Calcium is something most of us know about. We’re told to drink milk for strong bones, and we often hear about calcium in the context of healthy living. But what happens when there’s too much calcium in the body? That’s where hypercalcaemia comes into play—a condition that’s as serious as it sounds.
Most of the time, hypercalcaemia doesn’t happen for no reason. It’s often a symptom or a result of an underlying problem, such as an overactive parathyroid gland, certain types of cancer, or excessive intake of calcium supplements or vitamin D.
Another cause is cancer, particularly cancers that spread to the bones, like breast cancer or lung cancer. When these cancers invade the bone, they disrupt the normal processes that regulate calcium levels, causing calcium to be released into the blood.
Other causes include excessive use of calcium or vitamin D supplements, dehydration, and certain medications. The impact of excessive vitamin D or calcium is especially seen when people take large doses for prolonged periods, not fully aware of the risks involved.
In severe cases, hypercalcaemia can lead to life-threatening conditions, such as heart arrhythmias or coma. This is why it’s important to get diagnosed early.
Imaging tests, such as ultrasounds or CT scans, are often used to detect conditions like kidney stones or the spread of cancer to the bones. Once a diagnosis is confirmed, treatment options are tailored to the specific cause of hypercalcaemia.
In less severe cases, treatment may involve intravenous fluids to help dilute the calcium in the blood and medications like bisphosphonates, which can reduce bone breakdown and lower calcium levels. For people who have hypercalcaemia due to excessive supplements, simply adjusting the dose or stopping the supplements may be enough to restore balance.
The best prevention is awareness. If you notice symptoms like unexplained fatigue, frequent thirst, or stomach issues, consider getting a check-up. With early detection and treatment, it’s possible to overcome the challenges of hypercalcaemia.
DID YOU KNOW?
Hypercalcaemia is a condition characterised by unusually high levels of calcium in the blood, typically above 10.5 mg/dL (2.6 mmol/L). Calcium is essential for nerve transmission, muscle contraction, and bone health, but excessive levels can damage organs, particularly the heart, muscles, kidneys, and nervous system.
Hypercalcaemia is often discovered incidentally during routine blood tests and may not cause symptoms unless calcium levels are significantly elevated. When symptoms do occur, they can include frequent urination, excessive thirst, constipation, muscle weakness, nausea, fatigue, anorexia, confusion, and neuropsychiatric effects. Healthcare providers should consider testing calcium levels if hypercalcaemia is suspected based on these symptoms.
Routine blood testing is vital for detecting hypercalcaemia, as mild cases may be overlooked, especially when symptoms are vague or absent. Even mild, persistent hypercalcaemia requires investigation to determine its cause, which could range from benign conditions like hyperparathyroidism to more serious issues, such as malignancy. Early diagnosis is crucial to prevent long-term complications like osteoporosis, bone fractures, and kidney stones.
Preventing hypercalcaemia depends on its underlying cause. Conditions like hyperparathyroidism and malignancy require medical management. If the condition is medication-induced, such as from thiazide diuretics or excessive calcium and vitamin D supplements, patients may need to stop the offending drugs under their doctor's guidance. Increased hydration can help promote calcium excretion but should be monitored by a healthcare provider.
Public awareness of the connection between hypercalcaemia and certain endocrine or cancer-related disorders is key to encouraging early detection. Many are unaware of the serious consequences of untreated hypercalcaemia, which can lead to complications like osteoporosis and kidney stones. Raising awareness will help individuals seek medical advice when experiencing vague symptoms, leading to better outcomes.
Treatment for hypercalcaemia depends on its cause. In malignancy-related hypercalcaemia, medications like denosumab and bisphosphonates, such as zoledronic acid, can help manage calcium levels. Denosumab inhibits RANKL, reducing bone resorption. Cinacalcet, a calcimimetic, is used for secondary hyperparathyroidism in kidney failure and to reduce parathyroid hormone release, lowering calcium levels. Effective treatment relies on accurate diagnosis and targeted management.
Dr Stanley Liew Choon Fong
Endocrinologist, Senior Consultant, Medical Director
Specialist Care Group, Mount Elizabeth Medical Centre, Singapore
Instagram: @specialistcaregroup
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