Health Topics

Skip navigation

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS
A lock ( Lock Locked padlock icon ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.

You Are Here:
Home →
Calcium - ionized
URL of this page: //medlineplus.gov/ency/article/003486.htm

Calcium - ionized

Ionized calcium is calcium in your blood that is not attached to proteins. It is also called free calcium.

All cells need calcium in order to work. Calcium helps build strong bones and teeth. It is important for heart function. It also helps with muscle contraction, nerve signaling, and blood clotting.

This article discusses the test used to measure the amount of ionized calcium in blood.

How the Test is Performed

A blood sample is needed. Most of the time blood is drawn from a vein located on the inside of the elbow or the back of the hand.

How to Prepare for the Test

Many medicines can interfere with blood test results.

  • Your health care provider will tell you if you need to stop taking any medicines before you have this test.
  • Do not stop or change your medicines without talking to your provider first.

Why the Test is Performed

Your provider may order this test if you have signs of bone, kidney, liver or parathyroid disease. The test may also be done to monitor the progress and treatment of these diseases.

Most of the time, blood tests measure your total calcium level. This looks at both ionized calcium and calcium attached to proteins. You may need to have a separate ionized calcium test if you have factors that increase or decrease total calcium levels. These may include abnormal blood levels of albumin or immunoglobulins.

Normal Results

Results generally fall in these ranges:

  • Children: 4.8 to 5.3 milligrams per deciliter (mg/dL) or 1.20 to 1.32 millimoles per liter (millimol/L)
  • Adults: 4.8 to 5.6 mg/dL or 1.20 to 1.40 millimol/L

Normal value ranges may vary slightly among different labs. Talk to your provider about the meaning of your specific test results.

The examples above show the common measurements for results for these tests. Some labs use different measurements or may test different specimens.

What Abnormal Results Mean

Higher-than-normal levels of ionized calcium may be due to:

Lower-than-normal levels may be due to (or caused by):

Alternative Names

Free calcium; Ionized calcium

Images

References

Bilezikian JP, Walker MD, Binkley N, Goltzman D, Mannstadt M. Hormones and disorders of mineral metabolism. In: Melmed S, Auchus, RJ, Goldfine AB, Rosen CJ, Kopp PA, eds. Williams Textbook of Endocrinology. 15th ed. Philadelphia, PA: Elsevier; 2025:chap 27.

Klemm KM, Klein MJ, Zhang Y. Biochemical markers of bone metabolism. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 16.

Thakker RV. The parathyroid glands, hypercalcemia, and hypocalcemia. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 227.

Review Date 5/19/2025

Updated by: Jacob Berman, MD, MPH, Clinical Assistant Professor of Medicine, Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Related MedlinePlus Health Topics

A.D.A.M., Inc. is accredited by URAC, for Health Content Provider (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process, and privacy policy.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language.
© 1997- 2026 A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
All content on this site including text, images, graphics, audio, video, data, metadata, and compilations is protected by copyright and other intellectual property laws. You may view the content for personal, noncommercial use. Any other use requires prior written consent from Ebix. You may not copy, reproduce, distribute, transmit, display, publish, reverse-engineer, adapt, modify, store beyond ordinary browser caching, index, mine, scrape, or create derivative works from this content. You may not use automated tools to access or extract content, including to create embeddings, vectors, datasets, or indexes for retrieval systems. Use of any content for training, fine-tuning, calibrating, testing, evaluating, or improving AI systems of any kind is prohibited without express written consent. This includes large language models, machine learning models, neural networks, generative systems, retrieval-augmented systems, and any software that ingests content to produce outputs. Any unauthorized use of the content including AI-related use is a violation of our rights and may result in legal action, damages, and statutory penalties to the fullest extent permitted by law. Ebix reserves the right to enforce its rights through legal, technological, and contractual measures.