Hypercalcemia
Calcium - elevated; High calcium level; Hyperparathyroidism - hypercalcemiaHypercalcemia means you have too much calcium in your blood.
Causes
Parathyroid hormone (PTH) and Vitamin D help manage calcium balance in the body.
- PTH is made by the parathyroid glands. These are four small glands located in the neck behind the thyroid gland.
- Vitamin D is obtained when the skin is exposed to sunlight, and from food sources or supplements.
Vitamin D
Vitamin D is a fat-soluble vitamin. Fat-soluble vitamins are stored in the body's fatty tissue and liver.
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The most common cause of high calcium blood level is excess PTH released by the parathyroid glands. This excess occurs due to:
- An enlargement of one or more of the parathyroid glands.
- A growth on one of the glands. Most of the time, these growths are benign (not a cancer).
Calcium blood level may also be high if your body is low on fluids or water.
Other conditions can also cause hypercalcemia:
- Certain kinds of cancers, such as lung and breast cancer, or cancer that has spread to your organs.
- Too much vitamin D in your blood (hypervitaminosis D).
- Being immobile in bed for many days or weeks (mostly in children).
- Too much calcium in your diet. This is called milk-alkali syndrome. It most often occurs when a person is taking more than 2000 milligrams of calcium bicarbonate supplements a day along with high doses of Vitamin D.
- Overactive thyroid gland.
Overactive thyroid gland
Hyperthyroidism is a condition in which the thyroid gland makes too much thyroid hormone. The condition is often called overactive thyroid.
Read Article Now Book Mark Article - Chronic kidney disease or kidney failure.
Chronic kidney disease or kidney failur
Acute kidney failure is the rapid (less than 2 days) loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your b...
Read Article Now Book Mark Article - Medicines such as thiazide diuretics (water pills) and lithium.
- Some infections or health problems such as, Paget disease, tuberculosis and sarcoidosis.
- An inherited condition that affects the body's ability to manage calcium.
Men and women of all ages can have a high blood calcium level. However, it is most common in women over age 50 (after menopause). In most cases, this is due to an overactive parathyroid gland.
Symptoms
The condition is most often diagnosed at an early stage using routine blood tests. Most people have no symptoms.
Symptoms due to high calcium level may vary, depending on the cause and how long the problem has been present. They may include:
- Digestive symptoms, such as nausea or vomiting, poor appetite, or constipation
- Increased thirst or more frequent urination, due to changes in the kidneys
- Muscle weakness or twitches
- Changes in how your brain works, such as feeling tired or fatigued or confused
- Bone pain and fragile bones that break more easily
Bone pain
Bone pain or tenderness is aching or other discomfort in one or more bones.
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Exams and Tests
An accurate diagnosis is needed when someone has hypercalcemia. People with kidney stones should have tests to evaluate for hypercalcemia.
- Serum calcium
Serum calcium
The calcium blood test measures the level of calcium in the blood. This article discusses the test to measure the total amount of calcium in your blo...
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Serum PTH
The PTH test measures the level of parathyroid hormone in the blood. PTH stands for parathyroid hormone. It is a protein hormone released by the par...
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- Serum vitamin D level
- Urine calcium
Urine calcium
This test measures the amount of calcium in the urine. All cells need calcium in order to work. Calcium helps build strong bones and teeth. It is ...
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Treatment
Treatment is aimed at the cause of hypercalcemia whenever possible. People with primary hyperparathyroidism (PHPT) may need surgery to remove the abnormal parathyroid gland. This will cure the hypercalcemia.
Severe hypercalcemia that causes symptoms and requires a hospital stay may be treated with the following:
- Fluids through a vein -- This is the most important therapy.
- Calcitonin.
- Dialysis, if kidney damage is involved.
- Diuretic medicine, such as furosemide.
- Drugs that stop bone breakdown and absorption by the body (bisphosphonates).
- Glucocorticoids (steroids).
Outlook (Prognosis)
How well you do depends on the cause of your high calcium level. The outlook is good for people with mild hyperparathyroidism or hypercalcemia that have a treatable cause. Most of the time, there are no complications.
People with hypercalcemia due to conditions such as cancer or sarcoidosis may not do well. This is most often because of the disease itself, rather than the high calcium level.
Possible Complications
GASTROINTESTINAL
- Pancreatitis
- Peptic ulcer disease
Peptic ulcer
A peptic ulcer is an open sore or raw area in the lining of the stomach or intestine. There are two types of peptic ulcers:Gastric ulcer -- occurs in...
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KIDNEY
- Calcium deposits in the kidney (nephrocalcinosis) that cause poor kidney function
Nephrocalcinosis
Nephrocalcinosis is a disorder in which there is too much calcium deposited in the kidneys. It is common in premature babies.
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Dehydration
Dehydration occurs when your body does not have as much water and fluids as it needs. Dehydration can be mild, moderate, or severe, based on how much...
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High blood pressure
Blood pressure is a measurement of the force exerted against the walls of your arteries as your heart pumps blood to your body. Hypertension is the ...
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- Kidney stones
Kidney stones
A kidney stone is a solid mass made up of tiny crystals. One or more stones can be in the kidney or ureter at the same time.
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PSYCHOLOGICAL
- Depression
- Difficulty concentrating or thinking
SKELETAL
- Bone cysts
- Fractures
Fractures
If more pressure is put on a bone than it can stand, it will split or break. A break of any size is called a fracture. If the broken bone punctures...
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Osteoporosis
Osteoporosis is a disease in which bones become fragile and more likely to break (fracture).
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These complications of long-term hypercalcemia are uncommon today in many countries.
When to Contact a Medical Professional
Contact your health care provider if you have:
- Family history of hypercalcemia
- Family history of hyperparathyroidism
- Symptoms of hypercalcemia
Prevention
Most causes of hypercalcemia cannot be prevented. Anyone with symptoms of hypercalcemia should have their blood calcium level checked.
Talk to your provider about the correct dose if you are taking calcium and vitamin D supplements.
References
Coleman RE, Brown J, Holen I. Bone metastases. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 56.
Reid LM, Kamani D, Randolf GW. Management of parathyroid disorders. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 123.
Thakker RV. The parathyroid glands, hypercalcemia, and hypocalcemia. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 227.
Endocrine glands - illustration
Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the rate of metabolism in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).
Endocrine glands
illustration
Endocrine glands - illustration
Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the rate of metabolism in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).
Endocrine glands
illustration
Review Date: 2/28/2024
Reviewed By: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.