Biomarkers · Electrolytes & Minerals
Serum Calcium
Both low and high values go with higher risk of death. In NHANES 1999–2018 with linked mortality to 2019, each standard deviation above average goes with 5% lower risk of death. Risk rises at both ends: not comparable
Serum Calcium and risk of death
Published curve higher than the NHANES fitNHANES fit higher
Risk of death from our NHANES fit, relative to its reference value. The dotted vertical line marks the NHANES median.
Serum Calcium by age and sex
Each bar runs from the 5th to the 95th percentile, the darker part from the 25th to the 75th, and the tick is the median. Not a reference range or a target.
The percentiles as a table
| Sex | Age | 5th | 25th | Median | 75th | 95th | n | Cycle / source |
|---|---|---|---|---|---|---|---|---|
| All | 20-39 | 8.70 | 9.10 | 9.30 | 9.50 | 9.80 | 1,429 | NHANES 2017-2018 |
| All | 40-59 | 8.70 | 9.00 | 9.20 | 9.50 | 9.80 | 1,548 | NHANES 2017-2018 |
| All | 60+ | 8.80 | 9.10 | 9.30 | 9.60 | 10.0 | 1,890 | NHANES 2017-2018 |
| All | all | 8.70 | 9.10 | 9.30 | 9.50 | 9.90 | 4,867 | NHANES 2017-2018 |
| Men | 20-39 | 8.90 | 9.20 | 9.40 | 9.60 | 9.90 | 684 | NHANES 2017-2018 |
| Men | 40-59 | 8.70 | 9.10 | 9.20 | 9.50 | 9.80 | 723 | NHANES 2017-2018 |
| Men | 60+ | 8.70 | 9.10 | 9.23 | 9.50 | 9.90 | 958 | NHANES 2017-2018 |
| Men | all | 8.80 | 9.10 | 9.30 | 9.50 | 9.88 | 2,365 | NHANES 2017-2018 |
| Women | 20-39 | 8.70 | 9.00 | 9.20 | 9.40 | 9.70 | 745 | NHANES 2017-2018 |
| Women | 40-59 | 8.67 | 9.00 | 9.20 | 9.50 | 9.90 | 825 | NHANES 2017-2018 |
| Women | 60+ | 8.80 | 9.10 | 9.30 | 9.60 | 10.1 | 932 | NHANES 2017-2018 |
| Women | all | 8.70 | 9.00 | 9.30 | 9.50 | 9.90 | 2,502 | NHANES 2017-2018 |
What studies found when this marker was changed
They describe what happened in those study groups, not a recommendation. See all catalogued interventions.
Measured changes in Serum Calcium, study by study
2 effects with a numeric size, each from one study arm: the dot is the reported change, the line its 95% interval where one was given. Study results in the groups studied, not predictions for a person.
| Type | Intervention | Reported effect | Evidence | Source |
|---|---|---|---|---|
| clinical | Targeted parathyroidectomy in primary hyperparathyroidism | Cure (normalised serum calcium and PTH) in 163/164 (99.4%) after parathyroidectomy vs 0/169 with observation | meta-analysis | Pappachan JM, et al. Parathyroidectomy for adults with primary… |
| pharmacologic | Calcimimetics (e.g. Cinacalcet) in secondary hyperparathyroidism on dialysis | Calcimimetics significantly lowered serum calcium vs placebo in dialysis patients (effect size not reported) | meta-analysis | Nakai K, et al. Calcimimetics treatment strategy for serum calcium and… |
Things that worsen it
| Type | Condition or exposure | Reported effect | Evidence | Source |
|---|---|---|---|---|
| clinical | Malignancy-associated hypercalcemia (PTHrP secretion / osteolytic bone mets) | Hypercalcemia affects up to one in five cancer patients; most cases PTHrP-mediated, ~20% from bone metastasis (calcium magnitude not reported) | review | Sternlicht H, et al. Hypercalcemia of malignancy and new treatment options… |
| nutraceutical | Massive unmonitored Vitamin D intoxication (>50,000 IU/day chronic) | Excessive long-term vitamin D intake causes severe hypercalcemia; 25(OH)D >150 ng/ml is the hallmark of toxicity (calcium magnitude not reported) | review | Marcinowska-Suchowierska E, Kupisz-Urbańska M, Łukaszkiewicz J, Płudowski P… |
| pharmacologic | Calcitriol (1,25(OH)2D3) mean 0.579 microgram/day for 3 months in hemodialysis patients with renal osteodystrophy | Serum calcium rose from 8.7 to 10.25 mg/dL over 3 months (p<0.001); vitamin D3 had no appreciable effect | RCT | Maxwell DR, et al. Clin Pharmacol Ther. 1978. Calcitriol in dialysis patients. |
Sources
- NHANES curve: our Cox model adjusted for age and sex, NHANES 1999–2018 with linked mortality to 2019.
Map Serum Calcium against another biomarker.
Related markers: Albumin-Adjusted Anion Gap · Blood Lead · Serum Bicarbonate · Serum Chloride · Serum Magnesium · Serum Phosphate · Serum Potassium · Serum Selenium