Hypophosphatemia is a serum phosphate concentration < 2.5 mg/dL (0.81 mmol/L). Mild hypophosphatemia is somewhat common and usually isn’t a cause for concern however severe hypophosphatemia can be life-threatening and requires medical treatment. The UK Medicines Information group have provided excellent guidance on how to replace phosphate.
- Generally asymptomatic if mild
- Can cause many systemic features
- CNS & MSK: weakness/myalgia, lethargy, confusion, seizures
- Cardiorespiratory failure
- Rickets/Osteomalacia if chronic
- Refeeding syndrome
- Chronic alcohol use
- Check the calcium, U&Es, renal function
- Use local guidelines or consider the information above
- Typically oral replacement for a mild deficiency (e.g. phosphate Sandoz) & IV therapies if moderate or severe
References & further reading
- Katzel, J.A., Vucuscu, R., Garcia, R., 2013. Wards 101 pocket clinician’s survival guide. Börm Bruckmeier Publishing.
- Lewis III, J. L., 2018. Hypophosphatemia. MSD Manual Professional Version.
- Mozingo, D.W. and Mason Jr, A.D., 2018. Hypophosphatemia. In Total Burn Care (pp. 280-286). Elsevier.
By Dr Shoaib Hussain
Edited by Pratyush Pradeep
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