High Calcium on a blood test that does not make sense?

Ever experienced having the worse illness and then receiving your blood tests and you see that your calcium levels are high but you have no signs of high calcium? (check out our previous blog post talking all about high calcium symptoms) And on top of that your doctor did not even mention you had high calcium? A lot of us have been there and youtrition is here to answer your questions that keep you up at night.

Albumin is a protein made by the liver that helps maintain oncotic pressure (keeping fluid in the bloodstream) and transports hormones, drugs, and calcium. Albumin levels can become low in conditions where it is lost, such as nephrotic syndrome or protein losing enteropathy, or when the liver is not producing enough, such as in cirrhosis, hepatitis, severe malnutrition (including kwashiorkor), chronic illness, and in elderly individuals with poor dietary intake. Albumin can also appear low due to dilution states such as congestive heart failure, pregnancy, large IV fluid shifts, and critical illness. Inflammation also lowers albumin levels because it is a negative acute-phase reactant, meaning the liver makes less of it when the body is inflamed.

Because standard blood tests measure total calcium, low albumin can make calcium levels appear low even though the biologically active ionized (free) calcium is usually normal. This is because only the albumin bound portion of calcium decreases, not the ionized portion. To determine whether a patient actually has true hypocalcemia, clinicians calculate a corrected calcium value using:

Corrected Ca=Measured Ca+0.8×(4−Albumin)

This adjustment helps distinguish between falsely low calcium due to hypoalbuminemia and true low calcium that requires treatment. Your doctor usually does this calculation but Youtrition has got your back too!