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Doctor insights on: Serum Ionized Calcium

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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.

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.

Half if calcium: In the blood is bound to proteins and inactive. The other, active, half is the ionized or free calcium, which is what really does the heavy lifting and is more accurate cllinically. You really need the other lab and a good endocrinologist. ...Read more

Dr. Lynne Weixel
36 doctors shared insights

Ionized Calcium (Definition)

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


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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.

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

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For someone with serum calcium and ionized calcium both at the 95% cutoff level (highest normal), are vitamin D injections of safe?

For someone with serum calcium and ionized calcium both at the 95% cutoff level (highest normal), are vitamin D injections of safe?

Not advised: Vitamin D helps the gut absorb calcium into the bloodstream. If your calcium level is already relatively high, extra vitamin d would not be a good idea. You might want to check your parathyroid hormone level to find out why your calcium level is high. ...Read more

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What are common causes of normal calcium serum levels with high ionized calcium levels?

What are common causes of normal calcium serum levels with high ionized calcium levels?

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

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A low vitamin d=10.1mg/ml, calcium serum =10.9 mg/dl.Pth=31pg/ml and ionized calcium serum=5.1mg/dl is it normal?Doctor gave me 50, 000 units of vit

A low vitamin d=10.1mg/ml, calcium serum =10.9 mg/dl.Pth=31pg/ml and ionized calcium serum=5.1mg/dl  is it normal?Doctor gave me 50, 000 units of vit

D3: D3 is preferred over d2 as it is less toxic and more bioavailable. Aim for serum level of d to be about 60. I would dose you at 10000 iu d3 daily for 2 weeks then 5000 iu daily, and also encourage 5-15 mins of sun exposure daily. Recheck d level in 2-3 months. ...Read more

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My ionized calcium es 1.22 is that low?

My ionized calcium es 1.22 is that low?

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

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What does it mean if my ionized calcium in the blood is low?

What does it mean if my ionized calcium in the blood is low?

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

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What is the true measure of hypocalcemia? Low ionized calcium, or low calcium? Thank you.

What is the true measure of hypocalcemia? Low ionized calcium, or low calcium? Thank you.

Depends on context: More information is needed, especially in regards 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

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What can prolonged low ionized calcium in the blood do to one's body? How dangerous is it?

It's not good: low calcium levels cause a lot of problems, and can eventually be extremely serious. You might notice twitching and spasms or cramps. ...Read more

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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

Serum (Definition)

Serum is the component of blood that does not contain cells or clotting factors. It does contain electrolytes an ...Read more