Hypercalcemia

SYMPTOMS

There are no symptoms for mild hypercalcemia, but serious cases can cause:

• Frequent urination, dehydration, dry mouth, and excessive: High levels of calcium stressed the kidneys. As a result, the person will frequently urinate, leading to dehydration and extreme thirst.
• Digestive problems: Hypercalcemia can cause abdominal pain and cramps and constipation. One can also experience nausea, vomiting, and decreased appetite.
• Bone and muscle weakness: When too much calcium is released from the bone, the bones are left deficient; hence, the bone will weaken and may deform, and one can also experience muscle aches, weakness, cramping, and or twitches.
• Cognitive changes, confusion, lethargy, fatigue, sleep problems, memory loss, and irritability: High calcium levels affect normal brain functioning.
• Neuropsychiatric dysfunction: Serious cases of hypercalcemia can alter mental status, and cause anxiety, depression, psychosis, auditory hallucinations, paranoia, persecutory delusions, and coma.
• High Blood Pressure, and Arrhythmias: Excessive calcium in the blood induces an elevation in blood pressure, palpitations, and abnormal heart rhythm. Hypercalcemia increases the risk of coronary heart disease.

DIAGNOSIS

To diagnose hypercalcemia, the doctor will order a blood test to determine the calcium level in your bloodstream. The test will also check the parathyroid hormone levels. After diagnosing hypercalcemia, further tests will be administered to determine what could be the cause of the condition, such as:

• ECG: to record and check the heart rhythm
• Chest X-ray: to check for lung infections or cancer
• Mammogram: to check for breast cancer
• CT / MRI Scan: to check the body organs and structure
• Dual-energy X-ray absorptiometry (DEXA scan): to measure bone density

TREATMENT

When the hypercalcemia is mild, doctors choose to wait and monitor the kidney, heart, and bones. But for more severe cases, the following medicines may be recommended:

Medications

• Calcitonin: a hormone that controls calcium levels in the bloodstream
• Calcimimetics: a type of drug that controls overactive parathyroid glands
• Bisphosphonates: intravenous drugs that can lower the calcium levels quickly; often used in cancer patients
• Denosumab: this drug is commonly used for hypercalcemia caused by cancer
• Prednisone: this drug (steroid) is used for hypercalcemia caused by too much vitamin D
• When hypercalcemia is a medical emergency, IV fluid and diuretics can quickly lower the calcium level and prevent high blood pressure, arrhythmias, and neurologic dysfunctions.

Surgery

For more severe hypercalcemia cases, especially when caused by an overactive parathyroid gland, the problem can be resolved by removing the tissue on the parathyroid glands that are causing the problem.