High blood calcium is a condition of too much calcium in the blood. We catch these on routine blood draws, or rarely individuals have abdominal pain, flank pain, frequent urination, muscle weakness, or mood changes. We will also evaluate this if we have concern for parathyroid tumors or certainly with any #mentalhealth concerns.
The most common cause of hypercalcemia is primary hyperparathyroidism, which happens when the parathyroids over produce. Adrenal failure is another underlying cause of high calcium, as is kidney disease, some tumors, or even an excess of vitamin D. There are medications that cause an elevation in calcium, but of course, there are those who eat an excess of calcium and we then see this in their routine blood tests.
In my own practice, elevated calcium has been discovered in clients who thought they had a plethora of issues, but didn't have any awareness they had a parathyroid tumor. Finding this changed their lives. I often wonder how many people in mental health facilities or even those living on the streets have undiagnosed medical conditions that go untreated, but could be easily rectified with a thorough evaluation. I digress... Hemochromatosis has been yet another underlying cause of elevated calcium; this conditions can impact the kidneys. Surprisingly, while I have a few super eager vitamin D supplementers who do on occasion have impressively elevated vitamin D levels, I have yet to have one whose serum demonstrated elevated calcium as a consequence.
Treatment depends on identifying the underlying cause of course. Surgery may be required to remove a parathyroid gland that has resulted in tumor. Dialysis may be appropriate if the elevated calcium is related to kidney disease. Diuretics and steroids are sometimes utilized, or maybe this is an issue that simply needs dietary changes. If hemochromatosis is the underlying cause, then routine blood donations may be the fix. Cancer of course, specifically lung cancer, may be another cause.
Bone fractures, chest palpitations, difficulty with memory or even stupor are indications of elevated calcium and rather urgent assessment is necessary with these signs, but less ominous symptoms may be dementia, depression, irritability, lower back pain, muscle twitching, musculoskeletal pain, nausea and vomiting, or just plain old lethargy.
My point really is that are you asking why? Are you checking your basic, baseline labs? Do you have abnormals and dig into their underlying cause? Does your clinician think like a private investigator? They should be hungry for the truth below the surface? Dig in and discover the why.
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