Hypophosphatemia

A review of hypophosphatemia, including clinical manifestations, etiologies, diagnostic approach, and treatment. Specific topics of focus include refeeding syndrome, Fanconi syndrome, and the effect of hypophosphatemia on the oxygen hemoglobin dissociation curve.

[@StrongMed]

With calcium and phosphate metabolism, there are 2 major and 2 minor hormones of relevance. Calcitriol (major) is made from vitamin D with 2 steps - 1 in liver, 1 in kidney. Parathyroid hormone (major) is synthesized and released by the parathyroid glands in the neck. Calcitonin (minor) is synthesized and released from the thyoid gland, also in the neck. FGF23 (minor) is made in and released from bone. Brain is actually not involved at all here (unlike in sodium and water homeostasis).

[@StrongMed]

Phosphorus is an element. Phosphate (in medicine) is an inorganic compound consisting of a phosphorus atom surrounded by 4 oxygen atoms, with a charge ranging from 0 to -3. In common usage in US hospitals, these terms are imprecisely used as synonyms (both referring to inorganic phosphate). You should check with the lab as to whether they are using the term "phosphorous" in the same way. It would seem highly unusual for a lab to truly measure phosphorus levels...

[@Museangel87]

Thank you for creating this video. I am a third semester nursing student and I thought this video was extremely helpful.

[@noureenmurtaza3255]

thanks again for such an elaborated videos..really helpful

[@sunving]

Thank you Dr Strong. Good lecture

[@mrjakub-tn5dv]

Amazing video thank you!

[@895792]

Thank you for this great presentation I want to ask a question . In our hospital in Turkey lab can measure only phosphorous level but phosphate . Is it the same? How can we use phosphorous level for phosphate disorders? Thank you.

[@895792]

Thank you. In fact ranges are nearly identical .

[@degachibiochimie7745]

Hello Dr. Thanks for the video I have a question on this subject Obese patients known to have this imbalance (Hypophosphatemia ) How so? What physiology that explain it?

[@Jim-zj8vn]

Question: What might the possible cause and relationship of phosphate consumption (sodium phosphate, calcium phosphate, etc.) in a patient who suffers immediate symptoms (20 minutes after consumption) of feeling faint, passing out (approximately 2 hrs), followed by abdominal bloating and gas.

[@user-kg1lv9tc1m]

Thank you very much Doctor for this great lecture, I have a question on 10:00 , is PTH level is high or low in hungry bones syndrome?

[@jbeckwithnbacer]

Question ? Do all these hormones and elements / chemicals come from the hypothalamus or other areas of the brain or do some of them come from the liver or kiddy

[@benikramer5115]

Many thanks Probably most of the people with metabolic syndrome have hypophosphatemia too. Fructose , processed ba Fructokinase C depletes the cells from phosphorus, (AMP deaminase) and form uric acid ( (Uric Acid: From innocent bystander to key player in metabolic syndrome)

[@StrongMed]

...If your lab did happen to truly measure phosphorus levels (as in the element, and not the compound and/or ion), I imagine that as long as you had a normal range to compare your patient's value to, that the trends are all the same. (i.e. a phosphorus level above normal would have the same significance as a phosphate level above normal). You could also check your hospital's normal range for "phosphorus" against published normal ranges for "phosphate". I bet the ranges are nearly identical.

[@djkdee6486]

I almost died from low phosphorous....dont know why,

[@raju301]

Thanks! very helpful indeed.

[@armitzeolot3349]

My phosphate level is 0.1mg/dl. I am vitamin D difficient (8). I am taking osteoporosis medicine is it fine?

[@itsme95140]

How much of mg, 1 tablet of sevelamer carbonate 400 can remove phosphorous

[@chiefpygmy]

hello, my alka phosphate level is always at 40 ref 40-115 u/l plus my calcium has risen from 9.4 in 3/14 to 10.4 in 7/14 should i request a 24 urine in my next rhuematoid specialist visit?

[@StrongMed]

chiefpygmy I'm very sorry, but I can't give specific medical advice to my viewers. However, in general, labs which fall into the normal range (including right at the boundary of the normal range) are usually not something to worry about. If you are still concerns, I would ask your doctor for his/her opinion. as he/she has access to your medical chart, can examine you, and knows the complete details of your prior labs, medication history, etc...