Calcium Total & Ionized is a blood test that measures both the total calcium in the bloodstream and ionized calcium, the biologically active form. Calcium is essential for healthy bones, muscle contraction, nerve transmission, and normal heart function. The test is needed to evaluate abnormal calcium levels and investigate conditions affecting the parathyroid glands, kidneys, bones, or vitamin D metabolism, especially when routine calcium results require further clarification.
Measuring both provides a more complete assessment of calcium status. Ionized calcium can offer additional information when total calcium may be affected by changes in blood proteins.
Ionized calcium is the free, unbound form of calcium. It is the form directly involved in muscle contraction, nerve transmission, blood clotting, and other physiological processes.
Total calcium includes calcium bound to proteins, mainly albumin, as well as calcium that is freely circulating in the blood.
High calcium, or hypercalcemia, can occur with parathyroid disorders, certain cancers, excessive vitamin D or calcium intake, and other medical conditions.
Low calcium, or hypocalcemia, may occur with vitamin D deficiency, kidney disease, parathyroid disorders, low magnesium, or other conditions affecting calcium regulation.