Hypophosphatemia

Hypophosphatemia
Other namesLow blood phosphate, phosphate deficiency, hypophosphataemia
Phosphate group chemical structure
SpecialtyEndocrinology
SymptomsWeakness, trouble breathing, loss of appetite
ComplicationsSeizures, coma, rhabdomyolysis, softening of the bones
CausesAlcohol use disorder, refeeding in those with malnutrition, hyperventilation, diabetic ketoacidosis, burns, certain medications
Diagnostic methodBlood phosphate < 0.81 mmol/L (2.5 mg/dL)
TreatmentBased on the underlying cause, phosphate
Frequency2% (people in hospital)

Hypophosphatemia is an electrolyte disorder in which there is a low level of phosphate in the blood. Symptoms may include weakness, trouble breathing, and loss of appetite. Complications may include seizures, coma, rhabdomyolysis, or softening of the bones.

Nutritional phosphate deficiency is exceedingly rare as phosphate is abundant in most types of foods and is readily passively absorbed from the gastrointestinal tract; hypophosphatemia is thus typically a result of diseases or an adverse effect of medical treatments. Causes include alcohol use disorder, refeeding in those with malnutrition, recovery from diabetic ketoacidosis, burns, hyperventilation, and certain medications. It may also occur in the setting of hyperparathyroidism, hypothyroidism, and Cushing syndrome.

It is diagnosed based on a blood phosphate concentration of less than 0.81 mmol/L (2.5 mg/dL). When levels are below 0.32 mmol/L (1.0 mg/dL) it is deemed to be severe.

Treatment depends on the underlying cause. Phosphate may be given by mouth or by injection into a vein. Hypophosphatemia occurs in about 2% of people within hospital and 70% of people in the intensive care unit (ICU).