Hypercalcemia: Causes, Symptoms, and Treatment

Hypercalcemia is a disease in which the level of calcium in the blood is higher than normal. Too much calcium in the blood can weaken bones, form kidney stones, and interfere with heart and brain function.
Hypercalcemia is usually the result of overactivity of the parathyroid glands. These four small glands are located in the neck, near the thyroid gland. Other causes of hypercalcemia include cancer, other specific medical conditions, certain medications, and overuse of calcium and vitamin D supplements.
Hypercalcemia may have no signs or symptoms, or symptoms may be severe. Treatment depends on the cause.

Symptoms

If your hypercalcemia is mild, you may not have any signs or symptoms. The most severe cases produce signs and symptoms related to the affected body parts from high levels of calcium in the blood. For example:
kidney. Excess calcium makes the kidneys work harder to filter it out. This can cause excessive thirst and frequent urination.
Digestive System. Hypercalcemia can cause stomach upset, nausea, vomiting, and constipation.
Bones and muscles. In most cases, excess calcium in the blood comes from the bones, which weakens them. This can cause bone pain and muscle weakness.
Brain. Hypercalcemia can interfere with brain function, causing confusion, lethargy, and fatigue. This can also lead to depression.
Heart. Rarely, severe hypercalcemia can interfere with heart function, causing rapid heartbeat and fainting, signs of cardiac arrhythmias, and other heart problems.

When should you see a doctor?

Contact your doctor if you develop signs and symptoms that may indicate hypercalcemia, such as increased thirst, frequent urination, and abdominal pain.

diagnosis

Because hypercalcemia can cause few, if any, signs or symptoms, you may not know you have the disorder until routine blood tests reveal high levels of calcium in your blood. Blood tests can also show whether your parathyroid hormone levels are high, indicating you have hyperparathyroidism.
Your doctor may recommend imaging tests of the bones or lungs to determine whether your hypercalcemia is caused by cancer or a disease such as sarcoidosis.

treatment

If the hypercalcemia is mild, you and your doctor may choose to watch and wait and monitor your bones and kidneys over time to make sure they stay healthy.
In the case of more severe hypercalcemia, the doctor may recommend medication or treatment of the underlying disease, including surgery.

medicines

In some cases, the doctor may recommend the following:
Calcitonin (Miacalcin). This salmon hormone regulates blood calcium levels. Mild nausea can be a side effect.
Calcimimetics. These types of drugs can help control overactive parathyroid glands. Cinacalcet (Sensipar) is approved for the management of hypercalcemia.
Bisphosphonates. Intravenous osteoporosis drugs, which can rapidly reduce calcium levels, are often used to treat hypercalcemia caused by cancer. Risks associated with this treatment include cracking of the jawbone (osteonecrosis) and some types of femur fractures.
Denosumab (Prolia, Xgeva). This drug is often used to treat people with hypercalcemia caused by cancer who do not respond well to bisphosphonates.
Prednisone. If your hypercalcemia is caused by high levels of vitamin D, short-term use of steroid tablets such as prednisone is often helpful.
Intravenous fluids and diuretics. Extremely high calcium levels can be a medical emergency. You may be hospitalized for treatment with intravenous fluids and diuretics to quickly lower your calcium levels and prevent heart rhythm problems or nervous system damage. may need to be.

surgery and other procedures

Problems associated with overactive parathyroid glands can usually be corrected by surgery to remove the tissue causing the problem. In many cases, only one of a person’s four parathyroid glands is affected. A special scanning test involves injecting a small dose of radioactive material to locate glands that are not working properly.

With information from Mayo Clinic

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