Calcium- Total
- C1054
Rs 195
Tests Detail
| Observations Included |
| Calcium- Total * |
| The Test marked with (*) are in our NABL Scope. |
Sample Report
- Also Known As:
Calcium - Formal Name:
Total Calcium Ionized Calcium - Sample Instructions:
As part of a routine metabolic panel; when you have symptoms of a disorder, or known presence of one, affecting your kidneys, bones, thyroid, parathyroid, or nerves or when symptoms of significantly increased or decreased calcium concentrations are present; when someone is critically ill, to monitor ionized calcium levels; when someone has certain types of cancer; when someone is being treated for abnormal calcium levels, to evaluate the effectiveness of treatment - Test Preparation Needed?
A blood sample is taken by needle from a vein in the arm. If a urine collection is required, a 24-hour urine sample or a timed collection of a shorter duration is obtained. Sometimes a random urine collection may be used, although a timed collection is preferred. - What Is Being Tested?
Current practices do not require fasting. You may be instructed to stop taking certain medications, such as lithium, antacids, diuretics, and vitamin D supplements, among others, to ensure the most accurate test results. - How Is It Used?
Calcium is the most abundant and one of the most important minerals in the body. It is essential for cell signaling and the proper functioning of muscles, nerves, and the heart. Calcium is needed for blood clotting and is crucial for the formation, density, and maintenance of bones and teeth. This test measures the amount of calcium in the blood or urine, which reflects the amount of total and ionized calcium in the body. About 99% of calcium is found complexed in the bones, while the remaining 1% circulates in the blood. Calcium levels are tightly controlled; if there is too little absorbed or ingested, or if there is excess loss through the kidney or gut, calcium is taken from bone to maintain blood concentrations. Roughly half of the calcium in the blood is "free" and is metabolically active. The remaining half is "bound" to proteins, primarily albumin and to a lesser extend globulins, with a smaller amount complexed to anions, such as phosphate, and these bound and complexed forms are metabolically inactive. There are two tests to measure blood calcium. The total calcium test measures both the free and bound forms. The ionized calcium test measures only the free, metabolically active form. Some calcium is lost from the body every day, filtered from the blood by the kidneys and excreted into the urine and sweat. Measurement of the amount of calcium in the urine is used to determine how much calcium the kidneys are eliminating. - When Is It Ordered
A blood calcium test is ordered to screen for, diagnose, and monitor a range of conditions relating to the bones, heart, nerves, kidneys, and teeth. The test may also be ordered if a person has symptoms of a parathyroid disorder, malabsorption, or an overactive thyroid. A total calcium level is often measured as part of a routine health screening. It is included in the comprehensive metabolic panel (CMP) and the basic metabolic panel (BMP), groups of tests that are performed together to diagnose or monitor a variety of conditions. When an abnormal total calcium result is obtained, it is viewed as an indicator of an underlying problem. To help diagnose the underlying problem, additional tests are often performed to measure ionized calcium, urine calcium, phosphorus, magnesium, vitamin D, parathyroid hormone (PTH) and PTH-related peptide (PTHrP). PTH and vitamin D are responsible for maintaining calcium concentrations in the blood within a narrow range of values. If the blood calcium is abnormal, measuring calcium and PTH together can help determine whether the parathyroid glands are functioning normally. Measuring urine calcium can help determine whether the kidneys are excreting the proper amount of calcium, and testing for vitamin D, phosphorus, and/or magnesium can help determine whether other deficiencies or excesses exist. Frequently, the balance among these different substances (and the changes in them) is just as important as the concentrations. Calcium can be used as a diagnostic test if a person has symptoms that suggest: Kidney stones Bone disease Neurologic disorders Total calcium is the blood test most frequently ordered to evaluate calcium status. In most cases, it is a good reflection of the amount of free calcium present in the blood since the balance between free and bound is usually stable and predictable. However, in some people, the balance between free and bound calcium is disturbed and total calcium is not a good reflection of c - What Does The Test Result Mean?
A blood calcium test is often ordered when a person undergoes a general medical examination. It is typically included in the comprehensive metabolic panel (CMP) and the basic metabolic panel (BMP), two sets of tests that may be used during an initial evaluation or as part of a routine health screening. Many people do not have symptoms of high or low calcium until their levels are very out of range. A healthcare practitioner may order a calcium test when someone has: Kidney disease, because low calcium is especially common in those with kidney failure Symptoms of high calcium such as fatigue, weakness, loss of appetite, nausea, vomiting, constipation, abdominal pain, urinary frequency, and increased thirst Symptoms of very low calcium such as abdominal cramps, muscle cramps, or tingling fingers Other diseases that have been associated with abnormal blood calcium such as thyroid disease, parathyroid disorder, malabsorption, cancer, or malnutrition An ionized calcium test may be ordered when someone has numbness around the mouth and in the hands and feet and muscle spasms in the same areas. These can be symptoms of low levels of ionized calcium. However, when calcium levels fall slowly, many people have no symptoms at all. Calcium monitoring may be necessary when a person has certain kinds of cancer (particularly breast, lung, head and neck, kidney, or multiple myeloma), has kidney disease, or has had a kidney transplant. Monitoring may also be necessary when someone is being treated for abnormal calcium levels to evaluate the effectiveness of treatments such as calcium or vitamin D supplements. A urine calcium test may be ordered when someone has symptoms of kidney stones, such as a sharp pain in the person's side or back around the kidneys, pain that may progress to lower in the abdomen, and/or blood in the urine. - Is There Anything Else I Should Known?
Blood calcium levels do not indicate levels of bone calcium but rather how much calcium is circulating in the blood. Calcium absorption, use, and excretion are regulated and stabilized by a feedback loop involving PTH and vitamin D. Conditions and diseases that disrupt calcium regulation can cause inappropriate acute or chronic elevations or decreases in calcium and lead to symptoms of hypercalcemia or hypocalcemia. In most cases, total calcium is measured because the test is more easily performed than the ionized calcium test and requires no special handling of the blood sample. Total calcium is usually a good reflection of free calcium since the free and bound forms are typically each about half of the total. However, because about half of the calcium in blood is bound to protein, total calcium test results can be affected by high or low levels of protein. In such cases, it is more useful to measure free calcium directly using an ionized calcium test. Normal calcium A normal total or ionized calcium result together with other normal laboratory results generally means that a person's calcium metabolism is normal and blood levels are being appropriately regulated. High total calcium (hypercalcemia) Two of the more common causes of high blood calcium are: Hyperparathyroidism, an increase in parathyroid gland function: this condition is usually caused by a benign tumor of the parathyroid gland. This form of hypercalcemia is usually mild and can be present for many years before being noticed. Cancer: cancer can cause hypercalcemia when it spreads to the bones and causes the release of calcium from the bone into the blood or when a cancer produces a hormone similar to PTH, resulting in increased calcium levels. Some other causes of high blood calcium include: Hyperthyroidism Sarcoidosis Tuberculosis Prolonged immobilization Excess vitamin D intake Thiazide diuretics Kidney transplant HIV/AIDS Low total calcium (hypocalcem
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