From the Guidelines
Hypocalcaemia presents with various symptoms ranging from mild to severe, including numbness and tingling, muscle cramps, fatigue, tetany, muscle spasms, and facial twitching, as well as psychological manifestations like irritability, depression, and confusion, as noted in a study published in 2015 1.
Symptoms of Hypocalcaemia
The symptoms of hypocalcaemia can vary widely depending on the severity and rate of decline of calcium levels.
- Early symptoms include:
- Numbness and tingling around the mouth and in the fingertips and toes (paresthesia)
- Muscle cramps
- Fatigue
- As calcium levels drop further, patients may experience:
- Tetany (involuntary muscle contractions)
- Muscle spasms particularly in the hands (carpopedal spasm)
- Facial twitching
- Severe hypocalcaemia can cause:
- Seizures
- Abnormal heart rhythms
- Laryngospasm (vocal cord spasm) which may impair breathing
- Chronic hypocalcaemia might lead to:
- Dry skin
- Brittle nails
- Coarse hair
- Cataracts
- Dental abnormalities
Psychological Manifestations
Psychological manifestations of hypocalcaemia include:
- Irritability
- Depression
- Confusion
Physical Signs
Distinctive physical signs of hypocalcaemia include:
- Trousseau's sign (carpal spasm induced by blood pressure cuff inflation)
- Chvostek's sign (facial muscle twitching when tapping the facial nerve) These symptoms occur because calcium is essential for proper nerve and muscle function, and low levels disrupt normal neuromuscular excitability, leading to increased nerve sensitivity and muscle contractility, as discussed in various studies, including those published in 2003 1, 2018 1, and 2018 1.
From the Research
Symptoms of Hypocalcaemia
The symptoms of hypocalcaemia can vary depending on the severity and duration of the condition. Some common symptoms include:
- Muscular weakness and cramps 2, 3
- Extremity paresthesia (tingling or numbness in the hands and feet) 2, 4
- Tetany (involuntary muscle contractions) 5, 6, 4
- Seizures 5, 4
- Neuromuscular irritability 5, 4
- Chovestek's sign and Trousseau's sign (physical examination signs indicative of hypocalcaemia) 2
- Facial, leg, and foot pain 3
- Tingling in the lips or fingers 3
Acute vs Chronic Hypocalcaemia
Acute hypocalcaemia can cause severe symptoms such as laryngospasm, focal or generalized tonic muscle cramps, or seizures 4. Chronic hypocalcaemia, on the other hand, may have more subtle manifestations, including muscle weakness, fatigue, and neuromuscular irritability 5.
Underlying Causes
Hypocalcaemia can be caused by various underlying conditions, including hypoparathyroidism, vitamin D deficiency, and hyperphosphatemia 2, 5, 6, 3. The treatment and management of hypocalcaemia depend on the underlying cause and may involve calcium and vitamin D supplementation, as well as other medications such as thiazide diuretics 2, 5, 6, 3.