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The calcium blood test analyses the amount of calcium in the blood. If there is too much or too little calcium in the blood, this can be a sign of a wide range of medical conditions, such as bone disease, thyroid disease, parathyroid disorders, kidney disease, and other conditions in the body.
This calcium is one of the most important minerals in the body. About 1% of the calcium in the body is in the blood. And the rest is stored in the bones and teeth. Having the right amount of calcium in the blood is necessary for the nerves, muscles, and heart to work properly. It also helps blood vessels move blood throughout, helping to release hormones that affect many body functions.
The other names are total calcium, calcium test, and Ca++.
There is only one parameter.
The calcium (Ca) test analyses the amount of calcium in the blood. Calcium is essential for many body processes, including cell signaling, blood clotting, contraction of muscles, and nerve functioning. This plays a crucial role in the formation and maintenance of healthy bones. A deficiency results in osteoporosis, a disease in which the bones lose their density and become soft and fragile, causing them to fracture very easily.
About 99% of the total amount of calcium received by the body is bound as calcium complexes in the bones, and the remaining 1% lies in the blood circulation. Of the amount of calcium circulating in the blood, about half remains bound to albumin protein or other ions and is metabolically inactive, while the remaining half is free and metabolically active. Blood calcium tests can be of two types: The total calcium test is used to measure the total calcium concentration in the blood, including both the free and bound forms, and the ionized calcium test is used to measure the concentration of only the metabolically active form.
Calcium values in the blood are maintained within a very narrow range by a number of mechanisms. The deviation from the normal range of calcium concentration causes hypocalcemia (low levels of calcium) or hypercalcemia (excess of calcium). Both these conditions impact normal body processes in the short term and can give rise to other conditions in the long term.
The blood calcium test cannot be used to check for a lack of calcium in the diet or for osteoporosis (loss of calcium from the bones), as the body may have normal calcium levels even in the case of dietary deficiency of calcium. Our body may augment mild calcium deficiency by releasing the calcium stored in our bones.
8.4 –10.2 mg/dL
The blood calcium test is often recommended when a person undergoes a general medical examination. It is typically included in the comprehensive metabolic panel and the basic metabolic panel, two sets of the tests that can be used during an initial evaluation or as part of a routine health screening test.
People do not have any symptoms of high or low calcium until their values are out of the normal range. The doctor may recommend a calcium test when someone has:
Kidney disease, because of low calcium, is especially common in those with kidney failure.
Symptoms of high calcium such as fatigue, weakness, loss of appetite, nausea, vomiting, constipation, abdominal pain, frequency of urinary, and increased thirst
Symptoms of very low calcium, such as abdominal cramps, muscle cramps, or tingling in the fingers
Other diseases that have been associated with abnormal blood calcium such as thyroid disease, parathyroid disorder, malabsorption, cancer, and malnutrition.
An ionized calcium test can be recommended when someone has numbness around the mouth and in the hands and feet and muscle spasms in the same areas. These may be the symptoms of low levels of ionized calcium. However, when calcium levels decrease slowly, many people have no symptoms.
Calcium monitoring can be necessary when a person has certain kinds of cancer, particularly breast, lung, head and neck, kidney, or multiple myeloma; has kidney disease, or has had a kidney transplant. This monitoring may also be necessary when someone is being treated for abnormal calcium levels to evaluate the effectiveness of treatments such as calcium or vitamin D supplements.
The urine calcium test can be recommended when someone has symptoms of kidney stones such as a sharp pain in the person's side or back around the kidneys, pain that can progress to the lower abdomen, and or blood in the urine.
No special preparation is required and fasting is not required for this test.
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This test requires a blood sample.
A healthcare provider, who is also called a phlebotomist, usually performs blood draws, including those for calcium tests, but any healthcare provider trained in drawing blood can perform this task. Usually, these samples are sent to a lab where a medical laboratory scientist prepares the samples and performs the tests on analysers or manually.
You might expect the experience the following during the blood test or a blood draw:
You sit comfortably on the chair, and a healthcare provider will check your arms for an easily accessible vein near your elbow.
Once the phlebotomist has located a vein, they will clean the area and disinfect it with an alcohol swab.
They insert a needle into your vein to draw a blood sample. They can feel like an ant bite.
After the needle is inserted, the required amount of blood is drawn into a test tube.
When enough blood is drawn for the test, they’ll remove the needle and hold a cotton ball or gauze on the pricked site to stop any bleeding.
They apply a band-aid over the pricked site, and the blood collection is finished.
This process takes less than five minutes.
Once the phlebotomist has collected the blood sample in the vacutainer tube, it will be sent to the laboratory for processing. When the blood reports are ready, your healthcare provider will share the results with you.
Blood tests are common, and they do not carry any significant risks. You may have a slight pain like an ant bite when the needle gets inserted, and a small bruise can develop there.
Blood reports are available via email or WhatsApp within 6 hours of the blood sample collection.
The calcium levels in the blood do not indicate levels of bone calcium but rather how much calcium is in the blood.
Calcium absorption, use, and excretion are regulated and are stabilized by a feedback loop involving PTH and vitamin D. A condition or disease that disrupts calcium regulation might cause inappropriate, acute, or chronic elevations or decreases in calcium and can lead to symptoms of hypercalcemia or hypocalcemia.
In most cases, total calcium is analysed because the test is easier to perform than the ionized calcium test and requires no special handling of the blood sample. The total calcium is usually a good reflection of free calcium since the free and bound forms are typically each about half of the total. However, because about half of the calcium in the blood is bound to the protein, total calcium test results may be affected by high or low levels of protein. In such cases, it is more useful to analyse free calcium directly using an ionized calcium test.
A normal total or ionized calcium result together with other normal laboratory results generally means that a person’s calcium metabolism is normal and blood levels are appropriately regulated.
High total calcium (hypercalcemia)
Two or more common causes of high blood calcium are:
Hyperparathyroidism is an increase in parathyroid gland function. Usually, this condition is caused by a benign tumor of the parathyroid gland. This is usually a mild form of hypercalcemia and can be present for many years before being noticed.
Cancers may cause hypercalcemia when they spread to the bones and cause the release of calcium from the bone into the blood or when cancer produces a hormone similar to PTH, which increases calcium levels.
Some of the other causes of high blood calcium include:
Excess vitamin D intake
Low total calcium (hypocalcemia)
The common cause of low total calcium is:
Low blood protein levels, especially a low level of albumin, can result from liver disease or malnutrition. Both of those might result from alcoholism or other illnesses. This low albumin is also very common in people who are acutely ill. With low albumin, only the bound calcium will be low. Ionized calcium remains normal, and calcium metabolism is regulated appropriately.
Some other causes of low calcium include
underactive parathyroid gland (hypoparathyroidism).
It is inherited resistance to the effects of the parathyroid hormone.
Extreme deficiency in dietary calcium
Decreased levels of vitamin D
Increased levels of phosphorus
Acute inflammation of the pancreas (pancreatitis)
8.4 –10.2 mg/dL
Normal ranges might vary slightly among different laboratories. Some of the labs use different measurements or might test different samples. Speak to your health care provider about the meaning of your specific test results.
PTH Test, Vitamin D Test
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Frequently Asked Questions on Calcium Test
The most common cause of high calcium in blood levels is excess parathyroid hormone (PTH) released by the parathyroid glands. This excess occurs due to an enlargement of one or more parathyroid glands. Calcium blood values might also be high if your body is low on fluid or water.
A calcium blood test analyses the amount of calcium in your blood. If there is more or less calcium in the blood, it can be a sign of a wide range of medical conditions, such as bone disease, thyroid disease, parathyroid disorders, kidney disease, and other conditions.
The normal range for a calcium test is 8.4–10.2 mg/dL. This range might vary from lab to lab.
What are the symptoms of a lack of calcium?
Symptoms of having low calcium in your blood include:
Muscle cramps (especially in your back and legs)
Dry, scaly skin
Irritability or restlessness.
It is important to remember that a low calcium result does not necessarily mean that you have a medical condition. Certain medications and diets may also decrease your blood calcium levels.
If your body does not get enough Calcium and Vitamin D to support important functions, it takes calcium from your bones. This is called losing bone mass. Losing bone mass makes the inside of your bones become weak and porous. It puts you at risk of the bone disease osteoporosis.