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Hypercalcaemia

Raised calcium levels

Key points about hypercalcaemia

Having enough calcium in your body is important for healthy bones and teeth, and for muscle and nerve activity, including your heartbeat.
But having too much calcium can weaken your bones and cause kidney stones. It can be life-threatening.
The most common cause is overactive parathyroid glands producing too much of the hormone that controls the amount of calcium in your body.
Symptoms are quite general so you often don't know you have this condition until it's picked up in a blood test.
Treatment depends on the cause and how high your calcium levels are. It may involve monitoring (including diet and fluid intake), medication or surgery.

Glass of water with lemon, mint and a straw

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There are many causes of raised calcium levels, the most common being overactive parathyroid glands, which secrete too much parathyroid hormone. This hormone helps control the amount of calcium in your body. When too much parathyroid hormone is secreted, your bones may lose calcium and the levels of calcium in your blood and urine rise. Read more about overactive parathyroid glands (also called hyperparathyroidism).

People with cancers such as lung cancer or breast cancer are at increased risk of having hypercalcaemia.

Other less common causes include:

medicines such as diuretics (water tablets) or lithium
too much calcium or vitamin D in the diet, usually as a result of taking supplements
severe dehydration
kidney problems
other diseases such as tuberculosis and sarcoidosis
being inactive, such as spending a lot of time sitting or lying in bed.

Most people with hypercalcaemia are not usually aware they have it. It may be picked up by your doctor in a routine blood test. The symptoms are quite general and non-specific.

Symptoms of hypercalcaemia
feeling thirsty, dry mouth peeing (urinating) more than usual increasing weakness, tiredness and feeling unwell loss of appetite feeling drowsy, sleepy and having problems concentrating	constipation stomach upset nausea (feeling sick) vomiting (being sick) pain in the joints, bones or muscles

The treatment of hypercalcaemia depends on what is causing it and how severe it is. If the levels of calcium in your blood are only slightly high and you do not have any symptoms, your doctor will monitor your condition on an ongoing basis. This will involve having blood tests every 6 months to check your calcium levels and kidneys. Your doctor may advise you to:

drink more water each day to reduce the risk of kidney stones
not exceed the recommended dietary calcium intake ie, about 1000 mg per day
ensure you are getting enough vitamin D.

If you have extremely high calcium levels in your blood, you may need to be hospitalised. This is so a doctor can reduce your calcium levels and monitor you regularly.

If your hypercalcaemia is due to an overactive parathyroid gland, you may require surgery to remove the parathyroid gland. Read more about treatment options for hyperparathyroidism.

For hypercalcaemia due to cancer, osteoporosis medicines called bisphosphonates are given by injection into your vein. If it is caused by high levels of vitamin D or sarcoidosis, then a short course of steroids such as prednisone may be given.

What questions should I ask my healthcare team about hypercalcaemia?
If you are diagnosed with hypercalcaemia, you may have lots of questions for your doctor, nurse, pharmacist or other healthcare professional. It’s okay to ask questions. Here are a few suggestions. What is causing my hypercalcaemia? How severe is my hypercalcaemia? What are my treatment options? What are the side effects of treatment? What can I do to reduce the symptoms of hypercalcaemia? How will having hypercalcaemia affect my everyday life? Are there any foods I need to stop eating?

What questions should I ask my healthcare team about hypercalcaemia?

If you are diagnosed with hypercalcaemia, you may have lots of questions for your doctor, nurse, pharmacist or other healthcare professional. It’s okay to ask questions. Here are a few suggestions.

What is causing my hypercalcaemia?
How severe is my hypercalcaemia?
What are my treatment options?
What are the side effects of treatment?
What can I do to reduce the symptoms of hypercalcaemia?
How will having hypercalcaemia affect my everyday life?
Are there any foods I need to stop eating?

Apps reviewed by Healthify

You may find it useful to look at some Medication reminder apps and Nutrition, exercise and weight management apps.

Calcium supplements
Vitamin D
Bisphosphonates
Tuberculosis
Sarcoidosis | Mate pauku
What is a blood test?

The following links provide further information about hypercalcaemia. Be aware that websites from other countries may have information that differs from New Zealand recommendations.

Hypercalcemia(external link) Mayo Clinic, US
Hypercalcaemia(external link) Patient Info, UK
Hypercalcaemia and hypercalciuria(external link) NZ Formulary