Hypophosphatemia: Symptoms, Treatments, and Causes

Hypophosphatemia is a condition in which the body’s blood phosphate level drops to a low level. Phosphate is an electrolyte that aids in energy production and facilitates nerve conduction in the body. It also aids in the development of strong bones and teeth, and is found in foods such as milk, eggs, and meat.

What is Hypophosphatemia?

Hypophosphatemia is diagnosed when the phosphate level in the blood of an adult is lesser than 2.5 milligrams per deciliter (mg/dL). The typical amount of serum phosphate in children is much greater, with babies having a level of 7 mg/dL.

Phosphorus is a mineral present in bones that aids in the health of your bones and body. The ideal level of phosphorus levels in the blood should be between 2.5 and 4.5 mg/dL. 

What are the different types  and causes of Hypophosphatemia?

Basic reasons of low phosphate levels fall in the 3 categories 

• Reducation in the amount of phosphate your intestines absorb
• Increase in  the amount of phosphate your kidneys remove into your urine
• Movement of  phosphate from inside the cells to the area outside the cells

There are two types of hypophosphatemia:

Acute hypophosphatemia

The severe and common type of hypophosphatemia is acute hypophosphatemia. This type of hypophosphatemia is caused by the following factors:

• Diabetic ketoacidosis occurs when a person’s diabetes is mismanaged 
• Alcohol can impair your kidney’s ability to absorb phosphorus completely over time. 
• Kidney disorders 
• Phosphate is an intracellular energy source, and when someone gets a severe burn, their phosphate levels drop dangerously low. 
• Alkalosis of the lungs due to Hyperventilation or simply breathing in and out too quickly might cause this.

Chronic hypophosphatemia

Chronic hypophosphatemia is caused by the following factors:

• Long-term hunger, malnutrition, and anorexia can reduce phosphorous stores in the body.

• Cushing syndrome and hypothyroidism 
•  Hyperparathyroidism.
• Vitamin D deficiency especially in children 
• Acute hypophosphatemia can be caused by disorders such as hypomagnesemia and hypokalemia, which decreases the body’s ability to create and absorb electrolytes.
• The ability of the kidneys to absorb phosphorus can be damaged by the long-term use of diuretics and antacids.

What are the common symptoms of Hypophosphatemia?

For most patients, symptoms may not show until phosphate levels have plummeted to dangerously low levels. 

These symptoms include the following:

• Weakness in muscles
• Fatigue
• Bone ache
• Fractures of the bones
• Loss of appetite
• Irritability
• Numbness
• Confusion
• Tooth decay or late baby teeth 

When should you seek medical attention? 

Milder forms of hypophosphatemia can lead to bone weakness, fractures, and muscle damage. Very severe hypophosphatemia that isn’t treated can affect your breathing and heart function, and can be life threatening.

To treat hypophosphatemia, phosphorous supplements must be taken in dosages that are determined by the severity of illness. 

In mild situations, oral phosphorus supplementation of up to 80 mmol per day should be given. More severe instances should be treated with intravenous supplementation of up to.48 mmol/L. 

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What are the risk factors of Hypophosphatemia?

The risk factors of developing Hypophosphatemia are: 

• Family history of hypophosphatemia 
• Blood infection, often known as sepsis
• Hyperparathyroidism 
• Alcoholism
• Use of steroid, diuretic, or antacid drugs in excess or for long periods

What are the complications associated with leaving Hypophosphatemia untreated?

Phosphate is essential for healthy bones, and phosphate deficiency can lead to bone weakness, fractures, and muscle damage. Untreated severe hypophosphatemia can also adversely affect your breathing and heart function. 

Other complications include:

• muscle tissue death (rhabdomyolysis)
• failure to breathe
• destruction of red blood cells (hemolytic anemia)
• an abnormal heart rhythm (arrhythmia)

What are the possible treatments of Hypophosphatemia?

The primary treatment for hypophosphatemia is oral phosphorous supplementation. Mild cases of hypophosphatemia would require oral supplementation of 80mmol per day, and severe cases would require  intravenous supplementation. 

Apart from supplementation, Apollo experts recommend the following tips for ensuring optimal blood levels of phosphorous are maintained: 

• Add food sources that are rich in phosphate to your diet, such as milk and other dairy products.  
• Get your Vitamin D levels checked by your Apollo doctor. If they are on the lower side, your doctor would prescribe Vitamin D supplements.

A Note from Apollo Hospitals

Hypophosphatemia is a disorder in which the phosphate level in the blood is unusually low. Phosphorous is a mineral found in bones that helps to keep your bones and body healthy. The blood phosphorus level should be between 2.5 and 4.5 mg/dL. Hypophosphatemia is a condition in which your blood has an abnormally low amount of phosphorus. Low levels can cause muscle weakness, respiratory or cardiac failure, convulsions, or comas, among other complications.

Apollo specialists will determine the best course of therapy and improve your quality of life based on the diagnosis.

Frequently Asked Questions

Who is prone to Acute hypophosphatemia?

Acute hypophosphatemia is common in people suffering from alcoholism, burns, kidney disease,  malnutrition or those taking certain medications.

What are Hematologic disturbances?

Hemolytic anemia decreases oxygen release from hemoglobin, and leads to anemia.

How long does hypophosphatemia take to recover from?

Serum phosphate levels tend to drop within 2 days and then rebound over the next few days. This early nadir has also been described in patients with diabetic ketoacidosis and the refeeding syndrome, as well as after heart surgery.