Does immobility lead to both HYPO and HYPERcalcemia?

[boomerfriend]

We had a discrepancy on whether prolonged bed rest led to hypo or hyper calcemia. Several fellow students researched it and we are still getting conflicting info. I'm thinking immobility causes bone resorption because weight bearing is not occuring the bone is thinking "hey, we don't need all this calcium, let's dump it into the blood stream"....causing hypercalcemia.

However, some texts say it causes hypocalcemia. I can rationalize this because perhaps after an extended period of immobility, the bone no longer has much calcium to "dump", thus the hypocalcemia.

Am I way off base on this thinking? I've checked several texts, a friend even asked her veterinarian and he didn't have a straight answer. Our instructor didn't even know!

Can you tell this is bugging me?

[Daytonite, BSN, RN]

actually, i don't think it causes either. the body brings itself into homeostasis. any calcium dumped into the blood stream is filtered out through the kidneys. everything i've read indicates that urine calcium increases when a patient is immobile, not so much so the serum calcium. for this reason, patients who are bed ridden are more likely to develop kidney stones. i saw a patient very early in my nursing career who had carpal/pedal spasms (hypocalcemic tetany) because of hypocalcemia which is how it was learned that the surgeon accidentally removed one of her parathyroid glands during her thyroidectomy. i will never forget it. i think that the body's regulatory mechanisms for this electrolyte has too many fail safes built in for it to ever get to the stages that it did for the young lady i saw have the spasms.

http://www.osteo.org/wghtlss.html

http://www.orthoconcepts.com/docs/immobility.html#metabolic

[mattsmom64]

Deanna,

check out this article...this may help to clear things up....

Mary

http://www.merck.com/mmhe/sec12/ch155/ch155b.html

[sle2583]

Hello, have a test on immobility this Monday, and I can't find any questions on this...I have look in like 3 Nclex books......anyone have any questions????

[justme1972]

Immobility can cause hypercalcemia but not hypocalcemia.

The only reason I happen to know this is because I currently have hypercalcemia from hyperparathyroidism and I have done quite a bit of research on the subject lately.

I was wondering (sarcastically), if it may have been caused by my sitting on my rear studying so much!

Hypercalcemia r/t immobility is generally in regards to patients who are chronically bedridden, comatose, etc.

It is never, ever normal, providing a pt is not drinking tons of milk or doing overkill on Ca supplements. It is a symptom of an underlying program and blood tests are the best way to narrow it down as well as a consult with an endocrinologist.