This article shows that there is variability in the degree that bacteria bind to phosphate in the gut. Is it possible that intestinal bacterial overgrowth results in hypophosphatemia?
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Chronic small intestinal bacterial overgrowth (SIBO) can be associated with decreased calcium and vitamin D absorption, which can result in increased parathormone secretion, which can result in increased excretion of phosphate through the kidneys and thus in hypophosphatemia. In short-term cases, there would be no hypocalcemia, because calcium would be leached from the bones and maintain normal blood levels.
SIBO can be diagnosed by a hydrogen breath test. If the test is negative, other malabsorption conditions can be considered, for example, fructose malabsorption, lactose intolerance, celiac disease, Crohn's disease, etc.
