Hypercalcemia (Elevated Calcium Levels)

  • Medical Author:
    Ruchi Mathur, MD, FRCP(C)

    Ruchi Mathur, MD, FRCP(C) is an Attending Physician with the Division of Endocrinology, Diabetes and Metabolism and Associate Director of Clinical Research, Recruitment and Phenotyping with the Center for Androgen Related Disorders, Department of Obstetrics and Gynecology at Cedars-Sinai Medical Center.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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How is hypercalcemia diagnosed?

Hypercalcemia is easily diagnosed with a blood test. Diagnosing the causes of hypercalcemia, however, is a more involved process; in addition to a detailed history and physical examination, it may require further blood tests (such as a PTH level and vitamin D level), urine evaluation, X-rays, and other imaging procedures.

How is hypercalcemia treated?

The treatment of elevated levels of calcium in the blood involves the evaluation of the following:

  1. Is the level of calcium elevated enough to be dangerous, or is it causing symptoms?
  2. What is the underlying cause of the hypercalcemia, and does it need treatment?

If the hypercalcemia is causing severe symptoms, or if the values are critically high, lowering the blood levels may require hospitalization and the use of hydration, steroids, or even dialysis. There are intravenous medications that can be used to lower calcium as well.

If the hypercalcemia is modest, treatment with medications can be administered on an outpatient basis.

If the underlying cause is hyperparathyroidism (particularly from an adenoma), there are certain criteria that are reviewed to discuss if surgery should be considered. These criteria include the absolute calcium level, a history of kidney stones or other calcium-related complications, and the amount of calcium seen in a 24-hour urine collection. Based on these findings, surgical removal of the adenoma may be considered.

What is the prognosis for hypercalcemia?

The results of treatment for hypercalcemia depend on the underlying cause of the condition. If hypercalcemia is seen in the presence of cancer, the average 30-day survival rate is about 50%. The prognosis is excellent for many of the other causes of hypercalcemia provided the underlying cause is addressed and treated.

Medically Reviewed by a Doctor on 5/7/2015
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