What Causes High Calcium In The Blood – What causes high calcium levels in the body? Here are a few reasons, but if you’re concerned, it’s best to consult your doctor for a proper diagnosis.
High levels of calcium in the blood (hypercalcemia) are usually always caused by parathyroid disease, also known as hyperparathyroidism. It is a very dangerous condition and a test should be done as soon as possible to evaluate the reasons why it happened.
- 1 What Causes High Calcium In The Blood
- 2 Multiple Myeloma Symptoms
- 3 High Blood Pressure (hypertension)
What Causes High Calcium In The Blood
Most high blood calcium levels are caused by a small tumor in one of the parathyroid glands, causing a condition called hyperparathyroidism. Parathyroid glands are small glands of the endocrine system located in the neck behind the thyroid gland. The parathyroid glands regulate the calcium in our body – how much calcium is in our bones and how much calcium is in our blood.
What Causes High Calcium? Diagnosis, Prevention, And Treatment
When a tumor grows, the growth interrupts the regulation of the hormone that regulates calcium levels in our body. Therefore, too much calcium is produced.
A parathyroid tumor is almost always benign, but it must always be removed. The operation is usually very simple and quick and takes about 20-30 minutes.
In very few cases, hypercalcemia is one of the symptoms of cancer – often a tumor in the kidney. However, in almost all cases, a high calcium level is due to a rather less severe parathyroid disease.
In another rare case, high blood calcium levels can be caused by sarcoidosis. This is a disease in which the immune system is overactivated for unknown reasons. This is a condition that is barely noticed until a scan or x-ray is done for another reason. Symptoms include shortness of breath and cough. Often, sarcoid just goes away on its own. At other times, the patient is offered steroid treatment.
Hypercalcemia In Dogs
Vitamin D is very effective in its ability to allow the body to absorb calcium. However, too much can also have dangerous effects on the body. When the vitamin tells the kidneys to avoid calcium escaping into the urine, the body’s calcium level rises.
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Hypercalcemia (elevated blood calcium level) in dogs is a relatively rare electrolyte disorder that can affect several body systems. The most common pathological causes of hypercalcemia are malignancy and hyperparathyroidism. Comprehensive diagnostics must be done in order to obtain a concrete diagnosis, which enables the search for suitable treatment options. Treatment of the underlying cause is essential to correct hypercalcemia.
Hyperparathyroidism Vs. Hyperthyroidism: Signs, Causes
While waiting for diagnostic results, supportive treatments can be offered to lower calcium levels until a long-term solution is found. Treatment options include fluid diuresis, steroids, bisphosphonates and other pharmacological compounds. Surgery and/or chemotherapy may be necessary if a neoplastic process is detected. By combining diagnostic results and appropriate treatment methods, hypercalcemia can be resolved in most cases.
Hypercalcemia is a relatively rare electrolyte disorder caused by disease or an external influence that results in excess calcium in the body. The most common pathologic cause of hypercalcemia in dogs is neoplasia; 60% of dogs with hypercalcemia are diagnosed with cancer.1 Abnormal calcium levels can lead to serious disturbances in normal body function, as calcium is a key factor in neuromuscular transmission, enzyme activity, coagulation, vasodilation, vasoconstriction, and bone production and stability.
There are two primary ways to measure calcium: total and ionized. Total reflects all calcium in the body, while ionized reflects biologically active calcium levels. When only total calcium levels are used, hypercalcemia may be overestimated, while hypocalcemia may be underestimated. When assessing a patient’s calcium levels, ionized calcium is the more accurate value used initially to diagnose and monitor hypercalcemia.
Calcium regulation is maintained by three main substances in the body: calcitriol, parathyroid hormone (PTH) and calcitonin (PHOTO 1).
Multiple Myeloma Symptoms
The body gets much of its calcium from vitamin D, which is obtained through exposure to ultraviolet light or by consuming vitamin D-containing foods or supplements. Once vitamin D has entered the body, it is converted into 1,25-dihydroxyvitamin D in the liver. This precursor (an inactive substance that turns into an active substance) is then processed in the kidneys and converted to calcitriol. Calcitriol is released into the bloodstream and helps to increase the absorption of calcium from the intestines and supports both bone and kidney calcium reabsorption.
The parathyroid gland further regulates the body’s calcium levels. The parathyroid gland produces PTH, the primary function of which is to maintain homeostatic calcium levels. PTH increases plasma calcium levels through three mechanisms: utilizing bone calcium stores through resorption, increasing renal tubular calcium reabsorption, and increasing renal calcitriol synthesis.
The parathyroid gland regulates its PTH production, whereby PTH and calcitriol prevent further secretion of PTH. When the parathyroid gland detects excess levels of calcium, the production of calcitonin increases in the thyroid gland, which inhibits osteoclast activity and bone resorption, helping to stabilize calcium levels in normal dogs.
However, in dogs with a disease process in which this cycle is affected or bypassed (such as cancer), excessive calcium production continues despite the normal negative feedback loop in the calcium cycle.
Calcium And Phosphate Metabolism And Related Disorders During Pregnancy And Lactation
Other rare causes of hypercalcemia include excessive intestinal phosphate binders, excessive calcium supplementation, hypervitaminosis A, milk-alkali syndrome, thiazide diuretics, acromegaly, thyrotoxicosis, kidney transplantation, and aluminum exposure.
In dogs, HM is most often associated with T-cell lymphoma and adenocarcinoma of the anus. HM can also occur with multiple myeloma, parathyroid tumors (often benign), thymoma, melanoma, breast tumors, and others. HM is most commonly caused by the release of PTH-related peptide (PTHrP) from tumor cells into the bloodstream, called HHM. Other growth factors and cytokines released from cancer cells may further promote and synergize the role of PTHrP in HM. PTHrP may act much like PTH does in the calcium cycle by increasing osteoclast activity leading to bone resorption and increasing renal tubular calcium reabsorption. HM can also occur more directly as a result of osteolysis caused by bone tumors, when excessive calcium is released into the bloodstream.1, 3
Primary hyperparathyroidism is another possible cause of hypercalcemia, although it is less common than malignant causes. Hyperparathyroidism causes the parathyroid glands to produce and secrete too much PTH, leading to excessive calcium deposition in the bones, kidneys, and intestines. This excess production of PTH is caused by a nodule or nodules in the parathyroid glands. These nodules are statistically benign, although malignant nodules are possible.1
Primary hyperparathyroidism occurs most commonly in older dogs, around 7 years old. Sex and breed toxicity is not statistically significant, except for the keishond, which has a hereditary form of the disease.4
High Blood Pressure (hypertension)
The clinical symptoms of hyperparathyroidism coincide with the general symptoms of hypercalcemia, but are often milder or absent at the time of diagnosis. Evidence of primary hyperparathyroidism is often an incidental finding during routine laboratory work in older dogs.
About one-third of dogs diagnosed with hypoadrenocorticism are found to have mild hypercalcemia. Several factors may contribute to this finding, including increased calcium citrate, hemoconcentration, increased renal reabsorption of calcium, and increased affinity of serum proteins for calcium. When adrenocortical insufficiency is treated and is stable, hypercalcemia rapidly resolves.
Hypercalcemia can be a cause or sign of kidney failure. Hypercalcemia and renal failure are almost always associated with a primary comorbidity, such as neoplasia, primary hyperparathyroidism, or vitamin D toxicity. Severe hypercalcemia may contribute to acute renal failure. Mild to moderate hypercalcemia may result from chronic renal failure.1
Hypercalcemia due to toxicity can occur as a result of ingestion of calcium or vitamin D supplements, rodenticides containing cholecalciferol (vitamin D3), calcitriol, plants containing glycosides, and intestinal phosphate binders. Poison-specific treatments can be started in addition to treatments that support hypercalcemia.
Pathophysiology Of Hypercalcemia
Unlike cats, where idiopathic hypercalcemia is a common diagnosis when hypercalcemia is detected, idiopathic hypercalcemia is very rare in dogs.
Calcium is involved in many daily body processes. When calcium is not properly regulated, it can cause a variety of clinical symptoms:
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