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Calcium (Ca) in Blood

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Test Overview
A test for calcium in the blood checks the calcium level in the body that is not stored in the bones. Calcium is the most
common mineral in the body and one of the most important. The body needs it to build and fix bones and teeth, help
nerves work, make muscles squeeze together, help blood clot, and help the heart to work. Almost all of the calcium in the
body is stored in bone.
Normally the level of calcium in the blood is carefully controlled. When blood calcium levels get low ( hypocalcemia ),
the bones release calcium to bring it back to a good blood level. When blood calcium levels get high (hypercalcemia ), the
extra calcium is stored in the bones or passed out of the body in urine and stool. The amount of calcium in the body
depends on the amount of:
Calcium you get in your food.
Calcium and vitamin D your intestines absorb.
Phosphate in the body.
Certain hormones , including parathyroid hormone , calcitonin , andestrogen in the body.
Vitamin D and these hormones help control the amount of calcium in the body. They also control the amount of calcium
you absorb from food and the amount passed from the body in urine. The blood levels of phosphate are closely linked to
calcium levels and they work in opposite ways: As blood calcium levels get high, phosphate levels get low, and the
opposite is also true.
It is important to get the right amount of calcium in your food because the body loses calcium every day. Foods rich in
calcium include dairy products (milk, cheese), eggs, fish, green vegetables, and fruit. Most people who have low or high
levels of calcium do not have any symptoms. Calcium levels need to be very high or low to cause symptoms.
Why It Is Done
A blood calcium test may be done:
To check for problems with the parathyroid glands or kidneys, certain types of cancers and bone problems, or
inflammation of the pancreas (pancreatitis ).
To find a reason for an abnormal electrocardiogram (EKG) test.
After a kidney transplant .
To see if your symptoms may be caused by a very low calcium level in the blood. Such symptoms may include
muscle cramps, spasms, and twitching and tingling in the fingers and around the mouth.
To see if your symptoms may be caused by a very high calcium level in the blood. Such symptoms may include
weakness, lack of energy, not wanting to eat, nausea and vomiting, constipation, urinating a lot, belly pain, or bone
As part of a routine blood test.
A blood calcium test can't be used to check for a lack of calcium in your diet or for the loss of calcium from the bones
( osteoporosis ). The body can have normal calcium levels even if your diet does not have enough calcium in it. Other
tests, such as bone density , check the amount of calcium in the bones.
How To Prepare
Do not take calcium supplements for 8 to 12 hours before having a blood calcium test. Your doctor will tell you if you
should not eat or drink anything before your test.
How It Is Done
The health professional drawing blood will:
Wrap an elastic band around your upper arm to stop the flow of blood. This makes the veins below the band larger
so it is easier to put a needle into the vein.
Clean the needle site with alcohol.
Put the needle into the vein. More than one needle stick may be needed.
Attach a tube to the needle to fill it with blood.
Remove the band from your arm when enough blood is collected.
Put a gauze pad or cotton ball over the needle site as the needle is removed.
Put pressure to the site and then a bandage.
A test for calcium in the blood checks the calcium level in the body that is not stored in the bones.
The normal values listed here-called a reference range-are just a guide. These ranges vary from lab to lab, and your lab
may have a different range for what's normal. Your lab report should contain the range your lab uses. Also, your doctor
will evaluate your results based on your health and other factors. This means that a value that falls outside the normal
values listed here may still be normal for you or your lab.
Total calcium footnote1

Adults: 8.8-10.4 milligrams per deciliter (mg/dL) or 2.2-2.6 millimoles per

liter (mmol/L)

Children: 6.7-10.7 milligrams per deciliter (mg/dL) or 1.90-2.75 millimoles

per liter (mmol/L)

Normal blood calcium values are lower in older people.

An ionized calcium test checks the amount of calcium that is not attached to protein in the blood. The level of ionized
calcium in the blood is not affected by the amount of protein in the blood.
Ionized calcium footnote1

Adults: 4.65-5.28 mg/dL or 1.16-1.32 mmol/L

Children: 4.80-5.52 mg/dL or 1.20-1.38 mmol/L

High values
High values of calcium may be caused by:
Hyperparathyroidism .
Cancer, including cancer that has spread to the bones.
Tuberculosis .
Being on bed rest for a long time after a broken bone.
Paget's disease .
Low values
Low values of calcium may be caused by:
A low level of the blood protein albumin (hypoalbuminemia).
Hypoparathyroidism .
High levels of phosphate in the blood, which can be caused by kidney failure , laxative use, and other things.
Malnutrition caused by diseases such as celiac disease , pancreatitis , and alcoholism .
Osteomalacia .
Rickets .
What Affects the Test
Reasons you may not be able to have the test or why the results may not be helpful include:
Taking calcium or vitamin D in any form including milk, antacids, or supplements right before the test.
Taking medicines, such as diuretics . Many medicines can affect calcium levels in the blood.
Having dialysis .
Having a high volume blood transfusion or many blood transfusions in a short period of time.