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Calcium is one of the vital minerals for humans. Because it is not made by the body, calcium must be ingested with food. The daily calcium requirement of a middle-aged adult is 1000 milligrams, in adolescents and young adults the value is slightly higher at 1200 milligrams. If the person consumes too little calcium, calcium deficiency occurs (hypocalcaemia). This leads to a disturbance in the balance between the various electrolytes in the body and leads to overexcitability of the muscles and nerves.
Tasks of calcium in the body
Calcium, whose chemical element symbol is Ca, is one of the electrolytes that the human body needs for numerous vital tasks. Only when there is a sufficient amount of electrolytes does the body work without complications. In terms of quantity, calcium, at around one kilogram, is the electrolyte most of which is stored in the body.
99 percent of the calcium is in bones and teeth and only one percent in the blood and other tissues. Calcium is important for blood clotting, the excitability of muscles and nerves, the stability of bones and teeth and is responsible for the activation of various enzymes and hormones.
The intestine, kidneys and bones are responsible for regulating the calcium balance: the intestine is responsible for the absorption and excretion of calcium, the bones act as temporary stores and the excess calcium is excreted in the kidneys, the synthesis of vitamin D is regulated and the calcium intake in the Gut controlled.
The calcium balance is regulated by the hormones parathyroid hormone, calcitonin and vitamin D.
1. Parathyroid hormone The parathyroid hormone is produced in the parathyroid glands. Its main task is to increase the calcium concentration in the blood plasma, on the one hand by breaking down bones in which most of the mineral is stored, and on the other hand influencing the kidneys to excrete less of them with the urine.
2. Calcitonin The calcitonin formed in the C cells of the thyroid gland is primarily responsible for reducing the calcium concentration in the blood plasma. In contrast to the parathyroid hormone, calcitonin builds calcium from the blood into the bones and influences the kidneys and intestines to excrete less of the essential mineral with urine and stool.
3. Vitamin D Vitamin D is a hormone made by the body with the help of sunlight, which helps the body to absorb calcium well from food. Vitamin D can also be consumed in unfinished form through food. It is then completed with the liver and kidney. Vitamin D affects the intestine to absorb more calcium from the diet, increasing the concentration of the mineral in the blood plasma. It also counteracts bone loss by increasing the amount of calcium in the bones.
Causes of calcium deficiency
In addition to genetic predisposition (hereditary predisposition), various factors can lead to calcium deficiency, which are due to a reduced absorption capacity of calcium from the food, an insufficient calcium intake due to unhealthy or malnutrition, increased calcium loss or an increased calcium requirement.
Women have an increased calcium requirement of 1200 to 1500 mg per day during pregnancy and lactation. The needs of young people and the elderly are similarly high. If they do not get enough calcium, deficiency symptoms can occur.
An undersupply of calcium can also be triggered by malnutrition or malnutrition. Increased alcohol and coffee consumption promotes an increased excretion of the mineral via the kidneys. Bulimia (anorexia), anorexia (pathological refusal to eat), pancreatitis, kidney disease with decreased kidney function and bowel disease can all lead to deficiency.
Other possible causes include an underactive parathyroid gland and the associated lack of parathyroid hormone, reduced effects of parathyroid hormone, magnesium deficiency, hyperventilation, gluten intolerance and vitamin D deficiency.
Symptoms of calcium deficiency
Calcium deficiency leads to overexcitability of the muscles and nerves. Muscle cramps and feeling disorders occur. The so-called hypocalcaemic tetany is the main symptom. This means a malfunction of the motor skills and sensibility caused by the undersupply up to the painful muscle spasm, in which the patient remains conscious. The tetanic attack is life-threatening.
Affected people usually complain of feeling disorders such as tingling in the hands and arms. As the process progresses, the muscles contract. The hands take the so-called "paw position" and the feet can form a "pointed foot" due to the cramp. Spasms of the muscles in the mouth often lead to the formation of a "carp" or "fish mouth". In addition, there are muscle cramps in the intestine and bladder area, which can lead to diarrhea, abdominal pain and increased urge to urinate. If the larynx muscles also tense, life-threatening shortness of breath can occur.
If the cause is a lack of parathyroid hormone, additional calcification of various organs can occur. The eyes and brain are often affected, causing clouding of the eye lens and worsening eyesight, as well as headaches, movement and speech disorders, and dementia. If the parathyroid hormone deficiency occurs in childhood, tooth development disorders and short stature are possible. A persistent undersupply of the mineral can lead to the development of osteoporosis.
Treatment for calcium deficiency
If there is a suspicion of undersupply, a doctor should always be consulted who first looks for the cause. The intake of calcium and vitamin D increases the concentration of the mineral in the blood. However, the blood values must be checked regularly in order to rule out an overdose with hypercalcaemia (calcium excess) as a result.
Immediate medical attention should be sought during a life-threatening tetanic attack. As a rule, those affected are promptly supplied with infusions of calcium and other medications in an intensive care unit. The harmless hyperventilation tetany, in which involuntarily deep breathing exhales too much carbon dioxide, is to be distinguished from the tetanic attack, whereby the acid-base ratio is disturbed. The body tries to correct it by introducing calcium into the cells in exchange for hydrogen ions. This leads to an apparent calcium deficiency, which is remedied by compensating for the lack of carbon dioxide by inhaling and exhaling in a bag.
Prevention through a healthy diet
A healthy and balanced diet can prevent calcium deficiency in many cases. Coffee, alcohol, nicotine, fat, sugar and too much salt, on the other hand, lead to an increased excretion of the mineral.
A healthy diet includes many plant-based foods such as fruits and vegetables and whole grains. Fish, meat - not more than two to three times a week - and preferably poultry. Mineral water and milk products are also important to meet the need for calcium and vitamin D, but also phosphorus, vitamin B12, folic acid and protein components. Very good calcium suppliers are cow's milk, yoghurt and cheeses like Emmental, Parmesan, Tilsiter or Gouda.
In addition to milk and milk products, dark green vegetables such as kale, broccoli, spinach and arugula are important sources of calcium. Hazel and Brazil nuts as well as poppy and sesame seeds also contain a lot of the mineral. Children, pregnant women and nursing mothers in particular should drink a glass of milk daily to prevent a deficiency. (ag, no)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dipl. Geogr Astrid Goldmayer, Barbara Schindewolf-Lensch
- German Nutrition Society V .: Calcium reference values, (accessed 04.09.2019), dge
- James L. Lewis, III: Hypocalcaemia, MSD Manual, (accessed 04.09.2019), MSD
- Hans Konrad Biesalski, Stephan Bischoff, Matthias Pirlich et al .: Nutritional Medicine, According to the nutritional medicine curriculum of the German Medical Association and the DGE, Thieme Verlag, 4th edition, 2010
- Christoph Raschka, Stephanie Ruf: Sport and Nutrition, Thieme Verlag, 3rd edition, 2017
ICD codes for this disease: E58ICD codes are internationally valid encodings for medical diagnoses. You can find e.g. in doctor's letters or on disability certificates.