Hypercalcemia Health Article

Treatment

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

If your hypercalcemia is mild and caused by primary hyperparathyroidism, your health care provider will follow you closely over time.

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

• Calcitonin
• Dialysis
• 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 (for example, primary hyperparathyroidism or dietary hypervitaminosis D) may not have complications.

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

Complications

Gastrointestinal

• Hypertension
• Pancreatitis
• Peptic ulcer disease

Kidney

• Calcium deposits in the kidney (nephrocalcinosis)
• Dehydration
• 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 the age of 50 should see their health care provider regularly and have their blood calcium screened periodically.

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

References

Taniegra ED. Hyperparathyroidism. Am Fam Physician. 2004;69(2):333-339.

Carroll MF. A practical approach to hypercalcemia. Am Fam Physician. 2003;67(9):959-966.

Ariyan CE. Assessment and management of patients with abnormal calcium. Crit Care Med. 2004;32:S146-S154.

Bringhurst R, Demay MB, Kronenberg HM. Hormones and disorders of mineral metabolism. In: Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 27.