Hypercalcemia: causes, symptoms and treatment

Hypercalcemia corresponds to an excess of calcium in the blood, in which there are amounts of this mineral greater than 10.5 mg/dL in the blood test, which could be indicative of alterations in the parathyroid glands, tumors, endocrine diseases or side effect of some drugs.

This alteration usually does not cause symptoms, it only causes mild symptoms, such as lack of appetite and nausea. However, when calcium levels rise in excess, remaining above 12 mg/dl, it can cause symptoms such as stress, increased urination, drowsiness, fatigue, headache, arrhythmias and even coma.

The treatment of hypercalcemia varies according to the cause, considering an emergency if symptoms are present or the value of 13 mg/dl is reached. As a way of reducing calcium levels, the doctor may recommend the intravenous use of serum and medications, such as diuretics, calcitonin or bisphosphonates, for example.

possible causes

The main cause of excess calcium in the body is hyperparathyroidism, in which the small parathyroid glands, which are located behind the thyroid, produce in excess a hormone that regulates the amount of calcium in the blood. However, hypercalcemia can also occur as a result of other situations, such as:

• Chronic renal failure;
• Excess vitamin D, mainly due to diseases such as sarcoidosis, tuberculosis, coccidioidomycosis or due to excessive consumption;
• Secondary effect of the use of certain medicines such as lithium, for example;
• Tumor en los huesos, kidneys or intestine in advanced stage;
• Tumor in the pancreatic islets;
• multiple myeloma;
• Milk-alkali syndrome (milk and alkaline), caused by excessive calcium intake and use of antacids;
• Paget’s illness;
• Hyperthyroidism;
• Endocrine diseases such as thyrotoxicosis, pheochromocytoma and Addison’s disease.

Malignant hypercalcemia arises due to the production of a hormone similar to parathyroid hormones, by tumor cells, which causes severe hypercalcemia that is difficult to treat. Another form of hypercalcemia in cancer cases occurs due to lesions in the bones caused by bone metastasis.

Main symptoms of hypercalcemia

If calcium is good, it is a very important mineral for the health of the bones and for the vital processes of the organism, when it is in excess it can negatively affect its functioning, giving rise to signs such as:

• Headache and excessive tiredness;
• Sensation of constant thirst;
• Frequent desires to urinate;
• Nausea and vomiting;
• Decreased appetite;
• Changes in kidney function and risk of calculations;
• Frequent spasms or muscle spasms;
• Cardiac arrhythmias.

In addition, people with hypercalcemia can also present symptoms related to neurological alterations, such as memory loss, depression, easy irritability or confusion, for example.

How the diagnosis is confirmed

The diagnosis of hypercalcemia can be confirmed through the blood test, which detects total calcium values ​​above 10.5 mg/dl or ionic calcium above 5.3 mg/dl, and will depend on the laboratory where it was performed.

After confirming this alteration, the doctor must request tests to identify the cause, which include the levels of the PTH hormone produced by the parathyroids, imaging tests such as tomography or resonance to investigate the existence of cancer, in addition to evaluating the levels of vitamin D, kidney function or the presence of other endocrine diseases.

How is the treatment performed?

The treatment of hypercalcemia can only be indicated by an endocrinologist, performed mainly according to the cause, which includes the use of drugs to control hormonal levels, drug changes for others that do not have a secondary effect of hypercalcemia or surgery to remove tumors, which It could be causing the excess of calcium, if this is the cause.

The treatment is not carried out as a matter of urgency, except in cases where symptoms occur or when blood calcium levels reach 13.5 mg/dl, representing an important risk to health.

Therefore, the doctor may prescribe intravenous hydration, wing diuretics, such as furosemide, calcitonin or bisphosphonates, to try to reduce calcium levels and prevent changes in the heart rate or damage to the nervous system.

Surgery to treat hypercalcemia is only used when the cause of the problem is the malfunction of one of the parathyroid glands and it is recommended to remove it.