From the Research
For a corrected calcium level of 8.2 mg/dL, I recommend supplementation with 1000-1200 mg of elemental calcium daily, divided into 2-3 doses, as the most recent and highest quality study suggests that mild hypocalcemia can be managed with oral calcium supplementation 1.
Calcium Supplementation
- Calcium carbonate (Tums, Os-Cal) or calcium citrate (Citracal) are appropriate options, with calcium citrate being better absorbed on an empty stomach or in patients with reduced stomach acid.
- Take calcium carbonate with food for optimal absorption.
- Pair this with vitamin D supplementation of 800-1000 IU daily, as vitamin D is essential for calcium absorption 2.
Dietary Sources
- Dietary sources of calcium should also be increased, including dairy products, fortified plant milks, leafy greens, and canned fish with bones.
Monitoring and Medical Evaluation
- Mild hypocalcemia (calcium 8.2 mg/dL) typically doesn't require urgent correction unless symptoms like numbness, tingling, or muscle cramps are present.
- The goal is to gradually normalize calcium levels through consistent supplementation rather than rapid correction.
- If symptoms are severe or calcium levels drop further, medical evaluation is necessary as intravenous calcium might be required 3.
Treatment of Underlying Cause
- It is essential to identify and treat the underlying cause of hypocalcemia, as the treatment approach may vary depending on the cause 4.
- For example, in patients with hypoparathyroidism, calcium and vitamin D supplementation must be carefully titrated to avoid symptoms of hypocalcemia while keeping serum calcium in the low-normal range to minimize hypercalciuria, which can lead to renal dysfunction 1.