Hypercalcemia: Symptoms, Causes, Risk Factors, Diagnosis and Treatment

It is a condition in which the calcium level in your blood is above average. Too much calcium in the blood can weaken your bones and create kidney stones.

It can also interfere with the functioning of your heart and brain.

Hypercalcemia is usually the result of overactive parathyroid glands. These four tiny glands are located behind the thyroid gland.

Other causes of hypercalcemia include cancer, certain medical conditions, some medications, and taking too many calcium and vitamin D supplements.

The signs and symptoms of hypercalcemia vary from nonexistent to severe. The treatment depends on the cause.


You may not have signs or symptoms if your hypercalcemia is mild. The most severe cases produce signs and symptoms related to the body parts affected by the high calcium levels in your blood. Examples include:

Kidneys: too much calcium in your blood makes your kidneys work harder to filter it. This can cause the patient to experience constant thirst and frequent urination. Symptoms related to your kidneys can lead to:


  • Sed excess.
  • Excessive urination
  • Pain between the back and the upper part of the abdomen on one side due to kidney stones.

Digestive system: can cause pain in the stomach and discomfort of nausea, need to vomit, and constipation. Symptoms related to the abdomen include:

  • Abdominal pain.
  • Decreased appetite.

Bones and muscles: in most patients, considerable amounts of calcium in the blood cause bone pain and muscle weakness. Calcium levels can affect your muscles, causing spasms and cramps.

High levels of calcium can affect the bones, leading to:

  • Osteoporosis.
  • Fractures due to the disease.

Brain: hypercalcemia can interfere with the way your brain works, generating confusion, lethargy, and fatigue.

Hypercalcemia can also cause neurological symptoms, such as depression, memory loss, and irritability. Severe cases can cause you to fall into a coma.

If you have cancer and experience any symptoms of hypercalcemia, call your DoctorDoctor immediately. It is not uncommon for cancer to cause high levels of calcium. When this happens, it is a medical emergency.

Heart: Rarely, severe hypercalcemia can interfere with your heart function, causing palpitations and fainting, indications of cardiac arrhythmia, and other heart problems.

When to See a Doctor

Contact your DoctorDoctor if you have signs and symptoms that may indicate hypercalcemia, such as being very thirsty, urinating frequently, and having abdominal pain.

Causes of Hypercalcemia

In addition to developing strong bones and teeth, calcium helps muscles contract and nerves transmit signals. Usually, having insufficient calcium in the blood, the parathyroid glands produce a hormone that:

  • It causes bones to release calcium in the blood.
  • They cause the alimentary canal to absorb more calcium.
  • Your kidneys expel less calcium and activate more vitamin D, which is vital in calcium absorption.

This delicate balance between too little calcium in your blood and hypercalcemia can be affected by various factors. Hypercalcemia is caused by:

Hyperactive parathyroid glands: the most common cause of hypercalcemia, the overactive parathyroid glands (hyperparathyroidism), may come from a small, non-cancerous (benign) tumor or enlargement of one or more of the four parathyroid glands.

Cancer: Lung and breast cancer and some blood cancers may increase your risk of hypercalcemia. The spread of cancer (metastasis) to bones also increases the risk.

Other diseases: certain diseases, such as tuberculosis and sarcoidosis, can raise vitamin D levels in the blood, stimulating the digestive tract to absorb more calcium.

Hereditary factors: a hereditary disease such as familial hypocalciuric hypercalcemia causes an increase in blood calcium due to defective calcium receptors in the body. This condition does not cause symptoms or complications of hypercalcemia.

Immobility: People with the condition that makes them spend much time sitting or lying down can develop hypercalcemia. Over time, bones that do not support weight release calcium in the blood.

Severe dehydration: a common cause of mild or transient hypercalcemia is dehydration. Having less fluid in the blood causes an increase in calcium concentrations.

Medications: Certain drugs, such as lithium, used to treat bipolar disorder, may increase the release of parathyroid hormone.

Supplements: Over time, excessive amounts of calcium or vitamin D supplements can raise calcium levels in your blood above normal.

Risk factor’s

Women over 50 have a higher risk of overactive parathyroid glands.


Complications of hypercalcemia may include:

Osteoporosis: If your bones continue to release calcium in your blood, you may develop osteoporosis, a disease that thin bones, which could cause bone fractures, the curvature of the spine, and loss of height.

Kidney stones: if your urine contains too much calcium, crystals can form in your kidneys. Over time, the crystals can combine to form kidney stones. Passing a stone can be extremely painful.

Renal impairment: severe hypercalcemia can damage your kidneys, limiting your ability to cleanse the blood and remove fluids.

Nervous system problems: severe hypercalcemia can cause confusion, dementia, and coma, which are fatal.

Abnormal heart rhythm ( arrhythmia ): Hypercalcemia can affect the electrical impulses that regulate your heartbeat, causing your heart to beat irregularly.


Because hypercalcemia can cause few or no signs or symptoms, you may not know you have the disorder until routine blood tests show a high calcium level in the blood.

Blood tests can also reveal if your parathyroid hormone level is high, indicating hyperparathyroidism. To determine if your hypercalcemia is caused by an underlying problem, such as cancer or sarcoidosis, your DoctorDoctor may recommend imaging tests of your bones or lungs.

Treatment of Hypercalcemia

If your hypercalcemia is mild, you and your DoctorDoctor may choose to watch and wait, monitoring your bones and kidneys over time to ensure they stay healthy.


In some cases, your DoctorDoctor may recommend:

Calcitonin (Miacalcin): this salmon hormone controls calcium levels in the blood. Mild nausea can be a side effect.

Calcimimetics: this type of medication can help control the overactive parathyroid glands. Cinacalcet (Sensipar) has been approved to control hypercalcemia.

Bisphosphonates: intravenous medications for osteoporosis, which can rapidly reduce calcium levels, are often used to treat hypercalcemia due to cancer. The risks associated with this treatment include osteonecrosis of the jaw and certain types of thigh fractures.

Denosumab (Prolia, Xgeva): This medication is often used to treat people with hypercalcemia caused by cancer who do not respond well to bisphosphonates.

Prednisone: If high vitamin D levels cause your hypercalcemia, the short-term use of steroid pills such as prednisone is usually helpful.

Intravenous fluids and diuretics: extremely high calcium levels can be a medical emergency. You may need hospitalization for treatment with intravenous fluids and diuretics to rapidly decrease the calcium level to prevent heart rhythm problems or damage to the nervous system.

Surgical and Other Type Procedures

The problems associated with overactive parathyroid glands can often be cured by surgery to remove the tissue that causes the problem. In many cases, only one of the four parathyroid glands of a person is affected.

A unique scanning test uses an injection of a small dose of radioactive material to identify the gland or glands that do not work correctly.

Preparing for your Appointment

You can start by seeing your primary care provider. However, you will probably be referred to a doctor specializing in treating hormonal disorders (an endocrinologist). Here is information on what you can do to help you prepare for your appointment.

Before your appointment, make a list of:

  • Your symptoms, including those that do not seem related, and when they started.
  • Critical personal information, including significant stresses or recent changes in life, medical history, and family medical history.
  • All medications, vitamins, and other supplements you take, including doses.

Questions to ask your doctor doctor

If possible, take a family member or friend to help you remember the information they give you. For hypercalcemia, the basic questions you should ask your doctor include:

  • What is the most likely cause of my symptoms?
  • What tests do I need?
  • What treatments are available, and which ones are recommended?
  • What side effects can I expect from the treatment?
  • Are there alternatives to the primary approach you are suggesting?
  • I have other health conditions. How can I manage them better together?

What to expect from your DoctorDoctor

Your DoctorDoctor will probably ask you questions, which include:

  • Is there anything that improves your symptoms?
  • What, in any case, worsens your symptoms?
  • Have you had kidney stones, bone fractures, or osteoporosis?
  • Do you have bone pain?
  • Do you have unexplained weight loss?
  • Have members of the family had hypercalcemia or kidney stones?

Hypercalcemia can cause kidney problems, such as kidney stones and kidney failure. Other complications include irregular heartbeat and osteoporosis.

Hypercalcemia can also cause confusion or dementia since calcium helps keep the nervous system functioning correctly. Severe cases can lead to a potentially fatal coma.

Your long-term prognosis will depend on the cause and severity of your condition. Your DoctorDoctor can determine the best treatment for you. Talk to your DoctorDoctor regularly to stay informed and ask questions.

Be sure to keep up with the recommended tests and follow-up appointments.

You can do your part to help protect your kidneys and bones from damage due to hypercalcemia when making healthy life choices. Make sure you drink a lot of water.

This will keep you hydrated, reduce blood calcium levels and decrease your risk of developing kidney stones. Since smoking can accelerate bone loss, it is essential to quit as soon as possible.

Smoking also causes many other health problems. Quitting smoking can only help your health.

Combining physical exercises and strength training can keep your bones strong and healthy. Talk to your DoctorDoctor first to determine what types of exercises are safe for you. This is especially important if you have cancer that affects your bones.

Be sure to follow the guidelines for supplement doses and over-the-counter medications to decrease the risk of excessive vitamin D and calcium intake.