Hypercalcemia

Overview

Hypercalcemia is a medical condition where the calcium level in your blood is above normal. The excess calcium can affect various parts of your body, such as your bones, muscles, kidneys, digestive system, brain, and heart. The most common cause of hypercalcemia is overactive parathyroid glands, which can lead to the weakening of bones, kidney stones, and abnormalities in the functioning of the kidneys, digestive system, brain, and heart. Other causes include cancer, certain medical disorders, medications, and excessive calcium and vitamin D supplements. If you experience symptoms like extreme thirst, frequent urination, abdominal pain, confusion, depression, or palpitations, you should consult your doctor.

Understanding the disease

Symptoms

The symptoms of hypercalcemia can range from mild to severe, depending on the severity of the condition. Mild cases may not have any noticeable symptoms, while more severe cases can cause a variety of symptoms. The symptoms can affect different parts of the body, including the kidneys, digestive system, bones and muscles, brain, and heart. Some of the common symptoms of hypercalcemia include excessive thirst, frequent urination, abdominal pain, stomach upset, nausea, vomiting, constipation, bone pain, muscle weakness, confusion, lethargy, fatigue, and depression. If you experience any of these symptoms, it is essential to contact your doctor for proper evaluation and treatment.

Risk Factors

The risk factors for developing hypercalcemia include:

1. Overactive parathyroid glands: The most common cause of hypercalcemia is an overactive condition called hyperparathyroidism, which may result from a small, noncancerous (benign) tumor or enlargement of one or more of the four parathyroid glands.
2. Cancer: Certain types of cancer, such as lung cancer, breast cancer, and some blood cancers, can increase the risk of hypercalcemia. Cancer spreading to the bones (metastasis) can also contribute to the risk.
3. Other medical disorders: Certain diseases like tuberculosis and sarcoidosis can raise blood levels of vitamin D, which in turn increases calcium absorption in the digestive tract.
4. Medications: Certain medications, such as diuretics, lithium, and some antidepressants, may contribute to the development of hypercalcemia.
5. Excess calcium and vitamin D supplements: Taking high doses of calcium and vitamin D supplements can lead to hypercalcemia.
6. Immobility: Prolonged immobility due to conditions like bed rest or paralysis can cause bones to release calcium into the bloodstream.
7. Severe dehydration: Dehydration can cause mild or transient hypercalcemia. It is important to consult a doctor if you experience symptoms that may indicate hypercalcemia, such as extreme thirst, frequent urination, and abdominal pain.

Development

Hypercalcemia can develop due to a variety of causes, including:

1. Overactive parathyroid glands (hyperparathyroidism): This is the most common cause of hypercalcemia. It can be due to a small, noncancerous (benign) tumor or enlargement of one or more of the four parathyroid glands.
2. Kidney stones: If urine contains too much calcium, crystals might form in the kidneys, which can combine to create kidney stones.
3. Kidney failure: Severe hypercalcemia can damage the kidneys, limiting their ability to cleanse the blood and eliminate fluid.
4. Nervous system problems: Severe hypercalcemia can lead to confusion, dementia, and coma, which can be fatal.
5. Abnormal heart rhythm (arrhythmia): Hypercalcemia can affect the electrical impulses that regulate heartbeat, causing an irregular heartbeat.
6. Cancer: Certain types of cancer, such as lung cancer and breast cancer, as well as some blood cancers, can increase the risk of hypercalcemia. The spread of cancer (metastasis) to bones can also contribute to hypercalcemia.
7. Other diseases: Certain diseases, such as tuberculosis and sarcoidosis, can raise blood levels of vitamin D, which stimulates the digestive tract to absorb more calcium.
8. Hereditary factors: A rare genetic disorder called familial hypocalciuric hypercalcemia causes an increase in calcium in the blood due to faulty calcium receptors in the body. This condition typically doesn't cause symptoms or complications of hypercalcemia.
9. Immobility: People with conditions that keep them from moving around much can develop hypercalcemia over time, as bones that don't bear weight release calcium into the blood.
10. Severe dehydration: Mild or transient hypercalcemia can sometimes be caused by dehydration, as having less fluid in the blood leads to an increase in calcium concentrations. It is important to consult a doctor if you develop signs and symptoms of hypercalcemia, such

Assessment and Diagnosis

Triage

You should see a doctor if you develop signs and symptoms that might indicate hypercalcemia, such as being extremely thirsty, urinating frequently, and having abdominal pain.

Diagnosis

To diagnose hypercalcemia, blood tests are conducted to measure the level of blood calcium. These tests can also reveal whether there is an increased level of parathyroid hormone, indicating hyperparathyroidism. In some cases, imaging tests such as X-rays, CT scans, or MRIs may be recommended to determine if hypercalcemia is caused by an underlying disease like cancer or sarcoidosis.

Management and Treatment

Complications

Hypercalcemia can lead to several complications in different parts of the body, including the kidneys, nervous system, heart, and bones. Some potential complications of hypercalcemia are:

1. Kidney stones: High levels of calcium in the blood can lead to the formation of kidney stones.
2. Kidney failure: Hypercalcemia can damage the kidneys, limiting their ability to cleanse the blood and eliminate fluid.
3. Nervous system problems: Severe hypercalcemia can result in confusion, dementia, and even coma, which can be fatal.
4. Abnormal heart rhythm (arrhythmia): Hypercalcemia can affect the electrical impulses that regulate heartbeat, causing irregular heartbeats.
5. Bones and muscles: The excess calcium in the blood can cause the bones to weaken, leading to bone pain and muscle weakness.
6. Heart problems: In rare cases, severe hypercalcemia can interfere with heart function, causing palpitations, fainting, and other cardiac arrhythmia issues. It is essential to consult a doctor if you develop signs and symptoms of hypercalcemia, such as extreme thirst, frequent urination, and abdominal pain.

Home Remedies

It is important to consult with a healthcare professional for proper diagnosis and treatment of hypercalcemia.

Treatment

Treatment for hypercalcemia depends on the underlying cause. Some general approaches to managing hypercalcemia include:

1. Rehydration: If hypercalcemia is caused by dehydration, rehydration through increased fluid intake can help lower calcium levels.
2. Medications: Doctors may prescribe medications to reduce the activity of the parathyroid glands or to help the kidneys excrete excess calcium.
3. Surgery: For cases caused by an overactive parathyroid gland or tumor, surgery may be necessary to remove the affected gland or glands.
4. Treatment of underlying conditions: If hypercalcemia is due to another medical condition, treating that condition can help resolve the hypercalcemia.
5. Lifestyle changes: Making dietary and lifestyle adjustments, such as eating a balanced diet, getting regular exercise, avoiding alcohol and smoking, and managing stress, can help improve overall health and potentially lower calcium levels. It is essential to consult with a healthcare professional for an accurate diagnosis and personalized treatment plan.

Preparing for medical consultation

To prepare for an appointment for hypercalcemia, you should:

1. Make a list of your symptoms, including those that seem unrelated and when they began.
2. Gather key personal information, such as major stresses, recent life changes, medical history, and family medical history.
3. Create a list of all medications, vitamins, and supplements you take, including doses.
4. Bring a family member or friend along to help remember information discussed during the appointment.
5. Prepare a list of questions to ask your doctor, such as the most likely cause of your symptoms, recommended tests, and available treatments with potential side effects. Remember to ask your doctor if there are any pre-appointment restrictions, like limiting certain foods or drinks, and follow any instructions provided.