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Hypercalcemia

Elevation of blood calcium above normal; a broad clinical picture ranging from fatigue to kidney stones and cardiac effects.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Endokrinoloji department. Book Appointment →

What is Hypercalcemia?

Hypercalcemia is an increase in serum total calcium above 10.5 mg/dL (or ionized calcium above 1.32 mmol/L). Mild hypercalcemia (<12 mg/dL) is often asymptomatic or has nonspecific symptoms; levels >14 mg/dL can be life-threatening.

In the outpatient setting, the most common cause is primary hyperparathyroidism; in hospitalized patients, malignancy-related hypercalcemia is more common. Sarcoidosis, vitamin D toxicity, thiazide diuretics, lithium, and immobilization are other important causes.

Clinically, the classical mnemonic 'stones, bones, groans, psychic moans' (kidney stones, bone pain, abdominal complaints, psychiatric symptoms) is used.

Symptoms

Fatigue, weakness, and poor general well-being
Excessive thirst and frequent urination (polyuria-polydipsia)
Nausea, loss of appetite, and constipation
Kidney stones (renal colic)
Bone pain and increased fracture risk
Difficulty concentrating, depression, and confusion
Short PR and shortened QT (on ECG)

Risk Factors

Primary hyperparathyroidism
Malignancy (multiple myeloma, lung, breast, and kidney cancers)
Sarcoidosis and granulomatous diseases
Thiazide diuretic or lithium use
Excessive vitamin D and calcium supplementation
Prolonged immobilization

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • High calcium detected on blood testing
  • Recurrent kidney stones together with bone pain
  • Persistent excessive thirst, frequent urination, and fatigue
  • Confusion or altered consciousness with suspected high calcium (emergency!)

Treatment Methods

01
Mild asymptomatic: increase fluid intake, avoid excess thiazides and vitamin D
02
Acute symptomatic hypercalcemia: aggressive IV saline hydration followed by furosemide
03
Bisphosphonates (IV zoledronic acid): effective in malignancy-related hypercalcemia
04
Denosumab: in malignancy-related hypercalcemia unresponsive to bisphosphonates
05
Primary hyperparathyroidism: parathyroid adenomectomy (curative surgery)
06
Corticosteroids: first-line in sarcoidosis and vitamin D toxicity

Which Department to Visit?

You can visit our Endokrinoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.