets.
When the percentage of calcium is below normal, this indicates kidney disease and acute pancreatitis.
The reason is failures in hormonal balance in women, profuse sweating. The amount of the mineral is affected by insufficient intake of vitamin D and required quantity magnesium
Addiction to alcoholic beverages, taking medications for the treatment of epilepsy and tumors, glucocorticosteroids, laxatives and magnesium salts lead to a decrease in ionized calcium.
Symptoms
Hypocalcemia is determined by the following signs:
- increased excitability and irritability;
- deterioration of emotional state;
- blood clotting disorder;
- hypertension;
- periodic migraines and dizziness;
- dry skin;
- dullness, brittleness and lifelessness of hair;
- damage to hard dental tissues and destruction of nail plates.
Treatment
The general condition of the body improves greatly by following a diet.
The menu includes products containing calcium salts: milk, cottage cheese, butter, raw egg yolk, shrimp, squid, sea fish.
The diet includes some fruits, vegetables and berries, herbs, legumes, bran, honey.
In cases where the first method does not bring the desired results, vitamin complexes and medications are prescribed.
Ionized calcium regulates multiple processes occurring in the body. And changes, up or down, directly affect a person’s condition. In both cases, it is recommended to contact a specialist who, based on laboratory tests, venous blood, will make a diagnosis. In particular, self-medication is prohibited, as this can lead to complications.
Video on the topic
Increased blood calcium- a symptom that should always be the reason for an in-depth examination, since the underlying disorders can be truly dangerous for the patient. If you have done a test and your blood calcium is elevated, you need to mandatory undergo a consultation with an endocrinologist who will conduct an examination according to currently established standards.
Increased calcium in the blood - what could it be?
Theoretically, there are three most likely clinical problems that could cause increased content calcium in the blood. All possible reasons for calcium levels in the blood being higher than normal are quite serious.
The first cause of high blood calcium is primary hyperparathyroidism, a disease accompanied by the appearance of a tumor in one or more parathyroid glands (it would be more correct to say “parathyroid glands,” but the term “parathyroid glands” is very widely used). The main task of the parathyroid glands in the body is to maintain normal blood calcium levels. The cells of the parathyroid glands “know how” to sense the concentration of calcium in the blood plasma and, in accordance with the level of calcium, produce parathyroid hormone. The main effect of parathyroid hormone is to increase the level of calcium in the blood (by destroying bone tissue and releasing calcium from it into the blood, as well as by enhancing the absorption of calcium from primary urine in the kidneys and enhancing its absorption from the intestines). When a tumor occurs in the parathyroid gland, its cells stop sensing the concentration of calcium in the blood - it “seems” to them that there is no calcium in the blood, or that it is low. Tumor cells begin to uncontrollably produce parathyroid hormone, which sharply increases the breakdown of bone tissue and the release of calcium from it into the blood. As a result, in the laboratory we determine increased blood calcium and at the same time high levels of parathyroid hormone. Most often, such changes are also accompanied by a decrease in the level of phosphorus in the blood and an increase in the level of calcium in the urine. The danger of the disease lies in a decrease in bone density with a tendency to fractures, bone deformation, and decreased growth. An increased level of calcium in the blood leads to the deposition of calcium salts in the walls of blood vessels and heart valves, which reduces their elasticity and increases the tendency to thrombosis, which means the risk of strokes and myocardial infarction.
The second possible cause of elevated calcium– this is the breakdown of bone tissue due to the occurrence of metastases of a malignant tumor in it. Metastases have a so-called lytic effect, i.e. destroy bone tissue and release calcium salts from it, which enter the blood and lead to increased calcium levels in the blood. In this case, calcium in the blood is increased, but at the same time the level of parathyroid hormone is within normal limits or lower limit norms.
The third possible cause of high calcium levels in the blood– development of neuroendocrine tumors that produce so-called PTH-like peptides. These tumors are most often located in the lungs, although their location can be very variable. The size of such tumors is usually small - from 4-5 mm to 1-2 cm. They “know how” to produce chains of amino acids, the sequence of which coincides with the active end of parathyroid hormone. Such peptides (they are called PTH-like because they are very similar in action to parathyroid hormone) cause a situation where calcium in the blood is elevated, but laboratory analyzers do not show an increase in parathyroid hormone levels in this case, since PTH-like peptides do not completely copy the parathyroid hormone molecule.
Blood test for calcium - which one is better?
There are two main types of calcium tests - an ionized calcium blood test and a total calcium blood test. Total calcium includes “free”, ionized calcium not bound to proteins + calcium bound to blood proteins (primarily albumin). The concentration of total blood calcium may change due to changes in protein content in the blood. At the same time, it is not total calcium that has a biological effect, but only that part of it that is not associated with proteins - this part is called ionized calcium. The ionized calcium blood test is more accurate than the total calcium test, but it is also more complex - not all laboratories are able to perform this test, and when they do, not all do it accurately. There is an almost anecdotal situation when one of the largest laboratory networks in St. Petersburg “chronically”, for years, reveals low ionized blood calcium in almost all patients - and for years the laboratory does not want to correct this obvious laboratory error. But the consequence of such an error is tens of thousands of unnecessary additional studies performed on those patients who are “lucky” to receive such an incorrect analysis.
There are situations when ionized calcium is elevated, but total calcium is normal– in this case, it is the analysis for ionized calcium that should be “trusted” more. At the same time, in most cases, increased blood calcium is manifested in both analyzes at once - increased ionized calcium and at the same time increased total calcium.
Given the importance of ensuring maximum accuracy of blood tests for calcium and the high “price” of its incorrect definition, The North-Western Endocrinology Center conducts a blood test for calcium using equipment from the Russian representative office of the German laboratory network LADR. To carry out calcium analysis, an automatic biochemical analyzer Olympus AU-680 (Japan) is used, which provides maximum accuracy of the study and is capable of performing up to 680 tests per hour. Daily checks of the analyzer, the consistently high quality of its work and compliance by all center employees with standards for taking blood for calcium allow doctors of the North-Western Endocrinology Center to be confident in the quality of the blood test for calcium performed by the center’s laboratory. Exactly if in the blood test performed by our center the calcium is high, it means that the calcium is really high.
If blood calcium is elevated, what should you do?
As we noted earlier, increased calcium is always a reason for additional examination and consultation with an endocrinologist. In order to come to an appointment with an endocrinologist “not empty-handed,” it is better to take some additional tests before meeting the doctor.
The standard examination of patients with elevated blood calcium includes the following blood tests:
Parathyroid hormone;
Calcitonin;
This is the minimum with which you can already come to a consultation with a doctor. It is clear that the doctor can then order additional tests, but the three blood tests listed above will help him figure out in which direction he should conduct a diagnostic search.
When consulting patients with endocrinologists at the North-Western Endocrinology Center we almost insist on performing blood tests in the laboratory of our center- this is the only way we can be sure of the absence of laboratory errors and the correctness of our reasoning about possible reasons increased calcium levels in the blood. The ionic composition of blood in the laboratory of our center is studied using the Olympus AU-680 analyzer (Japan) already mentioned above, and a blood test for such important indicators, like parathyroid hormone and calcitonin, is performed by an automatic chemiluminescent immunoassay analyzer of the 3rd generation DiaSorin Liaison XL (Italy) - one of the best devices in the world for analyzing blood for hormones and tumor markers.
 Auto immunochemiluminescent 3rd generation analyzer DiaSorin Liaison XL (Italy) |
 Immunochemiluminescent 3rd generation analyzer allows you to identify situations where high calcium is combined with high parathyroid hormone |
Endocrinologists and endocrinologist surgeons of the North-Western Endocrinology Center perform independently– this is important for searching for possible tumors of the parathyroid glands, which we simply have to suspect in a patient if there is an increased level of calcium in the blood. Second important instrumental study which needs to be done for patients with increased level blood calcium is determination of bone tissue density,. Calcium in the blood does not increase on its own - it is “taken” from bone tissue, which releases calcium into the blood and, as a result, reduces its density, which can lead to fractures. Densitometry, as well as ultrasound of the thyroid gland, is performed independently by endocrinologists at the North-Western Endocrinology Center. This is also an important argument in favor of examination and treatment in a specialized center.
The third important argument to contact a specialized center in any case if your blood calcium is elevated is the opportunity to undergo any healing procedures within the walls of the same institution. Even during the examination, not only will you have high blood calcium, but it will also become clear that parathyroid hormone is elevated, and a parathyroid adenoma will be detected in your neck - its removal can also be effectively performed at the North-Western Endocrinology Center. IN currently our center is the undisputed leader in the treatment of patients with high calcium blood in Russia - every year the center's endocrinologist surgeons remove parathyroid adenomas from more than 300 patients. In terms of the number of operations on the parathyroid glands, our center is now in third place in Europe.
Blood calcium is elevated, other tests have been taken - how to decipher them?
Of course, deciphering the blood test is the prerogative of the attending endocrinologist, and self-study of your blood test can lead the patient to diagnostic errors, however, within the framework of this article we will provide some information about the possible results laboratory examination with increased blood calcium. Use the information obtained with caution and remember that it is not a substitute for consultation with a medical specialist.
So, possible options laboratory results and their interpretation.
Blood calcium is increased, parathyroid hormone is increased, phosphorus is decreased, calcitonin is normal, calcium in daily urine is increased - most likely we're talking about about primary hyperparathyroidism and the presence of parathyroid adenoma. Additional examination is necessary using ultrasound of the thyroid gland and neck, scintigraphy of the parathyroid glands with technetril, and in some cases, computed tomography of the neck. Treated surgically (possible in a specialized center) endoscopic surgery through an incision about 2 cm long).
Parathyroid hormone is elevated, calcium is normal, phosphorus is normal, calcitonin is normal– with a high degree of probability we are talking about secondary hyperparathyroidism due to a banal deficiency of vitamin D in the blood. It is treated by taking vitamin D and calcium. It is important to exclude a laboratory error associated with an underestimation of the level of ionized calcium in the blood (it is better to retake the test for ionized calcium in a specialized laboratory of the endocrinology center).
Calcium in the blood is increased, parathyroid hormone is normal, phosphorus is normal, calcitonin is normal- should be suspected neuroendocrine tumor, producing PTH-like peptides or forming lytic metastases in the bone. Examination and treatment depend on the type of tumor detected.
High calcium in the blood (usually slightly increased calcium is noted), parathyroid hormone is moderately increased, phosphorus is normal, calcitonin is normal, calcium concentration in daily urine is reduced - we can talk about a rare familial disease, the so-called familial benign hypocalciuric hypercalcemia. This disease is accompanied by changes in sensitivity cell receptors to parathyroid hormone and impaired calcium excretion in the urine. Does not require treatment and is not dangerous. Often, inexperienced doctors diagnose primary hyperparathyroidism in such cases and refer the patient to unnecessary surgery to remove a non-existent parathyroid adenoma.
Ionized calcium is increased, total calcium is normal, parathyroid hormone is increased– we are usually talking about parathyroid adenoma.
Ionized calcium is elevated, total calcium is below normal– laboratory error must be excluded. The analysis should be re-taken in a specialized laboratory.
Ionized calcium in the blood is increased, parathyroid hormone is increased, calcitonin is increased– the patient should be suspected of having both a parathyroid adenoma and medullary thyroid cancer. Together, these two diseases indicate high probability the patient has type IIA multiple endocrine neoplasia syndrome - rare hereditary pathology, transmitted in the family and leading to the development of three dangerous tumors: medullary thyroid cancer, parathyroid adenomas (usually multiple), pheochromocytoma (adrenal tumor that produces adrenaline or norepinephrine). Urgent consultation with an endocrinologist or endocrinologist surgeon is required!
Calcium in the blood is elevated during the first test, I want to retake the test - what is the best way to do this?
If you want to check whether your blood calcium is really elevated and are going to take a repeat blood test, follow some important rules, which will help the second analysis to be as accurate as possible:
1. a blood test should be taken only in a specialized laboratory using high-quality equipment;
2. a blood test must be taken only on an empty stomach;
3. if you are taking vitamin D or calcium supplements (or combination drugs with vitamin D and calcium) - cancel them at least 2-3 days before the repeat blood test; the entry of calcium from the drug into the blood can lead to an increased calcium level in the blood - of course, in this case a falsely elevated calcium is detected.
Where to turn if calcium in the blood is elevated?
Russian leader in the treatment of hypercalcemia (exactly so on medical language called elevated calcium levels in the blood) is the Northwestern Center for Endocrinology. The center’s specialists carry out all stages of diagnosis and treatment of patients with hypercalcemia:
Laboratory examination;
Conducting an ultrasound of the thyroid gland and neck;
Additional imaging methods (parathyroid scintigraphy with technetril, contrast-enhanced computed tomography);
Drug treatment for secondary hyperparathyroidism and vitamin D deficiency;
Minimally invasive surgery when primary hyperparathyroidism is detected;
Extended and combined operations on the thyroid gland, parathyroid glands, adrenal glands in case of multiple endocrine neoplasia syndrome.
Our recommendation (and believe me, this recommendation is based on the experience of treating thousands and thousands of patients!) - in all cases when the patient’s blood calcium is elevated, contact a specialized center - the North-Western Endocrinology Center. Even if you live in Kamchatka or Sochi, examination and treatment in a specialized institution will help you save time, money and health. We annually treat patients from almost all regions of Russia (it is important to consider that, if necessary, surgical treatment it will be carried out to all citizens Russian Federation free of charge under compulsory health insurance).
To make an appointment for a blood test or a consultation with a specialist doctor (endocrinologist or endocrinologist surgeon - if you have high blood calcium levels, both specialists will suit you), you need to call the phone numbers of the center’s branches in St. Petersburg or Vyborg:
- Petrograd branch of the Endocrinology Center in St. Petersburg - Kronverksky Prospekt, building 31, 200 meters to the left from the Gorkovskaya metro station, tel. 498-10-30, opening hours from 7.30 to 20.00, seven days a week;
- Primorsky branch of the Endocrinology Center in St. Petersburg - Primorsky district of St. Petersburg, st. Savushkina, 124, building 1, tel. 344-0-344, opening hours from 7.00 to 20.00, seven days a week;
- Vyborg branch of the Endocrinology Center– Vyborg, Pobedy Avenue, building 27A, tel. 36-306, opening hours from 7.30 to 20.00, seven days a week.
Reception of patients who have calcium in the blood is increased, carried out by specialists from the North-Western Endocrinology Center:
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Sleptsov Ilya Valerievich Doctor of Medical Sciences, surgeon, endocrinologist, oncologist, ultrasound diagnostics specialist. Professor of the Department of Surgery with a course in endocrinology. He is the head of the Northwestern Medical Center, is a member of the European Thyroid Association, the European Association of Endocrine Surgeons, and the Russian Association of Endocrinologists |
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Chinchuk Igor Konstantinovich Candidate of Medical Sciences, surgeon, endocrinologist, oncologist, ultrasound diagnostics specialist. Member of the European Thyroid Association, European Association of Endocrine Surgeons. |
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Uspenskaya Anna Alekseevna |
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Novokshonov Konstantin Yurievich Surgeon, endocrinologist, oncologist, ultrasound specialist. Member of the European Thyroid Association. |
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Endocrinologist, ultrasound diagnostic specialist. Member of the European Thyroid Association, Russian Association of Endocrinologists. |
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Isheiskaya Maria Sergeevna Endocrinologist, specialist in ultrasound diagnostics. Member of the Russian Association of Endocrinologists. |
At the end of this article, it should be noted once again that a situation where calcium in the blood is elevated ALWAYS requires further examination and consultation endocrinologist. The consequences of a lately detected and untreated disease that causes high calcium levels can in some cases even be fatal. Don't take risks - If you have elevated calcium levels in your blood, always consult a doctor.
Parathyroid glands
general information about the parathyroid glands (location, number, function, history of discovery, underlying diseases, operations)
Vitamin D and parathyroid adenomas
There is a close relationship between the concentration of vitamin D in the blood and diseases of the parathyroid glands. Low levels of vitamin D in the blood can lead to the development of secondary hyperparathyroidism, or to the appearance of parathyroid adenomas (primary hyperparathyroidism)
Medullary thyroid cancer
Medullary thyroid cancer (medullary thyroid carcinoma) is a rare hormonally active neoplasm of a malignant nature, developing from parafollicular cells of the thyroid gland
Paget's disease
Paget's disease or osteitis deformans - chronic pathological condition individual bones human skeleton, during which foci of increased decay of bone cells are formed with their subsequent replacement big amount defective bone tissue
Multiple endocrine neoplasia syndrome type I (MEN-1 syndrome)
Multiple endocrine neoplasia syndrome type 1, otherwise called Wermer's syndrome, is a combination of tumors or hyperplasias in two or more organs of the endocrine system (usually in tumor process parathyroid glands are involved, along with which islet cell neoplasms of the pancreas and pituitary adenoma are found)
Operations on the parathyroid glands
The Northwestern Center for Endocrinology and Endocrine Surgery performs operations to remove parathyroid adenomas for all types of hyperparathyroidism. More than 800 patients with this disease become our patients every year.
Consultation with an endocrinologist
Specialists at the Northwestern Endocrinology Center diagnose and treat diseases of the endocrine system. The center's endocrinologists base their work on the recommendations of the European Association of Endocrinologists and the American Association of Clinical Endocrinologists. Modern diagnostic and treatment technologies ensure optimal treatment results.
Ultrasound of the neck
Information about ultrasound of the neck - the studies included in it, their features
Consultation with an endocrinologist surgeon
An endocrinologist surgeon is a doctor specializing in the treatment of diseases of the endocrine system that require the use of surgical techniques (surgical treatment, minimally invasive interventions)
Intraoperative neuromonitoring
Intraoperative neuromonitoring - a technique for monitoring electrical activity laryngeal nerves, ensuring mobility of the vocal cords during surgery. During monitoring, the surgeon has the opportunity to assess the condition of the laryngeal nerves every second and change the surgical plan accordingly. Neuromonitoring can dramatically reduce the likelihood of developing voice disorders after surgery on the thyroid and parathyroid glands.
Densitometry
Densitometry is a method for determining the density of human bone tissue. The term "densitometry" (from the Latin densitas - density, metria - measurement) is applied to methods for quantitative determination of bone density or its mineral mass. Bone density can be determined using X-ray or ultrasound densitometry. Data obtained during densitometry are processed using a computer program that compares the results with indicators accepted as the norm for people of the corresponding gender and age. Bone density is the main indicator that determines bone strength and its resistance to mechanical load
Calcium (Ca) is an essential element for the female body. It is involved in various body processes. Monitoring Ca levels in the blood can prevent the development of many pathologies. The level of calcium in a woman’s blood depends on her age.
Normal blood calcium levels in women by age (table)
The level of calcium in a woman's blood varies depending on her age. This allows us to identify pathological processes in the body, taking into account age category. Optimal calcium levels are shown in the table.
Deviations from the norm do not provide grounds for diagnosis. If there are changes in the level of the element in question in the blood, the amount of Ca in the bones is determined. This makes it possible to identify a pathological process in which bones release calcium to other body systems.
Normal after 40 years
Calcium is just as necessary in the female body as in the male body. A blood test determines two indicators: free and isolated calcium.
For women whose age exceeds 40 years, normal indicators free calcium are 2.16-2.51 mmol/l. The optimal values for isolated Ca are 1.13-1.32 mmol/l.
The level of calcium in the blood of women depends on their age
Normal after 60 years
Determine the amount of free calcium in female blood can be done using a special analysis (in women, the normal level of calcium in the blood is presented in the table above).
Optimal level of microelement in the blood elderly woman should be 2.20-2.55 mmol/l. The norm of ionized calcium in the blood in women old age- 1.15-1.27 mmol/l.
Normal during pregnancy
During pregnancy, an analysis of the amount of the microelement in question in the blood allows you to determine whether there is a need for additional calcium intake.
The optimal amount of calcium for a pregnant woman is 2.15-2.5 mmol/l. If the readings fall below 2.1 mmol/l, you must immediately begin using calcium tablets.
Blood test for calcium
A blood test to determine the amount of Ca is a procedure that allows you to determine the level of total Ca in the blood structure. Total calcium includes:
- Ionized Ca. This type of microelement makes up 1/2 of the total Ca.
- Ca is bound to protein, mainly albumin. The volume of such an element is 40% of the total quantity.
- Microelement included in anionic complexes – 10% of the total volume.
Blood test to detect ionized calcium
Ionized Ca has no connection with other substances and circulates freely in the blood. This form of microelement is involved in all vital processes.
An analysis to determine the type of calcium in question allows you to evaluate calcium metabolism in the body. This analysis is prescribed when:
- undergoing therapy after surgery or serious damage to the body, for example, a major burn;
- diagnostics are carried out cancerous tumors in organism;
- the performance of the parathyroid gland is assessed;
- hemodialysis is necessary;
- The following medications are used: “Heparin”, “Magnesia” and drugs containing calcium.
An analysis of the blood composition for ionized Ca is carried out in conjunction with the determination of the content of total calcium and blood pH. There is an inverse relationship between ionized Ca and blood pH. Reducing the amount of ph by 0.1 units. leads to an increase in calcium levels by 1.5-2.5%.
A blood test to determine the level of calcium in it is prescribed for cancer. When should you determine the amount of calcium in the blood?
Experts prescribe a test to determine the amount of calcium in the blood of women (deviations from the norm are natural here) in the following cases:
- signs of increased or reduced level Ca in the body;
- cancerous tumors;
- stomach and duodenal ulcers;
- decrease in the amount of albumin;
- preparation for surgery;
- decreased muscle tone;
- hyperthyroidism;
- pathology of the urinary system;
- pain syndromes in the bones;
- abnormal conditions of the cardiovascular system;
- increased urine volume;
- paresthesia;
- convulsive syndrome;
- screening for osteoporosis.
In women, calcium in the blood may have deviations from accepted standards and in other pathological processes. The listed anomalies also have other manifestations, on the basis of which a specialist has the right to suggest a diagnosis and refer for additional examination.
Preparing for tests
In order for the results of the tests to be reliable, it is necessary to prepare for them. This requires:
- stop drinking alcohol, fried and fatty foods;
- exclude heavy physical exercise and psychological shocks;
- do not eat food on the day of testing;
- refrain from other types of examination a few days before donating blood.
Neglecting these rules will lead to false results. m, which in turn will complicate the correct diagnosis.
What affects test results
Test results are affected not only by improper preparation for them, but also by the use of pharmacological agents. For getting reliable results blood tests, you should stop using medications 7-14 days before donating blood. If this is not possible, you should inform your doctor about all medications you are taking.
The use of these substances leads to an increase in the element in question in the blood:
- vitamin A and D;
- teslak;
- tamoxifen;
- parathyroid hormone;
- progesterone;
- lithium;
- 13-cis-retinoic acid;
- ergocalciferol;
- dihydrotachysterol, etc.
Tetracycline antibiotics reduce calcium levels The following components reduce calcium levels in the blood:
- sulfuric acid salts;
- salts and esters of oxalic acid;
- fluorites;
- tetracycline antibiotics;
- plicamycin;
- methicillin;
- magnesium sulfate;
- phenytoin;
- isonicotinic acid hydrazide;
- insulin, etc.
Elimination of current medications may be necessary after results are obtained. clinical analysis blood for Ca.
Daily calcium intake for women
The World Health Organization states that per day, a woman over 16 years of age should absorb 800-1200 mg of Ca.
During pregnancy and breastfeeding daily consumption of the element in question should be increased to 1500-2000 mg.
On last weeks pregnancy, a woman should take at least 1800 mg of calcium daily.
Calcium deficiency in women: causes
The lack of the element in question in the body may be due to the following factors:
- Strict diet. Diet food often excludes the consumption of many products that are useful and necessary for the normal functioning of the body.
This is especially true for vegan diets that do not include dairy products.
- Bad habits. Use in large quantities alcohol- and caffeine-containing products, smoking contribute to the release of calcium from the body.
- Consumption of foods containing phosphorus which interferes with the absorption of calcium. For example, this applies to carbonated drinks.
Calcium deficiency caused by carbonated drinks - Taking some medications (list given above) reduces Ca levels in the blood.
- Unfavorable environment, heavy metals and toxic elements prevent calcium from being absorbed or remove it from the body.
In addition, active physical activity, constant overheating of the body, sudden loss weight – can also cause a lack of calcium in the blood.
Excess calcium in the body: symptoms in women
Excess Ca in the blood is no less dangerous than its deficiency. An excessive amount of the element in question in the body manifests itself as:
- excessive growth of bone tissue, leading to skeletal deformation;
- increased neuromuscular excitability, manifested in the form of involuntary muscle contractions;
- spasm of smooth muscles, resulting in constipation, attacks of nausea and vomiting, as well as frequent urination;
- increased secretion of enzymes, which leads to the development of pancreatitis and its complications;
- disruption of the functioning of the central uneven system, leading to hallucinations of various types (comas and loss of consciousness are possible);
- abnormalities in the functioning of blood vessels and cardiac muscles, leading to cardiac arrest.
If signs of hypercalcemia appear, emergency medical care is necessary, as death is possible.
Lack of calcium in the body: symptoms in women
Ca deficiency in the body, like any other pathological process, has its own manifestations. Symptoms of calcium deficiency are:
- general weakness and impairment of performance;
- increased irritability;
- dry skin and increased flaking;
- excessive sweating skin scalp;
- brittle nails;
- rapid tooth decay;
- numbness of the limbs and face;
- increased blood loss during menstruation;
- violation of bone integrity;
- abnormalities of the heart and blood vessels;
- decreased blood clotting ability;
- the occurrence of cataracts;
- disruption of the immune system;
- increased sensitivity to cold.
General weakness and decreased performance is the first sign of calcium deficiency in the body In the first few years of life, girls may experience developmental defects, such as abnormal formation of the skeleton and teeth.
What flushes calcium from the body
Food not only supplies calcium to the body, but also removes it. Use the following types products can lead to a deficiency of the element in question:
Drinks based on black and green tea in small quantities remove calcium from the body. After drinking 10 cups of tea, a person loses 6 mg of microelement.
- Alcohol.
- Oatmeal.
- Smoked products.
- Some pharmacological agents.
- Excessively salty foods.
Salt and sugar flush calcium from the body Also to increased loss calcium is caused by strict diets and overuse Sahara.
Does coffee flush calcium from the body?
It is believed that coffee has negative impact on the body and removes calcium from it. This is true.
Caffeine, entering the body, leads to an increase in acidity in the stomach, which in turn provokes the release of trace element reserves, and since Ca is not absorbed in an acidic environment, it leaves the body naturally.
Consequences of calcium deficiency in the human body
Lack of calcium, as one of the violations of its norm in the blood of women, men, and children, leads to such negative consequences, such as growth retardation, scoliosis, allergic manifestations, deformation of bone tissue, blood clotting disorders, capillary weakness and the occurrence of kidney stones.
The most serious consequences of hypocalcemia are osteoporosis and osteomalacia. These pathologies are characterized by softening of bone tissue.
Also, a deficiency of the element in question can lead to the development of multiple sclerosis.
Why calcium is not absorbed in the body: reasons
There are many different factors that lead to impaired absorption of calcium by the body. The main ones are:
- Improper functioning of the stomach.
As a result of poor nutrition and bad habits, insufficient production occurs. of hydrochloric acid and enzymes in the stomach. Without these components, the body is not able to independently absorb various microelements, including Ca.
Fatty and fried foods interfere with the body's absorption of calcium - Fried fatty foods.
Fatty acids, in contact with calcium salts, turn into complex deposits that are not only not absorbed by the body, but are also difficult to remove from it.
- Oxalic acid.
By consuming foods containing this substance, a person is unable to absorb calcium in the body. It, interacting with the acid in question, turns into difficultly soluble oxalate salts, which accumulate in the organs, leading to serious consequences.
- Vitamin D deficiency.
Vitamin D helps the body absorb calcium. Without this component, Ca is not retained in the body and is removed from it. Please note that To absorb vitamin D, the body needs fatty acids contained in foods such as fatty fish, eggs and vegetable oils.
For calcium to be well absorbed, the body must have vitamin D. sufficient quantity - Climax.
When the amount of estrogen (female sex hormone) in a woman’s body decreases, a disturbance in the conductivity of calcium in the tissue occurs. Output female hormone slows down when reproductive system, due to age, ceases to function.
Also leads to impaired absorption of calcium oral contraceptives, corticosteroids and pathological processes in the gastrointestinal tract. To exclude possible pathologies, you should undergo a preventive examination by specialists once a year.
Which calcium is better absorbed in the body?
In modern pharmacological agents there are various shapes calcium:
- calcium chloride;
- calcium carbonate;
- calcium citrate;
- calcium salt of gluconic acid (has minimum percentage digestibility).
The absorption of different forms of Ca varies. Calcium chloride when consumed orally leads to pathological processes in the gastrointestinal tract, so its use is carried out in the form of injections. This type of microelement is well absorbed by the body, but is not always convenient to use.
Calcium carbonate is most often used in pharmacological preparations. This form of micronutrient is produced from natural sources, for example, from eggshells or pearls. The absorption of this substance occurs in the stomach.
Among oral forms Calcium citrate is best absorbed by the body. The digestibility of this form is two times higher than that of calcium carbonate.
Medicines for calcium deficiency in the body
In case of calcium deficiency, it is necessary to restore the balance of the microelement in the body as quickly as possible to prevent complications. As a rule, for this purpose, specialists use drugs containing Ca in various forms.
The most effective means to maintain the normal level of calcium in the blood (including women) are:
1 ml of solution includes 0.1 g active substance. Implementation pharmacological agent carried out in the form of a solution for injection.
A complex medication aimed at treating hypocalcemia and preventing it. In addition to Ca, the composition includes Mg, zinc, copper, B, and fat-burning vitamin D3.
The drug is not a medicine, but during the period of therapy it is prescribed as an additional source of the missing microelement.
During the first month of therapy, it is important to check calcium levels in the blood weekly.
Calcium supplements for the prevention of osteoporosis in women
To prevent possible complications hypocalcemia, it is necessary to take preventive measures pharmacological drugs containing various types Ca and other components that help its absorption. Experts recommend using:
- "Calcemin".
The product is used to replenish and maintain optimal Ca levels in a woman’s body. The cost of one package in Russia is 450 rubles.
- "Vitrum calcium+D3".
A pharmacological agent that allows you to replenish the amount of the microelement in question. Since the product has a high degree of absorption by the body, experts recommend using it for girls during pregnancy and while breastfeeding. The price of one package is 400 rubles.
- "Calcium D3 nycomed."
A combined medication that allows you to regulate calcium-phosphate metabolism and replenish calcium deficiency in the female body. average cost in Russia 350 rubles.
- "Complivit calcium D3."
An effective remedy that accelerates the absorption of Ca in the gastrointestinal tract and replenishes the deficiency of this microelement. The use of the pharmacological agent in question makes it possible to regulate the metabolic processes of P and Ca. The price for one package varies from 150 to 400 rubles, depending on the locality.
Biological food additive made on the basis of hematogen. It is used for both therapeutic and prophylactic purposes. average price one preventive course is 500 rubles.
Vitamins with calcium and magnesium for women
Magnesium is no less necessary than calcium to maintain women's health. Experts recommend choosing vitamin complexes containing both of these substances. The most common are:
The average cost of a medicine is 180 rubles. Sold in the form of chewable tablets in various flavors (mint, menthol and orange). The product includes 680 mg Ca and 80 mg magnesium. Use is permissible from 12 years of age. Possible allergic reactions for flavorings.
- "Calcium D3 Nycomed Forte."
Sold in the form of round lozenges with fruit flavor. This medicine contains a high content of vitamin D3. The use of this product allows you to eliminate the fragility of hair, nails and bones in women, as well as prevent abnormal conditions of blood vessels and the heart, due to the magnesium content.
The vitamin complex contains calcium in the amount of 100 mg and magnesium - 40 mg. The preparation also contains other elements necessary for the body. The use of these vitamins will prevent hypocyemia and other pathological processes.
One tablet of a pharmacological agent includes calcium, magnesium and other vitamins and microelements. Consuming a vitamin complex will strengthen the female body and prevent many health problems.
Deficiency and excessive levels of calcium can lead to irreversible consequences. Therefore, the level of calcium in the blood of women should be maintained by food and vitamin complexes. In addition, it is recommended to carry out preventive examinations with specialists at the right time and adhere to a correct lifestyle.
What is a biochemical blood test, how does it stand and what is the normal level of calcium in the blood (in women and men):
Calcium: functions, symptoms of deficiency and excess + foods high in the element:
