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Excess of phosphate can lead to interactions within the human body with calcium, iron and magnesium, and can lead to diarrhoea and may even be toxic. Phosphate and calcium levels are directly connected, and an excess of phosphate will lead to the removal of calcium from the bones and teeth. This will cause osteoporosis and problems with the health of teeth and gums. Athletes often use phosphate supplementation, but a healthcare specialist should monitor this application.
Interactions for phosphate preparations with several over-the-counter and prescription drugs are known. Antacids containing aluminium, calcium and magnesium ions can bind phosphate in the digestive tract and prevent phosphate from being absorbed. This can lead in extreme cases to hypophosphataemia. Potassiumsparing diuretics and potassium supplements in combinationwith phosphate preparations may lead to elevated levels of blood potassium levels (hyperkalaemia). Hyperkalaemia can be a serious life-threatening problem.

Phosphate is useful in large volume parenteral fluids to correct or prevent hypophosphatemia when adequate oral phosphorous intake is not possible. Hypophosphatemia may cause hemolytic anemia, thrombocytopenia, neuromuscular and CNS disorders, bone and joint pain, and decompensation in patients with cirrhotic liver disease. There is some controversy whether “a low phos” indicates that treatment is necessary.