Doctor insights on:
Ionized Calcium Calculation
Why r my calcium levels normal, while my ionized calcium levels are high? I have bone pain, fatigue, kidney stones. I don't know pth level, or vit. D.
Most calcium in the blood is bound to a molecule called albumin, and this calcium fluctuates depending on the level of albumin. The rest is "ionized" calcium and this is freely available for biologic processes. Labs used to only be able to measure total calcium - calcium bound to Albumin + ionized. Now we can measure ionized calcium and not be mislead that calcium is low ...Read more
Ionized Calcium 4.65, PTH 133, Calcium 10.3, Vitamin D 7, Phosphorus 4.9, recurrent Kidney stones. Thyroid lobe, two parathyroids removed in 2004.
Uncertain: These test results don't add up to a straight forward answer. However, I would be concerned about the possibility of recurrent primary hyperparathyroidism. You should take Vit D to eliminate Vit D deficiency as a cause for high PTH levels. Once this is done, if you still have high PTH with high calcium levels, you have recurrent primary HPTH and will need surgery again. ...Read more
Don't think so.: Each lab report should have a reference range of "normal" values. The reference range changes from lab to lab because each lab runs their test differently. Automated (machine) analyzers tend to have less variability, and in most of those machines, an ionized calcium of 1.1 to1.2 Is about in the middle of the "reference range". ...Read more
All laboratory results need to be interpreted in the clinical context and the doctor who ordered the tests is usually in the best position to do that. Having said that, your level is just below the normal limit. You may consult this site for information on this topic:
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Ionized calcium: Measurement is more accurate than total calcium because it measures the amount of calcium in the blood that is actually available for cellular metabolism. Many possibilities for causes and consequences of low or high calcium, too many to list here. Ask your doctor to interpret your results for you. ...Read more
Unbound calcium: Most calcium in the blood is bound to a molecule called albumin, and this calcium fluctuates depending on the level of albumin. The rest is "ionized" calcium and this is freely available for biologic processes. Labs used to only be able to measure total calcium — calcium bound to Albumin + ionized. Now we can measure ionized calcium and not be mislead that calcium is low because Albumin is low. ...Read more
Just watch it: This is at the upper limit of normal for most reference ranges, and these in turn are set up so that several percent of healthy people will fall on either side. Watch and see what it's like on your next routine set of labs unless you develop symptoms. ...Read more
Calcium has a positive electrical charge; many proteins have a negative electrical charge. So, the opposite charges can cause calcium can bind to proteins. The test for serum calcium measures all the calcium in the blood (bound & unbound).
The ionized calcium measures just the unbound. ...Read more
Hypocalcemia: You should see your physician. Hypocalcemia has many causes, lab error, Vitamin D deficiency, hypoparathyroidism, pseudohypoparathyroidism, kidney disease or end stage renal disease causing vitamin D deficiency, critical illness, drugs, post-parathyroidectomy, malabsorption, etc. Signs to watch for are muscle spasms, parenthesias, numbness around the mouth. http://tinyurl.com/p22ebrx ...Read more
Albumin deficiency: Total calcium is attached to albumin, an important protein in the blood. Your serum calcium may be erroneously normal if your ionized calcium is significantly elevated, look at Albumin level and also repeat the calcium tests to make sure no mistake. May need to look at mg, phos, and intact pth. ...Read more
Depends on context: More information is needed, especially in regard to a correction factor against the serum albumin in hypocalcemia. Ionized calcium is a good measure too, but again, context is necessary. Please see your doctor to help you with clinical context of laboratory values, because the values are not really significant until they are applied to your clinical situation. ...Read more
What's the difference between low ionized calcium and low calcium? Which one is the true measure of hypocalcemia?
Both: If you can measure (rarely done), calculate (complicated formula) or estimate (calcium minus albumin), you will get the ionized calcium. About half of the calcium in the blood is ionized and this is the active form. In real-life, this means that a lot of sick people with low albumin also have low total calcium but needn't worry as the physiologic ionized calcium is what's regulated. ...Read more
Basic chemistry: About half of the calcium in your blood is protein-bound, mostly to albumin, and therefore exerts no phsyiologic effect. The rest is the active form and is what is regulated and what matters. The ionized calcium can be estimated from a formula using albumin, or measured directly by a more difficult technique. Total calcium is easy to measure. ...Read more
My calcium blood levels came back 10.6, my ionized calcium level came back 83, my age is 71, your thoughts?
High calcium: I would have the test redone. If still high, go see your GP for review of your labs and get a complete physical exam. ...Read more
What does blood test of ionized calcium mean? What does it measure? What does it mean if the ionized calcium is below the normal range?
Can't tell: By itself any one blood test, normal or abnormal, means absolutely nothing unless there is some context. You can't determine the significance of this without knowing when it was drawn, why it was drawn, and whether there are any other abnormal tests. Sometimes it means absolutely nothing. Ask the doctor who drew it. ...Read more
What does it mean when my IONIZED CALCIUM is LOW and my INTACT PTH is high? What's the cure to this alarming result? Please help. Thanks.
Low Ca highPTH: Calcium in our blood circulates in two forms. Bound to albumin. Unbound =ionized. Low ionized Calcium is low unbound calcium. It is abnormal. And low ionized calcium will trigger PTH secretoon to higher levels. Remedy requires figuring out why and fixing root cause. Meanwhile, under guidance, take vitamin D 2000 iu daily and 1000 mg calciun as calcium citrate. Is your kidney function normal? ...Read more