In hyperphosphatemia, the level of phosphate in the blood is too low. Phosphate is an essential mineral that supports nerve, muscle, and enzyme function, as well as building and maintaining bones and teeth. In adults, phosphate levels range between 2.5 and 4.5 mg/dL, and in children, 4.0 to 7.0 mg/dL.
Hypophosphatemia can be caused by various factors, such as:
Poor dietary intake of phosphate-rich foods, such as dairy products, meat, fish, eggs, nuts, and beans
Malabsorption of phosphate due to intestinal disorders, such as celiac disease, Crohn’s disease, or chronic diarrhea
Increased loss of phosphate through urine or stool due to kidney diseases, diuretics, laxatives, or antacids
Hormonal imbalances, such as hyperparathyroidism, hypothyroidism, or diabetes
Medications, such as corticosteroids, anticonvulsants, or bisphosphonates
Alcohol abuse or withdrawal
Severe burns, infections, or trauma
Respiratory alkalosis, a condition in which the blood becomes too alkaline due to hyperventilation
Refeeding syndrome, a condition in which phosphate levels drop rapidly when a malnourished person receives high-calorie nutrition
Hypophosphatemia may not cause any symptoms if it is mild or temporary. However, if it is severe or chronic, it may lead to various complications, such as:
Weakness, fatigue, and muscle pain or cramps
Bone pain, fractures, or osteomalacia (softening of the bones)
Rickets (bone deformities) in children
Confusion, irritability, depression, or seizures
Numbness, tingling, or burning sensation in the hands, feet, or mouth
Difficulty breathing, chest pain, or heart failure
Reduced appetite, nausea, vomiting, or constipation
Increased risk of infections or bleeding
A blood test that measures phosphate levels in the blood can be used to diagnose hypophosphatemia. Several other tests may be ordered by the doctor, including calcium, magnesium, vitamin D, parathyroid hormone, and kidney function. Additionally, the doctor may ask about the patient's medical history, diet, medications, and symptoms.
The treatment of hypophosphatemia depends on the cause, severity, and symptoms of the condition. The main goal of treatment is to correct the underlying cause and restore the normal phosphate level. The treatment may include:
Dietary changes, such as increasing the intake of phosphate-rich foods or taking phosphate supplements
Intravenous (IV) administration of phosphate and fluids, especially in cases of severe or symptomatic hypophosphatemia
Medication adjustments, such as reducing or stopping the drugs that lower phosphate levels or cause malabsorption
Hormone replacement therapy, such as taking thyroid hormone, insulin, or parathyroid hormone
Treatment of the associated conditions, such as kidney disease, diabetes, or alcoholism
Hypophosphatemia can be prevented by maintaining a balanced diet that provides adequate amounts of phosphate and other minerals and vitamins. Some tips to prevent hypophosphatemia are:
Eat a variety of foods that are rich in phosphate, such as dairy products, meat, fish, eggs, nuts, and beans
Avoid excessive intake of alcohol, caffeine, or soda, as they can interfere with phosphate absorption or increase phosphate loss
Follow the doctor’s advice on the use of medications, such as diuretics, laxatives, antacids, or bisphosphonates, and report any side effects
Monitor the blood phosphate level regularly, especially if there is a risk factor or a history of hypophosphatemia
Seek medical attention if there are any signs or symptoms of hypophosphatemia
It is possible to prevent or minimize the complications of hypophosphatemia by following a healthy diet and lifestyle, and consulting the doctor regularly.
