Hypercalcemia: Symptoms, Causes & Treatment

Hypercalcemia is a condition in which the calcium concentration in the blood rises above normal. Calcium is an essential mineral for bone health and the function of nerves, muscles, and the heart, and its blood level is precisely regulated by parathyroid hormone, vitamin D, and the kidneys. When this regulation is disturbed, calcium rises.

The two most common causes of hypercalcemia are overactivity of the parathyroid glands (four small glands in the neck that secrete a hormone that raises calcium) and some types of cancer that may cause it to rise. There are other causes such as excess vitamin D or calcium, some medications, and prolonged immobility. Symptoms depend on the severity and speed of the rise: a mild rise may be symptomless and found incidentally on a blood test, while a more severe one causes symptoms classically described as stones, bones, abdominal groans, and psychic moans: kidney stones, bone pains, constipation and nausea, fatigue and confusion and depression, in addition to thirst and frequent urination.

Hypercalcemia is diagnosed by a blood test, but most important is determining the cause because treatment depends on it. A mild, symptomless rise is often treated by monitoring, addressing the cause, increasing water intake, and avoiding unnecessary calcium and vitamin D supplements. A severe rise is a potentially emergency condition needing intravenous hydration and medications that lower calcium quickly in hospital, along with treating the underlying cause (such as surgery for an overactive parathyroid gland or treating cancer). Early detection prevents complications to the kidneys, bones, and heart.

• Thirst and frequent urination.
• Constipation, nausea, loss of appetite, and abdominal pain.
• Fatigue, weakness, and bone pains.
• Confusion and depression, and kidney stones.

• Overactive parathyroid glands (the most common cause).
• Some types of cancer.
• Excess vitamin D or calcium supplements.
• Some medications and prolonged immobility.

• A blood calcium test.
• Measuring parathyroid hormone and vitamin D to determine the cause.
• Additional tests for the kidneys or cancer when suspected.

Mild rise

• Monitoring, increasing water intake, avoiding unnecessary calcium and vitamin D supplements, and addressing the cause.

Severe rise

• Intravenous hydration and medications that lower calcium quickly in hospital.

Treating the cause

• Surgery for an overactive parathyroid gland or treating the causative cancer.

This content is educational and does not replace medical advice.

• Kidney stones and impaired kidney function.
• Osteoporosis and bone pains.
• Heart-rhythm disturbance and confusion in severe rise.

• Avoiding excess calcium and vitamin D supplements without need.
• Drinking enough water.
• Regular follow-up for those with parathyroid overactivity or cancer.