What is hypercalcemia?
Hypercalcemia means that the level of calcium in your blood is higher than normal. Hypercalcemia can be mild or severe and temporary or chronic (lifelong).

What is Calcium?
Calcium is one of the most important and common minerals in your body. Most of your body’s calcium is stored in your bones, but you also need calcium in your blood. Calcium present in your blood helps you in the following ways:-

1. Your nerves work.
2. Helps your muscles move together so you can move.
3. If you are bleeding, it helps in forming a blood clot, so that the bleeding can be stopped.
4. Your heart works properly.

Parathyroid hormone and calcitonin hormone, these two hormones control calcium levels in your blood and bones. Vitamin D also plays an important role in maintaining calcium levels because your body needs it to absorb calcium from the food you eat.

Your body normally carefully regulates the level of calcium in your blood, but certain medications and conditions can result in high blood calcium levels (hypercalcemia).

What is the difference between hypocalcemia and hypercalcemia? What is the difference between hypocalcemia and hypercalcemia?
Hypercalcemia and hypocalcemia are medical conditions that both have to do with the amount of calcium in your blood – the difference is how much.

In the medical world, the prefix “hyper-” means “high” or “very high.” Hypercalcemia means you have more calcium in your blood than normal.

The prefix “hypo-” means “less” or “not enough.” Hypocalcemia means that the calcium level in your blood is lower than normal.

Who does hypercalcemia affect?

Hypercalcemia can affect anyone at any age, but it is most common in people who have given birth over the age of 50 (post menopause). In most cases, it is caused by an overactive parathyroid gland.

How common is hypercalcemia?

Hypercalcemia affects approximately 1% to 2% of the general population. Most cases – about 90% – are caused by primary hyperparathyroidism and cancer related hypercalcemia (hypercalcemia of malignancy).

Is hypercalcemia life threatening? 

Most cases of hypercalcemia are not life-threatening and many people have no symptoms. Healthcare providers often catch it early with routine blood tests. But severe hypercalcemia can cause more serious problems, including:

1. Kidney failure.
2. Abnormal heart rhythm (arrhythmia).
3. confusion.
4. Deep unconsciousness (Coma).

If the above conditions occur, talk to a doctor as soon as possible and start appropriate treatment.

What are the symptoms of hypercalcemia?

Because healthcare providers often detect hypercalcemia in its early stages, most people do not have symptoms.

In more severe and/or chronic cases of hypercalcemia the following symptoms may occur:

1. More frequent urination.
2. Feeling very thirsty.
3. Tiredness.
4. Bone pain.
5. Headache.
6. Nausea and vomiting.
7. Constipation.
8. Loss of appetite.
9. Alzheimer’s Disease.
10. Depression.
11. Irritability.

Muscle pain, weakness, cramps and/or twitching.

What causes hypercalcemia?

More than 25 different diseases, many medications, and even dehydration can cause hypercalcemia. Primary hyperparathyroidism and various types of cancer account for the largest percentage of all people with hypercalcemia. Mentioned below are some of the reasons that cause hypercalcemia: –

Primary hyperparathyroidism and hypercalcemia

In primary hyperparathyroidism, one or more of your four parathyroid glands overproduce parathyroid hormone, the hormone responsible for controlling blood calcium levels.

Your parathyroid glands are located behind your thyroid gland in your neck. Normally, they work with your kidneys, bones, and intestines to carefully control blood calcium levels. But sometimes the parathyroid gland becomes overactive, resulting in the release of excess parathyroid hormone and increased calcium levels in the blood.

Cancer that can cause hypercalcemia

About 2% of all cancers are associated with hypercalcemia, and cases of cancer-related hypercalcemia (also called hypercalcemia of malignancy) often have a rapid onset and are severe. Following are some types of cancer which can cause hypercalcemia:-

1. Lung cancer.
2. Breast Cancer.
3. Multiple myeloma: This cancer is formed in a type of white blood cell.
4. Renal cell carcinoma is a type of kidney cancer.
5. Some cancers of the blood such as leukemia.
6. Lymphoma: This is cancer of the lymphatic system.
7. Rhabdomyosarcoma: This is a type of muscle cell cancer.

Medications that can cause hypercalcemia

Common drugs and supplements that can cause hypercalcemia include:

Hydrochlorothiazide and other thiazide diuretic drugs are prescribed for high blood pressure and edema.

Lithium.

Excessive intake of vitamin D, vitamin A or calcium supplements.

Other causes of hypercalcemia

Other less common causes of hypercalcemia include:

1. Lung diseases such as sarcoidosis and tuberculosis.
2. Kidney failure.
3. Thyrotoxicosis.
4. Lying/immobile in bed for a long time.
5. Paget’s disease of bone.

How is hypercalcemia diagnosed? How is hypercalcemia diagnosed?

Hypercalcemia is a fairly common finding on routine blood tests such as a comprehensive metabolic panel (CMP) or basic metabolic panel (BMP), which includes a calcium blood test. These tests help healthcare providers detect abnormally high calcium levels early.

The following blood calcium levels indicate different levels of diagnosis and severity of hypercalcemia:

1. Mild hypercalcemia: 10.5 to 11.9 mg/dL.
2. Moderate hypercalcemia: 12.0 to 13.9 mg/dL.
3. Hypercalcemic crisis (a medical emergency): 14.0 to 16.0 mg/dL.

If you have symptoms of hypercalcemia or are at risk for developing hypercalcemia because of having a certain type of cancer, your doctor will order various blood tests to determine if you have hypercalcemia. If you have elevated calcium levels in your blood, your doctor will review your medications and medical history and conduct a physical examination.

If there is no obvious cause for your hypercalcemia, your doctor may ask you to see an endocrinologist, a provider who specializes in hormone-related conditions, who will provide further evaluation and testing.

What tests will be done to diagnose hypercalcemia? What tests will be done to diagnose hypercalcemia?

Your healthcare provider may order any of the following tests to help diagnose hypercalcemia and its cause:

1. Calcium blood test.
2. Parathyroid hormone (PTH) blood test.
3. PTH-related protein (PTHRP) blood test.
4. Vitamin D blood test.
5. Calcium urine test.

If your provider suspects that primary hyperparathyroidism is causing hypercalcemia, they will recommend an imaging test to see if there are any growths on your parathyroid gland(s) or if they are enlarged. Various imaging tests for this purpose include:

1. Ultrasound test.
2. Nuclear medicine imaging, especially a parathyroid scan.
3. CT scan.

How is hypercalcemia treated? How is hypercalcemia treated?

Treatment of hypercalcemia depends on what is causing it and how severe it is. In mild cases of hypercalcemia, your healthcare provider may tell you:

1. Drink more water.
2. Switch to a non-thiazide diuretic or blood pressure medication.
3. Stop taking or reduce your dose of antacid tablets containing calcium.
4. Stop taking or reduce your dosage of calcium supplements and calcium-containing supplements, such as multivitamins.

If hypercalcemia is due to an overactive parathyroid gland, your provider will recommend surgery to remove the overactive parathyroid gland. If hypercalcemia is due to cancer, your doctor will treat you differently.

How can I prevent hypercalcemia?

Not all cases of hypercalcemia can be prevented, but avoiding overdosage of calcium tablets and calcium-based antacid tablets may help.
If you have a family history of high calcium, kidney stones or a parathyroid condition, be sure to talk to your healthcare provider. Avoid taking dietary supplements, vitamins, or minerals without first discussing it with your provider.