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Hypoparathyroidism

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Hypoparathyroidism

Endocrine System - Thryroid and Parathyroid Glands

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About

Main glands of the endocrine system

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About Hypoparathyroidism

Hypoparathyroidism is a rare disorder of calcium metabolism.

The body has four parathyroid glands, which are pea-sized and located in the neck behind the thyroid gland. The parathyroid glands make parathyroid hormone (PTH) and are part of the endocrine system.

PTH regulates the amount of calcium and phosphorus in the blood through its direct effects on the kidney and bone, where the body stores most of its calcium.

Decreased PTH levels lead to low calcium levels and high phosphorus levels in the blood. This imbalance can lead to problems with muscles, teeth, and nerve endings.

Source: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

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Hyperparathyroidism

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Hyperparathyroidism

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Parathyroid Glands

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0:44

Trousseau's Sign of Hypocalcemia

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18:49

Hypocalcemia

Strong Medicine/YouTube

What Is It?

Parathyroid Gland

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What Is Hypoparathyroidism?

Hypoparathyroidism is is an endocrine disorder in which the parathyroid glands in the neck do not produce enough parathyroid hormone (PTH). Common signs and symptoms include abdominal pain, brittle nails, cataracts, dry hair and skin, muscle cramps, tetany, pain in the face, legs, and feet, seizures, tingling sensation, and weakened tooth enamel (in children). It may be caused by injury to the parathyroid glands (e.g., during surgery). Other causes, include low blood magnesium levels, a side effect of radioactive iodine treatment for hyperthyroidism, metabolic alkalosis, DiGeorge syndrome, and type I polyglandular autoimmune syndrome. The goal of treatment is to restore the calcium and mineral balance in the body.

Source: Genetic and Rare Diseases (GARD) Information Center

Additional Materials (5)

Diagram showing the position of the thyroid and parathyroid glands

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Sensitive content

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Postoperative Hypoparathyroidism in Thyroid Surgery Fig4

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Sensitive content

This media may include sensitive content

Postoperative Hypoparathyroidism in Thyroid Surgery Fig4 Recorte

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Hypoparathyroidism vs Hyperparathyroidism | Hyperparathyroidism and Hypoparathyroidism Nursing NCLEX

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Diagnosis

Urine in Vial

Image by TheVisualMD

How Do Healthcare Providers Diagnose Hypoparathyroidism?

To diagnose hypoparathyroidism, a healthcare provider will usually start with a blood test to determine the levels of the following:

Parathyroid hormone
Calcium
Phosphorus
Creatinine
Magnesium

A urine test determines how much calcium the kidneys are releasing.

Source: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Additional Materials (5)

Urine Test

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1:09

Parathyroid Gland - Parathyroid Hormone - Explained in 1 Minute

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Thyroid Tests

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Parathyroid Hormone Test

Parathyroid Hormone (PTH) Blood Test

Also called: PTH, Intact PTH, Parathyroid Hormone

This test measures the level of parathyroid hormone (PTH) in the blood. PTH controls the level of calcium in the blood. Too much or little calcium in blood can cause serious health problems.

Parathyroid Hormone (PTH) Blood Test

Also called: PTH, Intact PTH, Parathyroid Hormone

This test measures the level of parathyroid hormone (PTH) in the blood. PTH controls the level of calcium in the blood. Too much or little calcium in blood can cause serious health problems.

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Use the slider below to see how your results affect your health.
pg/mL
15
65
Your result is Normal.
PTH is released by the parathyroid glands. PTH circulates in your blood and is needed to control the level of calcium in your blood.
Related conditions
This test measures the level of parathyroid hormone (PTH) in your blood. PTH, is made by your parathyroid glands. They are four pea-sized glands in your neck.
Hormones are chemical messengers in your bloodstream. They control the actions of certain cells or organs. PTH controls the level of calcium in your blood. Calcium is one of the most important minerals in your body. Most of it is stored in your bones and teeth. Having the right amount of calcium in your blood is important for your nerves, muscles, and heart to work properly.
If your calcium blood levels are too low, your parathyroid glands will release just enough PTH into your blood to return your calcium levels to normal. PTH raises your blood calcium by:
- Telling your bones to release calcium into your blood
- Helping your intestines to absorb calcium from the food you eat
- Helping your kidneys to keep calcium in your blood instead of getting rid of it through your urine (pee)
When your calcium blood levels return to normal, your parathyroid glands stop making PTH and your blood PTH levels decrease.
Because the amount of PTH in your blood changes with the amount of calcium in your blood, your health care provider will usually order a calcium blood test along with a PTH test. Comparing the results of both tests helps your provider understand if your parathyroid glands are working properly to control your calcium levels.
Other names: parathormone, intact PTH
A PTH test may be used to:
- Help find out whether parathyroid disorders are the cause of abnormal blood calcium levels. This is the most common use.
- Help find the cause of abnormally low results on a phosphate blood test. That's because PTH also helps control the amount of phosphate (phosphorus) in blood.
- Monitor people with chronic kidney disease.
- Help find the cause of severe osteoporosis, a condition that causes your bones to become weak and break easily.
- Check whether treatment for a known parathyroid disorder is working.
- Check whether all overactive parathyroid tissue has been removed during surgery to treat parathyroid disorders that cause too much PTH.
You may need a PTH test if you:
- Had a calcium test that showed your blood calcium levels aren't normal.
- Have symptoms of too much calcium in your blood. These symptoms may include:
  Digestive symptoms, such as:
  Constipation
  Nausea and vomiting
  Abdominal (belly) pain
  Loss of appetite
  Increased thirst
  Urinating (peeing) more than usual
  Kidney stones
  Bone, joint, and muscle symptoms, such as weakness, aches, and pains
  Fatigue
  A change in mental health, such as depression or confusion
- Have symptoms of too little calcium in your blood. These symptoms can range from mild to severe. They may include:
  Dry skin, coarse hair, and nails that easily break (after a long period of low levels)
  Muscle cramps, spasms, or stiffness
  Tingling in the lips, tongue, fingers, and feet
  Irregular heartbeat (arrhythmia)
  Seizures, if calcium levels are extremely low
- Have a parathyroid disorder or chronic kidney disease.
Many health conditions can cause abnormal PTH levels. To understand what your PTH test results mean, your provider will consider the results of other tests, especially a blood calcium test. Your symptoms, medical history, and family history will also be considered.
If your PTH level is higher than normal, it's called hyperparathyroidism. There are two types. The type you have generally depends on your blood calcium level:
- Primary hyperparathyroidism is high PTH levels with high blood calcium levels. This often means that a problem with your parathyroid glands is causing them to make too much PTH. The extra PTH raises your blood calcium levels. Possible causes of primary hyperparathyroidism include:
  A benign tumor (not cancer) in one of your parathyroid glands, called a parathyroid adenoma. This is the most common cause of high PTH levels.
  Hyperplasia of your parathyroid glands, which means that they have become larger than normal.
  A rare inherited condition, such as multiple endocrine neoplasia type 1 or familial hypocalciuric hypercalcemia.
  Parathyroid cancer, which is rare.
- Secondary hyperparathyroidism is high PTH levels with low blood calcium levels. Your parathyroid glands are working correctly by making extra PTH to try to increase your blood calcium. It's likely that a problem outside of your parathyroid glands is preventing your blood calcium levels from increasing.
  Your provider will probably order more tests to find out what's causing your low blood calcium. Possible causes include:
  Having low levels of vitamin D (vitamin D deficiency), phosphate, and/or magnesium
  Not getting enough calcium
  Digestive disorders, such as malabsorption syndromes, that make it hard for your body to absorb calcium from food
  Kidney failure, which causes your body to lose too much calcium through urine
If your PTH levels are lower than normal and your blood calcium level is also low, it may mean your parathyroid glands can't make enough PTH. This is called hypoparathyroidism. This condition is less common than hyperparathyroidism. Possible causes include:
- Damage to your parathyroid glands from surgery on your neck or radiation therapy for cancer
- Certain autoimmune disorders that destroy parathyroid tissue
- Certain genetic disorders, such as DiGeorge syndrome, also called 22q11.2 deletion syndrome
- Getting too much vitamin D and/or calcium from supplements or from antacids that contain calcium
- Serious illnesses
If your PTH levels aren't normal when compared to your blood calcium level and other test results, your provider will usually order other blood tests to learn more. If a parathyroid tumor is suspected, you may also have imaging tests. If you have questions about your results, talk with your provider.
1. Parathyroid Hormone (PTH) Test: MedlinePlus Medical Test [accessed on Jan 27, 2024]
2. Parathyroid hormone (PTH) blood test: MedlinePlus Medical Encyclopedia [accessed on Jan 27, 2024]
3. Parathyroid Hormone (PTH) Test - Testing.com. Jan 5, 2023 [accessed on Jan 27, 2024]
4. Parathyroid Hormone - Health Encyclopedia - University of Rochester Medical Center [accessed on Jan 27, 2024]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (1)

Parathyroid Hormone

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Calcium Test

Calcium Blood Test

Also called: Calcium, Hypocalcemia Test, Hypercalcemia Test

A calcium test measures the level of calcium in your blood. Abnormal calcium levels may be a sign of kidney problems, bone disease, thyroid disease, cancer, malnutrition, or another disorder.

Calcium Blood Test

Also called: Calcium, Hypocalcemia Test, Hypercalcemia Test

A calcium test measures the level of calcium in your blood. Abnormal calcium levels may be a sign of kidney problems, bone disease, thyroid disease, cancer, malnutrition, or another disorder.

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Use the slider below to see how your results affect your health.
mg/dL
8.2
10.2
Your result is Normal.
A normal total calcium result supported by other normal findings generally means that your calcium metabolism is normal and blood levels are being appropriately regulated.
Related conditions
{"label":"Ionized calcium reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"abnormal","label":{"short":"Low","long":"Low","orientation":"horizontal"},"values":{"min":0,"max":4.5},"text":"Low blood levels of ionized calcium can cause your heart rate to slow down or speed up, cause muscle spasms, and even result in a coma.","conditions":["Hypoparathyroidism","Malabsorption","Osteomalacia","Pancreatitis","Renal failure","Rickets","Vitamin D deficiency"]},{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":4.5,"max":5.6},"text":"Ionized calcium levels give more information about active, \"free\" calcium. It may be important to know your ionized calcium levels if you have abnormal levels of proteins, such as albumin, or immunoglobins in your blood.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":5.6,"max":15},"text":"High levels of ionized calcium in your blood may be due to a sedentary lifestyle or lack of mobility, use of medications and supplements or certain medical conditions.","conditions":["Decreased levels of calcium in the urine from an unknown cause","Hyperparathyroidism","Hyperthyroidism","Milk-alkali syndrome","Multiple myeloma","Paget disease","Sarcoidosis","Thiazide diuretics","Thrombocytosis","Certain kind of tumors","Vitamin A excess","Vitamin D excess"]}],"units":[{"printSymbol":"mg\/dL","code":"mg\/dL","name":"milligram per deciliter"}],"value":5.1,"disclaimer":"Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are \"within normal limits.\""}[{"abnormal":0},{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your health.
mg/dL
4.5
5.6
Your result is Normal.
Ionized calcium levels give more information about active, "free" calcium. It may be important to know your ionized calcium levels if you have abnormal levels of proteins, such as albumin, or immunoglobins in your blood.
Related conditions
A blood calcium test is used to check your general health. It's also used to help diagnose or monitor many types of medical conditions, including conditions that affect your bones, kidneys, digestive system, thyroid, and parathyroid glands.
There are two types of calcium blood tests that measure different forms of blood calcium:
- Total calcium test measures all the calcium in your blood. You have two types of blood calcium that are normally present in about equal amounts:
  "Bound calcium" is attached to proteins in your blood.
  "Free calcium" is not attached to proteins. It's also called ionized calcium. This form of blood calcium is active in many body functions.
  Normally, your body tightly controls the balance of bound and ionized calcium, so a total calcium test gives a good estimate of how much ionized calcium you have.
  A total calcium test is the most common test for blood calcium. It's often part of a basic metabolic panel (BMP) and a comprehensive metabolic panel (CMP), which are both routine screening tests.
- An ionized calcium test measures only the "free calcium" in your blood that isn't attached to proteins. An ionized calcium test is more difficult to do, so it's usually ordered if the results of a total calcium test aren't normal. You may also have this test if you have a condition that affects your body's ability to balance the amounts of ionized and bound calcium in your blood, or if you are seriously ill or having surgery.
Your health care provider may have ordered a basic or comprehensive metabolic panel, which includes a calcium blood test, as part of your regular checkup. You may also have this test to diagnose or monitor conditions that can affect your blood calcium or if you have symptoms of abnormal calcium levels.
Symptoms of high calcium levels may include:
- Digestive symptoms, such as:
  Constipation
  Nausea and vomiting
  Abdominal (belly) pain
  Loss of appetite
- Increased thirst
- Urinating (peeing) more than usual
- Kidney stones
- Bone, joint, and muscle symptoms, such as weakness, aches, and pains
- Fatigue
- A change in mental health, such as depression or confusion
Symptoms of low calcium levels may include:
- Dry skin, coarse hair, and nails that easily break (after a long period of low levels)
- Muscle cramps, spasms, or stiffness
- Tingling in the lips, tongue, fingers, and feet
- Irregular heartbeat (arrhythmia)
- Seizures, if calcium levels are extremely low
Many people with high or low calcium levels don't have any symptoms. So your provider may order a calcium test if you have a known condition that may affect your calcium levels, such as:
- Kidney disease
- Thyroid or parathyroid disease
- Malnutrition
- Problems absorbing calcium
- Certain types of cancer
Results from a total calcium test that are higher than normal may be a sign of many types of conditions, such as:
- Overactive parathyroid glands (hyperparathyroidism), a condition in which your parathyroid glands produce too much parathyroid hormone
- Certain types of cancer, including cancer that spreads to the bone
- Bone disorders, including Paget's disease of the bone
- Taking too much vitamin D over a long period of time
Results from a total calcium test that are lower than normal may be a sign of:
- Low blood protein levels, which may be caused by liver disease or malnutrition
- Underactive parathyroid glands (hypoparathyroidism), a condition in which your parathyroid glands produce too little parathyroid hormone
- Too little calcium in your diet
- Too little vitamin D or magnesium
- Pancreatitis
- Kidney disease
If your results from a total calcium blood test are not in the normal range, it doesn't always mean that you have a medical condition that needs treatment. Your diet and certain medicines can affect your calcium levels. If you have questions about your results, talk with your provider.
1. Calcium Blood Test: MedlinePlus Medical Test [accessed on Dec 19, 2023]
2. Blood Tests - Blood Tests | NHLBI, NIH. Mar 24, 2022 [accessed on Dec 19, 2023]
3. Calcium blood test: MedlinePlus Medical Encyclopedia [accessed on Dec 19, 2023]
4. Calcium Test - Testing.com. Nov 29, 2022 [accessed on Dec 19, 2023]

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Phosphate in Urine Test

Phosphate Urine Test

Also called: Urine Phosphate

A phosphate in urine test measures the level of phosphate in your urine. Abnormal levels may be a sign of a serious health problem.

Phosphate Urine Test

Also called: Urine Phosphate

A phosphate in urine test measures the level of phosphate in your urine. Abnormal levels may be a sign of a serious health problem.

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Use the slider below to see how your results affect your health.
mg/h
400
1300
Your result is Normal.
Normal results vary based on the laboratory and the method used. Your age, diet, and gender can also affect your phosphate levels, as can pregnancy, exercise, and even the time of year.
Related conditions
A phosphate in urine test may be used to help:
- Diagnose kidney problems
- Diagnose disorders of the parathyroid glands
- Find out if too much phosphate in urine is causing kidney stones, small, pebble-like material that form in the kidneys
You may need a phosphate in urine test if you have:
- Symptoms of a kidney problem
- Had a kidney stone
- Problems with your electrolyte balance, which affects your acid/base (pH) level
- Had abnormal results on a calcium test
Calcium and phosphate work together, so problems with calcium levels can mean problems with phosphate levels as well. Calcium testing in blood and/or urine is often part of a routine checkup.
You'll need to collect all your urine during a 24-hour period. This is called a 24-hour urine sample test. You will be given a special container to collect your urine and instructions on how to collect and store your sample. Your health care provider will tell you what time to start. The test generally includes the following steps:
- To begin, urinate in the toilet as usual. Do not collect this urine. Write down the time you urinated.
- For the next 24 hours, collect all your urine in the container.
- During the collection period, store the urine container in a refrigerator or in a cooler with ice.
- 24 hours after starting the test, try to urinate if you can. This is the last urine collection for the test.
- Return the container with your urine to your provider's office or the laboratory as instructed.
The terms phosphate and phosphorous are both used to mean the same thing in test results. So, your results may say "phosphorous levels" or "phosphate levels." Your results may include guidelines for normal, low, and high levels, but your provider will consider your health, age, and other factors when deciding what is normal for you.
High phosphate/phosphorous levels in your urine may mean you have:
- Kidney disease
- Hyperparathyroidism, a condition in which your parathyroid gland produces too much parathyroid hormone.
- Too much vitamin D in your body, usually from taking too many supplements
Low phosphate/phosphorous levels in your urine may mean you have:
- Kidney disease
- Liver disease
- Hypoparathyroidism, a condition in which your parathyroid gland produces too little parathyroid hormone
Your provider will likely order other tests to help make a diagnosis. If your phosphate/phosphorous levels are not normal, it doesn't always mean you have a medical condition that needs treatment. Eating a meal high in phosphorous or using laxatives with sodium phosphate can affect your results. Also, children often have higher phosphate levels because their bones are still growing. If you have questions about your results, talk with your provider.
1. Phosphate in Urine: MedlinePlus Medical Test [accessed on Oct 05, 2022]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Creatinine Test

Creatinine Test

Also called: Creat, Creatinine

This test measures creatinine levels in your blood or urine. Creatinine is a waste product that is made each time you move your muscles. People who have larger muscles tend to make more creatinine than people who have smaller muscles. Abnormal levels can be a sign of kidney disease.

Creatinine Test

Also called: Creat, Creatinine

This test measures creatinine levels in your blood or urine. Creatinine is a waste product that is made each time you move your muscles. People who have larger muscles tend to make more creatinine than people who have smaller muscles. Abnormal levels can be a sign of kidney disease.

{"label":"Creatinine reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"abnormal","label":{"short":"Low","long":"Low","orientation":"horizontal"},"values":{"min":0,"max":0.7},"text":"Lower-than-normal creatinine levels are rare and usually do not possess any clinical significance.","conditions":["Low muscle mass","Starvation","Severe hepatic disease","",""]},{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0.7,"max":1.2},"text":"Creatinine is a chemical waste product of muscle metabolism. The muscle mass in the body is related to creatinine levels in the blood. Creatinine is removed from blood by kidneys, therefore creatinine test gives an overview of kidney function.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":1.2,"max":3},"text":"High levels of creatinine indicate a kidney disease or condition that may affect kidney function.","conditions":["Pyelonephritis","Blockage in the urinary tract","Kidney stones","Prostate disease","Tubular necrosis","Damaged blood vessels in the kidneys","Reduced blood flow to the kidneys","Diabetes","Atherosclerosis","High blood pressure","Dehydration"]}],"units":[{"printSymbol":"mg\/dL","code":"mg\/dL","name":"milligram per deciliter"}],"value":1,"disclaimer":"Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are \"within normal limits.\""}[{"abnormal":0},{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your health.
mg/dL
0.7
1.2
Your result is Normal.
Creatinine is a chemical waste product of muscle metabolism. The muscle mass in the body is related to creatinine levels in the blood. Creatinine is removed from blood by kidneys, therefore creatinine test gives an overview of kidney function.
Related conditions
A creatinine test is used to help:
- Check the health of your kidneys
- Diagnose kidney disease
- Monitor known kidney problems and see how well treatment is working
- Check for side effects from medicines that may affect your kidneys
Creatinine testing alone isn't the best way to check how well your kidneys are working. That's because people make different amounts creatinine depending on how much muscle they have, the foods they eat, their age, and how active they are. So, the results from creatinine testing are often used in calculations or compared with other substances to help get more information:
- Creatinine levels in blood are often used to calculate how fast your kidneys filter waste out of your blood. This is called an estimated glomerular filtration rate (eGFR). The calculation includes information about your age, weight, height, and sex. An eGFR is a more accurate way to measure kidney health than creatinine levels in blood or urine alone. An eGFR can also help show how serious kidney disease may be.
- Creatinine levels in blood and urine maybe be compared with each other. This is called a creatinine clearance calculation. Like an eGFR, it estimates how fast your kidneys filter waste. But an eGFR is more accurate. A creatinine clearance may still be useful to help identify the cause of high or low levels of blood creatinine in people who have very high muscle mass or a loss of muscle mass from age, illness, or the loss of an arm and/or leg.
- Creatinine levels in urine may be used to calculate a urine albumin to creatinine ratio (UACR), which is sometimes called a microalbumin creatinine ratio. Albumin is the main protein found in blood. Normally your kidneys filter out just a trace of albumin, or none at all. If larger amounts of albumin pass into your urine, it may be a sign of kidney damage. A UACR compares the amounts of creatinine and albumin in your urine to get a more accurate measurement of how much albumin is in your urine.
- Creatinine blood levels measured as part of a CMP or a BMP may be compared with the level of BUN (blood urea nitrogen) that's measured in the same test. This can help find out the cause of a kidney problem.
Your provider may order a creatinine test:
- To check your kidney health as part of a routine checkup.
- If you have symptoms of kidney disease. Symptoms may include:
  Swelling in the hands and feet or puffy eyelids
  Dry skin, itching, or numbness
  Fatigue
  Increased or decreased need to urinate (pee)
  Urine that is bloody or foamy
  Loss of appetite and weight loss
  Muscle cramps
  Nausea and vomiting
  Shortness of breath
  Sleep problems
  Trouble thinking clearly
- If you have a high risk for developing kidney disease, even if you don't have symptoms now. Chronic (long-term) kidney disease (CKD) often doesn't have symptoms in the early stages. Your risk for kidney disease is increased if you:
  Have diabetes
  Have high blood pressure
  Have a family health history of kidney disease, diabetes, or high blood pressure
  Have heart disease
  Are over 50 years old
  Smoke
  Have obesity
- If you have kidney problems or possible kidney problems because you have:
  Had an abnormal result on a kidney test in the past
  Been diagnosed with kidney disease
  Taken certain medicines that could affect your kidneys
  Had a kidney transplant
For a creatinine blood test:
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
For a creatinine urine test:
You may need to provide all the urine you pass over 24 hours. That's because creatinine levels vary through the day. But your provider may use a urine sample from a shorter period of time.
For a 24-hour urine sample, you will be given a special container to collect your urine over a full day and instructions on how to collect and store your sample. Your provider will tell you what time to start. The test generally includes the following steps:
- To begin, urinate in the toilet as usual. Do not collect this urine. Write down the time you urinated.
- For the next 24 hours, collect all your urine in the container.
- During the collection period, store the urine container in a refrigerator or in a cooler with ice.
- 24 hours after starting the test, try to urinate if you can. This is the last urine collection for the test.
- Return the container with your urine to your provider's office or the laboratory as instructed.
If you have hemorrhoids that bleed or are having your menstrual period, tell your provider before your test.
Creatinine levels that are considered normal for you will depend on how much muscle you have, what you eat, your age, and how active you are. If you're healthy, your levels are usually fairly stable over time.
But a normal creatinine test result doesn't always mean that your kidneys are healthy. Sometimes, blood creatinine levels remain in a normal range during the early stages of kidney disease. They rise as the condition of your kidneys becomes more serious. If your provider suspects you have a kidney condition, you will likely have other kidney tests even if your creatinine results seem normal.
If your results are abnormal, a single high creatinine test can't diagnose a specific condition. You will likely need to be retested and/or have other tests, too.
In general, if your blood creatinine level is:
- High for you, it may be a sign of:
  Kidney disease or injury, including infection, poor blood flow to the kidneys, a blockage in the urinary system, or kidney failure
  A condition that affects your kidneys, such as heart failure or diabetes
  High blood creatinine levels don't always mean you have a kidney problem. They may be caused by dehydration, muscle disorders and injuries, muscular dystrophy, intense exercise, or a diet high in meat. Certain health problems in pregnancy can also cause increases in creatinine.
- Low for you, it may be a sign of malnutrition or a condition that causes your muscles to get smaller, such as a long illness, a nerve disorder, or muscle loss from aging. Serious liver disease can also lead to low levels. Low levels of blood creatinine aren't common.
If your results from creatinine blood or urine tests were used to calculate an eGFR, creatinine clearance, and/or a urine albumin to creatinine ratio, ask your provider to explain what these measurements say about your kidney health.
If you have questions about any your results, talk with your provider.
1. Creatinine Test: MedlinePlus Medical Test [accessed on Jan 23, 2024]
2. Creatinine blood test: MedlinePlus Medical Encyclopedia [accessed on Jan 23, 2024]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Additional Materials (17)

Creatinine Nursing Considerations, Normal Range, Nursing Care, Lab Values Nursing

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✔✔✔ What is BUN and Creatinine - Kidney Function Test ✔✔✔

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Creatinine Clearance Nursing Considerations, Normal Range, Nursing Care, Lab Values Nursing

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BUN and Creatinine

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Creatinine

Measuring serum creatinine is a simple test, and it is the most commonly used indicator of renal function.

Image by TheVisualMD

Healthy vs Damaged Kidney

A healthy kidney doesn’t let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine. Urine Test for Albumin If you are at risk for kidney disease, your provider may check your urine for albumin. Albumin is a protein found in your blood. A healthy kidney doesn’t let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine. The less albumin in your urine, the better. Having albumin in the urine is called albuminuria. A diagram showing a healthy kidney with albumin only found in blood, and a damaged kidney that has albumin in both blood and urine. A healthy kidney doesn’t let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine. A health care provider can check for albumin in your urine in two ways: Dipstick test for albumin. A provider uses a urine sample to look for albumin in your urine. You collect the urine sample in a container in a health care provider’s office or lab. For the test, a provider places a strip of chemically treated paper, called a dipstick, into the urine. The dipstick changes color if albumin is present in the urine. Urine albumin-to-creatinine ratio (UACR). This test measures and compares the amount of albumin with the amount of creatinine in your urine sample. Providers use your UACR to estimate how much albumin would pass into your urine over 24 hours. A urine albumin result of 30 mg/g or less is normal more than 30 mg/g may be a sign of kidney disease If you have albumin in your urine, your provider may want you to repeat the urine test one or two more times to confirm the results. Talk with your provider about what your specific numbers mean for you. If you have kidney disease, measuring the albumin in your urine helps your provider know which treatment is best for you. A urine albumin level that stays the same or goes down may mean that treatments are working.

Image by The National Institute of Diabetes and Digestive and Kidney Diseases/NIH

Diagnosing CKD

Glomerular Filtration Rate (GFR) Glomerular filtration rate (GFR) is the standard means of expressing overall kidney function. Normal GFR is approximate; it is about 100-140 mL/min in men and 85-115 mL/min in women. Patients are divided into five stages of chronic kidney disease based on their GFR. In the first four stages the kidneys are still working, but function lessens with each successive stage. In stage 5, kidney failure, the kidneys stop functioning altogether.

Image by TheVisualMD

Diagnosing CKD

Glomerular Filtration Rate (GFR) Glomerular filtration rate (GFR) is the standard means of expressing overall kidney function. Normal GFR is approximate; it is about 100-140 mL/min in men and 85-115 mL/min in women. Patients are divided into five stages of chronic kidney disease based on their GFR. In the first four stages the kidneys are still working, but function lessens with each successive stage. In stage 5, kidney failure, the kidneys stop functioning altogether.

Image by TheVisualMD

Understanding GFR - Glomerular Filtration Rate

Diagram showing the basic physiologic mechanisms of the kidney

Image by Madhero88

Creatine 3D Molecule

An amino acid that occurs in vertebrate tissues and in urine. In muscle tissue, creatine generally occurs as phosphocreatine. Creatine is excreted as CREATININE in the urine.

Creatine Kinase (CK)

Creatine kinase (CK) is an enzyme found in striated muscle of the heart, brain, and skeletal muscle. The enzyme plays a role in energy production, and becomes more concentrated in muscle tissue in response to energy demands. When muscle is damaged or diseased, CK leaks into the bloodstream, where elevated levels can be detected. There are three different forms of CK in the body, existing in varying ratios. CK-MB is found mostly in cardiac muscle; CK-MM mostly in skeletal muscle; and CK-BB mostly in the brain. Identifying which form is elevated in blood tests is helpful in determining which kind of tissue has been damaged.

Image by TheVisualMD

Formation of Urine. See link for real voice update in description!

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Kidney Function Tests and Interpretation of Results.

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Understanding Blood Test Video 2: Comprehensive Metabolic Panel

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CREATININE: LAB VALUES

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Understanding GFR - Glomerular Filtration Rate

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CREATININE: LAB VALUES

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Failing Kidneys and Different Treatment Options

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Magnesium Test

Magnesium Blood Test

Also called: Magnesium, Mag, Hypomagnesemia Test, Hypermagnesemia Test

This test measures the amount of magnesium in your blood. Magnesium is a mineral that is important for strong bones and muscles, heart health, energy production, and nerve function. A magnesium deficiency or excess magnesium can be a sign of a serious health problem.

Magnesium Blood Test

Also called: Magnesium, Mag, Hypomagnesemia Test, Hypermagnesemia Test

This test measures the amount of magnesium in your blood. Magnesium is a mineral that is important for strong bones and muscles, heart health, energy production, and nerve function. A magnesium deficiency or excess magnesium can be a sign of a serious health problem.

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Use the slider below to see how your results affect your health.
mg/dL
1.6
2.3
Your result is Normal.
Magnesium is one of many electrolytes in your body and normal levels of magnesium are important for the maintenance of heart and nervous system function.
Related conditions
A magnesium blood test measures the amount of magnesium in a sample of your blood. Magnesium is a mineral that you get from many kinds of foods you eat. Some examples include nuts, seeds, beans, fortified breakfast cereals, green leafy vegetables, and milk.
Your body needs magnesium to help your muscles, nerves, and heart work properly. Magnesium also helps control blood pressure and blood glucose, also called blood sugar. It's important for building strong bones, and it supports your immune system.
Magnesium is a type of electrolyte. Electrolytes are electrically charged minerals. They help control the amount of fluid and the balance of acids and bases (pH balance) in your body.
Most of your body's magnesium is stored in your bones, organs, and other body tissue. Only a small amount is found in your blood. Your body tightly controls the amount of magnesium in your blood mainly through your:
- Kidneys. They filter extra magnesium from your blood and get rid of it through urine (pee). If your magnesium level is low, your kidneys limit the amount lost through urine.
- Intestines. They control how much magnesium you absorb from the foods you eat.
Abnormal levels of blood magnesium can be caused by many different conditions. So, a magnesium test may be used to help diagnose a variety of disorders.
A magnesium blood test is used to check the level of magnesium in your blood. It's done if your health care provider thinks your levels may not be normal:
- A low magnesium level is also called magnesium deficiency or hypomagnesemia. This condition is more common than levels that are too high.
- A high magnesium level is also called hypermagnesemia. This condition is uncommon. Most cases happen in people who have kidney failure.
A magnesium blood test may also be used to help find the cause of abnormal levels of other minerals, including calcium, potassium, and phosphorus. That's because magnesium plays a role in how your body absorbs these minerals.
You may need a magnesium blood test if you have symptoms that could be caused by abnormal magnesium levels.
Symptoms of low magnesium include:
- Loss of appetite
- Nausea and vomiting
- Fatigue and weakness
- Muscle cramps
- Numbness and/or tingling
- Irregular heartbeat (arrhythmia)
- Seizures (if magnesium levels are extremely low)
Symptoms of high magnesium are much the same as symptoms of low magnesium. They may also include:
- Diarrhea
- Abdominal (belly) cramping
- Cardiac arrest from extremely high levels of magnesium
You may also need to have your magnesium levels checked to monitor your health if you:
- Have a condition that's linked to abnormal magnesium levels, such as:
  Chronic kidney disease
  Diabetes that's not well controlled
  Alcohol use disorder
  Malabsorption syndrome
  Malnutrition
  Chronic (long-lasting) diarrhea
  Low levels of potassium and/or calcium
- Take medicine that can decrease magnesium levels, for example:
  Diuretics ("water pills")
  Certain antibiotics
  Proton pump inhibitors to reduce stomach acid
- Take medicine that can increase magnesium levels, for example:
  Aspirin
  Medicines that contain magnesium, such as laxatives for constipation and certain antacids for heartburn or gastroesophageal reflux disease (GERD)
  Lithium
- Are being treated with magnesium and/or calcium.
If the results of your magnesium blood test are abnormal, your provider will use your medical history and the results of other tests to diagnose the cause. Many different conditions can affect magnesium levels, so ask your provider to explain what your test results mean.
In general, low magnesium levels may mean that:
- You're not getting enough magnesium in your diet. Older adults and people with alcohol use disorder or malnutrition are more likely to have this problem.
- Your body isn't able absorb magnesium, even if you eat the right amount. Causes of this problem include digestive disorders, such as Crohn's disease, or taking certain medicines.
- Your body is getting rid of too much magnesium. Causes include kidney problems, long-term diarrhea, and diabetes, which can cause frequent urination (peeing) if blood glucose levels are too high.
Other health conditions linked to low magnesium include underactive parathyroid glands and pregnancy, which increases the need for magnesium.
Higher than normal magnesium levels may mean that:
- You're getting too much magnesium from dietary supplements, laxatives, antacids, or certain prescription medicines. It's rare to get too much magnesium from food alone.
- Your body has a problem getting rid of magnesium. The most common cause is kidney failure.
Other health conditions linked to high magnesium include dehydration, hypothyroidism, Addison disease, and overactive parathyroid glands.
Treatment for abnormal magnesium levels will depend on your condition.
1. https://labtestsonline.org/tests/magnesium [accessed on Sep 08, 2019]
2. https://www.labcorp.com/test-menu/30781/magnesium [accessed on Sep 08, 2019]

Additional Materials (9)

Fluid and Electrolytes: Magnesium

Video by EmpoweRN/YouTube

Magnesium Ion

Magnesium, the fourth most abundant mineral in the body, is found in bone, the cells of body tissues, organs, and blood. Essential to more than 300 biochemical reactions in the body, magnesium helps maintain normal muscle and nerve function, keeps the heart rhythm steady, supports immunity, helps regulate blood sugar levels, promotes normal blood pressure, and keeps bones strong. It may assist in the prevention of diabetes and cardiovascular disease. Most dietary magnesium comes from vegetables, particularly dark green, leafy vegetables such as Swiss chard and spinach. Other good sources include mustard greens, summer squash, broccoli, blackstrap molasses, halibut, turnip greens, pumpkin seeds, and peppermint.

Image by TheVisualMD

Magnesium Ion

Magnesium, the fourth most abundant mineral in the body, is found in bone, the cells of body tissues, organs, and blood. Essential to more than 300 biochemical reactions in the body, magnesium helps maintain normal muscle and nerve function, keeps the heart rhythm steady, supports immunity, helps regulate blood sugar levels, promotes normal blood pressure, and keeps bones strong. It may assist in the prevention of diabetes and cardiovascular disease. Most dietary magnesium comes from vegetables, particularly dark green, leafy vegetables such as Swiss chard and spinach. Other good sources include mustard greens, summer squash, broccoli, blackstrap molasses, halibut, turnip greens, pumpkin seeds, and peppermint.

Image by TheVisualMD

Magnesium, Alcoholism

Most magnesium is stored in bones and tissues and then released as needed to keep blood levels stable (which means blood levels may be normal even as stores are depleted). Magnesium deficiency is often associated with alcoholism and malnutrition. While mild deficiency may cause few or no symptoms, severe or persistent deficiency can result in fatigue, nausea, muscle cramps, numbness or tingling, confusion, seizures, and cardiac arrhythmia.

Image by TheVisualMD

Nerve Function/Nerve Damage

Magnesium is necessary for healthy nerve function. The body maintains magnesium levels by regulating how much it absorbs and how much is excreted or recycled by the kidneys. Magnesium deficiencies can be caused by malnutrition, malabsorption, or kidney damage. Excess magnesium is usually easily eliminated, but persistently high levels (often caused by supplementation or antacid overuse) can cause depression of the central nervous system or cardiac arrest.

Image by TheVisualMD

Magnesium, Muscle Function

Magnesium is necessary for normal skeletal muscle contraction. Magnesium is also important to the function of smooth muscle. Magnesium will sometimes be used in emergency rooms to open up the airways of people having severe asthma attacks by relaxing the smooth muscle tissue surrounding the bronchi. Because of its calming effect on smooth muscle, the symptoms of migraines may similarly ease with magnesium supplementation.

Image by TheVisualMD

Foods High in Magnesium

Food sources of magnesium: bran muffins, pumpkin seeds, barley, buckwheat flour, low-fat vanilla yogurt, trail mix, halibut steaks, garbanzo beans, lima beans, soybeans, and spinach

Magnesium: Muscle Function

Magnesium is necessary for healthy muscle contraction. Among the symptoms of magnesium deficiency are muscle cramps, twitching, and weakness. Magnesium is also sometimes given to relax the smooth muscles surrounding the bronchi, thereby reducing the risk of death from severe asthma attacks.

Image by TheVisualMD

Magnesium: Nerve Function

Magnesium is necessary for healthy nerve function. And although excessive magnesium levels are rare and usually easily corrected through elimination in the urine, persistent or severe magnesium toxicity can cause depression of the central nervous system or cardiac or respiratory arrest.

Image by TheVisualMD

4:19

Fluid and Electrolytes: Magnesium

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Magnesium Ion

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Magnesium Ion

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Magnesium: Nerve Function

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Treatment

500 mg calcium supplements with vitamin D

Image by Ragesoss/Wikimedia

How Is Hypoparathyroidism Treated?

Unlike most other hormonal deficits, hypoparathyroidism is not treated with replacement of the missing hormone, parathyroid hormone (PTH).

Currently, the standard treatment for hypoparathyroidism consists of activated vitamin D (calcitriol) and calcium supplements. Some people may also need magnesium supplementation. Conventional therapy requires many pills taken throughout the day.

Diet recommendations usually include eating foods high in calcium, such as dairy products, breakfast cereals, fortified orange juice, and green, leafy vegetables, or avoiding foods high in phosphorus, such as meat, poultry, fish, nuts, whole grains, and beans.

Conventional therapy with vitamin D and calcium may lead to a buildup of calcium in the kidneys. This buildup may lead to problems, including kidney stones and deposits of calcium, reduced kidney function, tissue damage, or even kidney failure.

The development of PTH as a replacement therapy in patients with hypoparathyroidism was first explored by NICHD investigators beginning in 1992. Since then, NICHD researchers have conducted a series of classic studies evaluating PTH 1-34 regimens, including once-daily and twice-daily PTH injections without concurrent use of calcitriol or calcium supplements in adults and children. Recently, these NICHD researchers introduced PTH delivery by an insulin pump in two landmark studies in adults and in children. In January 2015, the U.S. Food and Drug Administration approved PTH 1-84 for adult hypoparathyroidism patients who do not respond well to standard treatment, as an add-on to that treatment.

Source: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Additional Materials (5)

Parathyroid Gland

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