Calcium is a fundamental mineral supporting numerous bodily functions, far beyond its well-known role in bone health. It plays a part in nerve function, facilitating communication between the brain and the rest of the body. Additionally, calcium is involved in muscle contraction, enabling movement, and contributes to proper heart function. Maintaining a balanced level of calcium in the bloodstream is important for the body’s overall well-being.
Understanding Calcium Levels
A normal serum calcium range falls between 8.5 to 10.2 milligrams per deciliter (mg/dL). A calcium level of 10.6 mg/dL is considered to be on the higher side, indicating a mild elevation above the normal range.
Blood tests measure total calcium, which includes both protein-bound and free or “ionized” calcium. While total calcium is usually the initial measurement, ionized calcium is the physiologically active form. Total serum calcium is often sufficient for initial assessment, with adjustments made if protein levels are abnormal.
Signs and Causes of Elevated Calcium
Hypercalcemia, or elevated calcium levels, may present with various signs, though mild elevations are often asymptomatic. Symptoms can include increased thirst and frequent urination as the kidneys work harder to filter excess calcium. Other symptoms include fatigue, muscle weakness, bone pain, and digestive issues like constipation, nausea, or stomach upset. Mental changes like difficulty concentrating, confusion, or depression may also occur.
The most common causes of elevated calcium levels are primary hyperparathyroidism and malignancy. Primary hyperparathyroidism occurs when parathyroid glands produce too much parathyroid hormone (PTH). This excess PTH signals bones to release more calcium, kidneys to reabsorb more calcium, and intestines to absorb more calcium from food. Malignancy is the second most frequent cause, due to tumors producing a protein similar to PTH or cancer spreading to bones.
Less common causes of hypercalcemia include certain medications. Excessive intake of vitamin D supplements can also lead to hypercalcemia, as vitamin D enhances calcium absorption. Prolonged immobility can cause bones to release calcium into the bloodstream. Dehydration is another factor that can temporarily raise calcium concentration in the blood.
Next Steps for High Calcium
Upon discovering an elevated calcium level, consulting a healthcare professional is important. The doctor will likely review your medical history and current medications, as some drugs can influence calcium levels. They may recommend a repeat blood test to confirm the elevation and rule out temporary factors like dehydration.
Further diagnostic tests are often ordered to pinpoint the underlying cause. These may include measuring parathyroid hormone (PTH) levels, which helps differentiate between parathyroid-related and non-parathyroid causes. A high or inappropriately normal PTH level alongside elevated calcium often points towards primary hyperparathyroidism. Vitamin D levels may also be checked, as both deficiency and excessive intake can impact calcium balance. Kidney function tests are also performed to assess kidney health, as elevated calcium can affect these organs.
Depending on the suspected cause, additional imaging tests may be necessary. If primary hyperparathyroidism is suspected, imaging of the parathyroid glands may be performed to identify an enlarged gland or tumor. Initial management strategies might include increasing fluid intake to combat dehydration or adjusting medications if they are contributing to the elevation. Definitive treatment depends on the specific cause identified.
Long-Term Considerations
Leaving elevated calcium levels unaddressed over time can lead to health complications. The kidneys may be particularly affected, with excess calcium leading to the formation of kidney stones. Chronic hypercalcemia can also impair kidney function over time, potentially progressing to kidney failure as calcium deposits build up in kidney tissue.
Bones can also suffer, as prolonged high calcium in the blood results from calcium being leached from the bones. This process can weaken bones, increasing the risk of osteopenia, osteoporosis, and fractures. In more severe or chronic cases, elevated calcium levels can impact the heart, potentially leading to abnormal heart rhythms. Identifying and treating the underlying cause of hypercalcemia is therefore important to prevent these long-term issues.