- Following parathyroidectomy or total thyroidectomy
- Hypoparathyroidism, for example autoimmune, infiltration, Di George syndrome
- Acute pancreatitis
- Severe hypomagnesaemia
- Vitamin D deficiency, for example poor intake, malabsorption
- Chronic kidney disease
- Cancer (either involving bone, with increased osteoblastic activity, or in response to chemotherapy, with phosphate released from tumour cells forming complexes with plasma calcium)
- Multiple citrated blood transfusions
- Rhabdomyolysis
- Septic shock
- Pseudohypoparathyroidism
- Hypercalciuric hypocalcaemia
- Drugs, for example loop diuretics, phenytoin
- Ethylene glycol poisoning
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