Hypercalcemia (High Calcium Level in the Blood)
TESTS AND PROCEDURES

Hypercalcemia (High Calcium Level in the Blood)

By Frogge, Margaret Hansen RN, MS,Goodman, Michelle RN, MS, OCN,Yarbro, Connie Henke RN, MS, FAAN 
 | 
October 30, 2018

Hypercalcemia (High Calcium Level in the Blood)

Symptoms and description

Hypercalcemia is an abnormally high amount of calcium in the blood. Calcium is needed by the body to function properly. Calcium can affect your nerves, muscles, digestive tract, kidneys, and the way your heart functions. When the calcium level becomes too high, you may have unusual symptoms. The calcium level in your blood is normally controlled by hormones, the kidneys, GI tract, and bone. Hypercalcemia may happen because your cancer has spread to the bones, causing calcium to be released. Or, your cancer may release certain hormones that affect the normal systems that control the calcium level in your blood. Hypercalcemia does not happen by drinking too much milk or by eating too many dairy products. The high calcium level happens because of your cancer. The symptoms may come on slowly. Or they may happen in a short period of time.

Learning needs

Symptoms of hypercalcemia can be similar to symptoms of other health conditions or symptoms of medicine side effects. You and your loved ones should learn which signs and symptoms to look for that mean your calcium level is getting too high. Some of these symptoms may also be caused by loss of appetite, nausea and vomiting, constipation, or confusion if you are taking strong pain medicines. However, But it is important to let your healthcare provider know if you develop have any of the following, especially if they are different from the way you usually normally feel:

  • Extreme tiredness (fatigue)

  • Excessive sleepiness

  • Confusion

  • Coma

  • Extreme muscle weakness

  • Loss of appetite

  • Nausea, vomiting

  • Stomach pain

  • Constipation

  • Changes in your heartbeat (too slow or too fast)

  • Frequent urination

  • Excessive thirst

  • Dry mucous membranes (the lining of your mouth and throat)

Prevention

Changes in the calcium level in your blood are influenced by your cancer. So the best way to control the calcium is to treat the cancer itself. Your healthcare provider will discuss this with you.

Management

Some people have symptoms when the calcium level is only slightly high. But others may not have these symptoms until the level is extremely high. Many medicines are available to help control the calcium level—even if the cancer is not being treated. If your calcium level is too high and you are having many problems, you may need to go in the hospital for a short period of time. If it is only mildly high, you might be able to control it at home. The decision of when to treat this condition is often based on your symptoms, not on the exact level of your blood calcium. Your healthcare provider will discuss this with you.

For mildly high calcium levels:

  • Extra fluids will be given by a needle in your vein or you may be told to drink more fluids

  • You will be closely watched

For higher calcium levels, or if you are having symptoms, you may be hospitalized, and you can expect:

  • Extra fluids will be given by a needle in your vein

  • Calcium-controlling medicines may be given by mouth, by shots, or in the vein

  • Frequent blood draws will be taken to check the level of calcium and other chemicals

  • For patients with kidney failure, dialysis may be needed 

Follow-up

Here is what to expect:

  • Blood draws may be needed

  • Drink plenty of fluid daily (unless directed not to by your healthcare provider)

  • Take medicines as ordered

  • Report any symptoms of high calcium level to your healthcare provider

Updated:  

October 30, 2018

Sources:  

Becker, C. Scientific American Medicine: Diseases of Calcium Metabolism and Metabolic Bone Disease. 2014., Treatment of Hypercalcemia. UpToDate.

Reviewed By:  

Gersten, Todd, MD,LoCicero, Richard, MD,Sather, Rita, RN,Ziegler, Olivia, MS, PA