Because hypercalcemia can cause few, if any, signs or symptoms, you might not know you have the disorder until routine blood tests reveal a high level of blood calcium. Blood tests can also show whether your parathyroid hormone level is high, indicating that you have hyperparathyroidism.

To determine if your hypercalcemia is caused by a disease such as cancer or sarcoidosis, your doctor might recommend imaging tests of your bones or lungs.

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If your hypercalcemia is mild, you and your doctor might choose to watch and wait, monitoring your bones and kidneys over time to be sure they remain healthy.

For more severe hypercalcemia, your doctor might recommend medications or treatment of the underlying disease, including surgery.


In some cases, your doctor might recommend:

  • Calcitonin (Miacalcin). This hormone from salmon controls calcium levels in the blood. Mild nausea might be a side effect.
  • Calcimimetics. This type of drug can help control overactive parathyroid glands. Cinacalcet (Sensipar) has been approved for managing hypercalcemia.
  • Bisphosphonates. Intravenous osteoporosis drugs, which can quickly lower calcium levels, are often used to treat hypercalcemia due to cancer. Risks associated with this treatment include breakdown (osteonecrosis) of the jaw and certain types of thigh fractures.
  • Denosumab (Prolia, Xgeva). This drug is often used to treat people with cancer-caused hypercalcemia who don't respond well to bisphosphonates.
  • Prednisone. If your hypercalcemia is caused by high levels of vitamin D, short-term use of steroid pills such as prednisone are usually helpful.
  • IV fluids and diuretics. Extremely high calcium levels can be a medical emergency. You might need hospitalization for treatment with IV fluids and diuretics to promptly lower the calcium level to prevent heart rhythm problems or damage to the nervous system.

Surgical and other procedures

Problems associated with overactive parathyroid glands often can be cured by surgery to remove the tissue that's causing the problem. In many cases, only one of a person's four parathyroid glands is affected. A special scanning test uses an injection of a small dose of radioactive material to pinpoint the gland or glands that aren't working properly.

Treatment of parathyroid disease at Mayo Clinic

Here at the Mayo Clinic in Endocrine and Metabolic Surgery, we treat the full spectrum of parathyroid problems. And that ranges from the simplest primary hyperparathyroidism to the most complex cases.

What they are are four little glands that regulate the calcium. And most often, it's just one of them that develops a tumor of it.

We utilize multimodal imaging, meaning various types of imaging to identify where the abnormal parathyroid is located. And that can include various imaging techniques such as ultrasound, parathyroid sestamibi scan, which is a nuclear medicine imaging. We use four-dimensional CT scan, which is an advanced CT scan imaging of the neck and parathyroid glands. And finally, cutting-edge imaging such as choline PET scan.

So PET choline is one of the newest imaging modalities that's out there. It requires generation of a choline isotope onsite. And so this is not widely available. It's really only available at a few centers across the country. And so with this type of scan, we can find parathyroid glands that are otherwise missed by traditional imaging techniques.

Once that step is complete, then the patient can very confidently move towards the next step, which is treatment.

Patients can come into the office feeling a variety of symptoms that are generally nonspecific, but rather debilitating for them. In many of these cases, we're able to treat hyperparathyroidism and watch these symptoms literally go away.

What we strive for is really to have a very efficient and effective itinerary for patients and know they're going to be operated on by very high-volume, experienced parathyroid surgeons. You feel confident that they're going to come here and get the care they need and deserve.

Preparing for your appointment

You might start by seeing your primary care provider. However, you'll likely be referred to a doctor who specializes in treating hormonal disorders (endocrinologist).

Here's some information to help you get ready for your appointment.

What you can do

Before your appointment, make a list of:

  • Your symptoms, including those that seem unrelated, and when they began
  • Key personal information, including major stresses or recent life changes, medical history, and family medical history
  • All medications, vitamins and other supplements you take, including doses
  • Questions to ask your doctor

Take a family member or friend along, if possible, to help you remember the information you're given.

For hypercalcemia, basic questions to ask your doctor include:

  • What's the most likely cause of my symptoms?
  • What tests do I need?
  • What treatments are available, and which do you recommend?
  • What side effects can I expect from treatment?
  • Are there alternatives to the primary approach that you're suggesting?
  • I have other health conditions. How can I best manage them together?

What to expect from your doctor

Your doctor is likely to ask you questions, including:

  • Does anything improve your symptoms?
  • What, if anything, worsens your symptoms?
  • Have you had kidney stones, bone fractures or osteoporosis?
  • Do you have bone pain?
  • Do you have unexplained weight loss?
  • Have family members had hypercalcemia or kidney stones?
April 14, 2023
  1. Shane E. Clinical manifestations of hypercalcemia. https://www.uptodate.com/contents/search. Accessed Jan. 22, 2020.
  2. AskMayoExpert. Hypercalcemia. Mayo Clinic; 2019.
  3. Hypercalcemia. Hormone Health Network. https://www.hormone.org/diseases-and-conditions/hypercalcemia. Accessed Jan. 22, 2020.
  4. Shane E, et al. Treatment of hypercalcemia. https://www.uptodate.com/contents/search. Accessed Jan. 22, 2020.
  5. Feingold KR, et al, eds. Approach to hypercalcemia. In: Anatomy and Ultrastructure of bone – Histogenesis, growth and remodeling. MDText.com. 2019. https://www.ncbi.nlm.nih.gov/books/NBK279129/. Accessed Jan. 23, 2020.


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