About Hypercalcemia
Hypercalcemia is when there is too much calcium in the blood. It’s diagnosed when total calcium levels are above 11 mg/dL or the active form of calcium (ionized calcium) is over 5.4 mg/dL. If a protein called albumin is low (a condition called hypoalbuminemia), calcium levels need adjusting for accuracy.
The condition is most often caused by an overactive parathyroid gland (hyperparathyroidism) or cancer. Symptoms can include feeling tired, stomach pain, loss of appetite, nausea, constipation, frequent urination, intense thirst, bone pain, and kidney stones. If untreated, it can lead to severe problems like nerve damage and kidney failure. The parathyroid gland, bones, intestines, and kidneys all work together to keep calcium levels balanced.
Hypercalcemia is a condition characterized by high levels of calcium in the blood. The pathophysiologic causes of hypercalcemia include:
- Hyperparathyroidism: Overactivity of the parathyroid glands, which regulate calcium levels in the body, can lead to increased calcium levels.
- Malignancy: Certain cancers, such as breast, lung, and kidney cancer, can cause hypercalcemia by releasing substances that increase calcium levels.
- Medications: Some medications, like thiazide diuretics and lithium, can disrupt calcium balance and contribute to hypercalcemia.
- Vitamin D disorders: Excessive intake or production of vitamin D can result in increased calcium absorption from the intestines and lead to hypercalcemia.
Non-modifiable risk factors for hypercalcemia are factors that cannot be changed. These include:
- Age: Older adults are more prone to developing hypercalcemia.
- Gender: Women have a higher risk compared to men.
- Genetic factors: Certain inherited conditions, like familial hypocalciuric hypercalcemia, can increase the risk.
Modifiable risk factors for hypercalcemia are factors that can be influenced or changed. These may include:
- Dietary factors: Consuming excessive amounts of calcium or vitamin D supplements can contribute to elevated calcium levels.
- Immobility: Lack of physical activity or prolonged bed rest can affect calcium metabolism and increase the risk.
- Dehydration: Inadequate fluid intake can lead to concentrated blood calcium levels.
It's important to note that these risk factors may vary from person to person, and individual circumstances should be considered. Always consult with a healthcare professional for personalized advice.
The most common early symptoms of hypercalcemia can be vague and may include:
- Fatigue
- Muscle aches,
- Loss of appetite
- Nausea
- Vomiting
- Excessive thirst
- Frequent urination
- Abdominal pain
- Constipation
- Muscle weakness
However, in the later stages or with higher severity of hypercalcemia, additional symptoms may occur. These can include:
- Confusion
- Kidney stones
- Bone fractures
- Kidney failure
- Hypertension
- Arrhythmia
- Coronary artery disease
- Enlarged heart
- Atherosclerosis (hardening of the arteries)
It's important to note that some people with hypercalcemia may not experience any symptoms at all. If you are experiencing any of these symptoms or have concerns about hypercalcemia, it is recommended to speak with a healthcare professional for further evaluation and guidance.
To diagnose hypercalcemia, doctors commonly perform the following examinations, tests, and procedures:
- Blood test: This test measures the levels of calcium and parathyroid hormone in the blood. Abnormal levels can indicate hypercalcemia.
- Electrocardiogram (EKG): This records the electrical activity of the heart and helps evaluate any cardiac complications associated with hypercalcemia.
- Chest X-ray: This imaging test checks for lung cancer or infections that may be causing hypercalcemia.
- Mammogram: This test is performed in women to check for breast cancer as a potential cause of hypercalcemia.
- CT or MRI scan: These imaging tests examine the structure and organs of the body to identify any underlying conditions causing hypercalcemia.
- Dual-energy X-ray absorptiometry (DEXA) scan: This measures bone density and helps assess the impact of hypercalcemia on bone health.
To determine the stage or severity of hypercalcemia, additional examinations, tests, and procedures may include:
- Further blood tests: These may include measuring kidney function, vitamin D levels, and other electrolyte levels to assess the impact of hypercalcemia on various body systems.
- Urine tests: These help evaluate calcium excretion in the urine and determine if there is an underlying kidney disorder contributing to hypercalcemia.
- Bone biopsy: In rare cases, a small sample of bone tissue may be taken for examination to evaluate bone health and identify any abnormalities.
Remember, these examinations, tests, and procedures should be conducted by a healthcare professional based on individual symptoms and medical history.
The goals of treatment for Hypercalcemia are to normalize blood calcium levels, relieve symptoms, and address the underlying cause. Here are the various treatment options and how they work:
Medications:
- Bisphosphonates: These drugs reduce bone reabsorption and help pull excess calcium from the bloodstream into the bones.
- Calcitonin: It reduces blood calcium levels by inhibiting bone breakdown and increasing calcium excretion in the kidneys.
- Steroids: Used for hypercalcemia caused by excessive vitamin D, steroids decrease intestinal absorption of calcium.
- Medication withdrawal: Discontinuing medications or supplements that contribute to hypercalcemia can help resolve the condition.
Therapeutic procedures:
- Dialysis: In cases of severe hypercalcemia and kidney failure, dialysis can be used to filter excess calcium and restore mineral balance.
- Parathyroid gland removal: For hyperparathyroidism, surgical removal of the parathyroid gland may be necessary.
Health behavior changes:
- Saline infusion: Increasing urination through saline infusion helps flush out excess calcium.
- Hydration: Drinking plenty of fluids can promote urine production and calcium elimination.
It's important to note that treatment options depend on the underlying cause, severity of symptoms, and individual factors. Consult with your healthcare professional for personalized advice.
Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Other side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.