Hypercalcemia: Understanding the Condition, Causes, and Treatment Options

Hypercalcemia refers to a medical condition in which the total calcium levels in the blood serum exceed the normal upper limit. Calcium in the blood exists in two forms: ionized calcium and non-diffusible calcium, which is bound to proteins. While the exact reference range may vary slightly depending on the laboratory and testing equipment, a total serum calcium level above 2.58 mmol/L is generally considered indicative of hypercalcemia.

What Causes Hypercalcemia?

Hypercalcemia is classified as an electrolyte disorder and can arise from several underlying causes:

1. Excessive Calcium Intake

Consuming large amounts of calcium-rich foods or supplements may elevate blood calcium levels, especially in individuals with impaired calcium regulation.

2. Primary Hyperparathyroidism

This condition occurs when the parathyroid glands become overactive and secrete excessive parathyroid hormone (PTH), leading to disrupted calcium metabolism and increased calcium levels in the blood.

3. Excessive Vitamin D Intake

High levels of vitamin D can enhance calcium absorption in both the intestines and kidneys, contributing to elevated serum calcium levels.

4. Malignancies and Bone Disorders

Certain cancers—especially those that metastasize to the bone—or other bone-related diseases can cause increased bone breakdown, releasing excess calcium into the bloodstream.

5. Prolonged Immobility

Extended periods of inactivity or immobilization can lead to bone demineralization, resulting in higher blood calcium levels due to reduced skeletal use.

Treatment Options for Hypercalcemia

In mild cases of hypercalcemia, lifestyle and dietary modifications can be effective. Reducing calcium intake and increasing fluid consumption can help normalize calcium levels. Additionally, certain diuretics may be prescribed to enhance calcium excretion through urine.

If hypercalcemia is caused by an underlying medical condition, targeted treatment of the primary issue is essential. For example, treating hyperparathyroidism may involve surgical removal of the affected parathyroid gland. In cancer-related cases, managing the tumor or using medications such as bisphosphonates can help control blood calcium levels.

Severe or symptomatic hypercalcemia often requires hospitalization for intravenous hydration and more aggressive medical interventions to rapidly lower calcium levels and prevent complications such as kidney damage or cardiac arrhythmias.