Hypercalcemia can be caused by supplements, overactive parathyroid glands, certain medications, dehydration, cancer, bipolar disorder medication, diuretics, tuberculosis, sarcoidosis, and genetic disorders. Diagnosis is based on medical history and blood tests. Severe hypercalcemia can cause fatigue, lethargy, and confusion.
Typically, causes of hypercalcemia include use of calcium and vitamin D supplements, overactive parathyroid glands, and certain medications, such as lithium. Also, temporary hypercalcemia may be related to dehydration. Generally, when a person becomes dehydrated, there is less blood volume, resulting in increased calcium concentration levels. This is a temporary condition, which often resolves on its own when the person rehydrates, either by taking fluids by mouth or by receiving intravenous fluids. Treatment for hypercalcemia usually depends on the cause.
Sometimes, the causes of hypercalcemia can be related to cancer. Some cancers, such as lung cancer, breast cancer, and some blood cancers, release proteins into the blood that mimic the actions of parathyroid hormones. This action can release calcium from the bones into the bloodstream. This condition is sometimes referred to as paraneoplastic syndrome, which is the body’s response to substances produced by cancer. Also, metastases or the spread of bone cancer can increase the risk of hypercalcemia.
Frequently, medications used to treat bipolar disorder can increase the release or presence of parathyroid hormone. This release can cause hypercalcemia, as can the intake of diuretics. Thiazide diuretics are “water pills” that are used to rid the body of excess water and lower blood pressure. While these diuretics are effective in treating edema and hypertension, they are one of the most common causes of hypercalcemia. They can cause the level of calcium in the blood to rise by depleting the calcium lost in the urine. Sometimes, when diuretic-induced hypercalcemia is severe, your doctor may switch your medications to another type of diuretic.
Other diseases causing hypercalcemia can include tuberculosis and sarcoidosis. These diseases produce inflammation due to tissue damage. These tissue lesions are referred to as granulomas, which can elevate blood levels of calcitriol. Typically, increased calcitriol levels can cause the digestive system to absorb more calcium, which can raise blood calcium levels. Also, a genetic disorder called familial hypocalciuric hypercalcemia can cause blood calcium to rise because the calcium receptors in the body don’t work effectively.
Generally, the presence of hypercalcemia can be detected by a simple blood test, however, the actual causes of hypercalcemia can be more difficult to diagnose. Diagnosing the cause of hypercalcemia will usually be based on a patient’s complete medical history, including any medications they have taken and the presence of certain diseases. Many times, mild hypercalcemia will be asymptomatic, however, severe hypercalcemia can cause fatigue, lethargy, and confusion.
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