What Is Hypercalcemia?

Hypercalcemia, an elevated calcium level in the blood, is a serious situation. It can cause vague effects, such as a loss of appetite and fatigue. But if severe or acute, hypercalcemia can affect your muscles and heart rate. High blood calcium is not common, but it can develop due to medical illnesses like kidney failure or cancer.

Your calcium level can be measured with a simple blood test, and excess calcium can be managed with procedures that lower calcium levels.

Hypercalcemia Symptoms

Many of the symptoms of hypercalcemia are ones that are characteristic of other conditions. Sudden elevations in calcium levels are generally more dangerous than chronic hypercalcemia. Additionally, mildly elevated calcium produces different effects than severely elevated calcium.

Calcium is an essential mineral that helps your muscles contract. If you have excessive calcium, your muscles may twitch or cramp. Even more importantly, your heart muscle can be affected by excess calcium.

Acute hypercalcemia can cause:

Symptoms of chronic hypercalcemia (usually mild) include:

• Muscle and joint pain
• Kidney stones

It's especially important for those with kidney disease or cancer to be familiar with the symptoms of hypercalcemia. However, know that symptoms can be hard to recognize and the condition can strike without warning.

Complications

Severe hypercalcemia is a major risk to your health. The effects on your heart and nervous system can cause confusion, hallucinations, behavioral changes, and even coma or death.

These issues are rare because the body is generally pretty good at rapidly adjusting variations in calcium concentration. But if you have an issue like kidney failure, your body might not be able to correct the problem.

Causes

There are several causes of high calcium, and the most common ones relate to bone breakdown, kidney problems, and thyroid concerns.

Causes of hypercalcemia include:

• Blood cell cancers: Lymphoma and leukemia can both interfere with bone formation and break down bones, releasing excess calcium into the blood.
• Kidney failure: The kidneys are responsible for filtering your blood to get rid of excess materials, including calcium. Kidney failure can lead to excess calcium.
• Hyperparathyroidism: The four parathyroid glands, located adjacent to the thyroid gland in your neck, make parathyroid hormone (PTH). This hormone acts on the kidneys to prevent too much calcium from being excreted. High PTH results in hypercalcemia. You can develop high PTH due to a parathyroid overactivity or a parathyroid tumor.
• Metastatic cancer: Cancer that spreads to the bone (such as breast cancer and prostate cancer) causes the bone to break down, releasing calcium into the blood.

Diagnosis

Generally, hypercalcemia is detected based on a blood test. If you have hypercalcemia, there is certainly a medical cause for it. Your medical team may order some other tests to help identify what that is.

Blood and Urine Tests

You can expect that some if not all of these tests will be run as part of the diagnostic process:

• Complete blood count (CBC): This test can help identify changes that correspond to lymphoma or leukemia
• Serum electrolytes: You may have other electrolyte abnormalities, such as alterations in sodium, potassium, magnesium, or phosphorous (also regulated by PTH). This test can help your doctor identify a parathyroid or kidney problem.
• Urine test: When kidney failure is considered, a urine test can help determine how well your kidneys are working.
• Parathyroid level: Your parathyroid hormone can be detected by a blood test.

Imaging Tests

Imaging may be required when select diagnoses are suspected. This may include:

• Kidney computerized tomography (CT) or ultrasound: If there is concern about your kidneys, you may need an imaging test to evaluate them.
• Parathyroid imaging test: If there is a concern about your parathyroid glands, you may need to have an imaging test that visualizes these glands.
• Bone scan: Because cancer can metastasize to the bone, a bone scan can help identify metastatic lesions.

Biopsy

A bone marrow biopsy can help your medical team with the diagnosis of lymphoma or leukemia.

Treatment

The treatment of hypercalcemia varies depending upon how elevated your calcium is, as well as the cause. Medical approaches used to decrease one's blood calcium level include medications and interventions.

Management of the primary problem that caused hypercalcemia is an important part of your treatment as well.

Strategies for treating hypercalcemia include:

• Staying hydrated, particularly if you have a condition that predisposes you to hypercalcemia
• Intravenous (IV) fluids to dilute calcium in the blood, if necessary

Medications used to treat hypercalcemia include:

• Bisphosphonates, which decrease bone breakdown
• Calcimar (calcitonin), a medication that can lower elevated calcium levels
• Gallium nitrate, used to treat cancer-related hypercalcemia
• Sensipar (cinacalcet), which lowers calcium in the blood
• Steroids: These drugs may be used in some situations, although steroids can also lower calcium in some instances. The cause of your hypercalcemia will dictate whether steroids are advised or not.

If your hypercalcemia is very severe, you may need dialysis—a process by which your blood is filtered with a machine to eliminate waste material.

A Word From Verywell

Hypercalcemia is rare because the body generally does a good job of maintaining control of calcium concentration. However, illnesses can make it difficult for your body to keep up with excess amounts of the mineral.

If you are prone to hypercalcemia, it is a good idea to meet with a dietitian, stay hydrated, and have your calcium level checked regularly.