Definition

Calcium is a mineral needed for bone health, muscle movement, and nerve function. Hypercalcemia is higher than normal levels of calcium in your blood.

Short-term or acute high levels of calcium can cause muscle twitching or weakness. Long-term high levels of calcium can lead to kidney stones, bone problems, and may intefere with mental abilities.

Causes

Vitamin D helps to absorb calcium from food or supplements. Once in your body, calcium may be stored in the bones or exist in the blood and cells. Levels of calcium in the blood are normally regulated by hormones from the parathyroid gland. Calcium is excreted through the kidneys.

Hypercalcemia may occur if an illness, such as cancer, or medication interferes with this process or destroys bone and other tissue releasing extra calcium into the blood. The most common causes of hypercalcemia are medications or an overactive parathyroid gland.

Dehydration can also cause temporary hypercalcemia. Decreased fluid in the blood causes an increase in concentration, but not amount of calcium.

Risk Factors

Factors that may interfere with hormones and lead to hypercalcemia:

• Parathyroid problems
• Certain disorders such as adrenal insufficiency and acromegaly
• Certain medications such as lithium

Factors that may increase the amount of calcium in the body or blood include:

• Excess vitamin D and/or vitamin A supplements—increases absorption of calcium and release of calcium from the bones into the blood
• Certain medications, including diuretics that reduce the amount of calcium eliminated and calcium-containing antacids
• Certain diseases associated with inflammation such as sarcoidosis, berylliosis, or tuberculosis
• Certain cancers such as Hodgkin lymphoma

Other factors that may increase the chances of hypercalcemia:

• Cancer treatment—causes release of calcium from damaged cells or bones
• Genetic disorders
• Phosphate deficiency in newborns
• Kidney disease or failure —inability to get rid of calcium

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Symptoms

Symptoms may include:

• Bone pain
• Muscle weakness
• Constipation
• Nausea and vomiting
• Irregular heartbeat
• Fatigue
• Appetite loss and weight loss
• Abdominal pain
• Difficulty concentrating and memory problems
• Itching
• Depression

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

Your bodily fluids will be tested. This can be done with:

• Blood tests
• Urine tests

If hypercalcemia is associated with a parathyroid problem or cancer your doctor may need imaging tests with:

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

Other tests may be done to look for any effects of hypercalcemia such as:

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

Treatment

Treatment will depend on the cause of hypercalcemia. Talk with your doctor about the best treatment plan for you. Options include:

Prevention

To help reduce the chances of hypercalcemia, your doctor may:

• Treat any underlying causes, such as hyperparathyroidism
• Use bisphosphonates when there is cancer in the bones