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Hypercalcemia is a condition in which your blood calcium level is higher than normal. Too much calcium in your blood can weaken your bones, cause kidney stones, and disrupt the function of your heart and brain.
Hypercalcemia is typically caused by hyperactive parathyroid glands. These four small glands are located near the thyroid gland in the neck. Other causes of hypercalcemia include cancer, certain other medical diseases, some drugs, and taking too much of calcium and vitamin D supplements.
Hypercalcemia symptoms range from non-existent to severe. Treatment is determined by the underlying cause.
WHAT ARE THE SYMPTOMS OF HYPERCALCEMIA?
If your hypercalcemia is minor, you may not notice any signs or symptoms. Severe cases cause signs and symptoms associated with the sections of your body impacted by elevated calcium levels in your blood. Here are several examples:
Muscles and bones: Most of the time, the excess calcium in your blood was leached from your bones, weakening them. This may result in bone discomfort and muscular weakness.
Brain: Hypercalcemia can disrupt how your brain functions, resulting in confusion, lethargy, and exhaustion. It may also lead to depression.
Heart: Severe hypercalcemia can occasionally interfere with heart function, causing palpitations and fainting, as well as indicators of cardiac arrhythmia and other heart issues.
Kidneys: Calcium overload causes your kidneys to work harder to filter it. This can result in increased thirst and urination.
Digestive system: Hypercalcemia can cause nausea, vomiting, and constipation.
WHAT ARE THE CAUSES OF HYPERCALCEMIA?
Calcium helps muscles contract and nerves transfer messages, in addition to strengthening bones and teeth. If you don't have enough calcium in your blood, your parathyroid glands secrete a hormone that causes:
- Your bones to release calcium into your bloodstream
- Calcium absorption in your gut tract
- Your kidneys to excrete less calcium and activate more vitamin D, which is necessary for calcium absorption.
A multitude of reasons might upset the delicate balance between too little calcium in your blood and hypercalcemia. Hypercalcemia is brought on by:
- Hyperparathyroidism (overactive parathyroid glands): A tiny, noncancerous (benign) tumor or enlargement of one or more of the four parathyroid glands is the most prevalent cause of hypercalcemia.
- Hereditary factors: Because of defective calcium receptors in your body, a rare genetic illness known as familial hypocalciuric hypercalcemia produces an excess in calcium in your blood. This disorder does not result in hypercalcemia symptoms or problems.
- Immobility: Hypercalcemia can develop in people who have a condition that leads them to spend a lot of time sitting or lying down. Bones that do not bear weight gradually release calcium into the blood.
- Cancer: Lung cancer, breast cancer, and some blood malignancies can all raise your risk of hypercalcemia. The spread of cancer to your bones (metastasis) increases your risk.
- Other diseases: Certain disorders, such as tuberculosis and sarcoidosis, can elevate vitamin D levels in the blood, stimulating the digestive tract to absorb more calcium.
- Hyperparathyroidism (overactive parathyroid glands): A tiny, noncancerous (benign) tumor or enlargement of one or more of the four parathyroid glands is the most prevalent cause of hypercalcemia.
- Cancer: Lung cancer, breast cancer, and some blood malignancies can all raise your risk of hypercalcemia. The spread of cancer to your bones (metastasis) increases your risk.
- Dehydration is severe: Dehydration is a common cause of mild or transitory hypercalcemia. Calcium concentrations rise when there is less fluid in the blood.
- Medications: Certain medications, such as lithium, which is used to treat bipolar disorder, may increase the secretion of parathyroid hormone.
- Supplements: Excessive calcium or vitamin D supplementation can boost calcium levels in your blood above normal over time.
- Other diseases: Certain disorders, such as tuberculosis and sarcoidosis, can elevate vitamin D levels in the blood, stimulating the digestive tract to absorb more calcium.
WHAT ARE THE COMPLICATIONS OF HYPERCALCEMIA?
Complications of hypercalcemia might include:
- Osteoporosis: If your bones continue to release calcium into your blood, you may develop osteoporosis, a bone-thinning disease that can lead to bone fractures, spinal column curvature, and height loss.
- Kidney stones: If your urine includes an excessive amount of calcium, crystals may form in your kidneys. The crystals can mix over time to produce kidney stones. It can be excruciatingly unpleasant to pass a stone.
- Kidney failure: Severe hypercalcemia can cause kidney injury, decreasing their ability to cleanse the blood and eliminate fluid.
- Problems with the nervous system: Severe hypercalcemia can cause confusion, dementia, and coma, all of which are fatal.
- Arrhythmia (abnormal heart rhythm): Hypercalcemia can interfere with the electrical impulses that control your heartbeat, causing it to beat erratically.
HOW IS HYPERCALCEMIA DIAGNOSED?
Because hypercalcemia has few, if any, symptoms, you may not realize you have it until normal blood tests reveal a high amount of blood calcium. Blood tests can also reveal whether your parathyroid hormone level is elevated, indicating hyperparathyroidism.
Your doctor may offer imaging studies of your bones or lungs to evaluate if your hypercalcemia is caused by a disease such as cancer or sarcoidosis.
WHAT ARE THE TREATMENTS FOR HYPERCALCEMIA?
If your hypercalcemia is minor, you and your doctor may decide to monitor your bones and kidneys over time to ensure they remain healthy.
For more severe hypercalcemia, your doctor may advise you to take drugs or seek therapy for the underlying illness, which may include surgery.
Medications
In some circumstances, your doctor may advise you to:
- Denosumab (Xgeva, Prolia): This medication is frequently used to treat patients with cancer-related hypercalcemia who do not react well to bisphosphonates.
- Prednisone: If your hypercalcemia is caused by high vitamin D levels, short-term use of steroid tablets such as prednisone is usually beneficial.
- IV fluids and diuretics: Extremely high calcium levels can be dangerous. You may require hospitalization for therapy with IV fluids and diuretics to quickly lower the calcium level in order to avoid heart rhythm difficulties or nervous system damage.
- Calcitonin (Miacalcin): This salmon hormone regulates calcium levels in the blood. Mild nausea may occur as a side effect.
- Calcimimetics: This sort of medication can aid in the regulation of hyperactive parathyroid glands. Cinacalcet (Sensipar) is now licensed for the treatment of hypercalcemia.
- Bisphosphonates: Intravenous osteoporosis medications, which can rapidly lower calcium levels, are frequently used to treat cancer-related hypercalcemia. The risks of this treatment include jaw disintegration (osteonecrosis) and some forms of thigh fractures.
Surgical and other procedures
Surgery to remove the tissue causing the disease will often cure problems associated with hyperactive parathyroid glands. In many cases, only one of the four parathyroid glands of a person is afflicted. A particular scanning test employs the injection of a small quantity of radioactive material to target the malfunctioning gland or glands.