High Calcium (Hypercalcemia): Symptoms, Causes and Testing

What it involves

MedlinePlus explains that hypercalcemia means you have too much calcium in your blood. Parathyroid hormone and vitamin D regulate the balance, and the parathyroid glands are four small glands in the neck behind the thyroid. The most common cause of a high calcium level is too much parathyroid hormone.

Who this is for

• Adults whose routine blood work showed a high calcium level.
• Patients with kidney stones, bone thinning or ongoing constipation and thirst.
• Women over 50, since MedlinePlus says it is most common after menopause.
• People who take calcium or vitamin D supplements, or water pills, and want a medication review.

What to expect

• Questions about thirst, urination, constipation, bone pain, kidney stones, supplements and medicines
• Repeat blood work, which the practice offers, to confirm the calcium level
• Further blood and urine tests such as parathyroid hormone and vitamin D, as a provider decides
• A referral to an endocrinologist or surgeon when a parathyroid problem is found

Often found without symptoms

The encyclopedia says hypercalcemia is most often diagnosed at an early stage using routine blood tests and that most people have no symptoms. That is one reason regular blood work matters. A result flagged high is not a diagnosis by itself, and the first step is usually a repeat test. The basic metabolic panel guide explains the routine panel that includes calcium, and the annual physical guide explains why those checks are done.

What it can feel like

When symptoms appear, MedlinePlus lists nausea or vomiting, poor appetite and constipation, increased thirst and frequent urination, muscle weakness or twitches, tiredness and confusion, and bone pain with bones that break more easily. They build slowly and overlap with many other problems. Thirst and urination are discussed in the excessive thirst guide and the frequent urination guide, and constipation in the constipation guide.

Common causes

Besides excess parathyroid hormone, the encyclopedia lists low body fluids, certain cancers such as lung and breast cancer, too much vitamin D, long bed rest, too much calcium in the diet, an overactive thyroid, chronic kidney disease, and medicines such as thiazide water pills and lithium. Infections and conditions such as tuberculosis and sarcoidosis, and rare inherited conditions, can also be behind it. A provider works through this list with your history and tests. The thyroid care page explains the thyroid side.

How the cause is found

The encyclopedia lists serum calcium, parathyroid hormone, parathyroid hormone-related protein, vitamin D level and urine calcium as tests that may be used. The practice offers blood work, and a provider decides which tests fit your situation. People with kidney stones should have tests to check for hypercalcemia, according to the encyclopedia. The flank pain guide and the blood in urine guide describe stone symptoms. Bone density testing is arranged by referral, as the bone density screening guide describes.

Treatment starts with the cause

MedlinePlus says treatment is aimed at the cause whenever possible. Primary hyperparathyroidism may need surgery to remove the abnormal parathyroid gland, which can cure the high calcium, and that is arranged through a specialist. Severe hypercalcemia with symptoms is treated in the hospital, where fluids through a vein are the most important therapy. The outlook is good for mild hyperparathyroidism or a treatable cause. Drink fluids as your provider advises and do not add calcium or vitamin D supplements without asking.

When to be seen quickly

Schedule a visit for a high result, new kidney stones, ongoing thirst with constipation or unexplained bone pain. Be seen the same day for repeated vomiting, marked weakness or new confusion, since the encyclopedia lists confusion as a symptom. Call 911 or go to the ER for severe confusion, fainting or a very irregular heartbeat. Same-day visits and walk-ins are welcome at the offices, and the fatigue guide covers tiredness more broadly. One common cause of persistently high calcium is an overactive parathyroid gland, which the primary hyperparathyroidism guide explains, including how it is diagnosed and when surgery is considered. Rarely, a bone disorder in which bone breaks down and regrows too quickly can also release extra calcium, and the Paget disease of bone guide describes its symptoms and the blood tests used to look for it.

Sources

• MedlinePlus: Hypercalcemia (encyclopedia)