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High Blood Calcium

If you have a blood test that shows high blood calcium (hypercalcemia), your doctor is obligated to investigate it as it is never normal to have high calcium levels in your blood.

HYPERCALCEMIA TABLE
 

CAUSE

DISEASE

 

PARATHYROID

Hyperparathyroidism

 

CANCER

Lung Cancer
Breast Cancer
Multiple Myeloma
Bone Metastasis

 

GRANULOMATOUS DISEASE

Tuberculosis
Sarcoidosis

 

HYPERTHYROID STATES

Overactive Thyroid
Excess Thyroid
Medications 

 

MEDICATIONS

Thiazide Diuretics
Lithium

 

SUPPLEMENTS

Excess Vitamin D intake
Excess Calcium intake
Milk Alkali Syndrome 

  DEHYDRATION Temporary
Hypercaclemia
 

IMMOBILIZATION

Being bed-bound for prolonged periods 

 

FAMILIAL

Familial Hypocalciuric
Hypercalcemia (FHH)

99% of all hypercalcemia that is persistant is due to abnormality of the parathyroid glands, which causes hyperparathyroidism. While many patients worry about cancer, most people will find the answers they are looking for by measuring the parathyroid function first. The majority of patients with high blood calcium will almost certainly have a small benign tumor on one of their parathyroid glands. While the tumor must be removed, it is important to remember that it is not cancer.

In addition to hyperparathyroidism there are several different causes of high blood calcium listed below.

CANCER - Certain cancers including lung and breast, as well multiple myeloma, among others, can cause high calcium levels. Some produce a hormone similar to PTH called PTH related peptide or PTHrp that acts like PTH in raising calcium levels (this is called a paraneoplastic syndrome). Others, such as metastasis, cause destruction of the bone and therefore release of the bone's calcium into the blood stream.

GRANULOMATOUS DISEASE - SARCOIDOISIS is a disease where the body’s immune system becomes over-active for unknown reasons. TUBERCULOSIS is an infectious disease of the lung. These disease cause inflamatory lesions (granulomas) that can increase the level of vitamin D (calcitriol) in the blood which in turn increases calcium absorption in the intestines and thus hypercalcemia.

HYPERTHYROID STATES - Overactive thyroid glands or excess use of thyroid medications can cause hypercalcemia.

SUPPLEMENTS - Vitamin D has a direct effect on the intestines and encourages them to absorb calcium from the food that you have eaten. Taking too much vitamin D means you absorb too much calcium from your diet. This will create high calcium levels.

Milk-Akali Syndrome occurs when a patient has a stomach ulcer and self treat it by using antacids containing calcium carbonate. Too much of this self treatment option will leave patients with high blood calcium. But because we have better ways to treat stomach ulcers today, this rarely happens. Normal parathyroid glands will not let the blood calcium reach high levels, unless you are ingesting a massive amount of calcium.

MEDICATIONS - Certain drugs, especially THIAZIDE DIURETICS for high blood pressure, can have an effect on the kidney in such a way that the kidney does not let enough calcium escape the blood into the urine. The excess calcium will then show up at a high blood calcium test.

LITHIUM can cause the release of PTH into bloodstream which will cause hypercalcemia. Some patients on lithium can develop parathyroid hyperplasia.

DEHYDRATION - Dehydration can cause increased concentration of calcium in the blood, but this is temporary and is corrected when the person is hydrated.

IMMOBILIZATION SYNDROMES - When a person is bed-bound for a long period of time and the bones are not bearing weight, they begin to release calcium into the blood which can cause hypercalcemia.

FAMILIAL HYPOCALCIURIC HYPERCALCEMIA - This is a genetic condition where the kidneys don't release calcium into the urine and therefore the level of calcium in the blood is higher. The 24 hour urine calcium shows a very low calcium level. These patients don't suffer the consequences of hypercalcemia and seem to be well adjusted to the higher calcium. They don't require any treatment.

If you are suffering from high blood calcium, schedule a consultation at the CENTER or give us a call at 310.933.4210 today!

Next, low vitamin d levels

Request your consultation with Dr. Larian today.
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Chief of Head & Neck Surgery at Cedars-Sinai

Assistant Clinical Professor of Surgery at UCLA

By Babak Larian, MD FACS   Privacy Notice © 2013 Babak Larian, MD FACS. All Rights Reserved.    

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