St. Luke's Hospital
Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
Find a Physician Payment Options Locations & Directions
Follow us on: facebook twitter Mobile Email Page Email Page Print Page Print Page Increase Font Size Decrease Font Size Font Size
America's 50 Best Hospitals
Meet the Doctor
Spirit of Women
Community Health Needs Assessment
Home > Health Information

Multimedia Encyclopedia

    Print-Friendly
    Bookmarks

    Hypercalcemia

    Hypercalcemia is too much calcium in the blood.

    Causes

    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:

    • Adrenal gland failure
    • 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)
    • Hyperthyroidism
    • Kidney failure
    • 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 stageso 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:

    • Constipation
    • Nausea
    • Pain
    • Poor appetite
    • Vomiting

    Kidney symptoms:

    • Flank pain
    • Frequent thirst
    • Frequent urination

    Muscle symptoms:

    • Muscle twitches
    • Weakness

    Psychological symptoms:

    • Apathy
    • Dementia
    • Depression
    • Irritability
    • Memory loss

    Skeletal symptoms:

    • Bone pain
    • Bowing of the shoulders
    • Fractures due to disease (pathological fractures)
    • Loss of height
    • Spinal column curvature

    Exams and Tests

    • Serum calcium
    • Serum PTH
    • Serum PTHrP (PTH-related protein)
    • Serum vitamin D level
    • Urine calcium

    Treatment

    Treatment isaimed 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, ifthe hypercalcemiais 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)

    Outlook (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.

    Possible Complications

    Gastrointestinal

    • Pancreatitis
    • Peptic ulcer disease

    Kidney

    • Calcium deposits in the kidney (nephrocalcinosis)
    • Dehydration
    • High blood pressure
    • Kidney failure
    • Kidney stones

    Psychological

    • Depression
    • Difficulty concentrating or thinking

    Skeletal

    • Bone cysts
    • Fractures
    • Osteoporosis

    These complications of long-term hypercalcemia are uncommon today.

    When to Contact a Medical Professional

    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.

    BACK TO TOP

    • Endocrine glands

      illustration

      • Endocrine glands

        illustration

      Tests for Hypercalcemia

        Review Date: 3/22/2012

        Reviewed By: 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.

        The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
        adam.com

        A.D.A.M. content is best viewed in IE9 or above, Fire Fox and chrome browser.


        Back  |  Top
        About Us
        Contact Us
        History
        Mission
        Locations & Directions
        Quality Reports
        Annual Reports
        Honors & Awards
        Community Health Needs
        Assessment

        Newsroom
        Services
        Brain & Spine
        Cancer
        Heart
        Maternity
        Orthopedics
        Pulmonary
        Sleep Medicine
        Urgent Care
        Women's Services
        All Services
        Patients & Visitors
        Locations & Directions
        Find a Physician
        Tour St. Luke's
        Patient & Visitor Information
        Contact Us
        Payment Options
        Financial Assistance
        Send a Card
        Mammogram Appointments
        Health Tools
        My Personal Health
        mystlukes
        Spirit of Women
        Health Information & Tools
        Clinical Trials
        Health Risk Assessments
        Employer Programs -
        Passport to Wellness

        Classes & Events
        Classes & Events
        Spirit of Women
        Donate & Volunteer
        Giving Opportunities
        Volunteer
        Physicians & Employees
        For Physicians
        Remote Access
        Medical Residency Information
        Pharmacy Residency Information
        Physician CPOE Training
        Careers
        Careers
        St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
        Copyright © St. Luke's Hospital Website Terms and Conditions  |  Privacy Policy  |  Patient Notice of Privacy Policies PDF Sitemap St. Luke's Mobile