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10 Signs of Calcium Deficiency, and What You Can Do About It

Cara Rosenbloom, RDKatie E. Golden, MD
Written by Cara Rosenbloom, RD | Reviewed by Katie E. Golden, MD
Published on July 8, 2024

Key takeaways:

  • Calcium is an essential mineral that you can get from foods, drinks, and supplements. Good sources of calcium include dairy products, leafy greens, and calcium-fortified drinks. 

  • Signs of calcium deficiency include tingling, muscle spasms, and heart arrhythmias. A serious long-term effect of calcium deficiency is osteoporosis, a bone disease. 

  • Calcium deficiency can be caused by not getting enough calcium from your diet. Another common cause is abnormal parathyroid hormone levels and it can be treated by increasing calcium intake through food or supplements.

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Calcium is an essential mineral that you need to consume daily. That’s easy to do if you love milk and yogurt, which contain lots of calcium. 

But many people in the U.S. — almost half of them — don’t meet their average daily requirement for calcium. This puts them at risk for calcium deficiency, which can lead to bone diseases if left untreated. 

You can prevent calcium deficiency by consuming calcium-rich foods and drinks, or using supplements when needed. Learn about the signs of calcium deficiency and how you can ensure you get enough calcium each day.

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Why is calcium important?

Calcium is an essential mineral in your diet. It’s the most abundant mineral in the human body. It plays a role in: 

  • The structure of bones, teeth, and body tissues

  • Muscle function

  • Blood vessel function 

  • Blood clotting

  • Nerve signaling

  • Hormone secretion

  • Normal heart rhythms

Most of the calcium in the body is stored in the bones. When other parts of the body require calcium, they borrow it from your bones. You need to consume foods, drinks, or supplements with calcium daily to ensure the body gets enough.

Adult males (ages 19 to 70) require 1,000 mg calcium per day. This amount increases to 1,200 mg over age 70. Adult females (ages 19 to 50) need 1,000 mg calcium per day. This increases to 1,200 mg per day for those over the age of 50. 

Calcium requirements are higher for females at age 50 because of their increased risk for osteoporosis — a bone disease marked by low bone mass. Menopause also decreases the ability for your body to absorb calcium.

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What is the definition of calcium deficiency?

Calcium deficiency is when there’s a low level of calcium in your blood. It’s also called hypocalcemia.

The normal range of calcium in your blood is typically 8.8 mg/dL to 10.4 mg/dL in healthy people. (Note that the normal range can vary from lab to lab.) 

Sometimes, calcium is measured with a lab test called ionized calcium. This measures the calcium in the blood that is active and available for your body to use. For this reason, healthcare professionals sometimes use it as a more sensitive measure of calcium deficiency. A normal ionized calcium level is 4.6 mg/dL to 5.3 mg/dL.

But you don’t need an ionized calcium level to diagnose calcium deficiency. Calcium deficiency is usually defined as either:

  • Total calcium level below 8.5 mg/dL

  • Ionized calcium below 4.61 mg/dL

What causes calcium deficiency?

The simplest cause of calcium deficiency is low calcium intake. This happens if you don’t consume enough calcium from foods, drinks, or supplements. If you avoid dairy products, you’re at increased risk for calcium deficiency.

Other reasons for calcium deficiency include:

What are the earliest signs of calcium deficiency?

Early on, calcium deficiency may have no symptoms. It takes time for low calcium levels to cause symptoms. So, it may go undetected. The symptoms really depend on how low calcium levels are and how quickly the blood level is dropping.

Symptoms are more likely when blood calcium levels are below 7.5 mg/dL, or when it drops quickly. If it’s dropping gradually over time, the body has a longer time to adjust to it and may produce fewer symptoms.

Since calcium is so abundant in the body, symptoms can affect all parts of the body once they do appear. Some possible symptoms of hypocalcemia include:

  • Tingling around the mouth

  • Numbness and tingling in hands and feet

  • Muscle spasms, especially in the hands and feet

  • Wheezing

  • Irritability

  • Depression

  • Fatigue

  • Coarse hair

  • Brittle nails and dry skin

  • Heart arrhythmias

  • Memory loss

The body tightly controls calcium levels in your blood. If you don’t get enough calcium daily to maintain blood levels, it’ll be borrowed from your bones. This makes bones weak. Over time it can lead to:

  • Osteoporosis (brittle bones)

  • Osteopenia (reduced minerals in bones)

  • Osteomalacia (soft bones)

  • Increased risk of falls and fractures

What are the best sources of calcium?

Dairy foods such as milk, cheese, and yogurt are the best sources of calcium. If you don’t eat dairy, you can choose other calcium-rich foods such as canned salmon, leafy greens, and tofu (made with calcium sulfate). 

Here’s the calcium content in some dairy foods.

Food

Amount

Calcium (mg)

Yogurt, plain

1 cup

488 mg

Kefir

1 cup

317 mg

Milk (non-fat, 1%, or 2%)

1 cup

305 mg

Greek yogurt, plain

1 cup 

250 mg

Cottage cheese

1 cup

233 mg

Cheddar or mozzarella cheese

1 slice (21 g)

148 mg

Here’s the calcium content in some non-dairy foods.

Food

Amount

Calcium (mg)

Tofu, prepared with calcium sulfate

½ cup

434 mg

Fortified milk alternatives (almond, rice, etc.) 

1 cup

280-440 mg

Fortified orange or grapefruit juice

1 cup

350 mg

Sardines, canned

3 oz

325 mg

Fortified soy beverage

1 cup

300 mg

Fortified soy yogurt

1 cup

300 mg

Spinach, mustard greens, or collard greens

1 cup, cooked

250-280 mg

Salmon, canned with bones

3 oz

180 mg 

Kale, bok choy, or turnip greens

1 cup, cooked

175-200 mg

Tahini (sesame seed paste)

1 tbsp

154 mg

While many non-dairy foods contain calcium, they may also contain factors that hinder calcium absorption. Nutrients such as phytates and oxalates can inhibit calcium absorption from foods like leafy greens and soy. That means even if you eat tofu, spinach, or kale, not all of the calcium will be absorbed. Your body is better at absorbing calcium from dairy products.

What should you do if you think you have calcium deficiency?

Speak with your healthcare professional if you have the symptoms of calcium deficiency or concern about your calcium intake. They can perform medical tests to assess your blood calcium levels, parathyroid hormone levels, and bone density. 

If your calcium intake is low, your healthcare professional may recommend high-calcium foods and/or supplements. In addition to calcium, they may recommend supplements that help your body absorb calcium like:

  • Vitamin D

  • Magnesium

  • Phosphorus

The best treatment varies from person to person, based on the cause and any other nutrient deficiencies.

The bottom line

Getting enough calcium every day is an important step to protect your bone health. Since calcium is the most abundant mineral in the body, it affects more than just bones. Your heart, brain, and muscles also benefit from getting enough calcium.

If you don’t eat many of the foods listed in this article, or if you have symptoms of calcium deficiency, talk to a healthcare professional. They can help you add calcium-rich foods or supplements to your diet to make sure you get enough each day. 

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Why trust our experts?

Cara Rosenbloom, RD
Cara Rosenbloom, RD, has been a registered dietitian for 22 years. She began her career working as a dietitian at Toronto's Hospital for Sick Children (SickKids).
Katie E. Golden, MD
Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

References

Bove-Fenderson, E., et al. (2015). Hypocalcemic disorders. Best Practice and Research Clinical Endocrinology and Metabolism

Brown, L. L., et al. (2021). Physiological need for calcium, iron, and folic acid for women of various subpopulations during pregnancy and beyond. Journal of Women’s Health

View All References (10)

Dietary Guidelines for Americans. (2019). Food sources of calcium. U.S. Department of Agriculture. 

Institute of Medicine Committee to Review Dietary Reference Intakes for Vitamin D and Calcium. (2011). Dietary reference intakes for calcium and vitamin D

Lewis, J. L., III. (2023). Hypocalcemia (low level of calcium in the blood). Merck Manual. 

Lewis, J. L., III. (2023). Overview of calcium’s role in the body. Merck Manual. 

National Institutes of Health. (2024). Calcium. U.S. Department of Health and Human Services. 

ScienceDirect. (n.d.). Search results for calcium absorption

Shkembi, B., et al. (2022). Calcium absorption from food products: Food matrix effects. Nutrients

Shlisky, J., et al. (2022). Calcium deficiency worldwide: Prevalence of inadequate intakes and associated health outcomes. Annals of the New York Academy of Sciences

Yu, E., et al. (2023). Physiology, calcium. StatPearls

Yu, Z., et al. (2024). Trends in calcium intake among the US population: Results from the NHANES (1999–2018). Nutrients.

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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