Definition

Hypercalcemia is when there is too much calcium in the blood. Calcium is a mineral needed for healthy bones, muscles, and nerves.

If left untreated, this condition can lead to kidney stones and other problems.

Causes

Hypercalcemia is caused by problems in how the body absorbs, balances, or keeps calcium.

Many conditions interfere with calcium balance. They cause extra calcium to be released into the blood. The most common cause of high calcium in the blood is an overactive parathyroid gland.

Low body fluids can cause short term high calcium levels.

Risk Factors

Things that raise the risk of hypercalcemia are:

• Parathyroid problems
• Certain cancers
• Too much calcium in the diet
• Excess vitamin D and/or vitamin A
• Certain medicines—such as lithium, diuretics, and antacids with calcium
• Certain inherited conditions
• Kidney disease or failure
• Certain endocrine diseases such as hyperthyroidism

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Symptoms

Symptoms of hypercalcemia may be:

• Bone pain
• Nausea and vomiting
• Loss of hunger and weight
• Problems passing stool (poop)
• Belly pain
• Problems with thinking or mood
• Tiredness and/or weakness
• Slow growth in children

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done.

Tests will be done to diagnose the condition and look for causes. They include:

• Blood tests
• Urine tests

If calcium levels are due to cancer or parathyroid problems, imaging may be done with:

• X-ray
• Ultrasound
• CT scan
• MRI scan

Other tests may be done to check the effects of high calcium. Tests may be:

• An ECG—to check electrical activity of the heart
• A bone mineral density test—to measure the amount of calcium in the bone

Treatment

The goal is to bring calcium levels back to normal. Underlying causes also need to be treated. Treatment depends on the cause and severity of hypercalcemia. If the condition is severe, hospital care is needed.

Treatment may include drinking more fluids. For severe symptoms, IV fluids are needed.

If medicines are causing a problem, they may need to be stopped or changed.

Medicines may be given to control the condition causing the problem. They may also be given to remove calcium from the blood. Options may be:

• Bisphosphonates
• Calcitonin
• Diuretics
• Glucocorticoids
• Denosumab

Other treatments depend on the cause of hypercalcemia. They may include:

• Limiting calcium and vitamin D
• Parathyroid surgery—for those with an overactive parathyroid gland
• Dialysis —for severe cases of hypercalcemia due to kidney failure

The outcome of treatment depends on the underlying cause.

Prevention

The risk of hypercalcemia may be reduced by:

• Treating underlying causes
• Using bisphosphonates—when cancer is in the bones