Calcium ionized that shows. Analysis of ionized calcium that shows

Increased blood calcium- a symptom that should always be the reason for an in-depth examination, since the disorders underlying it can be really dangerous for the patient. If you have done an analysis, and your blood calcium is elevated, you need to without fail consult 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 which can cause high levels of calcium in the blood. All possible reasons that calcium in the blood is above normal are quite serious.

The first reason for high blood calcium- This primary hyperparathyroidism, a disease accompanied by the appearance of a tumor in one or more parathyroid glands (it is more correct to say "parathyroid glands", but the term " parathyroid glands' is very widespread). The main task of the parathyroid glands in the body is to maintain normal level blood calcium. The cells of the parathyroid glands "know how" to feel the concentration of calcium in the blood plasma and, in accordance with the level of calcium, produce parathyroid hormone. The main action of parathyroid hormone is to increase the level of calcium in the blood (by destroying bone tissue and the release of calcium from it into the blood, as well as by increasing the absorption of calcium from the primary urine in the kidneys and increasing its absorption from the intestines). When a tumor occurs in a pair thyroid gland its cells cease to feel the concentration of calcium in the blood - they "seem" that there is no calcium in the blood, or it is low. Tumor cells begin to uncontrollably produce parathyroid hormone, which dramatically 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 calcium blood and at the same time a high level 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 the appearance of a tendency to fractures, to bone deformities, and reduced 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 high calcium- this is the breakdown of bone tissue due to the occurrence of metastases in it of any malignant tumor. Metastases have a so-called lytic effect, i.e. destroy bone tissue and release calcium salts from it, which enter the bloodstream and lead to an increased calcium content in the blood. In this case, calcium in the blood is increased, but at the same time the level of parathyroid hormone is within the normal range or lower bound norms.

The third possible cause of high blood calcium- the development of neuroendocrine tumors that produce the so-called PTH-like peptides. These tumors are most often localized in the lungs, although their location can be very variable. The sizes of such tumors are usually small - from 4-5 mm to 1-2 cm. They "know how" to produce chains of amino acids, the sequence of which matches the active end of the parathyroid hormone. Similar peptides (they are called PTH-like, since they are very similar in their action to parathyroid hormone) cause a situation when 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 to take?

There are two main types of calcium tests - a blood test for ionized calcium and a blood test for total calcium. Total calcium includes “free”, non-protein ionized calcium + calcium bound to blood proteins (primarily albumin). The concentration of total blood calcium may change, including due to changes in the protein content in the blood. However, biological action does not provide total calcium, but only that part of it that is not associated with proteins - this part is called ionized calcium. An ionized calcium blood test is more accurate than a total calcium test, but also more complex - not all laboratories are able to perform this analysis, and if 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, detects low ionized blood calcium in almost all patients - and this obvious laboratory error has not been corrected in the laboratory for years. But the consequence of such an error is tens of thousands of unnecessary additional studies conducted by those patients who are “lucky” to receive such an incorrect analysis.

There are situations when ionized calcium is elevated, and total calcium is normal- in this case, more "trust" should be precisely the analysis for ionized calcium. At the same time, in most cases, increased blood calcium is manifested immediately in both analyzes - increased ionized calcium and at the same time increased total calcium.

Considering the importance of ensuring the maximum accuracy of a blood test for calcium and the high "price" of its wrong definition, North-West Center of Endocrinology conducts a blood test for calcium using equipment Russian representation German laboratory network LADR. Calcium analysis is carried out automatically. biochemical analysis Olympus AU-680 (Japan), which provides the 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 employees of the center with the standards for taking blood for calcium allow the doctors of the North-West Center of Endocrinology to be confident in the quality of the blood test for calcium performed by the laboratory of the center. Exactly if in the blood test performed by our center, calcium is high, it means that calcium is really high.

If blood calcium is elevated - what to do?

As we noted earlier, increased calcium is always a reason for additional examination and consultations with an endocrinologist. In order to come to an appointment with an endocrinologist "not empty-handed", it is better to pass some additional tests even before meeting with the doctor.

The standard for examining patients with elevated blood calcium includes the following blood tests:

parathormone;

Calcitonin;

This is the minimum with which you can already come to a consultation with a doctor. It is clear that the doctor may then prescribe additional research, however, the three blood tests listed above will help him navigate in which direction he should conduct a diagnostic search.

When consulting patients with endocrinologists of the North-West Endocrinology Center we almost insist on performing blood tests in the laboratory of our center- only in this way can we be sure that there are no laboratory errors and the correctness of our reasoning about possible reasons elevated calcium in the blood. The ionic composition of the blood in the laboratory of our center is studied using the above-mentioned analyzer Olympus AU-680 (Japan), and the blood test for such important indicators as parathyroid hormone and calcitonin is performed by the 3rd generation automatic immunochemiluminescent analyzer DiaSorin Liaison XL (Italy) - one of the best devices in the world for testing 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 surgeons-endocrinologists of the North-Western Endocrinology Center independently perform- this is important for the search for possible tumors of the parathyroid glands, which we, with an increased level of calcium in the blood, are simply obliged to suspect in a patient. Second important instrumental research that needs to be done to patients with elevated blood calcium levels is determination of bone density,. Calcium in the blood does not increase by itself - it is "taken" from the bone tissue, which gives calcium to the blood and, as a result, reduces its density, which can lead to fractures. Densitometry as well as ultrasound thyroid gland, is performed by endocrinologists of the North-West Endocrinology Center independently. 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, you will not only have high blood calcium, but it will also become clear that parathyroid hormone is elevated, and a parathyroid gland adenoma will be detected on the neck - its removal can also be effectively performed at the North-West Endocrinology Center. IN currently our center is the undisputed leader in the treatment of patients with high calcium blood in Russia - every year, surgeons-endocrinologists of the center perform the removal of parathyroid gland adenomas in more than 300 patients. In terms of the number of operations on the parathyroid glands, our center is now in 3rd place in Europe.

Blood calcium is increased, other tests have been passed - how to decipher them?

Of course, deciphering a blood test is the prerogative of the attending endocrinologist, and independent study his blood test can lead the patient to diagnostic errors, however, in this article we will give some information about possible outcomes laboratory examination with increased blood calcium. Use the information obtained with caution and remember that it does not replace the advice of a medical specialist.

So, possible options laboratory results and their interpretation.

Blood calcium is increased, parathyroid hormone is increased, phosphorus is reduced, calcitonin is normal, calcium in daily urine is increased - most likely, we are talking about primary hyperparathyroidism and the presence of parathyroid adenoma. An additional examination is required using ultrasound of the thyroid gland and neck, scintigraphy of the parathyroid glands with technetrile, and in some cases computed tomography of the neck. being treated surgically(in a specialized center it is possible 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 vitamin D deficiency in the blood. It is treated with 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 an analysis 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- a neuroendocrine tumor producing PTH-like peptides or forming lytic bone metastases should be suspected. Examination and treatment depends on the type of tumor found.

High blood calcium (usually slightly elevated calcium is noted), parathyroid hormone is moderately elevated, phosphorus is normal, calcitonin is normal, calcium concentration is reduced in daily urine - we can talk about a rare family disease, the so-called familial benign hypocalciuric hypercalcemia. This disease is accompanied by a change in sensitivity cell receptors to parathyroid hormone and a violation of 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 an unnecessary operation to remove a non-existent parathyroid adenoma.

Ionized calcium is increased, total calcium is normal, parathyroid hormone is increased- it is usually all the same about parathyroid adenoma.

Ionized calcium is elevated, total calcium is below normal– it is necessary to exclude laboratory error. The analysis should be retaken in a specialized laboratory.

Calcium ionized in the blood is increased, parathyroid hormone is increased, calcitonin is increased- the presence of both parathyroid adenoma and medullary thyroid cancer should be suspected in the patient. Together, these two diseases are high probability the patient has a syndrome of multiple endocrine neoplasia type IIA - a rare hereditary pathology transmitted in the family and leading to the development of three dangerous tumors: medullary thyroid cancer, adenomas of the parathyroid glands (often multiple), pheochromocytoma (tumor of the adrenal gland that produces adrenaline or norepinephrine). An urgent consultation with an endocrinologist or an endocrinologist is required!

Calcium in the blood is increased during the first analysis, I want to retake the analysis - how best to do this?

If you want to check whether blood calcium is really elevated and are going to take a second 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 combined preparations with vitamin D and calcium) - cancel them at least 2-3 days before a second blood test; the intake of calcium from the drug into the blood can lead to an increased content of calcium in the blood - of course, in this case, a falsely elevated calcium is detected.

Where to turn if the calcium in the blood is elevated?

Russian leader in the treatment of hypercalcemia (that's how medical language called high blood calcium) is the Northwestern Center for Endocrinology. The specialists of the center carry out all stages of diagnosis and treatment of patients with hypercalcemia:

Laboratory examination;

Ultrasound of the thyroid gland and neck;

Additional imaging modalities (parathyroid scintigraphy with technetrile, CT scan with contrast enhancement)

Drug treatment for secondary hyperparathyroidism and vitamin D deficiency;

Minimally invasive surgery when detecting primary hyperparathyroidism;

Extended and combined operations on the thyroid gland, parathyroid glands, adrenal glands in the syndrome of multiple endocrine neoplasia.

Our recommendation (and believe me - this recommendation is based on the experience of treating thousands and thousands of patients!) - in all cases when a patient has elevated blood calcium, contact a specialized center - the North-West 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 held for all citizens Russian Federation free of charge under the compulsory health insurance policy).

To make an appointment for a blood test or a consultation with a specialist doctor (endocrinologist or endocrinologist surgeon - both specialists will suit you with high blood calcium) you need to call the center's branches in St. Petersburg or Vyborg:

- Petrograd branch of the Endocrinology Center in St. Petersburg - Kronverksky prospect, house 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, house 27A, tel. 36-306, opening hours from 7.30 to 20.00, seven days a week.

Admission of patients who elevated blood calcium, carried out by specialists of the North-West Center of Endocrinology:

	Sleptsov Ilya Valerievich MD, surgeon, endocrinologist, oncologist, specialist in ultrasound diagnostics. Professor of the Department of Surgery with a course of endocrinology. He is the head of the Northwestern medical center, is a member of the European Thyroid Association, the European Association of Endocrine Surgeons, Russian Association endocrinologists
	Chinchuk Igor Konstantinovich Candidate of Medical Sciences, surgeon, endocrinologist, oncologist, specialist in ultrasound diagnostics. Member of the European Thyroid Association, European Association of Endocrine Surgeons.
	Uspenskaya Anna Alekseevna
	Novokshonov Konstantin Yurievich Surgeon, endocrinologist, oncologist, specialist in ultrasound diagnostics. Member of the European Thyroid Association.
	Endocrinologist, specialist in ultrasound diagnostics. Member of the European Thyroid Association, Russian Association of Endocrinologists.
	Isheyskaya Maria Sergeevna Endocrinologist, specialist in ultrasound diagnostics. Member of the Russian Association of Endocrinologists. Doctor's personal website - spb-endo.ru.

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 an untimely detected and untreated disease that causes elevated calcium can, in some cases, even be fatal. Don't risk it - at elevated content blood calcium always consult a doctor.

• parathyroid glands

  general information about the parathyroid glands (location, number, function, history of discovery, major diseases, operations)

• Vitamin D and parathyroid adenomas

  Between the concentration of vitamin D in the blood and diseases of the parathyroid glands, there is a close relationship. Low level vitamin D in the blood can lead to the development secondary hyperparathyroidism, or to the appearance of adenomas of the parathyroid glands (primary hyperparathyroidism)

• Medullary thyroid cancer

  Medullary thyroid cancer (medullary thyroid carcinoma) is a rare hormonally active malignant neoplasm that develops from the 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, followed by their 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 hyperplasia in two or more organs endocrine system(usually in tumor process parathyroid glands are involved, along with islet cell neoplasms of the pancreas and pituitary adenoma)

• Operations on the parathyroid glands

  The North-Western Center of Endocrinology and Endocrine Surgery performs operations to remove parathyroid adenomas in all types of hyperparathyroidism. More than 800 patients with this disease become our patients annually

• Endocrinologist's consultation

  Specialists of the North-Western Center of Endocrinology diagnose and treat diseases of the endocrine system. The endocrinologists of the center in their work are based on the recommendations of the European Association of Endocrinologists and American Association clinical endocrinologists. Modern diagnostic and medical technologies provide optimal treatment results.

  neck ultrasound

  Information about the ultrasound of the neck - the studies included in it, their features

• Consultation with an endocrinologist

  An endocrinologist is a doctor who specializes 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 providing mobility vocal cords, during the operation. During monitoring, the surgeon has the opportunity to assess the condition of the laryngeal nerves every second and change the operation plan accordingly. Neuromonitorng can drastically reduce the likelihood of developing a voice disorder after surgery on the thyroid gland 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 the quantitative determination of bone density or its mineral mass. Bone density can be determined using X-ray or ultrasound densitometry. The 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 sex and age. Bone density is the main indicator that determines the strength of the bone, its resistance to mechanical stress.

When a disease is detected, it is sometimes not enough to determine total calcium (Ca), as a result, doctors prescribe a test for ionized calcium in order to find out its rate in the blood.

Some people are perplexed by the proposal of a specialist, as they believe that this is the same thing. Therefore, it is worth understanding what is the difference between them.

Ca- essential macronutrient coming into human body from food. The main share 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:

1. associated with proteins;
2. complexed with anions.

The first fraction makes up approximately 46% of the total and differs from the rest in that Ca ions are not bound to 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 humans, the balance between total and ionized is stable, but sometimes some diseases upset this balance, and the concentration of total Ca does not serve as a guideline for the entire calcium metabolism. Therefore, testing for Calcium free is desirable to detect pathologies in the body.

Ionized Ca occupies not the last place in metabolic processes. Among its tasks:

• Adjusting 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 the saturation of iron in the blood and enzymatic activity.
• Assistant in the creation of hormones.
• Affects the work 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 levels of calcium in the blood

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. After happening slow loss bone tissue.

The process usually accelerates during menopause. At this time, there is a risk of osteoporosis.

After examining the patient and based on his complaints, the doctor suggests that he take a biochemical blood test from a vein to find out the concentration of calcium 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 and 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 value of Ca ions is determined in millimoles per liter of quantitative composition.

The concentration of total Ca in the blood is usually determined in national medical institutions. To take an analysis 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 the deposition of the mineral on the walls of blood vessels, in the liver and kidneys.

Subsequently develops urolithiasis disease, the work of the heart is disturbed, destructive processes are activated in the biliary tract and the largest gland of the human body.

Other signs of pathology:

• high levels of vitamin D;
• Williams syndrome in newborns;
• malignant tumors and metastases affecting the bones;
• adrenal insufficiency;
• hereditary excess of calcium;
• blood diseases;
• increase in the number of thyroid hormones;
• dehydration of the body;
• progressive degeneration of the joints;
• 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, preparations containing lithium salts and excessive consumption of foods in which calcium is present.

Often, the coefficient is higher than normal due to an incorrectly conducted blood test. The results may be affected by contact of the biomaterial with open air.

Symptoms

At high level macronutrient content is characteristic fatigue, weakness in the whole body, convulsions are possible. Gradually subsides physical activity disrupted the rhythm of the heart. Hypercalcemia is accompanied by nausea, thirst.

Therapy

If an increased level of calcium ions is detected, the diet is adjusted. Coffee, cocoa, animal proteins, salt are removed from the menu.

When a person's kidneys are functioning normally, but there are other signs of the disease, then medical worker appoints a drinking regimen.

Water relieves the body of excess calcium, while protecting it from dehydration.

In some situations, fluid is given intravenously. If the method does not help, then the doctor prescribes a dialysis session.

Treatment for elevated Ca depends on specific disease.In the case of tumor formations, therapy is not carried out. For problems with the parathyroid glands, an operation is often performed to remove them.

Reasons for the decrease in Ca ions

The main factor is a violation in the work of the intestine, due to which there is a slow absorption of the substance.

Accordingly, deficiency leads to insufficient bone mineralization and acid-base imbalance.

Cause hypocalcemia severe burns, recovery period after a serious surgical intervention, children's rickets.

When percentage 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 the required amount of magnesium.

Addiction to alcohol, taking drugs for the treatment of epilepsy and tumors, glucocorticosteroids, laxatives and magnesium salts leads to a decrease in ionized calcium.

Symptoms

Hypocalcemia is determined by the following signs:

• increased excitability and irritability;
• worsening emotional state;
• blood clotting disorder;
• hypertension;
• periodic migraines and dizziness;
• dry skin;
• dullness, brittleness and lifelessness of hair;
• damage to the hard tissues of the teeth and the destruction of the nail plates.

Treatment

The general condition of the body is greatly improved 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 the case when the first method did not bring proper results, they are prescribed vitamin complexes and medicines.

Ionized calcium regulates multiple processes in the body. And changes up or down directly affect the human condition. In both cases, it is recommended to contact a specialist who, based on laboratory tests venous blood will make a diagnosis. In particular, it is forbidden to self-medicate, as this can lead to complications.

Related video

Calcium plays important role in the process of growth and life of the organism. In the blood, it is in the form of two fractions: free (ionized) and associated with plasma proteins, phosphates or citrates. Normally, the free fraction is about 45% of general level calcium. The analysis for ionized calcium is highly informative, since it is it that allows you to more accurately determine the diagnosis and select the right treatment.

What role does calcium play in the body?

Calcium - important trace element, which influences metabolic processes in organism. It performs the following functions:

• affects the growth and development of bone tissue;
• participates in the process of blood clotting;
• regulates enzymatic activity;
• provides good conductivity nerve fibers to the muscles
• affects the contraction of muscle fibers and the heart muscle;
• takes part in the production of hormones.

In addition, calcium ions contribute to the strengthening vascular wall, increase the body's resistance to infections and allergic reactions.

Normal levels of calcium in the blood

Causes of an increase in Ca ions in the blood and characteristic symptoms

An increase in calcium (hypercalcemia) can occur in the following conditions:

• metabolic disorders of hemostasis by type of acidosis;
• increased production of Ca in newborns, which does not have a reason for this (Williams syndrome);
• excess vitamin D;
• acute insufficiency of renal functions;
• malignant tumors and metastases in bone tissue;
• hereditary hypercalcemia;
• hyperparathyroidism, in which there is an overproduction of the hormone parathyroid glands(parathyroid hormone);
• blood diseases: leukemia, lymphoma and others;
• benign tumor-like formations of the parathyroid gland;
• insufficiency of the functions of the adrenal cortex;
• increased consumption of foods containing Ca.

Venous blood sampling is required to determine ionized calcium.

Hypercalcemia is characterized by the following symptoms:

• gradually increasing weakness, fatigue;
• decreased physical activity;
• dyspeptic disorders (nausea, vomiting);
• the appearance of thirst;
• convulsive twitching in the limbs;
• increased heart rate, heart rhythm disturbance.

With prolonged hypercalcemia, calcium is deposited in the vessels, kidney and liver tissue. Heart failure may develop.

Why does ionized Ca in the blood decrease and how does it manifest itself?

A decrease in calcium (hypocalcemia) can occur in the following conditions:

• with vitamin D deficiency;
• after extensive burns;
• with metabolic alkalosis;
• if the child has rickets;
• at renal pathologies, pancreatitis;
• if magnesium in the blood is low;
• in the postoperative period;
• with insufficient absorption of calcium in the intestine.

Insufficiency of Ca ions can manifest itself with the following symptoms:

• in patients, nervous excitability increases;
• emotional state becomes labile;
• migraine-like headaches, dizziness are characteristic;
• osteoporosis, destruction of dental tissue, nails;
• the skin becomes dry, and the hair is brittle and weak;
• tachycardia appears;
• blood clotting is disturbed - the period necessary to stop bleeding is lengthened.

With a lack of calcium in the body, osteoporosis develops.

Indications for testing for Ca ions

Biochemical analysis for ionized Ca is common in medical institutions. Because he carries important information By mineral metabolism in both adults and children.

Indications for research are the following conditions:

• signs of insufficiency or excess of calcium in the body;
• malignant tumors;
• diseases of the gastrointestinal tract;
• preoperative preparation;
• pathologies of the cardiovascular system;
• pain in muscles, bone tissue, muscle weakness;
• convulsive manifestations;
• violation of sensitivity in tissues;
• diseases of the urinary system;
• decrease in proteins in the blood.

When performing a patient intensive care With intravenous administration blood products and glucose-salt solutions, the level of Ca is monitored daily or more often, according to indications.

Rules for preparing for analysis

To obtain reliable result for calcium content, the following rules must be observed:

• before taking the analysis, exclude heavy physical exertion;
• do not drink alcohol fatty foods the day before the study;
• it is necessary to take the analysis strictly on an empty stomach, the last meal should be 12 hours before the study;
• stop smoking one hour before donating blood;
• research cannot be done after instrumental methods examinations and physiotherapy.

It must be remembered that many medications able to increase or decrease Ca in the body. Therefore, 1-2 weeks before the examination, it is necessary to stop taking medications. On this issue, you should definitely consult with your doctor. If it is not possible to cancel the medication, then the study form indicates which drug the patient is taking in this moment and at what dosage. This will help you conduct your research more accurately.

If there are symptoms of a violation of calcium metabolism in the body, you should immediately contact a specialist. You can not engage in self-diagnosis and try to eliminate the symptoms yourself. This may lead to serious violations in organism. timely qualified diagnostics and correction of violations will help prevent undesirable consequences and reduce the risk of complications.

Ionized calcium (Ca ++) in the blood - a non-protein part of calcium that is in the blood serum and represents it active form. The main indications for use: violations of the general calcium metabolism in various diseases (kidney failure, dysfunction of the thyroid and parathyroid glands, vitamin D deficiency, gastritis, neoplasms various localizations).

Calcium in the blood exists in three main forms. Approximately 40% of calcium is bound to proteins, about 15% is bound to complexes with phosphate and citrate, the rest is in an unbound form (free, active) in the form of ions (Ca2++).

Ca2++ ions play a central role in the regulation of many cellular functions. A change in the concentration of intracellular free calcium is a signal for the activation or inhibition of enzymes, which in turn regulate metabolism, contractile and secretory activity, adhesion and cell growth.

It is believed that the content of ionized calcium (active) in the best degree reflects the human body's calcium metabolism than the total calcium content. It is this part of calcium that realizes its numerous effects: transfer nerve impulse, muscle contractions, blood clotting and many others.

When interpreting the data obtained, it should be taken into account that, for example, with hypoalbuminemia, there is a decrease in the concentration of total calcium due to a decrease in calcium-binding proteins, however, the content of ionized calcium does not depend on the degree of decrease in blood albumin, therefore, the expected Clinical signs missing.

Why is it important to do

Calcium in the blood is a source of extracellular calcium that is able to interact with cells. Calcium in the blood is in several forms: bound (or in a complex) and free (or ionized).

Physiological significance calcium is to reduce the ability of tissue colloids to bind water, reduce the permeability of tissue membranes, participate in the construction of the skeleton and the hemostasis system, as well as in neuromuscular activity. It has the ability to accumulate in places of tissue damage by various pathological processes. Approximately 99% of calcium is in the bones, the rest is mainly in the extracellular fluid (almost exclusively in the blood serum). Approximately half of serum calcium circulates in an ionized (free) form, the other half - in a complex, mainly with albumin (40%) and in the form of salts - phosphates, citrate (9%). Changes in the content of albumin in the blood serum, especially hypoalbuminemia, affect total concentration calcium, without affecting the clinically more important indicator - the concentration of ionized calcium.

What are the symptoms for

The determination of ionized calcium (Ca2+) is used in the diagnosis of "physiological activity" or the level of free calcium in patients with protein disorders (chronic renal failure, nephrotic syndrome, malabsorption, multiple myeloma) and in disorders of acid-base metabolism.

How does it go

Blood sampling is carried out in vacuum system without an anticoagulant or with a coagulation activator (under anaerobic conditions). It is recommended to use tubes with gel filling. Whole blood should be delivered to the laboratory within 2 hours at 2-8°C.

How to prepare for delivery

The material is collected in morning time on an empty stomach

Delivery material

Serum - 1 ml.

Deadline

What are the normal indicators (decoding)

1.13-1.32 mmol / l.

Increases in the norm are observed in the following diseases

Increase in the level of ionized calcium: primary hyperparathyroidism, tumors (an increase can be observed even with normal values ​​of total calcium).

Decreases in the norm are observed in the following diseases

The level of ionized calcium better reflects the metabolism of calcium, compared with the level of total calcium. A significant decrease in ionized calcium, regardless of the level of total calcium, can lead to an increase in neuromuscular excitability.

Decrease in the level of ionized calcium: primary hypoparathyroidism (both fractions of calcium), pseudohypoparathyroidism, deficiency of magnesium, vitamin D; transfusion of citrated blood, after major trauma, surgery, sepsis, burns, pancreatitis, multiple organ failure, after hemodialysis using dialysate containing a low concentration of calcium, alkemia or an increase in ionic strength (for example, an increase in sodium).

Calcium in the human body is involved in many vital important processes. Most calcium (almost 99%) is found in bone tissue, and only the remaining 1% is found in the rest. biological fluids. The level of calcium in the blood is important indicator, which can tell about the presence of many diseases.

Why do we need calcium ions in the body?

Calcium in the human body does a lot different functions. For example, its ions are actively involved in the formation of the skeleton of bones, in the conduction of neuromuscular impulses, in the regulation heart rate and in blood clotting.

If the level of calcium is low, then blood clotting is disturbed, it is very difficult to stop bleeding. An analysis of calcium in the blood just allows you to evaluate calcium metabolism in organism.

In blood plasma, about 55% of calcium is in a bound state with various elements, mainly with proteins, lactate, phosphorus, etc. Only about 45% of calcium is found in a free state, it is called ionized. It circulates freely in the blood, as it is not associated with any substances.

Usually they analyze for total calcium and for ionized. The second option is more informative, but also more expensive. Bound calcium affects the functioning of the body much less than free ions of this substance. A general analysis for the content of calcium in the body does not accurately identify a metabolic disorder, therefore, an analysis is carried out for ionized calcium - its level is a more reliable indicator of various diseases.

When is a calcium test ordered?

A serum calcium test is usually given in conjunction with a phosphate test. These studies are necessary for the diagnosis of diseases of the kidneys, heart, digestive organs, as well as bone and nervous system. Other reasons why this analysis may be needed:

• diagnostics of oncology;
• preparation for surgery;
• diagnosis of osteoporosis;
• injuries and burns.

It is necessary to pass this analysis before surgical intervention, since with poor clotting, bleeding (if it occurs) will be difficult to stop.

The main reason is usually hidden in a low level of calcium. Symptoms of hypocalcemia, in addition to, are usually the following: headaches, dry skin covering brittle hair and nails, irregular heartbeat, general weakness, carious lesion teeth, convulsions, dizziness. To identify the causes of the lack of this substance and poor blood clotting, you must definitely consult a doctor.

Hypercalcemia is much less common, but it is more dangerous to health. The disease is usually accompanied by symptoms such as weakness, frequent headaches, cardiac or acute renal failure, vascular calcification, vomiting, weakness.

Causes of hypercalcemia are usually very serious, for example, a tumor in the slings, destruction of bone tissue due to malignant neoplasm or occurrence neuroendocrine tumor. Hypercalcemia can also be physiological - it can occur in a child after 4 days of life. In any case, to discover exact reasons such a condition requires a doctor's consultation.

How to prepare for the analysis?

For the analysis to show correct results need to prepare for it. Follow these simple guidelines:

• Do not drink on the eve of blood donation alcoholic drinks, smoke, and also eat high-calorie foods.
• Blood is usually donated in the morning, meals should be about 10 hours before donation. In the morning you can only drink still water.
• One day before the test, you should not be nervous, as well as engage in heavy physical work.
• It is impossible to donate blood after X-ray, ultrasound, fluorography, and also after physiotherapy.

Some medications can affect the result, so two weeks before the expected date of the test, it is better to completely refuse to take them. In the event that the medication cannot be canceled, it is necessary to tell the doctor which drug you are taking and in what doses.

Norms and deviations

Deciphering the analyzes is a matter for specialists, only a doctor can make a diagnosis and prescribe proper treatment. Therefore, the normal levels of calcium ions presented below are only average indicators.

At general analysis for calcium, the norm is considered to be:

• for a child up to a year - from 2.1 to 2.7 mmol / l;
• age up to 14 years - from 2.2 to 2.7 mmol / l;
• for adults, the indicator is from 2.2 to 2.65 mmol / l.

When checking for ionized calcium, the norm is:

• baby up to a year - from 1.03 to 1.37 mmol / l.
• up to 16 years - ranging from 1.29 to 1.31 mmol / l.
• for adults - from 1.17 to 1.29 mmol / l.

Pregnancy and lactation can affect the results, so deciphering the tests is the business of doctors. The reasons for the deviation of the calcium level from the norm must be known, since elevated level may indicate cancer reduced level- on poor clotting blood, and increased risk fractures.