Diagnosis

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

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

Treatment

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.

Medications

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 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.

Preparing for your appointment

You might start by seeing your primary care provider. However, you'll probably 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?
July 07, 2017
References
  1. Shane E. Clinical manifestations of hypercalcemia. http://www.uptodate.com/home. Accessed Dec. 27, 2016.
  2. AskMayoExpert. Hypercalcemia. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2016.
  3. Fact sheet: High blood calcium (hypercalcemia). Hormone Health Network. http://www.hormone.org/questions-and-answers/2012/hypercalcemia. Accessed Dec. 27, 2016.
  4. Shane E, et al. Treatment of hypercalcemia. http://www.uptodate.com/home. Accessed Dec. 28, 2016.
  5. Primary hyperparathyroidism. National Endocrine and Metabolic Diseases Information Service. http://endocrine.niddk.nih.gov/pubs/hyper. Accessed Dec. 28, 2016.
  6. Hypercalcemia. Merck Manual Professional Version. http://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/electrolyte-disorders/hypercalcemia. Accessed Dec. 27, 2016.