What does high blood calcium mean? Preparing and conducting analysis

A condition characterized by a decrease in the blood level of total calcium less than 2.0-2.2 mmol / l, and ionized (free) - less than 1.0-1.7 mmol / l is called hypocalcemia. This is a metabolic-endocrine syndrome that occurs with many severe somatic diseases, severe injuries and after major operations.

The causes and mechanism of development of hypocalcemia, the symptoms, principles of diagnosis and tactics of treating this condition will be discussed in our article.

Kinds

There are 2 variants of this pathology:

• hypocalcemia due to a decrease in the blood level of parathyroid hormone (parathyroid hormone, a hormone synthesized by the parathyroid glands);
• hypocalcemia associated with insensitivity of body tissues to parathyroid hormone; the content of the latter in the blood is higher than normal.

Causes and mechanism of development

The level of calcium in the blood is a fairly constant value. It is regulated by parathyroid hormone, vitamin D and active products of its metabolism. Depending on the amount of calcium in the plasma, the parathyroid glands produce more or less amount of parathyroid hormone.

Hypocalcemia is not an independent pathology, but a symptom complex that develops with a decrease in the level of parathyroid hormone in the blood, the development of the body's resistance to its action, and the intake of certain medications.

A decrease in blood calcium levels associated with low levels of parathyroid hormone (primary hypoparathyroidism) can occur in the following situations:

• underdevelopment of the parathyroid glands;
• destruction of the parathyroid glands by metastases, radioactive radiation (in particular, during radiation therapy), during surgery on the thyroid or parathyroid glands;
• damage to the parathyroid glands by an autoimmune process;
• a decrease in the release of parathyroid hormone with a low level of magnesium in the blood, hypocalcemia of newborns, hungry bones syndrome (the so-called condition after the removal of the parathyroid glands), defects in the parathyroid hormone gene.

To hypocalcemia against the background of high levels of parathyroid hormone in the blood lead to:

• hypovitaminosis D in liver diseases, malabsorption syndrome, nutritional deficiencies, excessive sun exposure, acute or;
• the body's resistance to vitamin D with its normal intake (in the case of a pathology of the receptors for vitamin D or dysfunction of the renal tubules);
• insensitivity of the body to parathyroid hormone (with hypomagnesemia and pseudohypoparathyroidism).

Certain medications can also cause hypocalcemia. These are:

• and calcitonin (inhibit the release of calcium from the bones into the blood);
• calcium donators (phosphates, citrate blood administered by blood transfusions);
• drugs that affect the metabolism of vitamin D in the body (anticonvulsants, some, in particular, ketoconazole).

Less commonly, hypocalcemia is caused by:

• genetic diseases of the parathyroid glands (isolated hypoparathyroidism, diGeorge and Kenny-Keiffey syndromes, pseudohypoparathyroidism types Ia and Ib, hypocalcemic hypercalciuria, and others);
• hyperventilation of the lungs;
• massive decay of a malignant tumor;
• osteoblast metastases;
• acute inflammation of the pancreatic tissue ();
• acute rhabdomyolysis (severe myopathy, accompanied by the destruction of myocytes (the cells that make up the muscles));
• state of toxic shock.

Symptoms

Paresthesias may be a sign of hypocalcemia.

If the level of calcium in the blood is slightly reduced, there are no external signs of such a condition - it is asymptomatic.

In cases where calcium drops below 2.0 mmol / l, the patient may experience the following symptoms:

• sudden spasms of the larynx and bronchi (laryngo- and bronchospasms);
• discomfort, a feeling of crawling, tingling, numbness in the fingers of the upper and lower extremities, around the mouth (this condition is called "paresthesia");
• Trousseau's symptom (when the upper limb is squeezed by the tonometer cuff, its fingers are slightly bent and brought to the palm);
• Chvostek's symptom (twitching of the lips when tapping with a finger between the corner of the mouth and the zygomatic lip or in front of the tragus of the auricle);
• convulsions, ;
• extrapyramidal hyperkinesis (involuntary movements caused by calcium deposition in the basal ganglia) - dystonia, tremor (trembling), athetosis, tics, myoclonus and others;
• visual disturbances (manifestation of subcapsular).

In addition, patients are often concerned about vegetative disorders (feeling hot, chills, headache and dizziness, palpitations, shortness of breath, pains of a stabbing, aching nature in the region of the heart).

Patients become irritable and nervous, their concentration and memory decrease, they sleep poorly and often become depressed.

Diagnostic principles

The process of making a diagnosis includes 4 mandatory successive steps:

• collection of complaints, anamnesis (history) of life and disease;
• objective examination of the patient;
• laboratory diagnostics;
• instrumental diagnostics.

Let's take a closer look at each of them.

Collection of complaints and anamnesis

To prompt the doctor to think about hypocalcemia, the patient must describe in detail what symptoms bother him, talk about when, under what conditions they arose and how they have manifested themselves so far. Also of great importance is information about other diseases of the patient, especially about genetic pathologies, pathologies of the digestive tract, chronic renal failure, cataracts. It is necessary to mention the facts of surgical interventions, especially massive ones, on the thyroid and parathyroid glands.

Objective examination

An attentive doctor will pay attention to the presence of convulsive contractions of muscles of various groups in the patient:

• organs of the gastrointestinal tract (manifested by swallowing disorders, vomiting, stool disorders in the form of diarrhea or);
• skeletal muscles (fibrillar twitching, paresthesia, tonic convulsions);
• spasms of the larynx and bronchi (the main manifestation is severe, suffocation, accompanied by cyanosis (blue) of the skin; this diagnosis can be established only by catching the patient during the attack itself, and suspect - from his words, according to his description.

Violations of tissue trophism will also be noticeable: pathology of tooth enamel, premature graying and impaired growth, brittle nails, cataracts.

Methods of laboratory diagnostics

The main method for diagnosing hypocalcemia is to determine the level of calcium in the blood.

To detect hypocalcemia, it is necessary to conduct 2 studies: the level of total calcium in the blood (the analysis is repeated 2-3 times) and ionized (otherwise - free) calcium.

The content of total calcium in the blood is directly dependent on the level of albumin protein in it. That is why, if it is impossible to carry out the above study, it is possible to determine the concentration of albumin and, based on it, calculate the concentration of calcium. It is assumed that a decrease in the level of albumin by 10 g/l is accompanied by a decrease in the level of total calcium in the blood by 0.2 mmol/l.

If the patient does not have chronic renal failure, and there is no acute pancreatitis, hypocalcemia is most likely associated with a violation of the secretion of parathyroid hormone and / or insensitivity of body tissues to it. Also, the cause may be a deficiency of vitamin D and disorders of its metabolism.

To diagnose the pathology, the consequence of which is hypocalcemia, the patient is prescribed the following studies:

• a biochemical blood test for the content of creatinine, urea, AST, ALT, bilirubin, amylase, phosphate and magnesium in it;
• a blood test for the content of parathyroid hormone in it;
• a blood test for the content of various forms of vitamin D in it (calcidiol, calcitriol).

Interpretation of results

Methods of instrumental diagnostics

To finally find out which disease caused hypocalcemia, carry out:

• X-ray of the bones (if the doctor suspects the patient has osteomalacia (softening of the bone) or rickets);
• (determination of bone mineral density; detects osteoporosis and allows you to assess the dynamics of the disease during treatment);
• computed tomography of the brain (to confirm or rule out calcification of the basal ganglia).

Treatment tactics

Patients with blood calcium levels of 1.9 mmol/L or below are in dire need of emergency medical care. The tactics of treatment directly depends on the severity of the symptoms of neuromuscular excitability and on the reaction of the patient's body to the ongoing therapeutic measures.

Emergency care for the patient

He may be assigned:

Non-drug treatment

It includes:

• a diet with sufficient calcium (1500-2000 mg per day);
• frequent and prolonged exposure to the sun (more than half an hour a day);
• avoiding the use of sunscreens (those that protect the skin from exposure to ultraviolet radiation).

Medical treatment

Persons suffering from hypoparathyroidism should receive therapy with vitamin D and calcium salts for a long time. At the same time, in order to prevent the formation of stones in the kidneys and hypercalciuria, it is important to maintain blood calcium not at the maximum, but only at the lower limit of normal values.

Vitamin D preparations include alfacalcidiol, calcitriol, ergocalciferol, cholecalciferol.

If hypocalcemia is a consequence of magnesium deficiency, the patient is prescribed intravenously or orally magnesium sulfate, as well as calcium salts and vitamin D preparations.

Against the backdrop of ongoing treatment, it is necessary:

• 1 time in 3-6 months to conduct a control study of the level of ionized and total calcium in the blood (to maintain it at the lower limit of the norm);
• Measure blood levels of calcidiol and/or calcitriol once every 12 months;
• Once every six months, measure the concentration of parathyroid hormone in the blood (its level should normalize when the content of vitamin D returns to normal);
• also, once every six months, examine the daily excretion of calcium and creatinine in the urine, determine the level of these substances in the blood (carried out in order to control the toxicity of treatment; with a daily calcium excretion of more than 300 mg / dl, the doses of the drugs should be adjusted or the question of the advisability of further administration should be resolved some of them).

Conclusion

A decrease in calcium levels in the blood can accompany a number of fairly serious diseases and manifest itself with symptoms that can even be life-threatening for the patient. In some cases, this condition requires the provision of emergency medical care to the patient, in others - long-term use of vitamin D and calcium supplements, in others - refusal to take certain medications.

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When conducting a survey, specialists who build their work on the basis of the principles of the Biological Laws of Nature are guided not only by the bodily (organic) sphere, as is the case in traditional medicine. We have at our disposal all three spheres - mental, cerebral and organic (levels of the psyche, brain and organ/tissue).
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Example: ( body level) always means a Hamer's focus in the process of recovery, localized in the white matter (in the parenchyma) of the cerebral hemispheres ( brain level), in the area responsible for the ovaries, and the mental cause of this ( mental level) is a previously experienced conflict of loss (loss) .
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Any research result in one area should be correlated with the results of the survey in other areas. This largely avoids . The saying “There are as many diagnoses in the world as there are doctors” should soon become a thing of the past.
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Laboratory data are the most important pillar of clinical examination and control of the course of the disease. Some indicators of these studies, thanks to the knowledge acquire a new meaning, while others retain the same meaning as in traditional medicine. Some indicators, such as enzymes lipase and amylase are very individual and acquire therapeutic value only in comparison with previous indicators in the same patient.
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On the other hand, the evaluation and interpretation of laboratory parameters is fraught with great danger in the sense that some patients attach so much importance to them that these indicators themselves become the cause of another conflict. Such hypochondriacal patients often run from one laboratory to another until the trap they have set for themselves one day snaps shut (“out of range!”)
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Post cycle "Laboratory research" it will just talk about how certain indicators of certain studies can be interpreted from the point of view of the Biological Laws of the functioning of our body.
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Increased calcium in the blood

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Elevated blood calcium is a symptom that should always be the reason for an in-depth examination, since the underlying disorders can be really really dangerous for the patient.There are three most likely clinical presentations that can cause elevated blood calcium levels.
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first cause:

(…) The first cause of high blood calcium is "primary hyperparathyroidism", a disease accompanied by the appearance of a tumor in one or more parathyroid glands. The main task of the parathyroid glands in the body is to maintain normal levels of calcium in the blood. The cells of the parathyroid glands "know how" to feel the concentration of calcium in the blood plasma and, in accordance with this level, produce parathyroid hormone. The main action of parathyroid hormone is to increase the level of calcium in the blood (by destroying bone tissue and releasing calcium from it into the blood, as well as by increasing the absorption of calcium from the primary urine in the kidneys and increasing its absorption from the intestines). When a tumor occurs in the parathyroid gland, its cells “cease to feel” the concentration of calcium in the blood - they “seem” that there is no calcium in the blood, or it is low. Tumor cells begin to uncontrollably produce parathyroid hormone, which dramatically increases the breakdown of bone tissue and the release of calcium from it into the blood. As a result, in the laboratory we determine the increased blood calcium and at the same time a high level of parathyroid hormone. Most often, such changes are also accompanied by a decrease in the level of phosphorus in the blood and an increase in the level of calcium in the urine. The danger of the disease lies in a decrease in bone density with the appearance of a tendency to fractures, to bone deformities, and reduced growth. An increased level of calcium in the blood leads to the deposition of calcium salts in the walls of blood vessels and heart valves, which reduces their elasticity and increases the tendency to thrombosis, which means the risk of strokes and myocardial infarction. (…)

Wow, here are strokes, and heart attacks, and salt deposits ... The individual ingredients of this "vinaigrette" have already been described in previous posts (for example - Stroke in terms of biological laws and Heart: myocardial infarction, heart attacks, clinical death ) , here we will describe only calcium itself.
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Thyroid and parathyroid glands and related biological conflicts.
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The main task of the endodermal tissue of the thyroid gland is the production of thyroxine (tetraiodothyronine, T4 and triiodothyronine, T3) and the accumulation of iodine. In addition, the thyroid gland produces a hormone calcitonin that reduces the amount of calcium in the blood. Calcitonin is an antagonist of the parathyroid hormone responsible for raising calcium levels.
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In terms of evolutionary history, the endodermal thyroid and parathyroid glands originally released their hormones directly into the gut, and now they do so directly into the bloodstream. According to the System of Biological Laws, the thyroid gland reacts to the so-called "lump conflict" - general conflict of slowness and the parathyroid gland conflict inability to muscle activity . The ectodermal excretory ducts of the thyroid gland once excreted thyroxine into the intestines. These thyroid excretory ducts can be thought of as the same as the bile ducts that carry bile from the liver to the intestines. Now these channels are dormant, but they still continue to exist. According to the System of Biological Laws, these ducts respond to the so-called powerlessness conflict .

In the System of Biological Laws, the traditional notions of so-called "diseases" such as "deficiency", "fault of nature", "evil" and others, to which traditional medicine has accustomed people over the millennia, are considered significant Biological Special Programs (SBPs).
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Today we should understand that mother nature arranged everything in the most reasonable way, because biology cannot be “insufficient”, we were just blinded by medical dogmas before. Therefore, now for each symptom it is necessary to find the corresponding conflict and understand the biological meaning of each Special Biological Program.
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Content conflicts that lead to adenocarcinoma thyroid gland, includes"lumpy" conflict - a person “moves too slowly”, falls under the “press”, from which he cannot get out because of his own slowness.

Right lobe of the thyroid gland: the impossibility of obtaining the necessary (for survival) "piece" due to one's own slowness.Left lobe of the thyroid gland: the inability to get rid of an extremely dangerous (for survival) "piece" due to one's own slowness.
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In the active phase of the conflict (CA-phase) there is an increase in function and growth of a compact secretory adenoma like a cauliflower = hard goiter (struma)-> increased production of thyroxine -> increased levels of T3 and T4 in the blood -> acceleration of metabolism, internal restlessness, sometimes a feeling of a lump in the throat, suffocation without coughing or hoarseness due to neoplasia. biological sense - with an increase in the level of thyroxine in the blood, the reaction rate of the individual increases.

Examples

- The pensioner has been working as an au pair in one family for many years and becomes almost a member of this family. One fine day, she is unexpectedly fired with the following rationale: “For us, you do everything too slowly!” -> she cannot keep this "piece of bread" because of her slowness. A woman has a growth of a thyroid tumor in the active phase. The tumor is removed during surgery.

- Some already quite elderly employee of the company feels that he is not able to keep up with the pace of work of his younger colleagues. With his old-fashioned, solid style of work, he fails to maintain strict time limits. The company's management would gladly entrust his work to some younger and more dynamic colleague. He is going to be retired. Some time after the events described, he is diagnosed with thyroid carcinoma -\u003e conflict "I can not get" a piece of food - workplace due to slowness.

- The patient looked after himself a house and was going to buy it. It is also necessary to discuss the terms of the loan with the bank. And at this time, another buyer intercepts the house from him, who pays in cash -> conflict “I can’t get a “piece” in the form of a house because of my own sluggishness” (right lobe of the thyroid gland).

- The broker takes too long to sell shares and loses half of his fortune on this -> conflict “I can’t get rid of the shares fast enough” (left thyroid gland).

- The 32-year-old doctor undertook to write his doctoral dissertation. However, the matter turned out to be more difficult than he thought. After the four years allotted for him to write his doctoral dissertation had passed, he had to ask for a rescheduling of the paper. He has since developed hyperthyroidism - thyroid adenocarcinoma on both sides - because he can't devote much time to writing his dissertation due to his main job - "can't spit out work" (swelling on the left) and because he "doesn't write fast enough ' to get his PhD (tumor on the right). He began to take the drug "Thyreostatika", which blocks the function of the thyroid gland. A drug-free solution could be (in the light of the understanding of Biological Laws): to present the thesis of his future dissertation, which would lead to the resolution of the conflict, the caseous disintegration of the tumor and the normalization of hyperactivity.
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In the recovery phase (PCL-phase), after the resolution of the conflict, thyroid tumors in the form of nodes often remain and encapsulate, and in the presence of fungi and mycobacteria in the body, tuberculous-caseous necrosis of these nodes occurs ( ). After the completion of the PCL phase, hormonal levels return to normal.
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Content of conflicts for parathyroid gland : "lumpy" conflict - conflict associated with the inability to obtain something desirable due to muscle weakness (right side) or get rid of something unwanted (left side). In other words, it is not possible to get anything - due to impotence, passivity, inertia or laziness.
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In the active phase of the conflict (SA-phase), there is an increase in function, the growth of a compact secretory adenoma like a cauliflower. Increase in the number of cells producing parathyroid hormone = "hard goiter (struma)"-> increased release of parathyroid hormone (hyperparathyroidism)-> increase in calcium levels due to the release of calcium from bone tissue. Prolonged conflict activity can lead to bone decalcification (fibroosteoclasia). The biological meaning is to increase muscle activity by increasing calcium levels. However, both too low and too high levels of parathyroid hormone can indicate a general deficiency of calcium in the body..
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Thus, an increased level of calcium in the blood can lead to:
- active conflict for parathyroid
- resolved conflict (recovery phase) for thyroid glands in the edema phase, when the function of the gland is significantly (temporarily!) reduced and cannot compensate for the normal function of the parathyroid gland .
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A competent specialist familiar with Biological Laws will determine the SBP phase by characteristic signs in order to understand whether it is worth resolving an active conflict or the conflict has already been resolved and you just need to wait a short time of the recovery phase without any (active) actions. Of course, the values ​​of laboratory parameters should be taken into account only in dynamics, and not for one study.

From the point of view of traditional medicine second

(...) is the disintegration of bone tissue due to the occurrence of metastases in it of any malignant tumor. Metastases have a so-called lytic effect, i.e. destroy bone tissue and release calcium salts from it, which enter the bloodstream and lead to an increased calcium content in the blood. In this case, calcium in the blood is increased, but at the same time the level of parathyroid hormone is within the normal range or at the lower limit of normal. (…)

About "tales of metastases" - read here:Metastases is a thriller from World Cancer Day. Here I will write only about the bones themselves.

Musculoskeletal system
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- self-devaluation conflict (CSR). In the active phase of the conflict, “destruction” of bone tissue occurs - osteolysis, i.e. decrease in its density. In this case, there really is a release of calcium (calcium salts) from the bones of the skeleton, which gives an increase in the level of calcium in the blood, despite the fact that the level of parathyroid hormone can be quite normal.
Therefore, an increased level of calcium in the blood can also lead to great force, which "beats" it in the bones (weaker CSR acts on the softer tissues of the musculoskeletal system - muscles, tendons, cartilage, joints and lymphatic system).

From the point of view of traditional medicine third The "official" possible reason for the increase in calcium:

(...) - the development of neuroendocrine tumors that produce the so-called PTH-like peptides (PTHPP). These tumors are most often localized in the lungs, although their location can be very diverse. The sizes of such tumors are usually small - from 4-5 mm to 1-2 cm. They "know how" to produce chains of amino acids, the sequence of which matches the active end of the parathyroid hormone. Similar peptides (they are called PTH-like, since they are very similar in their action to parathyroid hormone) cause a situation when calcium in the blood is elevated, but laboratory analyzers do not show an increase in parathyroid hormone levels in this case, since PTH-like peptides do not completely copy the parathyroid hormone molecule. PTHPP, produced in large quantities by malignant tumors, causes severe hypercalcemia. (…)
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The physiological role of PTHPP differs sharply from that of PTH (parathyroid hormone). PTHPP is produced in many tissues, both in the fetus and in the mature body. Among other things, it regulates the transport of calcium through the placenta, i.e. necessary for normal development. In the postnatal period, PTHPP is involved in the development of epithelial and mesenchial tissues, which determines the development of the mammary glands, skin, and hair follicles. Under physiological conditions, PTHPP usually acts locally rather than systemically.
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Thus, an increased level of calcium in the blood with a simultaneous normal level of PTH may mean the presence of any active SBP for the ancient brain (stem and cerebellum) with a significant growth of the corresponding tissues (cancer of the lungs, glandular tissue of the breast, various organs of the gastrointestinal tract, anterior pituitary gland, etc.). As soon as the relevant conflict is resolved, the level of PTHPP (and, accordingly, the level of calcium in the blood serum) will decrease.
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Why is the official emphasis put on the "malignancy" of these tumors? Because it is the growth of cells of the corresponding tissues that gives an increase in the level of PTHPP. As soon as growth stops (even in the presence of the tumor itself, which is now considered "benign"), the level of PTHPP decreases.

An explanation of the "benign" and "malignant" tumors -
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So, summary. Elevated calcium levels in blood tests from the point of view of Biological Laws can be caused by the following reasons:

- active conflict for parathyroid glands (increased production of parathyroid hormone);

- resolved conflict (recovery phase) for thyroid glands in the edema phase, when the function of the gland is significantly (temporarily!) reduced and cannot compensate for the normal function of the parathyroid gland (hypothyroidism) .

- active self-devaluation conflict great strength, which "beats" precisely in bones musculoskeletal system;

- active SBP for the ancient brain (stem and cerebellum) with significant growth appropriate fabrics .
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As you can see, the reasons are completely different, but knowledge of the principles of the functioning of the human body in the light of Biological Laws can give an accurate understanding of what kind of reason takes place in each specific case, because the specific symptoms for the above options are very different from each other - both at the level of the body as well as at the mental level. And if there is , then you can determine the exact cause with 100% probability.

From childhood, we are advised to eat more dairy products, as they are rich in bone-healthy calcium. But this element is necessary not only for our skeleton, but also for blood, muscles, and nerve fibers. There are 2 forms of calcium: ionized and bound. Ionized calcium is not bound to proteins, so it circulates freely in the blood. A blood test for calcium plays a significant role in diagnosing the state of the body. Thanks to its information content, you can choose the right dosage of drugs. According to its data, one can judge the metabolism of mineral substances in the body.

Protein-bound calcium does not have such a significant effect on the body. This is the state of Ca at the time of transport.

What is calcium for?

Calcium is one of the most important elements of the human body. It affects the course of metabolic processes. Blood contains two fractions of this element - ionized and bound. The composition of the bound may include plasma proteins, citrates, phosphates. This form of calcium makes up 55% of the total volume in blood plasma. 40% of them are associated with protein, 15% are phosphorus and citrate.

It turns out that 45% of blood plasma remains for active ionized calcium. In this state, calcium is capable of much. Here is a list of useful functions that it performs:

Promotes the growth and development of bone tissue;

Stimulates the secretion of a neurotransmitter, thereby improving the conductivity of nerve fibers, since without this substance the transmission of neural impulses throughout the body is impossible;

It is one of the elements involved in the process of blood clotting;

Stabilizes the enzyme activity of the body;

Affects the intensity of muscle and heart contractions;

Reduces the permeability of the walls of blood vessels, thereby protecting them from exposure to harmful substances.

The level of ionized calcium in the blood is important for the body. That is where he tries to send it in the first place. Therefore, if a person's teeth began to hurt or the bones became brittle, this is a clear signal of a mineral deficiency. Incidentally, calcium also plays an important role in regulating blood pressure. Another of its functions is to strengthen the immune system and activate most hormones and enzymes.

The bound form is less productive. Experts believe that deviations up or down are not always a symptom of a failure in the metabolic process.

A person should consume 850-1300 mg of calcium per day. The main thing is not to overdo it, since the upper limit is 2500 mg. However, there are times when increased consumption of this element is justified. For example, in the blood of pregnant women, or during lactation. The body's need for Ca also increases in athletes.

What to do to provide the body with this essential trace element? You should add the following foods to your diet:

From cereals - this is buckwheat;

From fruits - oranges;

Dairy;

legumes;

Helps absorb calcium vitamin D group. It is often prescribed by pediatricians for newborns and older children.

There are also foods that interfere with the absorption of ionized calcium. These include:

Palm oil. It is found in the composition of various products, where it is necessary to replace natural milk fat with various cheap "ersatz";

Some types of animal fats;

Sweets that have an alkaline reaction. For example, some sweets.

Norms for different age groups

The norm of the ionized mineral for each age group is different. The table below shows the numbers that the analysis for ionized calcium should show. Otherwise, the value obtained is considered a deviation from the norm.

In a child, ionized Ca is increased when compared with the adult category. This phenomenon is explained by the intensive growth of bones, which shows the high need of the body for this element. This situation lasts for children until they reach the age of 16.

During pregnancy;

During lactation;

When taking contraceptives.

Who should have the procedure?

Most often, knowing the level of total calcium in the blood is enough to assess the process of mineral metabolism, since the ratio of free (45%) and bound (55%) forms is constant. But in any rule there are exceptions, so for some people this ratio is violated. Therefore, it is advisable to conduct another type of study - an analysis for ionized calcium.

Significant fluctuations in the content of calcium ions have certain symptoms:

Unstable rhythm of the heart muscle. She speeds up, then slows down her pace;

Muscle spasms;

Disturbances of consciousness.

The following conditions may serve as indications for donating blood for research:

cancerous tumors;

Preparation before the operation;

Diseases of the gastrointestinal tract;

convulsions;

Pathology of the kidneys and urinary tract;

Changes in the cardiovascular system;

Pain in muscles and bones;

Low levels of proteins in the blood (hypoproteinemia).

So if you fall into one of these categories, then do not delay the study, as it will help you choose the right dosage of the necessary medication and make the course of therapy more effective.

Preparing and conducting analysis

In order for the result of the analysis for the level of calcium to be normal and undistorted by various factors, it is necessary to prepare for it. Here is a small list of rules to follow:

Rent biomaterial on an empty stomach. The last meal should be 12 hours ago;

You can smoke 1 hour before visiting the laboratory;

Heavy loads are also excluded before the analysis;

Many drugs can raise or lower calcium levels in the body. Therefore, 14 days before the test, you should refrain from taking them. Naturally, you should first consult with your doctor on this issue. If the doctor did not allow to interrupt the course of treatment, then the medications taken and their dosage will be indicated on the form of the study.

For analysis, venous blood will be taken. Currently, two methods for determining the level of free calcium are used in medical practice:

1. For total calcium;
2. Directly to the ionized form.

The first method is less expensive, therefore it is available in almost any state laboratory. It is funded by the CHI policy. The second method is more informative. It allows not only to establish an accurate diagnosis, but also to develop an individual course of treatment.

A very important condition is the study within 2 days after blood sampling. Otherwise, prolonged exposure to air may distort the results by increasing the reference value of calcium ions. So you will receive a form with the results of the analysis after 3 days.

Not the last role is played by the time of day when the biomaterial is taken for analysis. It is preferable to make a fence in the morning. If the biomaterial is taken in the evening, active calcium is likely to be higher than normal.

Reduced rate

If the patient's calcium ion level is low, the following symptoms indicate this:

With these symptoms, hypocalcemia is diagnosed. The reasons that caused this state are different in nature:

Vitamin D deficiency;

Extensive burn injuries;

Lack of magnesium in the blood;

The period after surgery;

The intestine does not absorb calcium well;

Metabolic alkalosis (violation of the acid-base state).

You should know that such a condition with an indicator of less than 0.7 mmol / l is critical and threatens with the possibility of death.

Increased rate. Hypercalcemia

Hypercalcemia is a disease in which there is too much calcium in the blood. The test results in this case are more than 2.6 mmol / l. At this concentration, a calcium precipitate is formed in the vessels, liver and kidney tissue, which makes them brittle. The risk of developing heart failure is high. Hypercalcemia at an early stage is characterized by the following symptoms:

Nausea;

Lack of appetite;

Intensive work of the kidneys;

Increased blood calcium- a symptom that should always be the reason for an in-depth examination, since the disorders underlying it can be really dangerous for the patient. If you have done an analysis, and your blood calcium is elevated, it is imperative to undergo a consultation with an endocrinologist, who will conduct an examination according to the currently established standards.

Increased calcium in the blood - what could it be?

Theoretically, there are three most likely clinical problems that can cause high blood calcium levels. All possible reasons that calcium in the blood is above normal are quite serious.

The first reason for high blood calcium- this is primary hyperparathyroidism, a disease accompanied by the appearance of a tumor in one or more parathyroid glands (it is more correct to say "parathyroid glands", but the term "parathyroid glands" is very common). The main task of the parathyroid glands in the body is to maintain normal levels of calcium in the blood. The cells of the parathyroid glands "know how" to feel the concentration of calcium in the blood plasma and, in accordance with the level of calcium, produce parathyroid hormone. The main action of parathyroid hormone is to increase the level of calcium in the blood (by destroying bone tissue and releasing calcium from it into the blood, as well as by increasing the absorption of calcium from the primary urine in the kidneys and increasing its absorption from the intestines). When a tumor occurs in the parathyroid gland, its cells cease to feel the concentration of calcium in the blood - they "seem" that there is no calcium in the blood, or it is low. Tumor cells begin to uncontrollably produce parathyroid hormone, which dramatically increases the breakdown of bone tissue and the release of calcium from it into the blood. As a result, in the laboratory we determine the increased blood calcium and at the same time a high level of parathyroid hormone. Most often, such changes are also accompanied by a decrease in the level of phosphorus in the blood and an increase in the level of calcium in the urine. The danger of the disease lies in a decrease in bone density with the appearance of a tendency to fractures, to bone deformities, and reduced growth. An increased level of calcium in the blood leads to the deposition of calcium salts in the walls of blood vessels and heart valves, which reduces their elasticity and increases the tendency to thrombosis, which means the risk of strokes and myocardial infarction.

The second possible cause of high calcium- this is the breakdown of bone tissue due to the occurrence of metastases in it of any malignant tumor. Metastases have a so-called lytic effect, i.e. destroy bone tissue and release calcium salts from it, which enter the bloodstream and lead to an increased calcium content in the blood. In this case, calcium in the blood is increased, but at the same time the level of parathyroid hormone is within the normal range or at the lower limit of normal.

The third possible cause of high blood calcium- the development of neuroendocrine tumors that produce the so-called PTH-like peptides. These tumors are most often localized in the lungs, although their location can be very variable. The sizes of such tumors are usually small - from 4-5 mm to 1-2 cm. They "know how" to produce chains of amino acids, the sequence of which matches the active end of the parathyroid hormone. Similar peptides (they are called PTH-like, since they are very similar in their action to parathyroid hormone) cause a situation when calcium in the blood is elevated, but laboratory analyzers do not show an increase in parathyroid hormone levels in this case, since PTH-like peptides do not completely copy the parathyroid hormone molecule.

Blood test for calcium - which one is better to take?

There are two main types of calcium tests - a blood test for ionized calcium and a blood test for total calcium. Total calcium includes “free”, non-protein ionized calcium + calcium bound to blood proteins (primarily albumin). The concentration of total blood calcium may change, including due to changes in the protein content in the blood. At the same time, it is not total calcium that has a biological effect, but only that part of it that is not associated with proteins - this part is called ionized calcium. An ionized calcium blood test is more accurate than a total calcium test, but at the same time more complex - not all laboratories are able to perform this analysis, and if they do, not all do it accurately. There is an almost anecdotal situation when one of the largest laboratory networks in St. Petersburg "chronically", for years, detects low ionized blood calcium in almost all patients - and this obvious laboratory error has not been corrected in the laboratory for years. But the consequence of such an error is tens of thousands of unnecessary additional studies conducted by those patients who are “lucky” to receive such an incorrect analysis.

There are situations when ionized calcium is elevated, and total calcium is normal- in this case, more "trust" should be precisely the analysis for ionized calcium. At the same time, in most cases, increased blood calcium is manifested immediately in both analyzes - increased ionized calcium and at the same time increased total calcium.

Considering the importance of ensuring the maximum accuracy of a blood test for calcium and the high “price” of its incorrect determination, the North-West Endocrinology Center performs a blood test for calcium using the equipment of the Russian representative office of the German laboratory network LADR. For calcium analysis, an automatic biochemical analyzer Olympus AU-680 (Japan) is used, which provides maximum accuracy of the study and is capable of performing up to 680 tests per hour. Daily checks of the analyzer, the consistently high quality of its work and compliance by all employees of the center with the standards for taking blood for calcium allow the doctors of the North-West Center of Endocrinology to be confident in the quality of the blood test for calcium performed by the laboratory of the center. Exactly if in the blood test performed by our center, calcium is high, it means that calcium is really high.

If blood calcium is elevated - what to do?

As we noted earlier, increased calcium is always a reason for additional examination and consultation with an endocrinologist. In order to come to an appointment with an endocrinologist "not empty-handed", it is better to pass some additional tests even before meeting with the doctor.

The standard for examining patients with elevated blood calcium includes the following blood tests:

parathormone;

Calcitonin;

This is the minimum with which you can already come to a consultation with a doctor. It is clear that the doctor may then prescribe additional studies, however, the three blood tests listed above will help him navigate in which direction he should conduct a diagnostic search.

When consulting patients with endocrinologists of the North-West Endocrinology Center we almost insist on performing blood tests in the laboratory of our center- only in this way can we be sure that there are no laboratory errors and the correctness of our reasoning about the possible causes of increased calcium in the blood. The ionic composition of the blood in the laboratory of our center is studied using the Olympus AU-680 analyzer (Japan) already mentioned above, and the blood test for such important indicators as parathyroid hormone and calcitonin is performed by the 3rd generation automatic immunochemiluminescent analyzer DiaSorin Liaison XL (Italy) - one of the best devices in the world for testing blood for hormones and tumor markers.

Auto immunochemiluminescent 3rd generation analyzer DiaSorin Liaison XL (Italy)

Immunochemiluminescent 3rd generation analyzer allows you to identify situations where high calcium is combined with high parathyroid hormone

Endocrinologists and surgeons-endocrinologists of the North-West Endocrinology Center independently perform- this is important for the search for possible tumors of the parathyroid glands, which we, with an increased level of calcium in the blood, are simply obliged to suspect in a patient. The second important instrumental study that needs to be done in patients with elevated blood calcium levels is determination of bone density,. Calcium in the blood does not increase by itself - it is "taken" from the bone tissue, which gives calcium to the blood and, as a result, reduces its density, which can lead to fractures. Densitometry, as well as ultrasound of the thyroid gland, is performed by endocrinologists of the North-Western Endocrinology Center independently. This is also an important argument in favor of examination and treatment in a specialized center.

The third important argument to contact a specialized center in any case, if your blood calcium is elevated, is the opportunity to undergo any medical procedures within the walls of the same institution. Even during the examination, you will not only have high blood calcium, but it will also become clear that parathyroid hormone is elevated, and a parathyroid gland adenoma will be detected on the neck - its removal can also be effectively performed at the North-West Endocrinology Center. At the moment, our center is the undisputed leader in the treatment of patients with high blood calcium in Russia - every year, surgeons-endocrinologists of the center perform the removal of parathyroid adenomas in more than 300 patients. In terms of the number of operations on the parathyroid glands, our center is now in 3rd place in Europe.

Blood calcium is increased, other tests have been passed - how to decipher them?

Of course, deciphering a blood test is the prerogative of the attending endocrinologist, and self-study of your own blood test can lead the patient to diagnostic errors, however, within the framework of this article, we will give some information about the possible results of a laboratory examination with elevated blood calcium. Use the information obtained with caution and remember that it does not replace the advice of a medical specialist.

So, the possible variants of laboratory results and their interpretation.

Blood calcium is increased, parathyroid hormone is increased, phosphorus is reduced, calcitonin is normal, calcium in daily urine is increased - most likely, we are talking about primary hyperparathyroidism and the presence of parathyroid adenoma. An additional examination is required using ultrasound of the thyroid gland and neck, scintigraphy of the parathyroid glands with technetrile, and in some cases computed tomography of the neck. It is treated surgically (in a specialized center, endoscopic surgery is possible through an incision about 2 cm long).

Parathyroid hormone is elevated, calcium is normal, phosphorus is normal, calcitonin is normal- with a high degree of probability we are talking about secondary hyperparathyroidism due to a banal vitamin D deficiency in the blood. It is treated with vitamin D and calcium. It is important to exclude a laboratory error associated with an underestimation of the level of ionized calcium in the blood (it is better to retake an analysis for ionized calcium in a specialized laboratory of the endocrinology center).

Calcium in the blood is increased, parathyroid hormone is normal, phosphorus is normal, calcitonin is normal- a neuroendocrine tumor producing PTH-like peptides or forming lytic bone metastases should be suspected. Examination and treatment depends on the type of tumor found.

High blood calcium (usually slightly elevated calcium is noted), parathyroid hormone is moderately elevated, phosphorus is normal, calcitonin is normal, calcium concentration is reduced in daily urine - we can talk about a rare family disease, the so-called familial benign hypocalciuric hypercalcemia. This disease is accompanied by a change in the sensitivity of cellular receptors to parathyroid hormone and a violation of calcium excretion in the urine. Does not require treatment and is not dangerous. Often, inexperienced doctors diagnose primary hyperparathyroidism in such cases and refer the patient to an unnecessary operation to remove a non-existent parathyroid adenoma.

Ionized calcium is increased, total calcium is normal, parathyroid hormone is increased- it is usually all the same about parathyroid adenoma.

Ionized calcium is elevated, total calcium is below normal– it is necessary to exclude laboratory error. The analysis should be retaken in a specialized laboratory.

Calcium ionized in the blood is increased, parathyroid hormone is increased, calcitonin is increased- the presence of both parathyroid adenoma and medullary thyroid cancer should be suspected in the patient. Together, these two diseases indicate a high probability of a patient having the syndrome of multiple endocrine neoplasia type IIA - a rare hereditary pathology transmitted in the family and leading to the development of three dangerous tumors: medullary thyroid cancer, parathyroid adenomas (often multiple), pheochromocytoma (tumors adrenal gland, which produces adrenaline or noradrenaline). An urgent consultation with an endocrinologist or an endocrinologist is required!

Calcium in the blood is increased during the first analysis, I want to retake the analysis - how best to do this?

If you want to check whether blood calcium is really elevated and are going to take a second blood test, follow some important rules that will help the second analysis be as accurate as possible:

1. blood test should be taken only in a specialized laboratory using high-quality equipment;

2. a blood test must be taken only on an empty stomach;

3. if you are taking vitamin D or calcium supplements (or combination preparations with vitamin D and calcium), cancel them at least 2-3 days before the second blood test; the intake of calcium from the drug into the blood can lead to an increased content of calcium in the blood - of course, in this case, a falsely elevated calcium is detected.

Where to turn if the calcium in the blood is elevated?

The Russian leader in the treatment of hypercalcemia (this is how high calcium in the blood is called in medical language) is the North-West Endocrinology Center. The specialists of the center carry out all stages of diagnosis and treatment of patients with hypercalcemia:

Laboratory examination;

Ultrasound of the thyroid gland and neck;

Additional imaging methods (scintigraphy of the parathyroid glands with technetrile, computed tomography with contrast enhancement);

Drug treatment for secondary hyperparathyroidism and vitamin D deficiency;

Minimally invasive surgical treatment in case of detection of primary hyperparathyroidism;

Extended and combined operations on the thyroid gland, parathyroid glands, adrenal glands in the syndrome of multiple endocrine neoplasia.

Our recommendation (and believe me - this recommendation is based on the experience of treating thousands and thousands of patients!) - in all cases when a patient has elevated blood calcium, contact a specialized center - the North-West Endocrinology Center. Even if you live in Kamchatka or Sochi, examination and treatment in a specialized institution will help you save time, money and health. We annually treat patients from almost all regions of Russia (it is important to bear in mind that if surgical treatment is necessary, it will be provided to all citizens of the Russian Federation free of charge under the compulsory medical insurance policy).

To make an appointment for a blood test or a consultation with a specialist doctor (endocrinologist or endocrinologist surgeon - both specialists will suit you with high blood calcium) you need to call the center's branches in St. Petersburg or Vyborg:

- Petrograd branch of the Endocrinology Center in St. Petersburg - Kronverksky prospect, house 31, 200 meters to the left from the Gorkovskaya metro station, tel. 498-10-30, opening hours from 7.30 to 20.00, seven days a week;

- Primorsky branch of the Endocrinology Center in St. Petersburg - Primorsky district of St. Petersburg, st. Savushkina, 124, building 1, tel. 344-0-344, opening hours from 7.00 to 20.00, seven days a week;

- Vyborg branch of the Endocrinology Center– Vyborg, Pobedy Avenue, house 27A, tel. 36-306, opening hours from 7.30 to 20.00, seven days a week.

Admission of patients who elevated blood calcium, carried out by specialists of the North-West Center of Endocrinology:

	Sleptsov Ilya Valerievich MD, surgeon, endocrinologist, oncologist, specialist in ultrasound diagnostics. Professor of the Department of Surgery with a course of endocrinology. He is the head of the North-Western Medical Center, a member of the European Thyroid Association, the European Association of Endocrine Surgeons, the Russian Association of Endocrinologists
	Chinchuk Igor Konstantinovich Candidate of Medical Sciences, surgeon, endocrinologist, oncologist, specialist in ultrasound diagnostics. Member of the European Thyroid Association, European Association of Endocrine Surgeons.
	Uspenskaya Anna Alekseevna
	Novokshonov Konstantin Yurievich Surgeon, endocrinologist, oncologist, specialist in ultrasound diagnostics. Member of the European Thyroid Association.
	Endocrinologist, specialist in ultrasound diagnostics. Member of the European Thyroid Association, Russian Association of Endocrinologists.
	Isheyskaya Maria Sergeevna Endocrinologist, specialist in ultrasound diagnostics. Member of the Russian Association of Endocrinologists. Doctor's personal website - spb-endo.ru.

At the end of this article, it should be noted once again that a situation where calcium in the blood is elevated ALWAYS requires further examination and consultation endocrinologist. The consequences of an untimely detected and untreated disease that causes elevated calcium can, in some cases, even be fatal. Don't risk it - If you have high calcium levels in your blood, always consult your doctor..

• parathyroid glands

  General information about the parathyroid glands (location, number, function, history of discovery, major diseases, operations)

• Vitamin D and parathyroid adenomas

  Between the concentration of vitamin D in the blood and diseases of the parathyroid glands, there is a close relationship. A low level of vitamin D in the blood can lead to the development of secondary hyperparathyroidism, or to the appearance of parathyroid adenomas (primary hyperparathyroidism)

• Medullary thyroid cancer

  Medullary thyroid cancer (medullary thyroid carcinoma) is a rare hormonally active malignant neoplasm that develops from the parafollicular cells of the thyroid gland.

• Paget's disease

  Paget's disease or osteitis deformans is a chronic pathological condition of individual bones of the human skeleton, during which foci of increased decay of bone cells are formed, followed by their replacement with a large amount of defective bone tissue

• Multiple endocrine neoplasia syndrome type I (MEN-1 syndrome)

  Syndrome of multiple endocrine neoplasia type 1, otherwise referred to as Wermer's syndrome, is a combination of tumors or hyperplasia in two or more organs of the endocrine system (as a rule, the parathyroid glands are involved in the tumor process, along with islet cell neoplasms of the pancreas and pituitary adenoma)

• Operations on the parathyroid glands

  The Northwestern Center of Endocrinology and Endocrine Surgery performs operations to remove parathyroid gland adenomas for all types of hyperparathyroidism. More than 800 patients with this disease become our patients annually

• Endocrinologist's consultation

  Specialists of the North-Western Center of Endocrinology diagnose and treat diseases of the endocrine system. The endocrinologists of the center in their work are based on the recommendations of the European Association of Endocrinologists and the American Association of Clinical Endocrinologists. Modern diagnostic and therapeutic technologies provide optimal treatment results.

  neck ultrasound

  Information about the ultrasound of the neck - the studies included in it, their features

• Consultation with an endocrinologist

  Surgeon-endocrinologist - a doctor specializing in the treatment of diseases of the endocrine system requiring the use of surgical techniques (surgical treatment, minimally invasive interventions)

• Intraoperative neuromonitoring

  Intraoperative neuromonitoring is a technique for monitoring the electrical activity of the laryngeal nerves, which ensure the mobility of the vocal cords, during surgery. During monitoring, the surgeon has the opportunity to assess the condition of the laryngeal nerves every second and change the operation plan accordingly. Neuromonitorng can drastically reduce the likelihood of developing a voice disorder after surgery on the thyroid gland and parathyroid glands.

• Densitometry

  Densitometry is a method for determining the density of human bone tissue. The term "densitometry" (from the Latin densitas - density, metria - measurement) is applied to methods for the quantitative determination of bone density or its mineral mass. Bone density can be determined using X-ray or ultrasound densitometry. The data obtained during densitometry are processed using a computer program that compares the results with indicators accepted as the norm for people of the corresponding sex and age. Bone density is the main indicator that determines the strength of the bone, its resistance to mechanical stress.

Hypercalcemiais an increased level of calcium in the blood. The cause may be an overactive parathyroid gland, certain medications, excessive vitamin D intake, or underlying diseases, including cancer.

Calcium plays an important role in the body. It keeps bones and teeth strong and also supports muscles, nerves and the heart. However, too much calcium can cause problems.

What is hypercalcemia?

Blood calcium levels are mainly controlled by the parathyroid glands. These four tiny glands are located behind the thyroid gland. When the body needs calcium, the parathyroid glands release a hormone that signals the kidneys to produce less calcium.

An overactive parathyroid gland can upset calcium balance.

If calcium levels become too high, a person may be diagnosed with hypercalcemia. This condition may be related to:

• poor bone health;
• kidney stones;
• dysfunction of the heart and brain.

Extremely high levels of calcium in the blood can be life-threatening.

Hypercalcemia - symptoms

Mild hypercalcemia causes no symptoms, while severe hypercalcemia can cause:

Excessive thirst and frequent urination

Too much calcium makes the kidneys work harder. As a result, a person urinates more often, which leads to dehydration and increased thirst.

Stomach pain and digestive problems

Too much calcium can cause indigestion, abdominal pain, nausea, vomiting, and constipation.

Bone pain and muscle weakness

Hypercalcemia can cause the bones to release a lot of calcium. This abnormal bone activity can lead to pain and muscle weakness.

Lethargy and fatigue

Too much calcium in the blood can affect the brain, causing these symptoms.

Anxiety and depression

Hypercalcemia can also affect mental health.

and arrhythmia

High calcium levels can increase blood pressure and lead to electrical abnormalities that change the rhythm of the heart.

Hypercalcemia - causes

Hyperactivity of the parathyroid glands

The parathyroid glands control calcium levels. If they work too hard, it can lead to hypercalcemia.

An overactive parathyroid gland is calledhyperparathyroidism. This may be the most common cause of hypercalcemia. Hyperparathyroidism is usually diagnosed in people between the ages of 50 and 60. It is three times more common in women than in men.

Too much vitamin D

Vitamin D causes calcium absorption in the intestine. After absorption, calcium enters the bloodstream. Only 10-20% of the calcium is usually absorbed and the rest is excreted in the feces. However, too much vitamin D causes the body to absorb more calcium, resulting in hypercalcemia. A high dose of vitamin D can cause hypercalcemia. These supplements can be used to treat and other diseases. The recommended daily dose for adults is 600-800 IU per day.

Crayfish

Cancer can cause hypercalcemia. Oncological diseases that usually lead to this disease:

• lungs' cancer;
• mammary cancer;
• blood cancer.

If the cancer spreads to the bones, it increases the risk of hypercalcemia.

Other health conditions

The following conditions cause high calcium levels:

• sarcoidosis;
• thyroid disease;
• chronic kidney disease;
• adrenal disease;
• severe fungal infections;
• limited mobility.

People who cannot move for long periods of time are also at risk for hypercalcemia. When bones have less work to do, they can release more calcium into the bloodstream.

Dehydration

Severe dehydration increases the concentration of calcium in the bloodstream. However, its imbalance can be corrected.

Medications

Some drugs can cause overactivity of the parathyroid gland, which can lead to hypercalcemia. One example is lithium, which is used to treat bipolar disorder.

Complications of increased calcium in the blood

Without proper treatment, hypercalcemia can cause:

Osteoporosis

Over time, bones can release excess calcium into the bloodstream. This makes the bones thin and less dense. People with osteoporosis are at increased risk of:

• bone fracture;
• curvature of the spine.

Stones in the kidneys

People with hypercalcemia are at risk for the formation of calcium crystals in the kidneys. These crystals can form kidney stones, which are often asymptomatic. They can also damage the kidneys.

kidney failure

Over time, severe hypercalcemia can impair kidney function. When the kidneys cannot effectively cleanse the blood and remove fluid from the body, this is called kidney failure.

Problems with the nervous system

If left untreated, hypercalcemia can affect the nervous system. Possible consequences:

• dementia;
• weakness;
• coma.

Heart rhythm disorder

The heart beats when electrical impulses travel through it and cause it to contract. Calcium plays a role in regulating this process, and too much calcium can lead to irregular heartbeats.

Hypercalcemia - diagnosis

A person with mild hypercalcemia may have no symptoms and the condition can be diagnosed with a blood test.

The analysis will show the level of calcium in the blood and parathyroid hormones. It can show how well the body's systems are functioning. After identifying hypercalcemia, the doctor may perform additional diagnostic methods, such as:

• ECG;
• chest x-ray to rule out lung cancer or infections;
• mammography to rule out breast cancer;
• CT or MRI to measure bone density.

Hypercalcemia - treatment

People with mild hypercalcemia do not need treatment, and calcium levels may return to normal over time.

For people with severe hypercalcemia, it is important to find the cause. A doctor may suggest treatment to lower calcium levels and prevent complications. Possible treatments include intravenous fluids and medications such as calcitonin or bisphosphonates.

If parathyroid activity, high vitamin D levels, or another medical condition is causing hypercalcemia, your doctor will treat the underlying conditions.

Hypercalcemia -prevention

Certain lifestyle changes can balance calcium levels. These include:

Consuming a lot of water

Water can lower blood calcium levels and prevent kidney stones from forming.

To give up smoking

Smoking increases bone loss.

Exercise and strength training

Exercise improves bone strength and health.

Literature

1. Gastanaga V. M. et al. Prevalence of hypercalcemia among cancer patients in the United States //Cancer medicine. - 2016. - T. 5. - No. 8. - S. 2091-2100.
2. Goldner W. Cancer-related hypercalcemia // Journal of oncology practice. - 2016. - T. 12. - No. 5. - S. 426-432.
3. Karthikeyan V. J., Khan J. M., Lip G. Y. H. Hypercalcemia and the cardiovascular system // Metabolic syndrome and its management. - 2006. - S. 25.
4. Marcus, J. F., Shalev, S. M., Harris, C. A., Goodin, D. S., & Josephson, A. (2012, January). Severe hypercalcemia following vitamin D supplementation in a patient with multiple sclerosis: A note of caution. Archives of Neurology, 69(1), 129–132.
5. Mirrakhimov, A. E. (November 2015). Hypercalcemia of malignancy: An update on pathogenesis and management. North American Journal of Medical Sciences, 7(11), 483–493.