Hypercalcemia describes an abnormally high amount of calcium in the blood. Calcium is an important mineral for the human body. It is important for the normal functioning of the muscles, cells, nerves, and organs. Calcium also helps the bones stay strong and is vital to blood clotting. However, too much calcium in the blood can weaken the bones. It can also lead to problems with the functionality of the brain and heart. Extremely high calcium levels in the blood can even be life-threatening.
Symptoms of Hypercalcemia
Individuals with mild cases may not experience any symptoms. Others may get headaches, fatigue, nausea, constipation, vomiting, decreased appetite, abdominal pain, muscle twitches, muscle cramps, bone pain, increased thirst, frequent urination, and muscle weakness. Neurological symptoms include depression, irritability, and memory loss. Severe cases can lead to confusion, fainting, and heart palpitations.
Complications of Hypercalcemia
When the urine contains excess calcium, crystals may develop. These crystals can combine and form kidney stones. In severe cases, the excess calcium in the body can interfere with the kidney’s ability to eliminate fluid and clean the blood, resulting in kidney failure. Arrhythmias (abnormal heartbeat) and osteoporosis, a bone-thinning disease, can also occur. In rare cases, very high calcium levels in the blood can lead to dementia and life-threatening coma.
Risk Factors for Hypercalcemia
Factors that put people at higher risk of developing hyperparathyroidism also put them at risk for hypercalcemia. These include long-term vitamin D or calcium deficiency, radiation exposure, and rare genetic diseases such as multiple endocrine neoplasias. Women over the age of 50 are also at higher risk. The condition is more likely to occur in people who have a family history of hypercalcemia or hyperparathyroidism.
When to See a Doctor
If you are experiencing symptoms such as fatigue, vomiting, muscle weakness, abdominal pain, increased thirst, and frequent urination, you should speak to a doctor. Individuals undergoing cancer treatment need to be especially vigilant; it isn’t uncommon for calcium levels to rise too high in people with cancer.
Causes of Hypercalcemia
Hyperparathyroidism (overactive parathyroid glands) is the most common cause of excess calcium in the blood. Granulomatous lung diseases such as sarcoidosis and tuberculosis may cause vitamin D levels in the blood to increase. As a result, the body absorbs more calcium and the levels in the blood also rise. Additionally, taking too much vitamin D or calcium in supplement form can lead to hypercalcemia, as can taking an excessive amount of calcium carbonate, which is in many over-the-counter antacids. Certain medications, breast cancer, lung cancer, and cancers of the blood can also lead to high calcium levels in the blood. Dehydration may lead to mild cases.
Four parathyroid glands sit behind the thyroid gland in the neck. These create the parathyroid hormone, which is responsible for maintaining calcium levels in the blood. Hyperparathyroidism occurs when one or more of the parathyroid glands become overactive, creating too much parathyroid hormone. This may occur due to the enlargement of one or more of the glands, or a noncancerous tumor. When the body produces too much parathyroid hormone, calcium levels in the blood become imbalanced.
Hypercalcemia may not cause any symptoms. Therefore, high calcium levels in the blood may not be detected until a doctor orders routine blood work. Once conducted, a blood test can also measure parathyroid hormone levels, which can help a doctor determine if someone has hyperparathyroidism. If hyperparathyroidism isn’t the cause of hypercalcemia, additional tests can help determine the underlying cause. For instance, imaging tests can look for breast cancer, lung cancer, and sarcoidosis.
Treating with Medication
In mild cases, a doctor may choose a “wait and see” approach, monitoring the health of the kidneys and bones over time. A doctor may prescribe a calcimimetic to help control the production of parathyroid hormone if hyperparathyroidism is the cause. Doctors usually treat hypercalcemia caused by cancer with bisphosphonates, IV osteoporosis medications that can quickly lower blood calcium levels. The short-term use of steroids may be useful if the condition is due to high levels of vitamin D. In severe cases, hospitalization with IV fluids and diuretics can lower calcium levels and prevent life-threatening complications.
Treating with Surgical Procedures
If hyperparathyroidism is causing high calcium levels in the blood, surgery can remove the tissue from the parathyroid glands causing the problem. A surgeon can use a small dose of radioactive material to determine which glands aren’t functioning correctly. Removing the affected glands typically cures hypercalcemia.
The prognosis for someone with this condition largely depends on what is causing the condition and how severe it is. People with it can help protect their kidneys by drinking a lot of water — this keeps the body hydrated and helps prevent the formation of kidney stones. Physical activity and strength training help keep bones strong, as well.