Calcium Deficiency Causes, Effects, And Treatment.

Calcium is the most abundant cation in the body and powerful homeostatic mechanisms control circulating ionized calcium levels. In this article will see Calcium deficiency causes, effects, and treatment.

A normal adult body contains about 1 kg of calcium, of which approximately 99% is present in the skeleton as hydroxyapatite [Ca10 (PO4)6(OH) 2] and 1% in soft tissues and extracellular fluids.

In spite of large movements of calcium between body compartments, serum calcium is maintained constant at about 10 mg/dl (2.5 mg).

The essential fraction is the biologically active free, ionized one which equals 50% of the total serum calcium (1.3 mg).

Forty percent of total serum calcium is protein-bound, principally to albumin. Remaining 10% of calcium is complexed with various anions such as nitrate, sulfate, bicarbonate, lactate, and phosphate.

A decrease in serum albumin of 1 g/dl results in a decrease in total serum calcium of 0.8 mg/dl without affecting the ionized fraction significantly.

World Health Organization (WHO) dietary guidelines for calcium differ between countries, with higher intakes usually recommended in places with higher fracture prevalence.

In the diet, 20% to 30% of calcium is absorbed. It depending on vitamin D status and food source. Calcium requirements depend on phosphorus intakes with an optimum molar ratio (Ca:P) of 1:1.

Calcium Sources to Reduce Calcium Deficiency.

  • Seaweeds
  • Soya drinks fortified with calcium
  • Bread, fortified with calcium any other products of flour
  • Crushed eggshell

Calcium Absorption in The Body

Important cellular functions of calcium.

  • Cell division.
  • Cell adhesion.
  • The integrity of the plasma membrane
  • Muscle contraction
  • Neuronal excitability.
  • Secretion of proteins.
  • Coagulation cascade.

Absorption of calcium takes place in the small intestine through two processes:-

Passive paracellular pathway:-

The paracellular pathway is dependent on calcium moving through tight junctions in the intestinal epithelium. This is a passive, nonsaturable process and is favored during states of high calcium intake.

Active transcellular pathway:-

The transcellular pathway is an active transport which is particularly important at low and normal calcium intake. In intestinal absorption of Ca2+ via the transcellular pathway, Ca2+ enters through Ca2+ channel TrPV5 or TrPV6, in the luminal membrane of the enterocyte (RBC).

Once absorbed, the transcellular movement of calcium to the basolateral membrane is dependent on binding to an intracellular protein known as calbindin-D9k.

The egress of calcium from the intestinal epithelium occurs through the actions of the plasma membrane calcium-dependent ATPase (PMCA1b).

This transcellular movement of calcium is closely regulated by 1,25(OH)2D3. It regulates the gene transcription of TRPV6, calbindin, and PMCA1b.

How Much Calcium Do We Need?

  • Children between 1- 9 years of age- 700-1300mg/day
  • Teenagers between 13-18 years of age- 1300mg/day
  • Premenopausal women, 25-50 years of age and post-menopausal women’s depend upon estrogen replacement therapy- 1000-1200 mg/day
  • Women above 65 years of age and those who are not on estrogen replacement therapy- 1500mg/day
  • Pregnant and lactating women’s- 1500mg/day
  • For men’s between 25-65 years of age- 1000mg/day
  • All people (both men’s and women’s) above the age of 65- 1500mg/day

Important Role Of Calcium in Our Body

  1. Building up stronger bones and teeth.
  2. Regulating muscular contractions
  3. Controls the muscular contraction of the heart including heartbeat
  4. Controlling the blood clots

Plays an important role in various cellular functions. Also in the activation of certain enzymes, without the presence of calcium, they are inactive.

Note:- Calcium does not absorb without vitamin D.

Symptoms of Calcium Deficiency

Deficiency occurs in those people who have consumed calcium at a low level in their adolescence and puberty age to maintain the normal requirement of the body.


Micro-architectural deterioration of bone tissue caused and leads to an increased risk of fracture. Especially in women bone density declines with age.

Fractures related to osteoporosis are estimated to affect around 30% of women and 12% of men at some point in developed countries and are a major public health problem.

Osteoporotic fractures can affect any bone, but the most common sites are the forearm (Colles Fracture), spine (vertebral fracture) and hip; out of these, hip fractures are the most serious.

In women, there is an accelerated phase of bone loss after menopause due to estrogen deficiency which causes uncoupling of bone resorption and bone formation, such that the amount of bone removed by osteoclasts exceeds the rate of new bone formation by osteoblasts.

Bone resorption is not particularly increased but the formation is reduced and fails to keep pace with bone resorption.

Accumulation of fat in the bone marrow space also occurs because of an age-related decline in the ability of bone marrow stem cells to differentiate into osteoblasts and an increase in their ability to differentiate into adipocytes.

Clinical features:- Patients with pathology stay symptomless until a fracture happens. Osteoporotic fractures gift with pain, tenderness, and deformity.


It is a condition in which calcium level is low in the blood. If hypocalcemia condition exceeds for a longer-term then changes are shown in teeth.

There are other symptoms which are seen due to deficiency of Calcium in the body:-

  • Muscle pain, cramps, and spasm
  • Insomnia
  • Extreme fatigue
  • Lethargy
  • Sluggishness feeling
  • Lack of energy
  • Dizziness, forgetfulness, confusion
  • Brain fag

Skin symptoms may involve- dryness and itching, in few cases, eczema and psoriasis have found. Redness, itching, blisters.

For female- painful menstruation, fatigue and depression.

In the dental-weakness of roots, irritated gums, brittle teeth, and tooth decay. For infants, calcium deficiency cause delay in tooth formation. In a few cases, calcium deficiency had shown some mental symptoms like depression, mood swings.

Complications due to Calcium Deficiency

In this article “Calcium deficiency- causes, symptoms, effects, and treatment” we will see complications of Calcium deficiency.

  • Dental problems
  • Seizures
  • Various skin conditions
  • Depression
  • Chronic joint and muscular pain
  • Disabilities
  • Fractures
  • depression

Treatment to Overcome Calcium Deficiency

The best way to overcome and prevent the deficiency of calcium is with the dietary source which contains calcium in it and fulfils the recommended amount of calcium needed by the body.

Supplements and calcium injections can be prescribed to overcome the deficiency in a few weeks.

Severe deficiency patients are kept under observation to prevent any complications.

An overdose of the supplement can cause harmful symptoms in the body. Please take a supplement under your doctor’s supervision.

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