Health Library

Hypophosphatemia

Low blood phosphate; Phosphate - low; Hyperparathyroidism - low phosphate

Hypophosphatemia is a low level of phosphorus (phosphate) in the blood.

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Causes

The following may cause hypophosphatemia:

• Alcoholism
• Antacids
• Certain medicines, including insulin, acetazolamide, foscarnet, imatinib, intravenous iron, niacin, pentamidine, sorafenib, and tenofovir
• Fanconi syndrome
• Fat malabsorption in the gastrointestinal tract
• Hyperparathyroidism (overactive parathyroid gland)
• Starvation
• Too little vitamin D

Symptoms

Symptoms may include:

• Bone pain
• Confusion
• Muscle weakness
• Seizures

Exams and Tests

Your health care provider will examine you.

The following tests may be done:

• Kidney function tests
• Parathyroid hormone level
• Vitamin D blood test

Exam and testing may show:

• Anemia due to too many red blood cells being destroyed (hemolytic anemia)
• Heart muscle damage (cardiomyopathy)

Treatment

Treatment depends on the cause. Phosphate can be given by mouth or through a vein (IV).

Outlook (Prognosis)

How well you do depends on what has caused the condition.

When to Contact a Medical Professional

Contact your provider if you have muscle weakness or confusion.

References

Chonchol M, Smogorzewski MJ, Stubbs, JR, Yu ASL. Disorders of calcium, magnesium, and phosphate balance. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 18.

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.

Yu ASL. Diseases of magnesium and phosphorus. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 105.

Review Date: 12/31/2023  

Reviewed By: Walead Latif, MD, Nephrologist and Clinical Associate Professor, Rutgers Medical School, Newark, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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