Symptoms:

Abdominal:

• Constipation
• Nausea
• Pain
• Poor appetite
• Vomiting

Kidney:

• Flank pain
• Frequent thirst
• Frequent urination

Muscular:

• Muscle twitches
• Weakness

Psychological:

• Apathy
• Dementia
• Depression
• Irritability
• Memory loss

Skeletal:

• Bone pain
• Bowing of the shoulders
• Fractures due to disease (pathological fractures)
• Loss of height
• Spinal column curvature

Signs and tests:

• Serum calcium
• Serum PTH
• Serum PTHrP (PTH-related protein)
• Serum vitamin D level
• Urine calcium

Treatment:

Treatment is directed at the cause of hypercalcemia whenever possible. In more severe cases of primary hyperparathyroidism, surgery may be needed to remove the abnormal parathyroid gland and cure the hypercalcemia.

However, if your hypercalcemia is mild and caused by primary hyperparathyroidism, your health care provider will most likely recommend that you not have surgery, but will monitor your condition closely over time.

Severe hypercalcemia that causes symptoms and requires a hospital stay is treated with the following:

• Calcitonin
• Dialysis
• Diuretic medication, such as furosemide
• Drugs that stop bone breakdown and absorption by the body, such as pamidronate or etidronate (bisphosphonates)
• Fluids through a vein (intravenous fluids)
• Glucocorticoids (steroids)

Expectations (prognosis):

How well you do depends on the cause of hypercalcemia. Patients with mild hyperparathyroidism or hypercalcemia with a treatable cause do well and do not have complications.

Patients with hypercalcemia due to conditions such as cancer or granulomatous disease may not do well, but this is usually due to the disease itself, rather than the hypercalcemia.

Complications:

Gastrointestinal

• Pancreatitis
• Peptic ulcer disease

Kidney

• Calcium deposits in the kidney (nephrocalcinosis)
• Dehydration
• High blood pressure
• Kidney failure
• Kidney stones

Psychological

• Depression
• Difficulty concentrating or thinking

Skeletal

• Bone cysts
• Fractures
• Osteoporosis

The complications of long-term hypercalcemia are uncommon today.

Calling your health care provider:

Contact your physician or health care provider if you have:

• Family history of hypercalcemia
• Family history of hyperparathyroidism
• Symptoms of hypercalcemia

Prevention:

Most causes of hypercalcemia cannot be prevented. Women over age 50 should see their health care provider regularly and have their blood calcium level checked if they have symptoms of hypercalcemia.

You can avoid hypercalcemia from calcium and vitamin D supplements by contacting your health care provider for advice about the dose if you are taking supplements without a prescription.