Hypercalcemia: Causes, Symptoms, Diagnosis, and Treatment

What is Hypercalcemia? 

Hypercalcemia occurs when calcium levels in our body become abnormally high. Calcium plays a vital role in maintaining good bone and teeth health. It aids in various other body processes, such as keeping the heart in rhythm and regulating nerve function. The right amount of calcium is also required for blood clotting and maintaining body weight control.

However, higher levels of calcium may affect health badly. Hypercalcemia symptoms are present in various parts of the human body. Severe cases of hypercalcemia may lead to coma, dementia, and many more.

Stay tuned to know more about this health condition.

What are the Causes of Hypercalcemia? 

In most cases, hypercalcemia is a result of overactive parathyroid glands. Several other reasons starting from medication to dehydration, also cause this condition.

1. Hyperparathyroidism- Overactive Parathyroid Glands 

Parathyroid glands consist of four small glands behind the neck's thyroid gland. These glands release the parathyroid hormone, which controls the calcium level in the blood. In hyperparathyroidism, parathyroid glands release extra hormones and signal the body to make more calcium available. Thus, more calcium enters the blood, which creates an imbalance.

This phenomenon is a familiar hypercalcemia cause seen mostly in women after age 50.

2. Certain Cancers 

Hypercalcemia is associated with 2% of cancer cases. [1] These are a few cancer types  the state. 

• Lung Cancer 
• Breast Cancer 
• Lymphoma- which affects the lymphatic system
• Blood Cancer 

3. Certain Diseases  

Diseases like tuberculosis and sarcoidosis can also cause hypercalcemia. These diseases cause a rise in vitamin D, which stimulates the digestive tract to absorb more calcium, elevating the chances of hypercalcemia.

4. Immobility 

People with less physical activity who spend most of their time sitting and lying also risk developing hypercalcemia. With long periods of immobility, bones reduce weight-bearing capacity, resulting in a higher calcium release level into the blood. 

5. Side effects of Medication 

Medicines such as lithium used to treat bipolar disorder may cause extra parathyroid hormone to be released. [2] Other medications, such as diuretics, also enhance the possibility of hypercalcemia.

6. Dehydration 

Dehydration is common among people of all age groups, and sometimes it may lead to mild or transient hypercalcemia. This is because the low amount of fluid in the blood raises calcium concentration. People with chronic kidney disease may also have dehydration problems due to restrictions on water consumption.

7. Dietary Supplements 

The overconsumption of calcium and vitamin D supplement increase calcium levels above normal in the blood. In addition, high doses of over-the-counter medications are another cause of hypercalcemia.

What are the Symptoms of Hypercalcemia? 

In the early stages, hypercalcemia symptoms may not be visible. However, in severe cases, these symptoms appear in various parts of the body: 

• Kidney disorder: Due to excess calcium, kidneys have to work harder to filter it. As a result, it causes excessive thirst, frequent urination, and pain between the back and upper abdomen
• Abdominal pain: The hypercalcemia symptoms in the abdomen include nausea, vomiting, stomach upset, pain in the abdominal area, and low appetite
• Brain symptoms: Hypercalcemia may affect brain functioning, causing depression, confusion, and fatigue
• Muscles and bone symptoms: The excess calcium discharge from bones results in bone pain, bone fracture, muscle cramps, and weakness
• Heart symptoms: In rare cases, hypercalcemia influences heart functioning and results in an improper heartbeat

How to Diagnose Hypercalcemia? 

In the cases of hyperparathyroidism, symptoms are mild, and this condition is usually diagnosable through a blood test. Another test, such as the urine test, is also run to check calcium, protein, and other nutrient levels. Often doctors suggest more than one test to be sure of the situation.

Following are the test conducted to check hypercalcemia: 

• Blood and Urine tests are used to detect Hyperparathyroidism. Patients with this disorder will have a higher level of calcium, parathyroid hormone, and vitamin D in their blood reports. The blood test will also reveal the functioning of the kidney
• A calcium blood test includes routine blood work, a basic metabolic panel (BMP), or a comprehensive metabolic panel (CMP)
• Chest X-rays help to diagnose lung cancer, another reason for hypercalcemia
• The bone density test is done to monitor or check for bone loss
• Mammograms to check for breast cancer
• A 24- hour urine collection test to know the calcium level and presence of other toxic substances. It helps to find the reason for hyperparathyroidism
• MRI scans help to get a broader picture of internal organs, including the brain, heart, and digestive system
• The bone marrow biopsy is used to determine cancer and other diseases

Treatment for Hypercalcemia

The hypercalcemia treatment aims to lower the concentration of calcium. The treatment depends on the seriousness of the condition.

At an early stage, treatment includes: 

• Keep rehydrating by drinking more water
• Lower the intake of calcium supplements 
• Lower the dose of calcium-rich antacid tablets

In mild cases, the doctor does not give immediate treatment. However, it is essential to monitor the speed of the hike in calcium levels because elevated levels can cause severe kidney damage.

In secondary and Severe Cases

In severe and moderate cases, it is essential to seek hospital treatment. The treatment aims to lower calcium levels and prevent this health condition from affecting other body parts, mainly bones, and kidneys. 

• Intravenous therapy, where fluid formed from specialized liquids is injected into the vein to treat dehydration, may lower the calcium level
• Loop diuretic medications help with kidney filtration. It removes the excess calcium and aids heart failure patients
• Intravenous bisphosphonates help to lower calcium levels in the blood by managing bone calcium
• In patients with damaged kidneys, dialysis can filtrate blood with extra calcium, and this method helps when another option is not working
• Calcitonin treatment treats bone loss and regulates calcium levels in the blood

Hyperparathyroidism 

The health care provider may recommend surgery if parathyroid glands produce excess parathyroid hormone. It cures most cases of hypercalcemia caused due to hyperparathyroidism.

There are also chances of a doctor recommending medication called cinacalcet (Sensipar) to lower calcium levels by decreasing parathyroid hormone production.

Cancer 

In case hypercalcemia is caused due to cancer, a doctor may suggest various medications; here are a few:

• Bisphosphonate, such as pamidronate and zoledronic acid, prevents the loss of bone density
• Denosumab is a bone-strengthening drug for those cancer-associated hypercalcemia patients. It is suggested to those who do not respond to Bisphosphonate
• As per research, cinacalcet helps in the treatment of hypercalcemia due to other cancers as well

Do Children Suffer from Hypercalcemia?

Hypercalcemia is a rare occurrence in children. The symptoms of this condition depend on the duration, degree, and age of the child. In severe cases, children may experience weakness, nausea, lower weight, and loss of appetite. If the symptoms are frequent, it is good to consult a pediatrician.

Complications Associated with Hypercalcemia

Proper check-ups and treatment can avoid the long-term complication of hypercalcemia. However, kidney problems such as kidney failure, kidney stones, depression, hypertension, nephrocalcinosis, bone fracture, and osteoporosis can happen.

A Positive Outlook 

The positive side for those suffering from hypercalcemia is that it is curable, and symptoms will disappear once calcium levels return to normal. However, in cases of cancer associated with hypercalcemia, regular check-up, and frequent doctor consultation is necessary.

As an effort from your end, you can choose to have a healthy lifestyle, drink plenty of water, have a good diet, and do physical exercise. Take the doctor's confirmation before proceeding with physical exercises. Try to avoid unhealthy practices such as smoking and alcohol.

If you are still looking for the right expert advice, start with Bajaj Finserv Health. In addition, you can talk to professional health experts from your home via video conferencing.

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