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  4. Can we make the correlation between level of hydration and serum calcium levels? I have encountered the opinion of an endocrinologist who says if serum calcium levels are over 9.5, it’s a sign the patient is not drinking enough water.

Can we make the correlation between level of hydration and serum calcium levels? I have encountered the opinion of an endocrinologist who says if serum calcium levels are over 9.5, it’s a sign the patient is not drinking enough water.

Chris Kresser: That’s interesting. I haven’t seen that in the research literature. As I have discussed in the course, serum calcium is not generally a marker of calcium status, and the body really tightly regulates calcium levels except at the extremes, like extreme deficiency or excess. Generally, serum calcium is due to things like hyperparathyroidism, hypoparathyroidism, or vitamin D—either excess vitamin D or vitamin D deficiency—in more rare cases, a tumor, either benign or malignant. Those tend to be the most, the things that affect serum calcium the most. There are certainly other markers that dehydration can affect that we talk about in the course, like BUN. I wasn’t aware of that with calcium and I’ve never seen it in any of the research that I’ve done, but certainly if that endocrinologist has that clinical experience, I find that interesting and it couldn’t hurt to just have the patient drink more water and retest and see what happens.

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