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Support For Those Quitting Prolia

Osteoporosis & Bone Health | Last Active: 5 days ago | Replies (153)
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@michaellavacot

Hi Mayblin,

Sure. A little background first. The form of calcium in your body that is considered physiologically active is called calcium ion or free calcium (Ca2+). When you read the "calcium" on your blood test, it's total calcium. Total calcium is roughly 45% calcium ion, 45% calcium bound to albumin, and 10% other calcium compounds (like calcium phosphate, calcium sulfate...).

Since measuring calcium ion is a bit tricky and more expensive, most doctors just use total calcium and assume the percentages listed above. When you use total calcium, you should adjust the number based on the blood albumin when albumin is less than 4. The equation for the adjustment is: Corrected calcium (mg/dL) = measured total Ca (mg/dL) + 0.8 (4.0 - serum albumin [g/dL]). If you like, here is a link to a calculator https://perinatology.com/calculators/Corrected%20Calcium.htm .

I'm putting together a presentation on Calcium and Vitamin D for Osteoporosis now. Below is the draft slide on corrected calcium.

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Replies to "Hi Mayblin, Sure. A little background first. The form of calcium in your body that is..."
mayblin | @mayblin | Mar 15 9:30pm

Thank you very much for your explanation. I got the conversion part. Is the corrected calcium level a better indication of calcium deficiency (or overage)? If so, whats the reference range?

Overall I'm still not quite getting how a blood calcium level would indicate whether or not a person is calcium difficient. It's said that our own PTH, if at normal functional level, would fine tune our blood calcium level to normal range for vital functions such as nerve, heart and muscle. And the biggest reservoir in the body for calcium is bone. That is, if we are truly difficient in calcium, our bones will be sacrificed to maintain a normal blood calcium level. How do blood level of free calcium ion, albumin bound calcium or other calcium salts reflect whether or not a person is actually difficient of calcium, if at all?

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