Hypercalcemia is a condition defined by abnormally high levels of calcium in the blood. It has many potential causes, including primary hyperparathyroidism, various cancers, and certain medications. Symptoms can include frequent urination, fatigue, nausea, and muscle weakness. Diagnosis involves blood tests to measure calcium levels. Treatment depends on the underlying cause but may include increased fluid intake, medication changes, surgery, or intravenous fluids in severe cases.

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Submitted by Viona Gupta, 218629
Submitted to Mrs. Jovita, Department of MSc FSND
HYPERCALCEMIA
Essentials Of Micro-Nutrients

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Hypercalcemia, also spelled hypercalcaemia, is a
high calcium (Ca2+) level in the blood serum. The normal range is
2.1–2.6 mmol/L (8.8–10.7 mg/dL, 4.3–5.2 mEq/L), with levels
greater than 2.6 mmol/L defined as hypercalcemia.
Higher than normal level of calcium in your blood, is a fairly common
finding. Blood tests, such as those drawn for an annual physical exam,
today routinely check calcium levels. This allows physicians to detect
abnormally high calcium levels early..
Hypercalcemia

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Calcium is the most common mineral in the body. It performs many important body functions. Around 99% of total body
calcium is stored in the bones and teeth, where it is essential for growth and maintenance. Around 1% is found in the
blood, muscle, and cell fluids where it is needed for muscle contraction to make limbs move, heart contraction, blood
clotting, secretion of hormones and enzymes, and sending messages through the nervous system.
The richest source of calcium amongst
plant foods are dairy foods (milk, yoghurt
and cheese) and amongst the plant foods
are green leafy vegetables like amaranth,
fenugreek leaves and broccoli. Cereals
like Ragi, nuts and seeds like almonds,
pistachios and sesame seeds, fishes like
salmon, sardines etc. are good sources of
calcium.
600 mg of calcium per day for your
children aged from 1 to 9 years of age
and for adult male and female . The
recommendation increases to 800 mg per
day for children 10 year onwards and
continues to be the same till for
adolescents till 17 years of age.
RDA increases to 1200 mg/d for pregnant
and lactating mothers.
Sources of Calcium RDASPECIFICATIONSBY ICMR

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• Hypercalcemia can be caused by more than 25 separate diseases, several medications and even dehydration.
Primary hyperparathyroidism and various kinds of cancers account for the greatest percentage of all patients with hypercalcemia
• Lung cancer, breast cancer and certain cancers of the blood can cause
• Common medications such as hydrochlorothiazide and other thiazide diuretics (prescribed for hypertension and edema), lithium, and
excessive intake of vitamin D, vitamin A or calcium can result in hypercalcemia
• Taking too much calcium carbonate in the form ofTums or Rolaids is actually one of the more common causes of hypercalcemia.
• Primary hyperparathyroidism and various kinds of cancers account for the greatest percentage of all patients with hypercalcemia.
•Lung diseases such as sarcoidosis and tuberculosis, Kidney failure
•Hyperthyroidism (an overactive thyroid)
•Being bedridden/immobilized, even for a relatively short period
•Paget’s disease of the bone
•Multiple myeloma
Causes

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Symptoms
It also shows an affect on
•Kidneys..
•Digestive system. .
•Bones and muscles.
• Brain.
•Heart. .
Although having symptoms of hypercalcemia is uncommon, symptoms can include:
•More frequent urination and thirst
•Fatigue, bone pain, headaches
•Nausea, vomiting, constipation, decrease in appetite
•Forgetfulness
•Lethargy, depression, memory loss or irritability
•Muscle aches, weakness, cramping and/or twitches

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Diagnosis
• Blood tests
• Clinical symptom diagnosis

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Treatment
•Drink more water
•Switch to a non-thiazide diuretic or blood pressure medicine
•Stop calcium-rich antacid tablets
•Stop calcium supplements
If the hypercalcemia is due to an overactive parathyroid gland,
•Close monitoring of the calcium level
•Referral to surgery to have the overactive gland(s) removed
•Starting a medication such as cinacalcet (Sensipar®), which is used to manage
hypercalcemia
•Using bisphosphonates, osteoporosis drugs given intravenously (with a needle
through the veins) that treat hypercalcemia due to cancer
•Using denosumab (XGEVA®), another bone-strengthening drug for patients with
cancer-caused hypercalcemia who don’t respond to bisphosphonates
If the hypercalcemia is severe, and/or causing significant symptoms, your doctor may recommend
immediate hospitalization for intravenous fluids and other treatment

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Review Article – Abstract
A Practical Approach to Hypercalcemia
Stewart, A. F. (2005). Hypercalcemia associated with cancer. New England Journal of Medicine 352(4),
373-379
Hypercalcemia is a disorder commonly encountered by primary care physicians. The diagnosis often
in asymptomatic patients. Clinical manifestations affect the neuromuscular, gastrointestinal, renal,
cardiovascular systems. The most common causes of hypercalcemia are primary hyper-para
Some other important causes of hypercalcemia are medications and familial hypocalciuric
diagnostic work-up should include measurement of intact parathyroid hormone, and any
be causative should be discontinued. Parathyroid hormone is suppressed in malignancy-associated
elevated in primary hyperparathyroidism. It is essential to exclude other causes before considering
and patients should be referred for parathyroidectomy only if they meet certain criteria. Many
hyperparathyroidism have a benign course and do not need surgery. Hypercalcemic crisis is a life-
emergency. Aggressive intravenous rehydration is the mainstay of management in severe
antiresorptive agents, such as calcitonin and bisphosphonates, frequently can alleviate the clinical
hypercalcemic disorders.

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Research article
The hypercalciuric or benign variant of familial
hypercalcemia clinical and biochemical featured in
15 kindred
Marx, S. J., Attie, M. F., Levine, M. A., Spiegel, A. M.,
W., & Lasker, R. D. (1981). The hypocalciuric or benign
familial hypercalcemia: clinical and biochemical features in
kindreds. Medicine, 60(6), 397-412.

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Reference
https://my.clevelandclinic.org/he
alth/diseases/14597-
hypercalcemia
https://www.mayoclinic.org/dise
ases-
conditions/hypercalcemia/sym
ptoms-causes/syc-20355523
Marx, S. J., Attie, M. F., Levine, M. A., Spiegel,
A. M., DOWNS JR, R. W., & Lasker, R. D.
(1981). The hypocalciuric or benign variant of
familial hypercalcemia: clinical and biochemical
features in fifteen kindreds. Medicine, 60(6),
397-412
Stewart, A. F. (2005). Hypercalcemia
associated with cancer. New
England Journal of Medicine 352(4),
373-379

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Thank you