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February 2 2017 by Ray Sahelian, M.D.
Hypercalcemia is defined as an excessive amount of calcium in the blood.
Symptom and sign, what people notice
Symptoms of hypercalcemia can influence many organs and tissues of the body. For instance, in the skeletal system, hypercalcemia can lead to bone pain, spinal column curvature, and pathological fractures. Abdominal symptoms of hypercalcemia include nausea, vomiting, and constipation. Psychological symptoms could include depression, irritability, apathy, and dementia. In the musculoskeletal system, hypercalcemia can lead to the symptoms of weakness, muscle twitches, and muscle atrophy. Kidneys can be damaged and lead to frequent urination.
Cause, why it happens
The two most common causes of hypercalcemia are primary
hyperparathyroidism and cancer.
Primary hyperparathyroidism is the most common cause of hypercalcemia and is due
to excess PTH. Parathyroidectomy is the only curative intervention for primary
hyperparathyroidism. Another cause of hypercalcemia
is multiple myeloma.
Some malignant tumors (for example, lung cancers, breast cancer) produce PTH-related peptide which increases blood calcium. Excess vitamin D (hypervitaminosis D) from diet or inflammatory diseases can also cause hypercalcemia. Kidney failure, adrenal gland failure, hyperthyroidism, prolonged immobilization, use of a class of diuretics called thiazides, and ingestion of massive amounts of calcium (milk-alkali syndrome) are other potential hypercalcemia causes.
First one has to determine the cause of the condition before considering any kind of treatment.
If it is causing severe symptoms, or if the values are critically high, lowering the blood levels may require hospitalization and the use of hydration, steroids, or even dialysis.
If the calcium level is modestly high, treatment with medications can be administered on an outpatient basis. If the underlying cause is hyperparathyroidism (particularly from an adenoma), surgery may be considered.
Cancer patients usually present with symptoms of hypercalcemia. Rapid institution of antihypercalcemic treatment is essential in preventing life-threatening deterioration. Fluid repletion and administration of bisphosphonates are the treatment mainstays in hypercalcemia of malignancy. Five bisphosphonates are currently licensed in Europe for treatment of tumor-associated hypercalcemia: etidronate, clodronate, pamidronate, ibandronate, and zoledronate. In the US, pamidronate and zoledronate are licensed for use in this indication. Bisphosphonates containing nitrogen atoms (e.g. pamidronate, ibandronate, and zoledronate) are more potent than those without (e.g. etidronate, clodronate, and tiludronate). In patients with malignant hypercalcemia, the efficacy of the individual bisphosphonate depends on dose administered and initial serum calcium concentration. If hypercalcemia is seen in the presence of cancer, the average one year survival rate is less than 40%.
Hypercalcemia defined as serum calcium >2.62 mmol/l (10.5 mg/dl) is a relatively common clinical problem. Malignancy and primary hyperparathyroidism remain its leading causes. The clinical symptoms depend on the degree and duration of the disorder. Very high levels of calcium in the blood and body can affect different organs or systems. The therapy involves saline hydration, loop diuretics, antiresorptive drugs (calcitonin, bisphophonates), steroids. In severe hypercalcemia hemodialysis may be necessary.
Are there alternative treatments or natural therapies such as vitamins and supplements for treating hypercalcemia?
I am not aware of any at this time.
Q. My mother went
to the doctor and has elevated levels of calcium, might be hypercalcemia but she
has not seen a specialist. She has been under allot of stress this year. My
younger brother passed away recently. So when I was on the Internet researching
a little, I came across your research writing on hyperthyroidism and
hypercalcemia. I was wondering if there is a natural way to help with
hypercalcemia or is surgery the only way?If there is any information you might
have for me anything will help.
A. There are many causes for elevated calcium levels in the blood and it is important for the doctor to first find out the cause which determines the treatment.