Hypercalcemia & Osteoporosis

Taking calcium to maintain optimal bone health is important, but too much or too little of a good thing can lead to bone problems such as hypercalcemia and osteoporosis. Patients with hypercalcemia and osteoporosis can show little or no symptoms during the early stages, but they should be aware of the causes, complications and risks associated with these conditions so that preventative measures can be taken and appropriate care and treatment can be given.

Identification

• Hypercalcemia occurs when calcium levels in the blood are too high, adversely affecting normal muscle contraction, and hormonal, nerve and brain function. Osteoporosis---which means "porous bones"---is a bone loss disease mainly affecting post-menopausal women (although men can also get it) that can result in painful fractures and other complications.

Symptoms

• Hypercalcemia may have few symptoms. However, more severe cases may cause nausea, vomiting, excessive thirst, frequent urination and stomach pain. There may be very little pain in the early stages of osteoporosis, but advanced symptoms include severe back pain---usually as the result of a fractured vertebra---height loss, a bent-over posture and fractures of the vertebra, hip or wrist.

Causes

• The leading cause of hypercalcemia is hyperparathyroidism. Other causes include lung, breast or blood-related cancers, diseases such as tuberculosis or other inflammatory lung disorders, taking medications such as lithium and thiazide diuretics, dehydration and overdosing on calcium and Vitamins A and D. The likelihood of developing osteoporosis depends on how much bone density is formed from age 20 to the early 30s and how quickly it's lost later in life.

Diagnosis

• Hypercalcemia is diagnosed through blood tests that show increased blood calcium and parathyroid hormone levels. Chest x-rays, CT scans, MRIs and mammograms can diagnose underlying conditions such as lung or breast cancer that can point to hypercalcemia. Osteoporosis is commonly diagnosed by measuring bone density with a dual energy X-ray absorptiometry. Other tests that measure bone density include ultrasound, CT scanning, and single-photon absorptiometry.

Treatment

• Hypercalcemia is treated with intravenous fluids, loop diuretic medications to flush excess calcium from the body, medications that inhibit bone loss, such as Aredia or Zometa, a hormone called Calcitronin, and corticosteroids. Hemodialysis treatment is used only if the kidneys have been damaged. Osteoporosis is treated with estrogen drugs such as Fosamax or Boniva; an estrogen receptor modulator such as Raloxifine, or a thyroid gland-producing hormone such as Calcitonin. Hormone therapy can also be used, as well as physical therapy to improve posture and build bone mass.

Complications

• Severe hypercalcemia can cause kidney damage, nervous system problems and an irregular heart beat. Kidney stones may also form if urine has too much calcium in it. It can also lead to osteoporosis if bones continuously release calcium into the blood. Fractures are the most serious and frequent complication of having osteoporosis, usually occurring in the bones that support weight, such as the spine or hip. Bone fractures occurring in weakened back bones usually happen due to compression that can also cause loss of height over time.

Risks

• Taking too much calcium can cause Hypercalcemia. Older white or Asian women with a body mass index of 19 or less and those with a family history are at risk of developing osteoporosis. A lack of calcium and Vitamin D, cigarette smoking, eating disorders, an inactive lifestyle, excessive alcohol, too much thyroid hormone and taking corticosteroid medications can also play a role in developing osteoporosis.