Hypercalcemia - Causes, Symptoms, and Risk Factors

What Is Hypercalcemia?

Calcium is the basic constituent of the body, which is essential for the normal functioning of organs, cells, muscles, and nerves. It is also necessary for blood clotting and the health of bone. All the vital components should be present in the right amount. Abnormal levels, either decrease or increase in the levels of calcium can cause illness in the body. Hypercalcemia makes it difficult for the body to carry out its normal functions. Extremely high levels of calcium can be dangerous.

What Is the Difference Between Hypoglycemia and Hyperglycemia?

Both are medical conditions that are caused by unbalanced levels of calcium in the blood. In the case of hyperglycemia, the amount of calcium is too high in the blood, and in the case of hypoglycemia, there is much less amount of calcium than normal in the blood.

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Is Hypercalcemia a Life-Threatening Condition?

Usually, this is not a life-threatening condition and most people do not show any symptoms of this condition. It is usually diagnosed through blood tests. But severe hyperglycemia can result in some other health conditions such as

• Kidney failure.

• Arrhythmia which is an abnormal heart rhythm.

• Coma.

• Confusion.

What Are the Causes?

When there is hypercalcemia, there is excess calcium in the bloodstream, and the body does not regulate the calcium level normally. Let us know the most important causes of hypercalcemia.

Hyperparathyroidism:

The parathyroid glands are small glands located behind the thyroid gland. They are four in number and are located in the neck. The function of these glands is to control the production of the parathyroid hormone. Thereby, the calcium level in the blood is influenced. PTH is the parathormone secreted by the parathyroid glands. It helps the body in controlling the calcium coming into the bloodstream right from the intestines, kidneys, and also the bones. Usually, parathormone increases when the calcium level in the blood decreases. When the calcium level increases, parathormone decreases. When the calcium levels exceed, the body can also produce calcitonin from the thyroid gland. When the parathyroid glands become overly active, it releases a huge amount of parathormone. This, in turn, leads to hyperparathyroidism. As a result, calcium imbalance happens, and the body cannot achieve the balance on its own. This causes hypercalcemia. It is common in women over 50 years of age.

Dietary Supplements:

Consuming too much vitamin D or calcium in the form of dietary supplements can raise the calcium level. Excessive use of calcium carbonate components can also lead to high calcium levels.

Cancers:

Certain types of cancer, such as lung cancer, and breast cancer, increase the risk of hypercalcemia. Blood cancer is also known to cause hypercalcemia.

Medications:

Some medications, such as diuretics, can produce hypercalcemia. This happens due to severe fluid diuresis, leading to loss of body water. This contributes to an excess concentration of calcium in the blood. Lithium causes more parathormone to be released into the blood.

Lung disorders:

Granulomatous diseases, such as tuberculosis and sarcoidosis, are well-known lung diseases that are known to cause vitamin D levels to rise in the body. This causes more calcium absorption to take place. This increases the calcium level in the blood.

What Are the Clinical Features?

The clinical features presented by hypercalcemia patients depend on the organ that is involved. They are:

1. Neurological- Fatigue, altered mental state-coma, posterior leukoencephalopathy.

2. Gastrointestinal- Nausea, vomiting, constipation, pancreatitis, peptic ulcer.

3. Cardiovascular- Short QT interval, ST-segment mimics myocardial infarction, ventricular arrhythmia, and hypertension.

4. Renal- Diabetic nephrogenic insipidus and acute kidney injury.

What Are the Symptoms of Hypercalcemia?

The symptoms of hypercalcemia include:

• Frequent urination and feeling thirsty most of the time.

• Fatigue.

• Headaches.

• Forgetfulness.

• Nausea and vomiting.

• Bone pain.

• Osteoporosis. Loss of density of the cortical bone.

• Weakness.

• Constipation.

• A decrease in appetite.

• Lethargy.

• Depression.

• Neuromuscular effects like memory loss or irritability

• Muscle aches.

• Cramping and twitches.

• Abdominal moans.

• Psychic groans.

• Corneal calcification.

• Cardiovascular effects include hypertension.

What Are the Complications of Hypercalcemia?

1. Kidney stones and kidney failure.

2. Confusion or dementia.

3. Severe cases can lead to coma.

How Is Hypercalcemia Diagnosed?

The doctor will suggest a few blood tests to check the calcium level in the blood.

• Chest X-rays are the best diagnostic tool to reveal lung cancer.

• Mammograms will help to diagnose breast cancer.

• CT scans can give a detailed image of the body.

• MRI scans produce detailed images of the body’s specific organs and other structures.

• The DEXA test shows bone mineral density to evaluate bone strength.

• Urine tests that measure the level of calcium, protein, and other substances.

What Are the Treatment Options for Hypercalcemia?

Treatment options for hypercalcemia totally depend on the severity level of the condition and the underlying causes of the condition. The treatment options are:

Mild Cases:

If the person has a mild case of hypercalcemia, they may not need immediate treatment. Finding the underlying reason is very important. They need to monitor its progress. This should be done with the help of a physician. Therefore, it is important to stick to the recommendations of the doctor, along with the follow-up. Even a minor increase in the levels of calcium can lead to kidney stones and kidney damage over time.

Moderate to Severe Cases:

Hospital treatment might be needed if the person has a moderate to severe type. The goal of treatment is to bring back the calcium level to normal. Treatment also aims to prevent further damage to the bones and kidneys. Common treatment options include:

• Calcitonin is a hormone produced by the thyroid gland. It slows down the process of bone loss.

• Giving intravenous supplementation of fluids can hydrate the calcium levels in the blood.

• Corticosteroids are anti-inflammatory medications that are highly useful in the treatment of excessive vitamin D.

• Loop diuretic medications can improve the kidneys to move the fluid and get rid of extra calcium. This should be performed especially if the person has heart failure.

• Intravenous supplementation of bisphosphonates can lower blood calcium levels by regulating bone calcium levels.

• Dialysis is performed to get rid of extra calcium and waste. This is usually done if other treatment methods have failed.

Primary Hyperparathyroidism and Cancer:

Depending on the age, the functioning of the kidney, and the effects of bone, the need for surgery to remove the abnormal parathyroid glands will be decided. Different specialists will determine the method of surgical removal. This procedure cures most cases of hypercalcemia that is caused by hyperparathyroidism. The person will be suggested medications by the doctor to lower the calcium level by decreasing the production of parathormone. If they have osteoporosis, then the doctor might suggest some bisphosphonates to reduce the risk of fractures. If they have cancer symptoms, the doctor will discuss different options to help them determine the best ways to treat hypercalcemia as it requires a multi-disciplinary approach.

How to Prevent Hypercalcemia?

Hypercalcemia can not be prevented in all cases, but it can be prevented by reduced intake of calcium pills and calcium-based antacids. The person should consult a health care provider if they have a family history of hypercalcemia, kidney stones, etc. Intake of any dietary supplements, minerals, or vitamins should be done only after consulting with a doctor.

Conclusion

Hypercalcemia is a condition where there in a high level of calcium in the blood. This condition can be moderate to severe. This is usually caused by some cancer conditions or hyperparathyroidism. This condition can be treated through medications and surgery. This condition can be prevented by reducing the intake of calcium supplements.