Tetany
By: Hannah Gilman
What is it?
• Muscle cramps, spasms or tremors
• Can occur anywhere
▫ Face, fingers, calves
• Due to low calcium levels: hypocalcemia
▫ Ca concentration in extracellular fluids drops
▫ Affects the nervous system
▫ Sending impulses to skeletal muscles
Hyperventilation
• Removes too much CO2: resulting in respiratory
alkalosis (lower H+ and increased pH)
• Increases Calcium proteinate and lowers free
Ca++
• Increased excitability causes spontaneous
tingling in fingers and toes due to increased
sensitivity in the motor axons and peripheral
nerves
 Parathyroid hormone regulates Ca++
 Tetany is a major sign of hypoparathyroidism
Causes
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Diarrhea
Kidney disease
Thyroid or pancreas problems
Pregnancy and breast feeding
Malnutrition
Vitamin D deficiency
Some medications
Calcium deficiency
Symptoms of Tetany
Non-Severe
Severe
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Abdominal pain
Chronic diarrhea
Muscle pain
Tingling in hands or feet
Twitching fingers
Loss of muscle coordination
Loss/change in vision
Paralysis
Seizures
Slurred speech
Sudden difficulty with
memory, thinking, talking,
writing or reading
• Sudden weakness or
numbness on one side
Who Does it Affect?
• Anyone
▫ As a consequence of sustained
hyperventilation or following excessive vomiting
▫ Often from an endocrine disorder
•
•
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Neonatal, children, cows, chickens and dogs
Occurs more in temperate zones/winter
Marathoners
Anorexic or bulimic
Old people
Treatment
• Detection of low calcium levels is important
▫ Tetany can be fatal if it involves laryngeal or
pharyngeal muscles; which blocks the airway
• IV Treatment
▫ Calcium carbonate is used in the initial stage of
Hypocalcemia
▫ Calcium gluconate is used for muscle cramps or
nerve weakness
▫ Calcium chloride is for patients in serious
condition
Calcium
Factors enhancing absorption
Factors that limit absorption
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•
•
•
• Large amounts of phytic acid
• Excess of phosphorus and
magnesium in diet
• Polyphenols in tea
• Vitamin D deficiency
• Diarrhea
• Old age
Parathyroid hormone
Glucose and lactose
Digestive motility
Vitamin D & K
Age
0-6 mo 7-12mo 1-3 yr
Daily
210 mg
Calcium
Intake
270 mg
* Upper limit 2500 mg
500 mg
4-8 yr
9-18 yr
19-50
yr
Over
50 yr
800 mg
1300
mg
1000
mg
1200
mg
How vitamin D & Calcium work
together
• Vitamin D facilitates Ca absorption in the
intestine
▫ By going thru the intestine and into the blood
stream
• Helps reclaim Ca in kidneys
• 1% of the body’s Ca is in the blood plasma, the
rest is in the bones
• RDA Calcium: ~1000mg
• RDA vitamin D: ~600IU
Where they can be found
Calcium
Vitamin D
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•
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•
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• The Sun: 400 IU/15min
• Salmon: 238 IU
• Sardines: 136 IU
• Canned tuna: 136 IU
• 1% milk: 99 IU
• Mushrooms: 73 IU
• Special K cereal: 30 IU
• Others: cheeses, cereal,
energy bars, eggs, butter, liver
Yogurt: 450 mg
Parmesan cheese: 390 mg
1% milk: 300 mg
Spinach: 250 mg
Salmon: 210 mg
Chocolate pudding: 160 mg
Tofu: 140 mg
Others: cheese, kale, soy milk,
energy bars
Diet Plan: Day 1
Breakfast
Food
Ca
VitD VitK Kcal
(mg) (IU) (mg)
Yogurt
419
0
537
208
Fortified
milk
285
105
366
122
Food
Ca
VitD VitK Kcal
(mg) (IU) (mg)
Grape nut
flakes
11
401
99
106
Shrimp
cocktail
91
147
23
218
Banana
6
0
422
105
Spinach
500
0
334
14
TOTALS
721
506
1424
541
Swiss
cheese
214
12
21
103
Mushrooms
1
27
110
8
Italian
dressing
8
0
28
14
TOTALS
814
186
516
357
Snack
Food
Ca
VitD
(mg) (IU)
Chocolate 188
milkshake
58
VitK Kcal
(mg)
250
211
Lunch
Diet Plan: Day 1
Dinner
Food
Ca
VitD VitK Kcal
(mg) (IU) (mg)
Brown
Rice
0
0
0
160
Salmon
420
476
704
254
Kale
90
0
299
34
Yam
26
0
1224
176
Sour
cream
40
0
0
60
Fortified
milk
570
210
732
244
TOTALS
1146
686
2959
928
Totals
for the
Day
Ca
VitD VitK Kcal
(mg) (IU) (mg)
2869
1436
5149
2037
Diet Plan: Day 2
Breakfast
Food
Ca
VitD VitK Kcal
(mg) (IU) (mg)
Cocoa
Pebbles
40
40
42
115
Chocolate
soy milk
300
120
350
140
Kiwi
60
0
552
108
Honey
100
peanut bar
80
115
TOTALS
240
Snack
500
1059
Lunch
Food
Ca
VitD VitK
(mg) (IU) (mg)
Kcal
439
11
264
431
200
Grilled
cheese on
whole
wheat
120
0
934
287
563
Chili
w/beans
TOTALS
559
11
1198
718
Food
Ca
VitD VitK Kcal
(mg) (IU) (mg)
Vanilla
milkshake
203
61
290
185
Diet Plan: Day 2
Dinner
Food
Ca
VitD
(mg) (IU)
VitK Kcal
(mg)
Tuna
28
272
620
312
Spinach
500
0
334
14
Muenster
cheese
203
0
38
104
Bell Peppers 8
0
158
20
Mushrooms
1
27
110
8
Fortified
milk
285
105
366
122
TOTALS
1025
404
1626
580
Totals Ca
VitD
for the (mg) (IU)
Day
2287 716
VitK
(mg)
Kcal
4173
2046
Diet Plan: Day 3
Lunch
Food
Ca
VitD VitK
(mg) (IU) (mg)
Kcal
Power
Boost
smoothie
600
240
810
280
Tuna salad
sandwich
76
72
168
326
Mushrooms
3
73
301
21
Ranch
9
1
18
137
TOTALS
688
386
1297
764
VitK
(mg)
Kcal
260
170
Breakfast
Food
Ca
VitD VitK Kcal
(mg) (IU) (mg)
Omelet
w/
sausage
64
Fortified
milk
285
105
366
122
Whole
wheat
biscuit
155
10
200
199
Orange
52
0
237
62
TOTALS
556
168
965
550
53
162
167
Food
Snack
Ca
VitD
(mg) (IU)
Banana 200
crème
yogurt
80
Diet Plan: Day 3
Dinner
Totals Ca
for the (mg)
Day
Food
Ca
VitD VitK Kcal
(mg) (IU) (mg)
Salmon
420
476
704
254
Baked
potato
0
0
0
70
Swiss
cheese
224
13
22
103
Spinach
250
0
167
7
Mushrooms
3
73
301
21
Fortified
milk
285
105
366
122
TOTALS
1182
667
1560
577
2626
VitD
(IU)
VitK
(mg)
Kcal
1301
4082
2061
Questions
1. What two components must work together to
prevent tetany and osteoporosis?
1. Calcium & Vitamin D
2. What is the best source of vitamin D?
2. Sunshine!
3. What percent of Ca is in the blood plasma?
Where is the majority held?
3. 1% in the blood plasma & 99% in the bones
Bibliography
"Tetany." - Symptoms, Causes, Treatments. Healthgrades, 02 May 2011. Web. 03 Mar.
2012. <http://www.bettermedicine.com/article/tetany>.
Blakemore, Colin. "Tetany." Encyclopedia.com. The Oxford Companion to the Body,
2001. Web. 03 Mar. 2012. <http://www.encyclopedia.com/topic/tetany.aspx>.
Dr.John. "Hypocalcemia - Causes, Symptoms and Treatment." Current Health Articles
and Tips. Howshealth, 04 Sept. 2010. Web. 03 Mar. 2012.
<http://howshealth.com/hypocalcemia/>.
"Calcium Rich Foods, Foods With Calcium." , Calcium Deficiency Symptoms. Fat Free
Kitchen, 2005. Web. 03 Mar. 2012.
<http://www.fatfreekitchen.com/nutrition/calcium.html>.
Food Composition Table. Boston: McGraw-Hill Higher Education, 2009. Print.
Wardlaw, Gordon M., and Anne M. Smith. Contemporary Nutrition. New York:
McGraw-Hill, 2009. Print.
Drezner, Marc, and Kimberly Hoben. "Vitamin D and Calcium Absorption." Sunset Tan.
Sunsettan, 17 Sept. 2010. Web. 07 Mar. 2012. <http://www.sunsettan.ca/vitamin-dand-calcium-absorption/>.