Is your blood calcium level high? Let's talk about Hypercalcemia in simple terms!

Do you sometimes feel tired, have body aches, or are constantly thirsty? You may think these are normal things. But these can also be signs of high calcium levels in your blood. That's what we call hypercalcemia in medicine. Don't worry, this is usually not a serious problem. Let's talk about everything in a simple and clear way.

Simply put, what is Hypercalcemia?

Hypercalcemia is when you have more calcium in your blood than is normal. Sometimes it can be just a little higher, other times it can be much higher. Also, for some people it is temporary and goes away, while for others it can be lifelong.

Now you might be thinking, calcium is good for bones, so what happens when calcium in the blood increases? True, most of the calcium in our body is in our bones. But, there must be some calcium in the blood as well. Do you know why?

• For the functioning of our nervous system: Calcium is essential for transmitting messages through nerves.
• Muscle function: Calcium helps our muscles contract and relax, which means we move.
• Blood clotting: When there is an injury somewhere and blood is flowing, calcium is needed for the blood clotting process to stop the bleeding.
• Heart function: Calcium plays a very important role in keeping our heart beating properly.

Because it does so many important things, our body carefully controls the level of calcium in our blood. Two hormones help with this. They are the parathyroid hormone and calcitonin . In addition, vitamin D is also essential for the body to absorb calcium from the foods we eat.

What is the difference between Hypercalcemia and Hypocalcemia?

These two words sound a bit similar, don't they? But they have completely different meanings. In medicine, the word "Hyper" means "too much." "Hypo" means "too little." So the difference between the two is very simple.

Who is most likely to develop this condition?

Hypercalcemia can occur at any age, in anyone. However, it is more common in women over the age of 50 , especially after menopause. Often, it is caused by an overactive parathyroid gland, which we discussed earlier.

It is estimated that between 1% and 2% of the general population has this condition. Of these, 90% are reported as hypercalcemia caused by a problem with the parathyroid glands (primary hyperparathyroidism) or a cancer condition.

Is hypercalcemia life-threatening?

However, if calcium levels become very high (severe hypercalcemia), it can cause serious problems. In such a case, immediate medical attention is needed. In such a severe case, the following may occur:

• Kidney failure
• Irregular heartbeat (Arrhythmia)
• Confusion
• Coma

So, while this is usually not serious, it is not a situation to take lightly.

What are the symptoms of Hypercalcemia?

As we mentioned earlier, many people may not experience any symptoms, especially when their calcium levels are only slightly elevated. However, if calcium levels are significantly elevated or if the condition persists for a long time, the following symptoms may occur.

Why does calcium in the blood increase like this? What are the causes?

There are many causes of hypercalcemia. Some diseases, medications, and dehydration can all contribute to it. But the two main causes are overactive parathyroid glands and cancer.

1. Parathyroid gland problem (Primary Hyperparathyroidism)

Imagine that there are four little managers in our body that control the calcium level. These four parathyroid glands are located in our neck, behind the thyroid gland. Their main job is to produce parathyroid hormone (PTH), which controls the calcium level in the blood. When one or more of these glands start working too much for some reason, too much calcium accumulates in the blood. This is the main cause of hypercalcemia.

2. Cancers

Some types of cancer can also cause high blood calcium levels. This is called hypercalcemia of malignancy. Hypercalcemia caused by cancer usually comes on quickly and can be severe. Some types of cancer that can cause this are:

• Lung cancer
• Breast cancer
• Multiple myeloma, a cancer of the white blood cells
• Renal cell carcinoma
• Leukemia and Lymphoma
• Rhabdomyosarcoma

3. Some medications

This condition can also be caused by some medications and vitamins we take.

• Thiazide diuretics: Certain diuretics (e.g., Hydrochlorothiazide) used to treat high blood pressure and fluid retention.
• Lithium: A medication used to treat certain mental illnesses.
• Vitamins and calcium: Taking too much vitamin D, vitamin A, or calcium supplements.
• Antacids: Taking too much of the calcium carbonate tablets (such as Tums® or Rolaids®) that we often take for heartburn can temporarily increase calcium levels.

4. Other reasons

In addition to this, there are several other rare reasons.

• Lung diseases such as sarcoidosis and tuberculosis.
• Kidney failure.
• Hyperthyroidism (Thyrotoxicosis).
• Being confined to bed for a long time.
• Bone-related diseases such as Paget's disease of the bone.

How to recognize this condition?

It is often detected during a routine blood test that you have for another reason. Tests like the Comprehensive Metabolic Panel (CMP) or Basic Metabolic Panel (BMP) also measure calcium levels in the blood. This can help detect it before symptoms appear.

Your doctor will determine the severity of the condition based on the calcium level in your blood.

If your blood calcium level is high, your doctor will examine you, ask about your medications and family medical history. If no clear cause can be found, you may be referred to an endocrinologist.

It is possible that several more tests may be done to find the exact cause.

• A blood test that checks parathyroid hormone (PTH) levels.
• Blood test to check vitamin D levels.
• A test that checks the level of calcium in the urine.
• An ultrasound or CT scan to check for a tumor or swelling in the parathyroid glands.

How is it treated?

Treatment for hypercalcemia depends on the cause and severity of the condition.

For mild conditions

If your calcium levels are slightly elevated, your doctor may advise you to:

• Drink plenty of water: This reduces dehydration in the body and helps to eliminate excess calcium through urine.
• Changing medications: If you are taking thiazide-type medications for high blood pressure, you may be asked to switch to a different medication instead.
• Stopping supplements: Stop taking calcium or vitamin D supplements, antacid tablets containing calcium, or reduce the dosage.

Treatment according to the cause

• If there is a problem with the parathyroid glands: In most cases, the best treatment is to perform surgery to remove the overactive gland or glands.
• If the condition is caused by cancer: Drugs such as bisphosphonates or denosumab may be given.

For severe conditions

However, if your calcium levels are very high and your symptoms are severe, your doctor may decide to admit you to the hospital and give you intravenous fluids (IV fluids) and other treatments. This can quickly lower your calcium levels and prevent complications.

What complications can occur due to this condition?

Long-term complications are rare because this condition is usually diagnosed early. However, if left untreated for a long time, the following problems can occur:

• Calcium deposits in the kidneys (Nephrocalcinosis) and impaired kidney function.
• Kidney stones.
• High blood pressure (Hypertension).
• Depression.
• Osteoporosis and easy bone fractures.

Can it be prevented? When should you see a doctor?

Not all cases of hypercalcemia can be prevented. However, it is wise to avoid unnecessary calcium supplements, vitamins, and calcium-containing antacids without your doctor's advice .

When you should see a doctor:

• If anyone in your family has a history of high calcium levels, parathyroid disease, or kidney stones, talk to your doctor about it.
• If you have any of the symptoms we discussed in this article (such as excessive thirst, frequent urination, body pain, nausea), see a doctor immediately.

It's normal to feel scared and anxious when you're newly diagnosed with a condition. But remember, hypercalcemia is a treatable condition. Once your calcium levels return to normal, your symptoms will go away. Don't be afraid to ask your doctor any questions you have about this.

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