Calcium plays an essential role in the body. It helps to build strong bones and teeth, while also supporting the muscles, nerves, and heart. However, too much calcium can lead to problems.
In this article, we explore the symptoms, causes, and complications of hypercalcemia. We also describe how it can be diagnosed and treated.
What is hypercalcemia?
Calcium levels in the blood are mostly controlled by the parathyroid glands. These four tiny glands sit behind the thyroid.
When the body needs calcium, the parathyroid glands secrete a hormone. This hormone signals:
- the bones to release calcium into the blood
- the kidneys to excrete less calcium into the urine
- the kidneys to activate vitamin D, which helps the digestive tract to absorb more calcium
Overactive parathyroid glands or an underlying health condition can disrupt the balance of calcium.
If calcium levels become too high, a person may be diagnosed with hypercalcemia. This condition can impede bodily functions, and may specifically be associated with:
- poor bone health
- kidney stones
- abnormal heart and brain function
Extremely high levels of calcium in the blood can become life-threatening.
Symptoms
Mild hypercalcemia may not result in symptoms, while more serious hypercalcemia can cause:
- Excessive thirst and frequent urination. Too much calcium means that the kidneys have to work harder. As a result, a person may urinate more often, leading to dehydration and increased thirst.
- Stomach pain and digestive problems. Too much calcium can cause an upset stomach, abdominal pain, nausea, vomiting, and constipation.
- Bone pain and muscle weakness. Hypercalcemia can cause the bones to release too much calcium, leaving them deficient. This abnormal bone activity can lead to pain and muscle weakness.
- Confusion, lethargy, and fatigue. Too much calcium in the blood can affect the brain, causing these symptoms.
- Anxiety and depression. Hypercalcemia may also affect mental health.
- High blood pressure and abnormal heart rhythms. High levels of calcium can increase blood pressure and lead to electrical abnormalities that change the heart’s rhythm, adding strain.
Over time, the bones may release excessive amounts of calcium into the bloodstream. This makes the bones thinner, or less dense. As calcium continues to be released, osteoporosis can develop.
People with osteoporosis have an increased risk of:
- bone fractures
- significant disability
- loss of independence
- prolonged immobility
- a curvature of the spine
- becoming shorter over time
Kidney stones
People with hypercalcemia are at risk of developing calcium crystals in their kidneys. These crystals can become kidney stones, which are often very painful. They can also lead to kidney damage.
Kidney failure
Over time, severe hypercalcemia can stop a person’s kidneys from working correctly. The kidneys may become less effective at cleaning the blood, producing urine, and efficiently removing fluid from the body. This is called kidney failure.
Problems with the nervous system
If left untreated, severe hypercalcemia may impede the nervous system. Possible effects include:
- confusion
- dementia
- tiredness
- weakness
- a coma
Falling into a coma is serious and can be life-threatening.
An irregular heartbeat
The heart beats when electrical impulses move through it and cause it to contract. Calcium plays a role in regulating this process, and too much calcium can lead to an irregular heartbeat.
Diagnosis
Anyone experiencing symptoms of hypercalcemia should speak with a doctor, who will order a blood test and make a diagnosis based on results.
A person with mild hypercalcemia may have no symptoms, and the condition may only be diagnosed after a routine blood test.
The test will check for blood calcium and parathyroid hormone levels. These can show how well the body’s systems are functioning, such as those involving the blood and kidneys.
After diagnosing hypercalcemia, a doctor may perform further tests, such as:
- an ECG to record of the electrical activity of the heart
- a chest X-ray to check for lung cancer or infections
- a mammogram to check for breast cancer
- a CT or MRI scan to examine the body’s structure and organs
- dual energy X-ray absorptiometry, commonly known as a DEXA scan, to measure bone density
Treatment
People with mild hypercalcemia may not require treatment, and levels may return to normal over time. The doctor will monitor calcium levels and the health of the kidneys.
If calcium levels continue to rise or do not improve on their own, further testing will likely be recommended.
For people with more severe hypercalcemia, it is important to discover the cause. The doctor may offer treatments to help lower calcium levels and prevent complications. Possible treatments include intravenous fluids and medications such as calcitonin or bisphosphonates.
If overactive parathyroid glands, too much vitamin D, or another health condition is causing hypercalcemia, the doctor will also treat these underlying conditions.
A person with a noncancerous growth on a parathyroid gland may require surgery to remove it.
Prevention
Certain lifestyle changes can help to keep calcium levels balanced and bones healthy. These include:
- Drinking plenty of water. Staying hydrated may lower blood calcium levels, and it can help to prevent kidney stones.
- Quitting smoking. Smoking can increase bone loss. In addition to improving the health of the bones, quitting will reduce the risk of cancer and other health problems.
- Exercising and strength training. This promotes bone strength and health.
- Following guidelines for medications and supplements. Doing so may decrease the risk of consuming too much vitamin D and developing hypercalcemia.
Outlook
A person’s outlook depends on the cause and severity of hypercalcemia.
Mild hypercalcemia may not require treatment. If the condition is more serious, a doctor may prescribe medications that lower levels of calcium and treat the underlying cause.
Anyone experiencing symptoms of hypercalcemia should speak with a doctor.
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