Treatments that can Cause Hypercalcemia

The excess levels of calcium can be dangerous when they are elevated to a level (>14 mg/dL) that causes symptoms like polyuria or polydipsia due to nephrogenic diabetes insipidus, nephrolithiasis, and bone nausea, pain as well as confusion, anorexia, rare cardiac arrhythmias, and coma. The body's calcium homeostasis is dependent on the parathyroid hormone (PTH) and vitamin D and the hormone calcitonin (to less extent) as well as other organs of the target, including the kidneys, the gut, and bone. The diagnosis of hypercalcemia is usually a result of an increase in levels in blood tests. The most frequent medical reasons for hypercalcemia are malignancies and primary hyperparathyroidism; however, we will also review the most frequently used medicines that trigger hypercalcemia.

Calcium-containing supplements and antacids

Ingestion of excessive calcium carbonate through antiacids could cause an illness called milk-alkali syndrome that is characterized by hypercalcemia, metabolic alkalosis, and acute kidney damage. This is among the most common causes of hypercalcemia, which is behind the malignancy of hyperparathyroidism. Calcium citrate is a commonly utilized calcium supplement that may cause hypercalcemia. Making sure to take a thorough history of medications to discover the amount of calcium a patient is taking will help determine the excessive use supplementation with calcium, in particular those who self-medicate with Tums in addition to an everyday calcium supplement.

Thiazide Diuretics

Being among the most common drugs to result in hypercalcemia, thiazide diuretics tend to cause mild hypercalcemia when they are used with other medications that cause the elevation of calcium levels. The absorption of calcium to the membrane of luminal is increased in order to enable an exchange between sodium, and this leads to an increase in blood calcium and lower urinary calcium. This is a benefit in certain situations, for example, the reduction of kidney stones; however, it is a class of drugs to look out for in patients suffering from hypercalcemia.

Vitamin D

Vitamin D levels that are toxic could result from an excess of OTC vitamin D, could cause hypercalcemia. With very excessive concentrations of vitamin D, macrophages trigger an increase in extra-renal conversion of 25-hydroxyvitamin D3 to calcitriol. This could cause granulomas as being able to reduce PTH levels. This leads to elevated levels of 1,25-dihydroxyvitamin D3. The most common response to this is the short-term use of glucocorticoids.

Lithium

Another medication that may trigger hypercalcemia could be lithium. Lithium consumption increases the PTH set point and needs higher levels of serum calcium to shut off the PTH production. Patients taking lithium ought to be monitored for calcium levels. Another interaction with other medications to keep in mind is the capacity of diuretics that contain thiazide to raise the level of lithium in the serum, thereby increasing the risk of hypercalcemia.

Vitamin A

The last drug that could cause hypercalcemia is vitamin A. Be aware it is true that vitamin A derivatives are utilized to treat acne. It is believed that excessive vitamin A levels can result in osteolytic damage to bones; however, the mechanism of action isn't clear. People suffering from chronic renal impairment are at greater risk of developing hypercalcemia due to hypervitaminosis A.