What is hypophosphatemia?

Hypophosphatemia is a low level of phosphate in your blood. Phosphate is an electrolyte (mineral) that works with calcium to help build bones. It also helps produce energy. Hypophosphatemia can be acute or chronic. Acute means the level in your blood drops suddenly. Chronic means the level has been low or drops slowly, over time.

What causes or increases my risk for hypophosphatemia?

You may develop hypophosphatemia if your body cannot absorb phosphate, or if it gets rid of too much. Any of the following can increase your risk:

• Alcoholism
• Malnutrition, a lack of vitamin D, or problems absorbing nutrients
• Eating large amounts of carbohydrates
• Too much calcium in your blood, low magnesium, a kidney condition, or overtreatment during dialysis
• Steroid medicine, or use of too many diuretics (water pills) or antacids
• Certain cancer medicines can lower your phosphate level
• Diabetic ketoacidosis (DKA), hypothyroidism, obesity, or certain lung problems, such as asthma
• Severe or chronic diarrhea, or inflammatory bowel disease
• A severe burn, major surgery, or stress
• Intense exercise, or exercise for a long period of time

What are the signs and symptoms of hypophosphatemia?

You may not have any signs or symptoms at first. If the condition becomes more severe, you may develop any of the following:

• Lack of energy, or an energy drop
• Being irritable
• Muscle weakness or pain, trouble walking, or tremors
• Confusion or seizures
• Bone pain and fractures from weakened bones

How is hypophosphatemia diagnosed?

Your healthcare provider will examine you and ask about your symptoms. Tell him or her about any medicines you are taking, and the amounts. Your provider may ask if you have problems with alcoholism or an eating disorder. Also tell your provider if you had any recent surgery or injury, or you have a lung disease. You may also need any of the following:

• A blood sample is used to check the level of phosphate. Your calcium, vitamin D, or magnesium levels may also be checked.
• A urine sample is sometimes also checked. Your body gets rid of extra phosphate through your urine. High levels in your urine may mean your body is getting rid of too much phosphate.

How is hypophosphatemia treated?

Treatment is not needed if you do not have symptoms or your condition is mild. If you develop symptoms, treatment will depend on the cause:

• Your phosphate level will be increased. Your healthcare provider may recommend that you have more food or drinks that contain phosphate. Examples include breads that contain yeast, dairy products, meat, eggs, peas, nuts, and beans. Your provider or a dietitian can tell you how much of these to have each day. Medicine may be given to increase your phosphate level. You may be able to take this as a pill at home. You will need to be admitted to the hospital if you need to get this medicine through an IV. Medicines may also be used to lower your calcium level or to raise other mineral levels.
• Medicines may need to be changed or stopped. Your healthcare provider will review all of your medicines with you. He or she may recommend that you change or stop taking medicines that are causing your symptoms.
• Health conditions may need to be treated. If you were brought into the hospital because DKA caused hypophosphatemia, the DKA will be treated. If it was caused by malnutrition or lack of vitamin, you will be given the nutrients or vitamin you need.

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

• Phospha 250 Neutral
• K-Phos Neutral
• PHOS-NaK
• Drisdol
• Calciferol

View more treatment options

How can I prevent or manage hypophosphatemia?

• Manage health conditions that can lead to hypophosphatemia. If you have diabetes, it is important to follow your management plan so you prevent DKA. Ask your healthcare provider for information if you are having problems with alcoholism and need help to stop drinking. Obesity and eating disorders such as bulimia or anorexia can cause malnutrition. This increases your risk for hypophosphatemia. Your provider can help you manage these health conditions or give you information on treatment plans.
• Do not take more antacids or water pills than directed. Follow the directions on the label or that are given to you by your healthcare provider. These medicines are often available without a prescription. It can be easy to take too many at one time or in the same day.
• Eat a variety of healthy foods. Healthy foods include fruits, vegetables, low-fat dairy foods, beans, meats, fish, and whole-wheat breads and cereals. You can prevent malnutrition by eating enough healthy foods every day. Your healthcare provider or dietitian can help you plan meals and snacks.
• Exercise as directed. Your phosphate level may drop suddenly if you exercise too much or too intensely. Always warm up before you exercise and cool down after. Your healthcare provider can help you create a safe exercise plan.
• Drink liquids as directed. Liquids help your kidneys function well. Liquids can also help prevent dehydration, especially if you have diarrhea. Talk to your healthcare provider about how much liquid to have every day. Too much or too little liquid can affect the balance of phosphate and other minerals in your body.

Call your local emergency number (911 in the US) or have someone call if:

• You have a seizure.

When should I seek immediate care?

• You are confused or have severe trouble thinking.
• You break a bone.

When should I call my doctor?

• You have new or worsening symptoms.
• You have nausea or are vomiting.
• You have diarrhea or constipation that continues for more than 2 days.
• You have muscle pain.
• You have questions or concerns about your condition or care.

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