What Is Hypercalcemia?
Hypercalcemia is a condition in which you have too much calcium in your blood. Calcium performs important functions, such as helping to keep your bones healthy. However, too much of it can cause problems. Hypercalcemia makes it hard for calcium to do its job.
Hypercalcemia is fairly rare. It occurs in less than one percent of people, according to the National Institutes of Health (NIH).
What Causes Hypercalcemia?
Your body manages the calcium level in your blood through parathyroid hormone (PTH) and another hormone called calcitonin. Normally, PTH increases when the level of calcium in your blood falls and decreases when your calcium level rises. Your body also makes calcitonin when your calcium level gets too high. When you have hypercalcemia, your body is unable to regulate your calcium level as it normally would. There are several possible causes of this condition.
Parathyroid glands (four small glands) are located near the thyroid gland in the neck and regulate parathyroid hormone which in turn regulates calcium in the blood. When at least one of your parathyroid glands becomes overly active, the condition is called hyperparathyroidism. This is the leading cause of hypercalcemia, especially in women over 50 years old. It occurs when the glands release too much PTH.
Lung Diseases and Cancers
Granulomatous diseases, such as tuberculosis, are lung diseases that can cause your vitamin D levels to rise. This causes more calcium absorption, which increases the calcium level in your blood. Some cancers, especially lung cancer, breast cancer, and blood cancers, can raise your risk for hypercalcemia.
Medication Side Effects
Some types of drugs, such as thiazide diuretics, can cause hypercalcemia because less calcium is excreted and more retained in the body. Other drugs, such as lithium, cause more PTH to be released.
Taking too much vitamin D or calcium in the form of supplements can raise your calcium level.
This usually leads to mild cases of hypercalcemia. When you’re dehydrated, your calcium level rises due to the low amount of fluid you have in your blood.
What Are the Symptoms of Hypercalcemia?
If you have mild hypercalcemia, you might not have any symptoms. If you have a more serious case, you might have symptoms that affect various parts of your body. These various body organs and tissues involved are:
Kidney problems can lead to:
- excessive thirst
- excessive urination
- pain between your back and upper abdomen on one side
Abdomen-related symptoms include:
- abdominal pain
- decreased appetite
Calcium levels can affect your muscular system, causing:
High calcium levels can also cause bone issues, including:
- pain in your bones
- height loss
- bowed shoulders
- curvature of the spine
- fractures from disease
Hypercalcemia can also cause psychological symptoms, such as depression, memory loss, and irritability.
If you have cancer and experience any symptoms of hypercalcemia, call your doctor immediately. Hypercalcemia is considered a medical emergency in cancer patients.
Potential Complications of Hypercalcemia
Severe cases of hypercalcemia can cause kidney problems, such as kidney stones and kidney failure. Other complications include irregular heartbeats and osteoporosis. Hypercalcemia can also cause confusion or dementia since calcium helps keep your nervous system functioning properly. Serious cases can lead to a potentially life-threatening coma.
What Tests Do You Need?
Your doctor can use blood tests to check the calcium level in your blood. Once a high calcium level is found, you’ll need to have other tests done to find out what’s causing your condition. Blood tests can help your doctor diagnose hyperparathyroidism. The following tests might be done to check for evidence of cancer or other diseases that can cause hypercalcemia:
- chest X-rays, which can reveal lung cancer
- mammograms, which help diagnose breast cancer
- computed tomography (CT) scans, which combine multiple X-rays to form a more detailed image of your body
- magnetic resonance imaging (MRI) scans, which use radio and magnetic waves to produce detailed images of your body’s organs and other structures
What Are Your Treatment Options?
If you have mild hypercalcemia, your doctor might suggest simply keeping track of your condition and waiting to see if it improves or gets worse on its own.
If your case is severe, you might have to go to a hospital for treatment. The goal of treatment is to return your calcium level to normal. Treatment also aims to prevent damage to your bones and kidneys. Treatment options include:
- calcitonin (a hormone produced in the thyroid gland) to slow down bone loss
- intravenous fluids to keep you hydrated
- corticosteroids, which are anti-inflammatory medications that can help your body handle having too much vitamin D
- loop diuretic medications to help your kidneys function and get rid of extra calcium
- intravenous bisphosphonates, which are drugs that keep your bones from breaking down
- dialysis to rid your blood of extra calcium and waste when your kidneys have suffered damage; this is only done if other treatment methods aren’t working
Treating Primary Hyperparathyroidism
If you have kidney stones or bone loss due to this condition, you might need surgery to remove the abnormal parathyroid glands. This procedure cures most cases of hypercalcemia caused by hyperparathyroidism. If you can’t have surgery (you object to it, your doctor determines surgery to be unsafe for you, or the surgery has failed on you previously), your doctor might give you a medication called cinacalcet. This lowers your calcium level by decreasing PTH production. If you have osteoporosis, your doctor might have you take bisphosphonates to lower your risk of fractures.
If you have cancer, your doctor will discuss treatment options with you to help you determine if you want to treat hypercalcemia. You might be able to get relief from symptoms through intravenous fluids and medications. This might make it easier for you to deal with your cancer treatments.
You can protect your kidneys and bones from damage due to hypercalcemia by adopting a healthier lifestyle. Make sure you drink plenty of water—this can keep kidney stones from developing. Since smoking can speed up bone loss, it’s important to quit as soon as possible if you are a smoker. Smoking, of course, also causes many other health issues, so quitting can only help your health.
Do a combination of weight-bearing exercises and strength training to keep your bones strong and healthy. Talk to your doctor first to find out what types of exercises are safe for you to do. This is especially important if you have cancer that affects your bones.