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Serum ionized calcium refers to the fraction of calcium in the blood that is not bound to proteins or complexed with anions, but exists as free, physiologically active ions. This "free" or "ionized" form constitutes about 50%–55% of total serum calcium and is responsible for most of the biological actions attributed to calcium in the body. It is crucial for muscle contraction, nerve conduction, blood clotting, hormone secretion, and enzyme activity regulation. Abnormal levels can indicate various health issues like kidney disease, hyperparathyroidism, vitamin D deficiency, or certain malignancies.
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