Hypocalcemia, also known as calcium deficiency disease, occurs when the blood has low levels of calcium.

A long-term calcium deficiency can lead to dental changes, cataracts, alterations in the brain, and osteoporosis, which causes the bones to become brittle.

A calcium deficiency may cause no early symptoms. It is usually mild, but without treatment, it can become life threatening.

In this article, we describe how to prevent or treat calcium deficiency disease. We also describe its symptoms and who is at risk.

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Calcium is essential for many bodily functions, so a deficiency can have widespread effects, including on the muscles, bones, and teeth, as well as on mental health.

If a low dietary intake is responsible for the deficiency, there are usually no early symptoms. In the longer term, a person may experience osteopenia, or low bone density. Without treatment, this can lead to osteoporosis, or brittle bones.

However, the diet is not usually responsible — a calcium deficiency primarily results from health problems or treatments, such as kidney failure, the removal of the stomach, or the use of certain medications, such as diuretics.

The following sections look at symptoms of a calcium deficiency in more detail.

Muscle problems

A person with a calcium deficiency may experience:

  • muscle aches, cramps, and spasms
  • pain in the thighs and arms when walking or moving
  • numbness and tingling in the hands, arms, feet, and legs, as well as around the mouth

These symptoms may come and go, but they do not tend to disappear with activity.

More extreme sensations may indicate a more severe deficiency, which can also lead to:

  • convulsions
  • arrhythmias
  • death

Extreme fatigue

Low levels of calcium can cause extreme fatigue, which involves a lack of energy and an overall feeling of sluggishness. It can also lead to insomnia.

Fatigue associated with a calcium deficiency can also involve lightheadedness, dizziness, and brain fog — characterized by a lack of focus, forgetfulness, and confusion.

Nail and skin symptoms

A lasting calcium deficiency can cause:

  • dry skin
  • dry, broken, or brittle nails
  • coarse hair
  • alopecia, which causes hair to fall out in patches
  • eczema, or skin inflammation that can lead to itchy or dry patches
  • psoriasis

Osteopenia and osteoporosis

The bones store calcium well, but they require high levels to stay strong. When overall levels of calcium are low, the body can divert some from the bones, making them brittle and prone to injury.

Over time, having too little calcium can cause osteopenia, a reduction of mineral density in the bones.

This can lead to osteoporosis, which causes the bones to thin and become vulnerable to fractures, as well as pain and problems with posture.

It can take takes years for osteoporosis and other complications of a calcium deficiency to develop.

Severe PMS

Low calcium levels have been linked to severe premenstrual syndrome (PMS).

Participants in one 2017 study reported improved mood and reduced rates of fluid retention after taking 500 milligrams (mg) of calcium daily for 2 months.

In 2019, researchers concluded that low levels of vitamin D and calcium during the second half of the menstrual cycle might contribute to symptoms of PMS. The team proposed that supplements may help relieve the symptoms.

Dental problems

When the body lacks calcium, it pulls it from sources such as the teeth. This can lead to dental problems, including:

  • tooth decay
  • brittle teeth
  • irritated gums
  • weak tooth roots

Also, a calcium deficiency in an infant can impair tooth development.

Depression

Some evidence suggests that calcium deficiency may be linked with mood disorders, including depression, though confirming this will require further research.

Anyone who suspects that a calcium deficiency is contributing to symptoms of depression should consult a doctor. After checking the person’s calcium levels, the doctor may recommend a calcium supplement.

For more in-depth resources about vitamins, minerals, and supplements, visit our dedicated hub.

Anyone experiencing symptoms of a calcium deficiency should speak with a doctor. They can order tests and check the levels of calcium in the blood.

Doctors define hypocalcemia, or a calcium deficiency, as blood calcium concentrations of below 8.8 milligrams per deciliter.

The recommended dietary allowance of calcium for adults aged 19–50 is 1,000 mg.

Older adults need more, however: Females aged at least 51 and males aged at least 71 should be consuming 1,200 mg of calcium per day.

While health experts have yet to establish exactly how common this deficiency is, groups with a higher risk include:

In the United States, females older than 4 years, and especially adolescent females, and males aged 9–18 years or older than 51 years may also have a higher risk of a deficiency.

According to estimates published in 2015, 3.5 billion people worldwide are at risk of a calcium deficiency, due to a low dietary intake.

Meanwhile, in 2013, researchers in the United Kingdom reported that calcium deficiency is still common among people with chronic illnesses.

Three years later, researchers in Pakistan reported that among 252 female participants aged 18–51, 41% reported deficiencies of calcium and vitamin D, and 78% reported symptoms consistent with these deficiencies, including pain in the back, legs, and joints.

Overall, females are less likely to get enough calcium from their diets than males. Many females have low levels without knowing it.

Calcium deficiency has been linked to:

  • dental problems
  • depression
  • various skin conditions
  • chronic joint and muscle pain
  • fractures
  • seizures
  • disability

The safest and easiest way to treat or prevent a calcium deficiency is to add more calcium to the diet.

Some calcium-rich foods include:

  • dairy products, such as milk, cheese, and yogurt
  • beans
  • figs
  • broccoli
  • tofu
  • soy milk
  • spinach
  • fortified cereals
  • nuts and seeds, including almonds and sesame seeds

Learn more about vegan dietary sources of calcium.

Before taking calcium supplements, talk to a doctor. Taking in too much calcium, an issue called hypercalcemia, can increase the risk of cardiovascular disease, kidney stones, and other serious health problems.

When a deficiency is severe or when supplements and dietary adjustments are not achieving sufficient results, a doctor may prescribe calcium injections.

A calcium deficiency may result from dietary factors, health issues, or medical treatments.

The best approach is to add more calcium to the diet. When this is not possible, a doctor may recommend supplements, either as oral tablets or injections.

Most people who receive treatment experience an improvement in symptoms within a few weeks.