Calcium has several important functions in the body including helping to maintain healthy bones and teeth, regulating muscle function and ensuring your blood clots normally, so it's something we all need to consume, every single day.
You should be able to get all the calcium you need from your daily diet and deficiency is rare. But as calcium plays such an important role in many different parts of the body, low levels can lead to serious health complications.
Family GP Dr Lara Batchat looks at how much calcium you really need and how to hit your daily targets to ensure you stay in optimum health:
What is calcium deficiency?
Calcium deficiency, or hypocalcaemia, is defined as low calcium levels in the bloodstream. Exact definitions vary, but generally a calcium level of less than 2.3mmol/L is considered low.
Having a low calcium level is actually much less common than having high calcium levels. This is because if the body detects low levels of calcium circulating in the blood, it will pull calcium out of the bones to compensate. This is all very well for the delicate balance in the bloodstream, but has a detrimental effect on the skeleton, which suffers as a result.
Having a low calcium level is actually much less common than having high calcium level.
One might expect that calcium deficiency happens because of a lack of calcium in the diet, but in fact the most common causes are vitamin D deficiency and kidney disease (because both vitamin D and the kidney are very much involved in regulating calcium levels). Occasionally, low dietary calcium can cause it too.
How much calcium do we need every day?
To ensure you stay in optimum health you need the following amounts of calcium on a daily basis:
Adults and children over the age of one: should have 800mg of calcium a day.
Teenagers, pregnant or breastfeeding women: need about 1200mg a day.
7 calcium deficiency signs and symptoms
Mildly low calcium levels may well go unnoticed, but as calcium deficiency becomes more severe, different groups of symptoms may arise. This is because, although it’s well known that calcium is needed for bone health, it’s also vital for many other functions, too. It’s an important part of the body’s blood clotting system, which helps you stop bleeding when you cut yourself; and crucially, calcium is also used to send signals from nerves to muscles and vital organs.
Common calcium deficiency symptoms include the following:
1. Muscle problems
Because calcium is needed in order for muscles to contract and relax appropriately, deficiency causes muscle aches, cramps and spasms, which might be particularly noticeable in the hands. Unlike pains from pulled muscles or injuries, these aches and cramps won’t be related to exercise and can come at any time.
2. Nerve problems
Calcium is needed for nerve transmitters to work properly, and so low levels cause confused signals, resulting in numbness and tingling in the hands, arms, feet, legs, or around the mouth. At extremely low levels, calcium deficiency can cause fits and irregular heart rhythms because the nerves don’t work properly, and this can be life-threatening.
Low levels of calcium in the brain and muscles gives a general feeling of malaise, or extreme tiredness and lethargy, with consequent light-headedness and dizziness.
4. Mental health problems
The brain needs adequate levels of calcium to function well. Calcium deficiency can cause anything ranging from mild forgetfulness and confusion, to severe psychosis (seeing or hearing things that are not really there and believing things that aren’t true).
5. Skin, nail and hair problems
Calcium is a key mineral in forming healthy nails and hair, so low levels can result in brittle nails, coarse hair, hair loss and dry skin.
6. Bone and tooth problems
Low levels of calcium in the bloodstream sends alarm bells to the body, which reacts by drawing calcium out of ‘storage’ from the bones and teeth. Although this is a very important consequence of calcium deficiency, it is a silent process which happens over a long period of time – see the section on complications of calcium deficiency, below, to learn more.
7. Premenstrual Syndrome (PMS)
There is some evidence that low calcium levels during the ‘premenstrual’ phase of the menstrual cycle (the week or two before a period) increases troublesome PMS symptoms such as irritability, low mood and bloatedness.
What are the best sources of calcium?
It is well known that dairy foods such as milk, cheese and yogurt are rich in calcium, but there are many other good sources, too:
Green leafy vegetables including kale, okra, spinach and broccoli
Soya drinks with added calcium
Fortified bread and cereals
Nuts and seeds
Fish such as sardines and pilchards, where the bones are eaten.
Should you supplement calcium?
If you eat a well-balanced and varied diet, you will get all the calcium you need and there is no need to take a calcium supplement. Taking additional calcium could make your levels too high, which can be dangerous - if you think you need supplements, it’s best to speak to your doctor first.
Calcium deficiency treatment
Treatment of calcium deficiency depends very much on the cause. For cases due to dietary deficiency, calcium (and sometimes vitamin D) needs to be supplemented – your doctor may advise you to eat calcium rich foods or may advise over-the-counter or prescribed supplements for you to take. In severe cases, calcium injections may be required, but this would usually be in a hospital setting.
Calcium deficiency potential complications
Left untreated, calcium deficiency can have serious complications. All the symptoms discussed above will persist and possibly worsen if nothing is done to supplement calcium levels. In addition to these, over time, calcium deficiency can cause the following:
• Brittle bones
Brittle bones is what medics refer to as low bone density. This is when the body draws calcium out of the bones in order to keep the blood levels steady, inadvertently causing the bones to becomes thin and more likely to break at even the slightest injury. Mild low bone density is referred to as osteopenia, and at more severe levels it is termed osteoporosis. Both conditions are painless – there are no symptoms of low bone density, until a bone breaks.
• Dental problems
Calcium deficiency can lead to dental problems such as tooth decay, brittle teeth and gum disease can all occur, and in babies low calcium can hamper tooth development.
Calcium deficiency can cause cataract - this is when the lens of the eye becomes cloudy.
• Fits and irregular heart rhythms
Severe calcium deficiency can be life threatening as a result of fits and irregular heart rhythms.
When to see your doctor
If you have any symptoms of calcium deficiency, speak to your doctor, who will be able to make a full assessment and run tests if necessary.
Remember that many of the symptoms of calcium deficiency are quite vague and can also be caused by other medical problems, so your doctor may request several tests to be done.
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