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Hypercalcemia - Causes, Symptoms, and Risk Factors

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Hypercalcemia - Causes, Symptoms, and Risk Factors

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Too much calcium in your blood can be a sign of hypercalcemia. Read this article to know more about the causes, symptoms, and risk factors.

Written by

Dr. Lochana .k

Medically reviewed by

Dr. C. Elanchezhian

Published At August 14, 2020
Reviewed AtFebruary 10, 2023

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 Are the Causes?

When there is hypercalcemia, there is excess calcium in the bloodstream, and your body would not regulate your 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 gets 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 your 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 your calcium level. Excessive use of calcium carbonate components can also lead to high calcium levels.

Cancers:

Certain types of cancer, such as lung cancer, 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 the 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 in 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 mimic 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 thirst 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?

Your 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 your body.

  • MRI scans produce detailed images of your 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 conditions. The treatment options are:

Mild Cases:

If you have a mild case of hypercalcemia, you may not need immediate treatment. Finding the underlying reason is very important. You 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 your 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 you have 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 your 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 your kidneys to move the fluid and get rid of extra calcium. This should be performed especially if you have 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 your 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. You will be suggested medications from your doctor to lower your calcium level by decreasing the production of parathormone. If you have osteoporosis, your doctor might suggest some bisphosphonates to reduce the risk of fractures. If you have cancer symptoms, your doctor will discuss different options to help you determine the best ways to treat hypercalcemia as it requires a multi-disciplinary approach.

Are you experiencing any of these issues?

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Frequently Asked Questions

1.

What Is the Common Cause of Hypercalcemia?

The most common causes of hypercalcemia are the overactive parathyroid glands, also known as hyperparathyroidism that can arise from a small, benign (noncancerous) tumor or enlargement of the four parathyroid glands.

2.

What Are the Symptoms of Hypercalcemia in the Blood?

The symptoms of hypercalcemia may include elevated levels of calcium in your blood that can induce your muscles to feel tired and weak. If you have hypercalcemia, you may also undergo pain in your muscles and the area throughout your joints. Too much calcium can lead to constipation, frequent urination, abdominal pain, fatigue, lethargy, excessive thirst, vomiting, and malaise.

3.

What Is the Initial Treatment for Hypercalcemia?

The initial treatment for hypercalcemia are intravenous osteoporosis drugs that can instantly lower calcium levels, and are often used to manage hypercalcemia due to cancer. Risks linked with this treatment include breaking (osteonecrosis) of the jaw and specific types of thigh fractures. Few drugs used to treat hypercalcemia are:
Bisphosphonates inhibit osteoclastic bone resorption and effectively treat hypercalcemia due to conditions producing increased bone resorption and malignancy-related hypercalcemia.
- Pamidronate.
- Calcitonin.
- Corticosteroids.
- Etidronate.

4.

How to Get Your Calcium Levels Down?

To bring your calcium levels down, you should drink at least 2 to 3 quarts of liquid every day because staying hydrated is vital in lowering your calcium levels. Frequent urination is a common symptom amongst people suffering from hypercalcemia, so the intake of fluids helps prevent dehydration.

5.

What Should You Not Eat If You Have Hypercalcemia?

Foods that are high in calcium should be avoided in patients with hypercalcemia. The foods to be avoided are:
- Fishbones.
- Dairy foods.
- Dark green vegetables.
- Antacids that are used for ingestion, heartburn, or acid reflux have high levels of calcium.
- Hypercalcemia.

6.

What Are the Foods I Should Eat If I Have Hypercalcemia?

A low calcium diet is essential to overcome the disorder. The person with hypercalcemia can go for a diet that is lacking or having less calcium. Therefore this issue can be resolved with their diet itself. Foods to eat if you have hypercalcemia are:
- Fish.
- Beans.
- Legumes and grains.
- Fruits less in calcium like kiwis, oranges, raspberries, and papaya are high in nutrients but low in calcium.
- Foods low in calcium are black beans, dark chocolate, bok choy (raw), ima beans, sunflower seeds, dandelion greens (raw), lentils, tuna, collard greens (raw), brown rice, kidney beans, corn, white beans, kale (raw), beets, Tempe, turnip greens (raw), and garbanzo beans.

7.

How Can Calcium Deposits Be Dissolved in the Body?

Calcium deposits in the body can be dissolved by kidney stone treatments. The doctor may prescribe a diuretic and thiazide to help stop future calcium kidney stones. This diuretic indicates the kidneys release urine while enduring more calcium.

8.

Can Overeating Dairy Products Cause Hypercalcemia?

Eating dairy products, including milk, yogurt, and cheese, are rich in calcium, and can lead to hypercalcemia if consumed in huge quantities. The evolution of hypercalcemia from drinking too much milk is called a milk-alkali syndrome. Restricting the number of dairy products in the diet can help control blood calcium levels.

9.

Does Magnesium Help to Reduce Hypercalcemia?


When magnesium levels are normal, hypercalcemia can be avoided. Calcium competes with zinc, copper, manganese, magnesium, iron in the intestine, and a high intake of one can reduce others' absorption. Magnesium is vital for regulating calcium levels in the blood. It is also a co-factor in the generation and activation of vitamin D. Osteoporosis can be prevented by magnesium. Therefore the ratio of calcium to magnesium is fundamental. Supplements of Magnesium 400-800 mg can be taken daily, in divided doses or as magnesium oil.

10.

At What Level Is Hypercalcemia Dangerous?

The normal range is 2.1 to 2.6 mmol/L when levels are greater than 2.6 mmol/L, is it defined as hypercalcemia. Hypercalcemia is considered severe and a medical emergency if the level is above 15 to 16 mg/dL or 3.75 to 4 mmol/L, it can lead to coma and cardiac arrest. It can also cause the following symptoms:
- Osteoporosis.
- Kidney stones.
- Kidney failure.
- Nervous system problems.
- Abnormal heart rhythm (arrhythmia).

11.

What treatment should be given for a patient with severe cancer-induced hypercalcemia?

The bisphosphonates can be used to treat patients with cancer-induced hypercalcemia. IV hydration with isotonic saline describes the most immediate and significant intervention in the acute treatment of malignant hypercalcemia.

12.

What causes hypercalcemia of malignancy?

Hypercalcemia in malignancy is most commonly by the tumoral product of parathyroid hormone–related protein or cytokines stimulating osteoclast degeneration of bone.

13.

Can hypercalcemia be a sign of cancer?

Hypercalcemia can occur in cancer and another etiology for hypercalcemia, such as granulomatous diseases and primary hyperparathyroidism.

14.

How do you fix hypercalcemia?

Eating various grains and legumes will help stop your body from ingesting too much calcium from the phytic acid in these foods. Beans and wheat germ will reduce calcium, so try adding a variety of these into your diet.
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Dr. C. Elanchezhian
Dr. C. Elanchezhian

General Medicine

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