Calcium (adjusted)

What it is

Calcium is a vital mineral that plays a crucial role in many bodily functions. It's most famously known for its importance in building and maintaining strong bones and teeth. However, calcium is also essential for your muscles to contract, your nerves to send signals, and for your blood to clot properly.

Most of the calcium in your body is stored in your bones and teeth. The rest circulates in your blood. The level of calcium in your blood is carefully controlled by your body, with help from certain hormones and vitamin D.

The "adjusted" in "calcium (adjusted)" refers to a calculation that takes into account the amount of a protein called albumin in your blood. Albumin is the most common protein in your blood, and it binds to calcium. If your albumin levels are unusually high or low, it can affect the measured calcium level, even if your actual free calcium is normal. The adjusted calcium level gives a more accurate picture of the amount of calcium that is actually available for your body to use.

In the UK, a typical reference range for adjusted calcium is between 2.2 and 2.6 millimoles per litre (mmol/l). It’s important to remember that laboratory reference ranges can vary slightly.

Why it matters

The amount of calcium in your blood is a key indicator of your overall health, particularly for your kidneys. Your kidneys play a vital role in regulating calcium levels in your body. They help to filter waste products from your blood and also control how much calcium is reabsorbed back into your bloodstream or excreted in your urine.

When kidney function is compromised, it can disrupt this delicate balance, potentially leading to abnormal calcium levels. Monitoring adjusted calcium levels can therefore provide valuable insights into how well your kidneys are working and help detect potential problems early on.

Beyond kidney health, balanced calcium levels are crucial for preventing conditions like osteoporosis (weak bones) and can be linked to other metabolic processes in the body.

What can cause it to be high or low

High Adjusted Calcium (Hypercalcaemia)

Several factors can lead to an elevated adjusted calcium level.

• Kidney problems: As mentioned, impaired kidney function can lead to calcium building up in the blood.
• Overactive parathyroid glands (Hyperparathyroidism): The parathyroid glands, located near the thyroid gland in your neck, produce a hormone that helps regulate calcium. If they become overactive, they can release too much of this hormone, leading to high calcium levels. This is a common cause of high calcium.
• Certain medications: Some medicines can affect calcium levels.
• Other medical conditions: Less commonly, conditions affecting other glands or certain types of cancer can be associated with high calcium.
• Excessive intake of calcium or vitamin D: While less common, very high intake from supplements can sometimes contribute.

Low Adjusted Calcium (Hypocalcaemia)

Conversely, low adjusted calcium levels can also occur due to various reasons.

• Kidney disease: Advanced kidney disease can sometimes lead to low calcium levels, often in conjunction with other mineral imbalances.
• Low levels of parathyroid hormone: If the parathyroid glands aren't producing enough of their regulating hormone, calcium levels can drop.
• Vitamin D deficiency: Vitamin D is essential for your body to absorb calcium from your diet. A lack of vitamin D can therefore lead to low calcium.
• Certain medications: Some drugs can interfere with calcium absorption or increase its excretion.
• Pancreatitis: Inflammation of the pancreas can sometimes cause calcium levels to drop.
• Malnutrition or malabsorption: Conditions that affect your ability to absorb nutrients from food can also impact calcium levels.

Lifestyle factors that may help

Maintaining healthy lifestyle habits can support overall well-being and may contribute to balanced calcium levels.

• Diet: A balanced diet that includes good sources of calcium and vitamin D is important. Foods like dairy products, leafy green vegetables, and fortified foods can be good sources. Discussing your dietary intake with a healthcare professional can be helpful.
• Sunlight exposure: Moderate, safe exposure to sunlight helps your body produce vitamin D, which is crucial for calcium absorption.
• Regular physical activity: Weight-bearing exercises, such as walking or strength training, can help maintain bone health.
• Hydration: Drinking adequate fluids is important for overall kidney function.

Questions to discuss with your GP

If your adjusted calcium result is outside the typical reference range, or if you have concerns about your kidney health, it’s a good idea to have a conversation with your GP. Here are some questions you might consider discussing:

• What does my adjusted calcium level mean in the context of my overall health?
• Could my adjusted calcium level be related to my kidney function?
• Are there any specific dietary changes or lifestyle adjustments you would recommend for me?
• Are there any other tests that might be helpful to understand this result further?
• What are the potential causes for my specific calcium level?
• Are there any medications or supplements that might be affecting my calcium levels?