Hypercalcemia is the excess of calcium in the blood, and occurs when the value of this mineral is greater than 10.5mg / dl in the blood test, which can be caused by alterations of the parathyroid glands, tumors, endocrinological diseases, or by collateral effect of certain medicines, for example.
This change usually does not cause symptoms, or causes only mild symptoms such as poor appetite and motion sickness. However, when calcium levels rise excessively, staying above 12mg / dl, it can cause symptoms such as constipation, increased urine, drowsiness, fatigue, headache, arrhythmias and even coma.
The treatment of hypercalcemia varies according to its cause and is considered an emergency if it causes symptoms or reaches the value of 13mg / dl. As a way to lower calcium levels, your doctor may recommend use of serum in your vein and remedies such as diuretics, calcitonin, or bisphosphonates.
Possible symptoms
Although calcium is a very important mineral for bone health and for the vital processes of the body, when it is in excess it can negatively affect the functioning of the organism, causing signs like:
- Headache and excessive tiredness;
- Feeling of constant thirst;
- Frequent urge to urinate;
- Nausea and vomiting;
- Decreased appetite;
- Changes in kidney functioning and risk of formation of stones;
- Frequent cramps or muscle spasms;
- Cardiac arrhythmias.
In addition, people with hypercalcemia may also have symptoms related to neurological changes such as memory loss, depression, easy irritability or confusion, for example.
Main causes of hypercalcemia
The main cause of excess calcium in the body is hyperparathyroidism, in which the small parathyroid glands, which are located behind the thyroid, produce in excess a hormone that regulates the amount of calcium in the blood. Learn more about hyperparathyroidism.
However, other causes may be:
- Chronic renal insufficiency;
- Excess vitamin D, mainly due to diseases such as sarcoidosis, tuberculosis, coccidioidomycosis or overconsumption;
- Side effect of using certain medications such as lithium, for example;
- Tumor in the bones, kidneys or intestine in advanced stage;
- Tumor in pancreatic islets;
- Multiple myeloma;
- Milk-alkali syndrome, caused by excessive intake of calcium and use of antacids;
- Paget's disease;
- Endocrine disorders such as thyrotoxicosis, pheochromocytoma and Addison's disease.
Malignant hypercalcemia arises due to the production of a hormone similar to the parathyroid hormone by the cells of a tumor, which causes severe hypercalcemia and difficult to treat. Another form of hypercalcemia in cases of cancer happens due to bone lesions caused by bone metastases.
How to confirm the diagnosis
The diagnosis of hypercalcemia can be confirmed by blood test, which detects total calcium values above 10.5mg / dl or ionic calcium above 5.3mg / dl, depending on the laboratory performed.
After confirmation of this change, the doctor should request tests to identify the cause, which includes the dosage of the hormone PTH produced by the parathyroid, imaging tests such as tomography or resonance to investigate the existence of cancer, as well as evaluation of vitamin D levels, kidney function or the presence of other endocrine diseases.
How is the treatment done?
The treatment of hypercalcemia is usually indicated by the endocrinologist, done mainly according to its cause, which includes the use of medicines to control hormone levels, exchange of medicines for others that do not have hypercalcemia as a side effect or surgery for withdrawal of tumors that may be causing excess calcium if this is the cause.
The treatment is not done urgently, except in cases where symptoms are caused or where blood calcium levels reach 13.5mg / dl, which poses a great risk to health.
Thus, the doctor may prescribe hydration in the vein, loop diuretics, such as Furosemide, calcitonin or bisphosphonates, to try to reduce calcium levels and prevent changes in heart rhythm or injury to the nervous system.
Surgery to treat hypercalcemia is used only when the cause of the problem is the malfunction of one of the parathyroid glands, and it is recommended to remove it.
