From the Research
Yes, lithium can cause hypercalcemia, as evidenced by the most recent and highest quality study available 1. This side effect occurs in approximately 10-20% of patients taking lithium, typically after long-term use. Lithium interferes with calcium homeostasis by altering parathyroid hormone (PTH) regulation, leading to increased PTH secretion and subsequent elevation of calcium levels. The hypercalcemia is usually mild to moderate, with serum calcium levels typically ranging from 10.5 to 12 mg/dL. Key points to consider include:
- Lithium-associated hyperparathyroidism is a recognized condition that can lead to hypercalcemia 1.
- The condition can be caused by both acute and chronic effects of lithium on the parathyroid glands 1.
- Regular monitoring of calcium levels in patients on lithium therapy is crucial for early recognition and management of lithium-associated hyperparathyroidism 1.
- Patients with pre-existing parathyroid disorders or calcium metabolism abnormalities should be monitored more closely when taking lithium 2, 3, 4.
- The effect of lithium on calcium levels is generally reversible upon discontinuation of lithium therapy, though it may persist in some patients who have developed parathyroid hyperplasia after prolonged lithium exposure 2, 3. In terms of management, patients on lithium therapy should have their calcium levels monitored periodically, especially during the first few months of treatment and then annually thereafter. If hypercalcemia develops, it may require adjustment of lithium dosage, additional treatments to normalize calcium levels, or in severe cases, discontinuation of lithium therapy 2, 1. Overall, the evidence suggests that lithium can cause hypercalcemia, and regular monitoring and management are necessary to minimize the risk of this side effect 1, 4.