Navigate Up

Full Library - A-Z Index


Print This Page

Hypercalcemia

Hypercalcemia is too much calcium in the blood.

Causes, incidence, and risk factors

Calcium is important to many body functions, including:

  • Bone formation
  • Hormone release
  • Muscle contraction
  • Nerve and brain function

Parathyroid hormone (PTH) and vitamin D help manage calcium balance in the body. PTH is made by the parathyroid glands -- four small glands located in the neck behind the thyroid gland. Vitamin D is obtained when the skin is exposed to sunlight, and from dietary sources such as:

  • Egg yolks
  • Fish
  • Fortified cereals
  • Fortified dairy products

Primary hyperparathyroidism is the most common cause of hypercalcemia. It is due to excess PTH release by the parathyroid glands. This excess occurs due to an enlargement of one or more of the parathyroid glands, or a growth (usually not cancer) on one of the glands.

Other medical conditions can also cause hypercalcemia:

  • An inherited condition that affects the body's ability to regulate calcium (familial hypocalciuric hypercalcemia)
  • Being bedbound (or not being able to move) for a long period of time
  • Calcium excess in the diet (called milk-alkali syndrome, usually due to at least 2,000 milligrams of calcium per day)
  • Medications such as lithium and thiazide diuretics (water pills)
  • Some cancerous tumors (for example, lung cancers, breast cancer)
  • Vitamin D excess (hypervitaminosis D ) from diet or inflammatory diseases

Hypercalcemia affects less than 1 percent of the population. The ability to measure blood calcium since the 1960s has improved detection. Today, the condition is diagnosed at an early stage so most patients with hypercalcemia have no symptoms.

Women over age 50 are most likely to have hypercalcemia, usually due to primary hyperparathyroidism.

Symptoms

Abdominal symptoms:

Kidney symptoms:

Muscle symptoms:

Psychological symptoms:

Skeletal symptoms:

Signs and tests

Treatment

Treatment is aimed at the cause of hypercalcemia whenever possible. In people with primary hyperparathyroidism (PHPT), surgery may be needed to remove the abnormal parathyroid gland and cure the hypercalcemia.

However, if the hypercalcemia is mild, your health care provider will offer you the option of monitoring your condition closely over time.

Severe hypercalcemia that causes symptoms and requires a hospital stay is treated with the following:

  • Calcitonin
  • Dialysis
  • Diuretic medication, such as furosemide
  • Drugs that stop bone breakdown and absorption by the body, such as pamidronate or etidronate (bisphosphonates)
  • Fluids through a vein (intravenous fluids)
  • Glucocorticoids (steroids)

Expectations (prognosis)

How well you do depends on the cause of hypercalcemia. Patients with mild hyperparathyroidism or hypercalcemia with a treatable cause do well and usually do not have complications.

Patients with hypercalcemia due to conditions such as cancer or granulomatous disease may not do well, but this is usually due to the disease itself, rather than the hypercalcemia.

Complications

Gastrointestinal

Kidney

Psychological

  • Depression
  • Difficulty concentrating or thinking

Skeletal

These complications of long-term hypercalcemia are uncommon today.

Calling your health care provider

Contact your physician or health care provider if you have:

  • Family history of hypercalcemia
  • Family history of hyperparathyroidism
  • Symptoms of hypercalcemia

Prevention

Most causes of hypercalcemia cannot be prevented. Women over age 50 should see their health care provider regularly and have their blood calcium level checked if they have symptoms of hypercalcemia.

You can avoid hypercalcemia from calcium and vitamin D supplements by contacting your health care provider for advice about the dose if you are taking supplements without a prescription.

References

Bringhurst R, Demay MB, Kronenberg HM. Hormones and disorders of mineral metabolism. In: Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 27.

Wysolmerski JJ, Insogna KL. The parathyroid glands, hypercalcemia, and hypocalcemia. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 266.

Updated: 3/22/2012

Shehzad Topiwala, MD, Chief Consultant Endocrinologist, Premier Medical Associates, The Villages, FL. Review Provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.


©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

© UPMC
Pittsburgh, PA, USA UPMC.com