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Doctor insights on: Serum Ionized Calcium

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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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Dr. Peter Kurzweil
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Dr. M. Hytham Beck
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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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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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Dr. Peter Kurzweil
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Is there a difference between a calcium vs. Ionized calcium test?

Is there a difference between a calcium vs. Ionized calcium test?

Yes: 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 of the calcium in the blood (bound & unbound). The ionized calcium measures just the unbound. ...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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Dr. Peter Kurzweil
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My IONIZED CALCIUM is slightly low and my INTABT PTH is slightly elevated. My 24-hr Urine Ca is 105.64 and the normal is 100-240. Problem?

My IONIZED CALCIUM is slightly low and my INTABT PTH is slightly elevated. My 24-hr Urine Ca is 105.64 and the normal is 100-240. Problem?

Calcium homeostasis: It depends on the exact numbers, but a slightly low calcium with a slightly elevated PTH is contradictory. If PTH is elevated, your serum calcium should be high. Your urine calcium is normal. Overall , there does not appear to be a problem. You should be seeing an endocrinologist to put it all together. There is not enough information to give you more guidance. ...Read more

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Now that my IONIZED CALCIUM is low and my INTACT PTH is high, does it mean or does it confirm that I have kidney disease?

Not diagnostic: Hi. Low ionized calcium and high PTH (a condition called secondary hyperparathyroidism) is in no way diagnostic of kidney disease. Secondary hyperparathyroidism may be seen in kidney disease. Kidney disease is usually diagnosed by an elevated serum creatinine and sometimes by other things like protein or blood in the urine. There are common non-kidney causes of secondary hyperparathyroidism. ...Read more

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Female 26- calcium 10.5 ionized calcium 1.34, is that normal?

Female 26- calcium 10.5 ionized calcium 1.34, is that normal?

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

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What does an elevated or low ionized calcium results mean?

What does an elevated or low ionized calcium results mean?

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

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What is the definition or description of: ionized calcium?

What is the definition or description of: ionized calcium?

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

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Serum (Definition)

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


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Dr. Peter Kurzweil
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