Hypercalcemia. Symptoms, causes, diagnosis and treatment
Calcium plays an important role in the implementation of many body functions. It provides the strength of bones and teeth, supports the health of muscles, nerves and heart. However, too much calcium in the body can cause problems.
In the current article, we describe the symptoms, name the causes, and talk about potential complications of hypercalcemia. We will also explain how this condition is diagnosed and treated.
What is hypercalcemia?
The main regulator of calcium in the body are the parathyroid glands. These are four small structures located behind the thyroid gland.
When the body needs calcium, the parathyroid glands secrete hormones. These hormones perform the following functions:
stimulate the bones to release calcium into the blood;
stimulate the kidneys to reduce the amount of calcium excretion in the urine;
stimulates the kidneys to activate vitamin D, which helps the digestive tract absorb calcium.
Excessive activity of the parathyroid glands and some medical conditions can cause an imbalance of calcium in the body.
If the calcium level becomes too high, hypercalcemia can be diagnosed in a person. This condition makes it difficult for the body to work and may be associated with the following:
bone diseases;
kidney stones;
deviations in the work of the heart and brain.
An excessively high level of calcium in the blood can carry a life hazard.
Symptoms of hypercalcemia
Mild hypercalcemia may not show symptoms, but in more serious cases, the following may be observed in humans.
Great thirst and increased urination. Too much calcium in the body suggests that the kidneys must work very actively. As a result, the person has a need for more frequent urination, as well as dehydration, which is accompanied by a feeling of thirst.
Stomach pain and problems with the digestive tract. Too much calcium can cause stomach upset, abdominal pain, nausea, vomiting and constipation.
Bone pain and muscle weakness. Hypercalcemia causes bones to release too much calcium and become more vulnerable. Such a deviation in bone activity can cause pain and muscle weakness.
Consciousness, lethargy, drowsiness and fatigue. Too much calcium in the blood can affect the brain and cause these symptoms.
Anxiety and depression. Hypercalcemia can also affect a person’s emotional state.
High blood pressure and heart rate abnormalities. Excessive calcium levels can increase blood pressure and lead to electrical abnormalities that change the nature of the heart rhythm, causing excessive stress.
Causes of hypercalcemia
Many factors and medical conditions can cause hypercalcemia. These include the following.
Parathyroid Hyperactivity
Parathyroid glands regulate calcium levels in the body. If they are too active, then the person may develop hypercalcemia.
The parathyroid glands may become hyperactive when enlarged or when noncancerous structures form on them.
The condition in which the parathyroid glands are too active is called hyperparathyroidism. This is one of the most common causes of hypercalcemia.
Hyperparathyroidism is usually diagnosed in people aged 50 to 60 years. In addition, this condition is three times more likely to affect women than men.
Excessive intake of vitamin D
Vitamin D starts the process of absorption of calcium in the intestine. Immediately after absorption, calcium is directed to the bloodstream.
From food the body usually manages to extract only 10-20% of the calcium contained in them, and the rest of the mineral comes out of the body along with the stool. However, excessive amounts of vitamin D sometimes cause the body to consume more calcium, causing people to develop hypercalcemia.
According to a study conducted in 2012 by American scientists, it became known that high therapeutic doses of vitamin D can lead to hypercalcemia. Such supplements can be used to treat multiple sclerosis and other medical conditions.
It should be noted that the recommended daily dose of calcium for an adult is 600-800 international units. A high dose is considered to exceed 4,000 international units per day.
Cancer
If a person suffers from cancer, then he can also develop hypercalcemia. Among the forms of cancer that can lead to hypercalcemia, include the following:
lungs' cancer;
breast cancer;
blood cancer.
Thanks to a group of American researchers in 2013, it became known that hypercalcemia sooner or later affects more than 2% of patients with all types of cancer. In addition, in 30% of cancer patients, an increased level of calcium in the blood is observed during the course of treatment.
If cancer spreads to the bone, the risk of developing hypercalcemia increases.
Other medical conditions
In addition to cancer, the following conditions can lead to increased levels of calcium in the body:
tuberculosis;
sarcoidosis;
thyroid disease;
chronic kidney disease;
adrenal gland diseases;
serious fungal infections.
Reduced mobility
People who are unable to move for a long period of time also have the risk of developing hypercalcemia. When the bones have to work less, they weaken and begin to release more calcium into the bloodstream.
Severe dehydration
With severe dehydration, the proportion of water in a person’s blood decreases, due to which the concentration of calcium in the bloodstream may increase. However, this imbalance is usually corrected immediately after a sufficient amount of water enters the body.
In some cases, a high level of calcium can lead to dehydration, so it is always important for a doctor to determine which condition occurred initially - an excess of calcium or a lack of water.
Medications
Some pharmacological products may excessively stimulate the parathyroid gland and thus cause hypercalcemia. One of these drugs is lithium, which is sometimes used to treat bipolar disorder.
Complications of hypercalcemia
Without proper treatment for hypercalcemia, the following conditions may occur.
Osteoporosis
Over time, the bones can secrete excess amounts of calcium into the blood, resulting in the bones themselves becoming thinner and less dense. As calcium continues to be released into the bloodstream, osteoporosis can occur in a person.
People with osteoporosis have an increased risk of the following:
bone fractures;
substantial lack of safeguards;
loss of independence;
long-term loss of mobility;
growth reduction (with time);
curvature of the spine.
Stones in the kidneys
People with hypercalcemia have an increased risk of calcium crystals in their kidneys. Such crystals can become stones and cause severe pain. They can also cause kidney damage.
Renal failure
Over time, severe hypercalcemia can disrupt the proper functioning of the kidneys. These organs begin to poorly purify the blood, less efficiently produce urine and poorly remove fluid from the body. This condition in medicine is called renal failure.
Problems with the nervous system
If serious hypercalcemia is left untreated, it can affect the functioning of the nervous system and cause the following symptoms:
clouding of consciousness;
dementia;
fatigue;
weakness;
to whom
Coma is a serious medical condition that is life threatening.
Palpitations
The heart beats when electrical impulses pass through it, causing contractions. Calcium plays an important role in regulating this process, and too much calcium can lead to irregular heartbeat.
Diagnosis of hypercalcemia
Anyone who experiences symptoms of hypercalcemia should tell a physician who is able to perform a blood test and make a diagnosis based on the results of this test.
People with mild hypercalcemia often do not observe symptoms. They can learn about the problem after a blood test performed as part of a regular medical commission or during the diagnosis of other conditions.
A blood test allows the doctor to assess the level of calcium in the bloodstream and measure the content of parathyroid hormone. As a result of the examination, the doctor will determine how well the body systems work, in particular those in which the kidneys and blood are involved.
If hypercalcemia is established, the doctor may suggest further diagnostic procedures, for example:
electrocardiogram for fixing the electrical activity of the heart;
chest x-ray to check for lung cancer or infection;
mammography screening for breast cancer;
computed tomography or magnetic resonance imaging to check the structures and organs of the body;
Densitometry for measuring bone density.
Treatment of hypercalcemia
People with hypercalcemia may not need treatment, and their calcium levels may eventually return to normal. These patients need to visit the hospital regularly so that the doctor can monitor the calcium content in their blood and kidney health.
If the calcium level continues to rise or does not return to normal for an extended period, the doctor will offer to undergo in-depth diagnosis.
In cases of more severe hypercalcemia, it is important for doctors to uncover the underlying cause of the disorder. The patient may be offered a treatment aimed at reducing the level of calcium and preventing possible complications. The therapeutic approach may include intravenous fluids and drugs such as calcitonin and bisphosphonates.
If hypercalcemia is caused by a hyperactive parathyroid gland, high vitamin D or other medical conditions, then the doctor may also recommend a course of therapy.
If the parathyroid glands are noncancerous, surgery may be necessary to remove them.
Prevention of hypercalcemia
Some changes in lifestyle will help people maintain the necessary level of calcium in the body and ensure healthy bones. These changes include the following.
Consumption of large amounts of water. Proper water balance can reduce the level of calcium in the bloodstream and thus prevent the appearance of kidney stones.
To give up smoking. Smoking increases bone loss. In addition, avoiding a bad habit reduces the risk of developing cancer and other health problems.
Strength exercises. Regular exercise helps keep bones strong and healthy.
Follow the doctor's advice on the use of drugs and supplements. If you strictly follow the instructions of a specialist, you can avoid the risk of consuming too large portions of vitamin D, which sometimes leads to hypercalcemia.
Prospects for the treatment of hypercalcemia
Prospects for the treatment of hypercalcemia depend on the severity of the disease.
Mild hypercalcemia may not require treatment. If a more serious condition is observed, the doctor may prescribe drugs to reduce the level of calcium and treat the diseases that underlie the imbalance.
Anyone who observes the symptoms of hypercalcemia should discuss this problem with their doctor.