Symptoms and Signs of Hypercalcemia (Elevated Calcium Levels)

Doctor's Notes on Hypercalcemia (Elevated Calcium Levels)

Hypercalcemia is a condition in which levels of calcium in the body are elevated above what is considered normal (normal calcium vary with age; most labs consider 10.5 mg/dL and above as hypercalcemia in adults over age 35).

Signs and symptoms of hypercalcemia are minor in most patients but as calcium levels increase, symptoms become more pronounced. Symptoms of hypercalcemia (elevated calcium levels) are often described as "moans, stones, groans, and bones." “Moans” symptoms of hypercalcemia refer to gastrointestinal conditions including 

• abdominal pain, 
• constipation,
• decreased appetite, 
• nausea, 
• peptic ulcer disease, and 
• vomiting.

“Stones” symptoms of hypercalcemia refer to kidney-related conditions and include

• flank pain, 
• frequent urination, and 
• kidney stones.

“Groans” symptoms of hypercalcemia refer to psychological conditions and include

• confusion, 
• dementia, 
• depression, and
• memory loss.

“Bones” symptoms of hypercalcemia refer to bone pain and bone-related conditions including

• bone aches and pains,
• curving of the spine and loss of height, and
• fractures.

Extreme elevations in calcium levels may cause coma.

What is the treatment for hypercalcemia?

Treatment depends on the symptoms and calcium levels as follows:

• Mild: > 10.5 <12 mg/dL; little or no symptoms – avoid such compounds like thiazide diuretics, lithium carbonate therapy, volume depletion and any other compounds or life styles that tend to increase calcium levels like inactivity, high calcium diet and some vitamin supplements.
• Moderate: 12 to 14 mg/dL; may be managed by methods listed for mild but require treatment listed for severe if a patient develop sensorium changes.
• Severe: > 14 mg/dL; symptoms of lethargy, stupor, confusion, coma for example, need aggressive therapy with IV isotonic saline and calcitonin. Other compounds such as bisphosphonates and denosumab and/or dialysis may be used in some patients.