What you should know about hypercalcemia or high blood calcium

The mineral calcium is well-known for building and maintaining strong bones and teeth.  Lesser known functions of the most abundant mineral in the body is to support contraction of the muscles, release neurotransmitter, regulation of your heartbeat, and normal clotting of the blood.

Even though calcium is a vital nutrient we need, is it possible to have too much?  The answer is “yes” and this condition is called hypercalcemia.

What is hypercalcemia?

On the one hand, many individuals do not take in adequate calcium in their diet, making them susceptible to developing the brittle bone disease of osteoporosis. But on the other hand, having high blood calcium levels can be harmful.

When calcium levels in your blood are above the normal range this is known as hypercalcemia. Causes of hypercalcemia can range from not drinking enough water each day to taking high dosages of supplements to having an abnormally functioning parathyroid gland. If you were to high mildly elevated calcium in your blood, you probably would not know it. But very high-calcium levels can result in abdominal pain, kidney stones, excessive thirst, bone pain, muscle weakness, and confusion.

Possible symptoms of hypercalcemia

Again, anyone with mildly elevated hypercalcemia likely will not know it.  Usually the way it is even found is accidentally when you go in for a routine checkup or a routine blood test.

The way to detect if you had hypercalcemia is with a simple blood test. Having symptoms of hypercalcemia are not common but they could include the following:

·      Frequent urination and thirst

·      Fatigue and bone pain

·      Abdominal pain and confusion

·      Forgetfulness and confusion

·      Lethargy and depression

·      Muscle aches

What can cause hypercalcemia?

There are several things that can cause hypercalcemia including several diseases, medications and even dehydration. Here are some possible causes of it:

·      Primary hyperparathyroidism – This is the most common cause of high blood calcium levels. People with primary hyperparathyroidism usually have a benign tumor of the parathyroid glands causing excessive amounts of calcium to leave the bone and enter into the blood.

·      Malignancy  or cancer – This is the second most common cause of high blood calcium levels and has nothing to do with the parathyroid glands. Types of cancer that cause hypercalcemia of malignancy include cancers of the lung breast, esophagus, mouth, tongue, lip, kidney ovary, uterus, and cervix. Blood-borne cancers such as lymphoma and multiple myeloma can also cause high calcium levels.

·      Thiazide diuretics – Thiazide diuretics are a class of medicines that are commonly used to treat hypertension. They cause the kidney to “hold on” to calcium preventing it from exiting in the urine and thereby increasing the blood calcium level slightly.  Examples of thiazide diuretics are hydrochlorothiazide, chlorothiazide, chlorothalidone, indapamide, and metolazone.

·      Kidney disease – This is also known as renal failure or chronic renal failure. High blood calcum levels can be found in people with slow or reduced kidney function, including those on dialysis and those who have had a kidney transplant.

·      Overuse of calcium supplements – Taking too much calcium in the form of calcium supplements or calcium-based antacid tablets is another cause of hypercalcemia. Taking an occasional calcium-rich antacid tablet is not harmful but if taking more than one or two per week, could be a sign of a digestive disorder needed to be addressed.

What are possible harms from having hypercalcemia?

There are several ways in which hypercalcemia can cause harm which include the following:

·      Heart – High calcium can affect the electrical system of the heart causing abnormal heart rhythms.

·      Muscles – Calcium levels that are elevated can affect your muscles causing twitches, cramps, and weakness.

·      Skeletal system – High calcium levels can affect bones leading to bone pain, osteoporosis, and fractures from disease.

·      Neurological symptoms – Hypercalcemia can also cause neurological symptoms such as depression, memory loss, and irritability.  Severe cases can cause confusion and coma.

How is hypercalcemia treated?

If your hypercalcemia is mild, your doctor may choose to watch and wait, monitoring your bones and kidneys over time to be sure they are healthy. In some cases, your doctor may recommend certain medications that can control calcium levels in the blood.  These might include the following:

·      Calcitonin – This hormone from salmon controls calcium levels in the blood.

·      Calcimimetics – this type of drug can control overactive parathyroid glands.

·      Bisphosphonates – These are intravenous osteoporosis drugs which can quickly lower calcium levels. They are often used to treat hypercalcemia due to cancer. 

·      Denosumab – This drug is often used to treat people with cancer-caused hypercalcemia who don’t respond well to bisphosphonates.

·      Prednisone – If your hypercalcemia is caused by high levels of vitamin D, short-term use of steroid pills such as prednisone are usually helpful.

·      IV fluids and diuretics – Extremely high calcium levels can be a medical emergency.  You may need hospitalization for treatment with IV fluids and diuretics to promptly lower the calcium level to prevent heart rhythm problems or damage to the nervous system.

Sometimes if the hypercalcemia is due to overactive parathyroid glands, this can often be cured by removing the tissue that’s causing the problem.  In many cases, only one of a person’s four parathyroid glands is affected. A special scanning test uses an injection of a small dose of radioactive material to pinpoint the gland or glands that are not working properly.