Hypercalcemia is a condition that occurs when there is an abnormally high concentration of calcium in your bloodstream. The excess calcium can affect the functioning of your kidneys, intestines, bones and heart. Symptoms can be subtle and can include stomach upset, diarrhea and nausea. In severe cases, they can lead to confusion and a lack of energy.
Symptoms depend on the severity and rate of change in the serum calcium level. Chronic elevations of serum calcium 12 to 14 mg/dL may not cause any symptoms, while a sudden rise in this concentration to more than 14 mg/dL can lead to a host of serious problems.
Primary hyperparathyroidism is the most common cause of hypercalcemia, but there are also other conditions that can cause it. It occurs when one or more parathyroid glands release too much of the hormone parathyroid hormone (PTH) that controls calcium levels in your body. This hormone is secreted by the four small parathyroid glands behind your thyroid gland in your neck.
Some of the most common causes of hypercalcemia are:
Getting too much calcium in your diet or taking too many medications that contain calcium can also cause it. Vitamin D deficiencies can also increase your risk of hypercalcemia. If you have any of these health conditions, your doctor will help you manage them.
Drinking plenty of water can also help lower your calcium levels, and quitting smoking can decrease the amount of calcium that gets into your bloodstream. Exercising can also strengthen your bones, making it less likely that you will develop hypercalcemia in the future.
Your doctor might suggest you take drugs called calcimimetics to reduce the amount of PTH that your body makes. They also might give you medicine to help your kidneys get rid of calcium faster.
If you have a noncancerous growth on your parathyroid glands, your doctor might recommend surgery to remove the gland. They can also treat overactive parathyroid glands with medicine to reduce the amount of PTH that they make.
In rare cases, your doctor might suggest that you take a drug called diuretics to increase the amount of fluids in your body. This can help you avoid dehydration, which can cause the other symptoms of hypercalcemia.
The other most common cause of hypercalcemia is the spread of cancer to your bones, which can lower your bone density and make it more likely that you will develop hypercalcemia. If you have a cancer or are receiving treatment for it, your doctor will also check your calcium levels and run tests on your kidneys regularly.
Other causes of hypercalcemia are hereditary factors, milk-alkali syndrome and other health conditions. Patients who have a hereditary disease like idiopathic infantile hypercalcemia, for example, can develop this disorder at an early age and show signs of skeletal dysmorphism and heart problems later in life.
Patients who have lung diseases like sarcoidosis or tuberculosis can also have hypercalcemia because of increased activity of the extra-renal 1-alpha hydroxylase enzyme. They must manage their intake of calcium and vitamin D to prevent this from happening.