Does hypercalcemia cause tremors?

From the Guidelines

Hypercalcemia can potentially cause tremors, although it is not a common or characteristic symptom, and its management should prioritize addressing the underlying cause and reducing calcium levels to prevent morbidity and mortality. Hypercalcemia, which is an elevated level of calcium in the blood, primarily affects the nervous system by causing symptoms like confusion, lethargy, and muscle weakness. While tremor is not typically listed as a primary symptom, the disruption of normal calcium levels can interfere with proper nerve and muscle function, potentially leading to tremors in some cases. The mechanism behind this is related to calcium's crucial role in muscle contraction and nerve signal transmission.

According to the most recent guidelines, treatment of hypercalcemia should involve hydration, bisphosphonates, denosumab, steroids, and/or calcitonin, with zoledronic acid being the preferred bisphosphonate for treatment of hypercalcemia 1. If you're experiencing tremors and suspect hypercalcemia, it's essential to consult a healthcare provider for proper diagnosis and treatment. Management of hypercalcemia usually involves addressing the underlying cause, which can range from hyperparathyroidism to certain medications or malignancies.

Some key points to consider in the management of hypercalcemia include:

• The use of plasmapheresis as adjunctive therapy for symptomatic hyperviscosity 1
• The consideration of erythropoietin therapy for anemic patients, especially those with renal failure 1
• The importance of measuring endogenous erythropoietin levels in treatment planning 1
• The need for careful planning of radiation therapy to minimize toxicity to the spinal cord, brain, bone marrow, and adjacent organs at risk 1

It's also important to note that hypercalcemia can have significant effects on the body, including:

• Excess bone resorption, leading to the release of calcium into the blood 1
• Decreases in glomerular filtration rate, which can worsen hypercalcemia 1
• Increased risk of venous thromboembolism, particularly in the first 6 months after a new diagnosis of multiple myeloma 1

Overall, the management of hypercalcemia should prioritize reducing calcium levels and addressing the underlying cause to prevent morbidity and mortality, and to improve quality of life.

From the Research

Hypercalcemia and Tremors

• There is no direct evidence in the provided studies that hypercalcemia causes tremors 2, 3, 4, 5, 6.
• The studies discuss various symptoms and clinical manifestations of hypercalcemia, including nausea, vomiting, dehydration, confusion, somnolence, and coma, but tremors are not mentioned 2, 3, 4, 5, 6.
• Hypercalcemia can affect the neurological system, but the specific symptom of tremors is not associated with hypercalcemia in the provided evidence 2, 3, 4, 5, 6.

Symptoms of Hypercalcemia

• Mild hypercalcemia is usually asymptomatic, but may be associated with constitutional symptoms such as fatigue and constipation 2.
• Severe hypercalcemia can cause nausea, vomiting, dehydration, confusion, somnolence, and coma 2, 3, 4, 5, 6.
• The symptoms of hypercalcemia are related to the level of calcium in the blood, with higher levels leading to more pronounced symptoms 3.

Diagnosis and Treatment of Hypercalcemia

• The diagnosis of hypercalcemia should be confirmed with an albumin-adjusted or ionized calcium level 4.
• The treatment of hypercalcemia depends on the underlying cause and the severity of the symptoms 2, 3, 4, 5, 6.
• Initial treatment involves vigorous intravenous hydration and drugs to reduce bone resorption, such as bisphosphonates and denosumab 2, 3, 5.