What is hypercalcemia?
Hypercalcemia is a condition in which there is higher than a normal level of calcium in your blood. Calcium is important to many body processes, including bone growth, maintaining proper hormone levels, and correct functioning of nerves, muscles, and the brain. This level is usually controlled very precisely by the body. However, in certain conditions, patients can develop hypercalcemia. It is a fairly common condition.
What are the symptoms of hypercalcemia?
Although showing symptoms of hypercalcemia is uncommon, symptoms can include:
- Frequent urination and/or thirst
- Hard to-treat increased blood pressure
- Bone pain
- Loss of height
- Nausea, vomiting, or decrease in appetite
- Depression or irritability
- Muscular weakness and/or twitches
What causes hypercalcemia?
Hypercalcemia can be caused by over 25 separate disease states. Primary hyperparathyroidism and malignancy account for 80 to 90% of all hypercalcemic cases.
In primary hyperparathyroidism, the four parathyroid glands, located near your Adam’s apple and behind the thyroid glands, produce too much parathyroid hormone. This hormone works with vitamin D and calcitonin to maintain a healthy level of calcium in the blood. Calcitonin is produced by the specialized cells in the thyroid gland.
Several cancers can also result in hypercalcemia.
Genetics or certain medicines, particularly lithium (Eskalith CR®, Eskalith®, or Lithobid®), may prevent the body from maintaining proper blood calcium levels and so result in too much calcium in the blood.
Other less common causes of hypercalcemia include:
- Taking in too much vitamin D or calcium (dietary or supplemental)
- Granulomatous inflammatory diseases, such as sarcoidosis, and some fungal infections
- Failure of kidneys or adrenal glands
- Hyperthyroidism (an overactive thyroid or fast metabolism)
- Being bedridden
- Taking thiazide diuretics (medicines that increase urination)
How is hypercalcemia diagnosed?
Your doctor will need a blood test to determine if you have hypercalcemia. The doctor will check the sample to see if you have high levels of calcium and also check to see if you have any illnesses that are causing hypercalcemia. For a urine test, you will need to collect urine over a 24-hour period to assess the severity of the hypercalcemia.
How is hypercalcemia treated?
Treatment of hypercalcemia depends on what is causing the disorder and how severe it is. If it is in an early stage and the cause is an overactive parathyroid gland, there are several options:
- You may be closely monitored by your doctor.
- You may be given fluids to treat dehydration.
- You may be prescribed a medication such as cinacalcet (Sensipar®) to better control your condition.
- You may be prescribed medications to control bone loss.
- You may be hospitalized in severe cases.
- You may need to undergo surgery and have your parathyroid gland removed.
How can hypercalcemia be prevented?
Hypercalcemia usually cannot be prevented. Because of this, it is good to know your family history as well as the symptoms to watch for. You should have your calcium levels checked by your doctor. Also, ask your doctor before you take calcium or vitamin D supplements to be sure you really need them.
What is the prognosis (outlook)?
Prognosis, like treatment, depends on the cause and severity of hypercalcemia. If you are only slightly hypercalcemic, you will probably have few or no health complications. Also, if the cause is genetic or dietary, the outlook is optimistic. When hypercalcemia is the result of a different medical issue, the prognosis depends on your overall health and your specific condition.
What complications could occur?
Complications are unlikely since hypercalcemia is easy to detect. However, if not detected and treated, the following health effects could occur:
- Osteoporosis and bone fractures
- Kidney stones or failure
- Morton AR, Lipton A. Hypercalcemia. In: Niederhuber JE, Armitage JO, Doroshow JH, et al., eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2013:chap 37. National Institute of Diabetes and Digestive and Kidney Diseases. U.S. Department of Health and Human Services. National Institutes of Health. Primary Hyperparathyroidism Accessed 11/20/2014.
- Hormone Health Network. Hypercalcemia Fact Sheet Accessed 11/20/2014.
- Hyperparathyroidism. American Academy of Family Physicians Accessed 11/20/2014.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 11/19/2014…#14597