Calcium is a mineral needed for bone health, muscle movement, and nerve function. Hypercalcemia is higher than normal levels of calcium in your blood.
Short-term or acute high levels of calcium can cause muscle twitching or weakness. Long-term high levels of calcium can lead to kidney stones, bone problems, and may intefere with mental abilities.
Vitamin D helps to absorb calcium from food or supplements. Once in your body, calcium may be stored in the bones or exist in the blood and cells. Levels of calcium in the blood are normally regulated by hormones from the parathyroid gland. Calcium is excreted through the kidneys.
Hypercalcemia may occur if an illness, such as cancer, or medication interferes with this process or destroys bone and other tissue releasing extra calcium into the blood. The most common causes of hypercalcemia are medications or an overactive parathyroid gland.
Dehydration can also cause temporary hypercalcemia. Decreased fluid in the blood causes an increase in concentration, but not amount of calcium.
Factors that may interfere with hormones and lead to hypercalcemia:
- Parathyroid problems
- Certain disorders such as adrenal insufficiency and acromegaly
- Certain medications such as lithium
Factors that may increase the amount of calcium in the body or blood include:
- Excess vitamin D and/or vitamin A supplements—increases absorption of calcium and release of calcium from the bones into the blood
- Certain medications, including diuretics that reduce the amount of calcium eliminated and calcium-containing antacids
- Certain diseases associated with inflammation such as sarcoidosis, berylliosis, or tuberculosis
- Certain cancers such as Hodgkin lymphoma
Other factors that may increase the chances of hypercalcemia:
- Cancer treatment—causes release of calcium from damaged cells or bones
- Genetic disorders
- Phosphate deficiency in newborns
- Kidney disease or failure —inability to get rid of calcium
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Symptoms may include:
You will be asked about your symptoms and medical history. A physical exam will be done.
Your bodily fluids will be tested. This can be done with:
- Blood tests
- Urine tests
If hypercalcemia is associated with a parathyroid problem or cancer your doctor may need imaging tests with:
Other tests may be done to look for any effects of hypercalcemia such as:
Treatment will depend on the cause of hypercalcemia. Talk with your doctor about the best treatment plan for you. Options include:
Rehydration and Medications
IV fluids may be given to help flush out the excess calcium.
Medication may also be given to control the condition causing the problem or to encourage removal of calcium from the blood. Medication options may include:
Other Supportive Steps
Other treatments depend on the cause of hypercalcemia, but may include:
To help reduce the chances of hypercalcemia, your doctor may:
- Treat any underlying causes, such as hyperparathyroidism
- Use bisphosphonates when there is cancer in the bones
Family Doctor—American Academy of Family Physicians
The American Association of Clinical Endocrinologists
The Canadian Society of Endocrinology and Metabolism
Carroll M, Schade D. A practical approach to hypercalcemia. Am Fam Physician. 2003;67(9):1959-1966.
Hypercalcemia. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116018/Hypercalcemia. Updated December 27, 2016. Accessed March 14, 2018.
Hypercalcaemia. Patient website. Available at: https://patient.info/doctor/hypercalcaemia. Updated February 1, 2017. Accessed March 14, 2018.
Last reviewed March 2018 by EBSCO Medical Review Board Marcie L. Sidman, MD Last Updated: 3/14/2018