What is hypercalcaemia?

Hypercalcaemia is a fluid and electrolyte disorder in which there are higher levels of calcium in the blood than usual. The normal level of calcium in the blood ranges from 2.1mmol/L to 2.6mmol/L, and anything greater than this is defined as hypercalcaemia.

Hypercalcaemia is relatively common, and if the increase is mild, it tends to be asymptomatic. However, in those who experience a more rapid onset, or who have higher levels of calcium in the blood, hypercalcaemia can produce an increase in gastrin production, peptic ulcers, heart rhythm disorders and cognitive impairment amongst other problems.

What are the symptoms of hypercalcaemia?

Symptoms may vary depending on the cause, but the main signs and symptoms are:

• More frequent urination and increased thirst
• Lack of appetite, nausea, vomiting or constipation
• Bone pain
• Feeling tired, fatigue or confusion
• Spasms or muscle weakness
• Gastritis

What are the causes of hypercalcaemia?

The most common causes for hypercalcaemia are primary hyperparathyroidism or cancer. Hyperparathyroidism is estimated to account for around ninety per cent of cases.

Hypercalcaemia can also be caused by other conditions, such as kidney (renal) failure, multiple myeloma and other cancers with metastatic spread, vitamin D disorders (including excess vitamin D and calcium intake) and drug-associated and adrenal insufficiency.

Can hypercalcaemia be prevented?

Most causes of hypercalcaemia cannot be prevented. However, several measures can be taken to avoid its onset if it is due to excess calcium in the diet. Consult with your doctor as to whether calcium and vitamin D supplements should be avoided, ask for advice on the amount of calcium which is appropriate for you as an individual, and make sure you are drinking enough fluids.

What is the treatment for hypercalcaemia?

Treatment usually focuses on the underlying cause of hypercalcaemia. For example, if its origin is primary hyperparathyroidism, surgery can be performed to remove the affected parathyroid gland.

If the hypercalcaemia is mild, it can be controlled with lifestyle changes and monitoring calcium intake. On the other hand, if the hypercalcaemia is serious, and produces symptoms, treatment may be required, including:

• administration of intravenous fluids
• dialysis (if the hypercalcaemia is related to kidney failure)
• medication, depending on the cause of the hypercalcaemia