Hypercalcemia (patient information)

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What are the symptoms?
What are the causes?
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Hypercalcemia is a disorder in which there is too much calcium in the blood.

What are the symptoms of Hypercalcemia?

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

What causes Hypercalcemia?

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 stage so most patients with hypercalcemia have no symptoms.

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