Calcium is the most abundant mineral in the human body. About 99% of the body’s calcium is present in the bones, while the remaining 1% is present in the blood; roughly half as ionized/free/metabolically active calcium, and the other half as inactive/bound (to the protein albumin) calcium.
Calcium plays a number of roles in the functioning of the human body. These include:
There exists a balance between the calcium in blood and the calcium that is stored in the bones. Even in blood, there is equilibrium between the bound and free forms of calcium. Calcium levels in the body are also regulated by:
This balance is necessary, as alterations in the levels of calcium can have many consequences, such as:
Calcium levels in blood are often measured through basic/comprehensive metabolic panels (tests) to diagnose/monitor a number of diseases, concerned with the kidneys, bones, nerves, heart, or teeth, as well as, in critically ill patients, in whom calcium fluctuations can have significant adverse consequences.
Calcium levels are often measured along with levels of phosphates, PTH, and vitamin D. While total calcium value is the measure that is usually estimated; in the following cases ionized calcium values are measured:
Urine calcium measurements are usually done over a span of 24 hours. These help in assessing, if the kidneys are excreting the right amount of calcium.
Blood calcium is often estimated as part of a general medical examination. It is included under the basic metabolic panel/comprehensive metabolic panel of tests, performed during a routine health screening.
A healthcare provider may order a Calcium Test, in the following scenarios:
Sample required: Blood; urine for estimating urinary calcium
Process:
Preparation required: Individuals are generally advised to avoid calcium supplements for 8-12 hours, before testing for calcium in blood.
The normal range of calcium values, called the reference range, may vary slightly amongst different laboratories. Each laboratory may show the reference range used by them. A physician interprets the results based on the reference values provided.
One such standard reference range is:
In adults:
In children:
The reference range for urine calcium varies, depending on the amount of calcium in the diet.
Some of the causes for a high value of blood calcium (hypercalcemia) include:
Some of the causes for a low value of blood calcium (hypocalcemia) include:
These conditions also produce corresponding changes in urine calcium levels. However, in one condition called idiopathic familial hypocalciuric hypercalcemia, the blood calcium levels are elevated, but urine calcium levels remains low.
The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario.
Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider, the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.
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