What are the treatments for hypercalcemia?

Answer 1

For those who do NOT know what Hypercalcemia is, let's start with the basics:

Hypercalcemia is a condition that is caused by the elevation of calcium (Ca) in the blood; this elevation is due to high concentrations of calcium in the blood's serum. Calcium concentrations in amounts of 12.0 mg/dL or higher can be life threatening, the elevation of calcium in these amounts require urgent treatment. (Normal blood calcium levels are 9.5-10.5 mg/dL.)

Initially, there may be little or no symptoms (asymptomatic) of elevated blood calcium levels. In the beginning, symptoms are often nonspecific and worsen as blood calcium levels rise; symptoms may consist of fatigue/lethargy; irregular heart-rate; visual disturbances; increased urination; Natriuresis (loss of sodium through urination); thirst; nausea/vomiting; anorexia; pancreatitis; stomach cramps/pain; constipation; confusion; erratic/usual behavior; depression; hallucinations; delirium; even renal failure. However, more serious symptoms are seizures/convulsions, coma, and heart failure, which can result in death. Women over the age of 50 are most often affected, but anyone, at any age can be affected. (Hypercalcemia is NOT limited to the human population; cats and dogs can also be affected with this condition. The symptoms of hypocalcemia in animals are even less noticeable in animals; they don't complain or show pain; in fact, in nature they tend to hide their pain, a form of protection, thereby protecting them from other animal attacks. In animals, hypercalcemia symptoms may NOT be treated or cared for, over an extended period of time; thereby, death is more apt to be the resulting outcome of many untreated hypercalcemia cases.)

Some causes for Hypercalcemia:

Thiazide diuretics can cause a rise in blood calcium levels; other causes are kidney stones; a build-up of calcium in the kidney (Nephrocalcinosis); abnormal function of the parathyroid gland (Paget's disease), which raises the level of the parathyroid hormone causing hyperparathyroidism and primary hyperparathyroidism; gout; being immobilized for extended periods of time; familial hypocalciuric hypercalcemia (a genetic disorder); vitamin D intoxication (toxicity caused by vitamin D2 - ergocalciferol and vitamin D3 - cholecalciferol); high blood-pressure; not drinking enough fluids (dehydration); Granulomatous diseases; parathyroid tumors; HIV/Aids; Addison's disease, and more. However, most often Hypercalcemia is associated with forms of malignancies (types of cancers/ tumors are kidney; hematological; leukemia; myeloma; breast; pulmonary; prostate; bladder; colon; stomach; spinal; neck; liver; spleen…). Hypercalcemia that is caused by a malignancy is hard to treat, without treating the cancer too.

Malignancies and primary hyperparathyroidism are responsible for more than 80-90% of hypercalcemia cases. Some cases of hypocalcemia are caused by forms of nonlymphoid neoplasm and varied forms of inoperable carcinomas. Another common cause of hypercalcemia is the over production of the parathyroid hormone which results in hyperparathyroidism. Hypercalcemia resulting from a bone malignancy causes the blood's calcium level to rise; this results as the bone(s) breaks down and dissolves as the calcium is leached from the bone into the blood.

Now your question is how is hypercalcemia corrected? I assume by "corrected," you mean emergency treatments and preventative treatments.

Treatments for Hypercalcemia in the more acute stages:

Hypercalcemia in its more dangerous stages requires hospitalization and symptomatic treatment. Medications are used to lower the body's calcium level; enzyme therapy for Pancreatitis (pancreatic secretory block/Celiac plexus blocks); as well as, managing the side effects caused by some forms of the treatments. Other treatments may include Dialysis; Saline infusion; I.V. Diuretics; Calcitonin; I.V. or oral Etidronate Disodium… (Treating hypercalcemia with diuretics can adversely affect potassium levels, thereby causing serious health effects (excess potassium loss can be life threatening). Some treatments may require the use of a potassium-protecting diuretic, which is used to prevent potassium loss.)

The most important treatment for Hypercalcemia is prevention:

Prevention should start with an accurate diagnosis, finding its precise underlying cause, and follow-up with an appropriate preventive treatment. Treatment should include diet changes and regulation, diet can be used as a preventive or to remove excess calcium that is already in the system. It can also help prevent and treat excessive amounts of vitamin D, i.e., resulting in vitamin D intoxication which has an effect on hypercalcemia. Over-exposure to sunlight/ultraviolet light can also cause a harmful rise in vitamin D levels; it has the same effect as taking excessive vitamin D supplements. But over-exposure to sunlight/ultra violet light has an additional risk, which may cause melanoma or other forms of skin cancers/malignancies. Hemodialysis can be used to remove excess amounts of calcium and vitamin D from the blood. Also avoiding excessive calcium supplements, calcium based antacids… by those who are susceptible to hypercalcemia attacks.

Medication can be beneficial in preventing future attacks; treating chronic hypercalcemia; minor flare-ups; or treating those with a family history of hypercalcemia:

Prescriptions drugs can help prevent hypercalcemia attacks in those suffering from on-going chronic high blood calcium levels. Treatments may include the use of diuretic medications -- Furosemide (Delone, Lasix, Lo-Aqua, Furocot); Torsemide (Demadex); Methyclothiazide (Aquatensen, Enduron); Bumetanide (Bumex)... can be useful. Other medications used are Zolendronic acid (Reclast, Zometa, Zomera, Aclasta); Pamidronate (Aredia)… Additional treatments used for hypercalcemia may be associated with malignancies/cancers - Pyrophosphoric acid (Bisphosphonate, Diphosphonate) drugs used to avert the loss of bone mass; and drugs that are used to alleviate symptoms or to increase fluids (hydration) in the body. There is a new treatment for Hypercalcemia; this treatment is called Continuous Arteriovenous Hemofiltration Dialysis (CAVH); this procedure can assist in the support of renal failure and its management. Continuous Arteriovenous Hemofiltration Dialysis is also used removing toxins; waste produces; excess amounts calcium; heavy metals; removing excess medications… from the blood.
Hypercalcemia probably means to much calcium. I would say the drug of choice is some sort of acid to leach the calcium out.

The above answer is absolutely incorrect, other than the fact that Hypercalcemia does mean too much Calcium in the blood. Hypercalcemia is typically caused by hyperparathyroidism which is often times caused by an enlargement of one or more of the parathyroid glands in the neck, situated behind the thyroid gland.

The ONLY way to cure hyperparathyroidism and thus, bring calcium levels back to normal, is to have a parathyroidectomy.