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Electrolytes & Minerals

Calcium, Ionized

Normal range 4.6–5.3 mg/dL (1.15–1.33 mmol/L SI). Specimen: Serum or whole blood.

Also known as: free calcium, iCal.

4.6–5.3 mg/dLCritical: read below

Reference range

Conventionalmg/dL
4.65.3
SImmol/L
1.151.33
SpecimenSerum or whole blood
Conventional range4.6–5.3 mg/dL
SI range1.15–1.33 mmol/L
Conversion factor×0.25 (conventional → SI)
Critical value< 3.2 or > 6.2 mg/dL
PanelElectrolytes & Minerals

Convert any Calcium, Ionized result between units on the unit converter.

What is the normal range for Calcium, Ionized?

The standard teaching reference range for Calcium, Ionized is 4.6–5.3 mg/dL in conventional units, or 1.15–1.33 mmol/L in SI units. This value is measured in serum or whole blood.

A commonly taught critical (panic) value is < 3.2 or > 6.2 mg/dL. Critical results are reported to the provider immediately under your facility's policy.

Source: Adult reference values compiled from Pagana & Pagana, Mosby's Diagnostic and Laboratory Test Reference, and Fischbach & Dunning, A Manual of Laboratory and Diagnostic Tests. Reference ranges vary by laboratory, method, age, sex, and population — always use the range printed on the actual result.

Above the range

Common causes of a high Calcium, Ionized

  • Primary hyperparathyroidism
  • Malignancy
  • Acidosis (raises free fraction)

Below the range

Common causes of a low Calcium, Ionized

  • Alkalosis
  • Massive transfusion (citrate)
  • Hypoparathyroidism

At the bedside

Nursing considerations

  • The physiologically active fraction; unaffected by albumin, so preferred in critical illness.

Study aid

Your notes on Calcium, Ionized

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