What is hypophosphatemia?

Hypophosphatemia is a condition that describes low levels of phosphate in your blood. You get phosphate from foods like milk, eggs and meat. Your body uses it to build strong bones and teeth. Your body can also use it to produce energy and help your nerves function. One rare type of hypophosphatemia is passed down from parents to children. It leads to bone diseases, including a condition called rickets. This can make your bones soft and weak.

Causes of hypophosphatemia

This condition usually starts when your kidneys have trouble reabsorbing phosphate in your body. A variety of conditions might make this happen with your kidneys, including:

  • Vitamin D deficiency
  • Long-term alcoholism
  • Having chronic vomiting or diarrhea
  • Using diuretics (drugs that increase urine production) long-term
  • Having conditions like Cushing's syndrome that disrupt your body's ability to make and use hormones

Risk factors for hypophosphatemia

Overall, this condition is rather rare. It's common in people who are admitted to the hospital. If you're malnourished from eating disorders, alcoholism or long-lasting diarrhea, you're at greater risk for getting this condition. People with severe burns and complications from diabetes are also at risk. The kidney disorder called Fanconi syndrome is also a risk factor, as is a lack of vitamin D in children. One type of the condition is genetic, meaning you inherit it from your parents.

Symptoms of hypophosphatemia

In the inherited type of this condition, doctors start to notice changes in children as early as 18 months. Their legs start to bow. They might complain of bone pain when they're active. Their spines may curve, and they may have muscle pain. Otherwise, people with this condition tend to develop symptoms when their phosphate levels drop very low.

Other symptoms of hypophosphatemia include:

  • Confusion
  • Appetite loss
  • Muscle weakness
  • Feeling tired and upset
  • Bone pain and fractures
  • Tooth decay or late baby teeth
  • Slow growth and short height in children

Diagnosis of hypophosphatemia

It can be hard to diagnose this condition. That's because hypophosphatemia is so rare and sometimes has no symptoms. If you do have symptoms, your doctor can start with a review of your medical history. They might also ask about your family members' medical histories. Your doctor may do a physical exam and look for signs of weakness in your muscles or bones.

Next, the doctor might want you to do urine and blood tests. You may need to do these after you haven't eaten for two days. These tests can show the doctor the amount of calcium in your blood. This is an indication of some underlying causes of the condition. Sometimes, your doctor might also order imaging tests like X-rays. These tests take pictures of the inside of your body. They can show the doctor your bone structure.

Treatments for hypophosphatemia

When you're diagnosed with hypophosphatemia, your doctor might have you stop taking drugs that may be causing the condition. You'll also want to make sure you're eating enough foods that are rich in phosphates, such as nuts and poultry. Addressing the underlying cause of the condition is also an important part of treatment. Other treatments might include:

  • Getting extra phosphates through an IV in the hospital
  • Taking phosphate and vitamin D supplements if you have the kind of hypophosphatemia that runs in families
  • You may need to increase your intake of foods that are rich in phosphates during treatment. Milk and other dairy products are also good sources.

Recovery from hypophosphatemia

Hypophosphatemia can lead to many other problems if you don't get treatment. It can impact your breathing and your heart. It can possibly lead to death. However, mild cases are easier to treat when you consume more phosphates. Once you've been treated, the condition is unlikely to return.

If you have the genetic type of this condition, you might need different treatments. Some doctors recommend counseling for the family and the person with the disease. You should stay in close contact with your doctor. That's because there are side effects that can occur over time with this illness. Once you've returned to your normal activities, be sure to tell your doctor if you start to develop any symptoms of the condition again.

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