What Is the Treatment for Hypophosphatemia (Low Phosphate)?

Treatment of hypophosphatemia or low serum phosphate levels can include treating the underlying cause, dietary changes, or surgery.

The treatment of hypophosphatemia or low serum phosphate levels largely depends upon:

• The cause of hypophosphatemia
• The severity of hypophosphatemia
• The duration of hypophosphatemia

Depending on these factors, the doctor may decide the management of the condition with treatment options such as:

• Treatment of the underlying cause:
  • The trigger or precipitating factor for hypophosphatemia needs to be identified and managed as per the protocol.
  • Triggers may include:
    • diabetic ketoacidosis or DKA,
    • renal failure,
    • malnutrition,
    • liver diseases,
    • alcoholism,
    • vitamin D deficiencies, and
    • certain medications (antacids, diuretics, certain herbal preparations, and herbal preparations).
• Dietary changes:
  • These include ensuring adequate hydration and consuming phosphate-rich foods such as:
    • Dairy products (milk, cheese, yogurt, cream, ice cream, cottage cheese). One quart of cow's milk provides about the amount of phosphate consumed by the average person in a day.
    • Meat, chicken, fish, and eggs
    • Nuts and seeds
    • Beans including soy
    • Peas and lentils
    • Wheat germ, granola, bran cereal, and oatmeal
• Oral phosphate supplementation:
  • It may be done in mild to moderate cases of hypophosphatemia (serum phosphate levels between 1.0 and 1.9 mg/dL).
  • The dosages are determined by the doctor based upon the patient’s age and severity of hypophosphatemia.
• Intravenous phosphate:
  • Given for the treatment of severe hypophosphatemia (serum phosphate levels lower than 1.0 mg/dL).
  • Intravenous phosphate supplementation is particularly helpful in seriously ill patients or those who cannot take supplements orally or those who have severe malabsorption.
  • Serum phosphate levels are assessed every six hours during intravenous phosphate supplementation. Once the phosphate levels are above 1.5 mg/dL, oral phosphate supplementation is started.
• Other treatments:
  • Calcium supplementation and vitamin D supplementation.
  • Burosumab (Crysvita) is a U.S. Food and Drug Administration–approved medication used for the treatment of some genetic causes of hypophosphatemia.
• Surgery:
  • May be needed in people who have hypophosphatemia due to a tumor or an overactive parathyroid gland (primary hyperparathyroidism).
  • Surgery may involve removal of the parathyroid gland (parathyroidectomy) or the tumor that is causing hypophosphatemia.