Talk with your doctor about the risks and benefits of taking steroids. ... Around 10%-30% of people with cancer may get hypercalcemia. Advanced Cancer. Or, you may not have any symptoms. Taking too much vitamin D or calcium in the form of supplements can raise your calcium level. High calcium levels due to cancer are not caused by too much calcium in your diet. Eating fewer dairy products and other high-calcium foods will not lower high blood calcium levels. We'll…, Although metastatic breast cancer can be treated, there isn’t a current cure. High calcium levels can affect bones, leading to: Hypercalcemia can also cause neurological symptoms, such as depression, memory loss, and irritability. Blood tests, such as those drawn for an annual physical exam, today routinely check calcium levels. It is the most common life-threatening complication of cancer in adults. Fatigue Symptoms of severe hypercalcemia include: … Last medically reviewed on July 27, 2017. Constipation 6. Most of the calcium in your body is in your bones. They’re useful in the treatment of too much vitamin D. Loop diuretic medications can help your kidneys move fluid and get rid of extra calcium, especially if you have heart failure. Some cancers can cause hypercalcemia themselves, without spread to the bone. However, the severity greatly depends on your kidney function. The main thing all individuals with hypercalcemia have is an excessive amount of calcium in the blood. Common treatment options include the following: Depending on your age, kidney function, and bone effects, you might need surgery to remove the abnormal parathyroid glands. However, they may also cause negative health effects for many people. You and your family should know these serious symptoms. These effects, called humoral hypercalcemia of cancer, are considered a paraneoplastic syndrome. Treatment depends on the cause. Hyperparathyroidism occurs when one or more of your parathyroid glands becomes overly active and releases too much PTH. Because hypercalcemia can cause few, if any, signs or symptoms, you might not know you have the disorder until routine blood tests reveal a high level of blood calcium. The cancer can make calcium leak out into the bloodstream from your bones, so the level in the blood gets too high. A review of cancer-related hypercalcemia found that rates varied by tumor type, being highest in multiple myeloma (7.5–10.2%) and lowest in prostate cancer (1.4–2.1%). High doses of these over-the-counter products are the third most common cause of hypercalcemia in the United States. In these cases, the health care team will discuss whether to treat hypercalcemia. Dec 10, 2014 - How long can a person live with untreated Uremia ? Some medications cause hypercalcemia such as: alkaline antacids, diethylstilbestrol (DES), long … Hyperparathyroidism a disorder of the four parathyroid glands. The blood test usually provides a report regarding the levels of parathyroid hormone and blood calcium. This is the leading cause of hypercalcemia, especially in women over 50 years old. Severe hyperthyroidism can also cause hypercalcemia by increasing resorption of bone tissue. Calcium is a mineral found in different places in the body, including your blood. Up to 30% of all people with cancer will develop a high calcium level as a side effect.A high calcium level can be treated, and it is important to talk with your doctor if you We were told that the high calcium is eating his … That is, someone with only a slightly high calcium can feel just as bad as someone with a much higher blood calcium level, and they will have the same chances of getting all of the complications. Hypercalcemia, or higher than normal level of calcium in your blood, is a fairly common finding. Hypercalcemia may be the result of parathyroid, adrenal gland disorders or kidney disease. Hypercalcemia can be life-threatening and rapid reduction may be necessary. You may be prescribed a bisphosphonate, such as zoledronic acid (Zometa), pamidronate (Aredia), or ibandronate (Boniva), or denosumab (Prolia, Xgeva). The excessive amounts of calcium in the blood can be very problematic. And that's just the average. For people with advanced cancer, high calcium levels can occur when they are approaching the last weeks of life. Although it is most commonly a result of overactive parathyroid glands, it can also be a result of an unbalanced diet, too much vitamin D, dehydration, certain medications, a sedentary lifestyle, and some medical conditions (including cancer, tuberculosis, sarcoidosis). The effect that elevated calcium levels have on your body relate not just to the level of calcium present, but how quickly it rises. Additionally, mildly elevated calcium produces different effects than severely elevated calcium.2 Symptoms of mild hypercalcemia include: 1. Taking a hormone called calcitonin. Hypercalcaemia, also spelled hypercalcemia, is a high calcium (Ca 2+) level in the blood serum. People have two copies of each gene (one inherited from each parent). You should stay adequately hydrated by drinking the proper amount of fluids, including water. Research suggests it may also have a role in the treatment of hypercalcemia due to other cancers as well. Management of Hypercalcaemia. Lung cancer, breast cancer and multiple myeloma are the most prevalent malignancies associated with hypercalcemia. Some doctors out there do not know this! Everybody needs calcium for many body functions. You should have this condition evaluated further. Learn the signs and…. You may also have blood tests to check how well your kidneys are working. Hypercalcaemia occurs in an estimated 10-20 per cent of all patients with cancer 1 and is associated with a poor prognosis. It can have pretty severe symptoms such as stomach pains and frequent urination. A cancer cell may break away from the original location in the body and travel in the circulatory system until it gets lodged in a small capillary network in bone tissue. It’s also important in blood clotting and bone health. Blood tests can also show whether your parathyroid hormone level is high, indicating that you have hyperparathyroidism. Intravenous bisphosphonates lower blood calcium levels by regulating bone calcium. Hypercalcemia can also be caused by overactive parathyroid glands. Hypercalcemia: A higher-than-normal level of calcium in the blood. But some doctors try to diagnose it with urine calcium results. Talk with your doctor about the risks and benefits of taking such medications. Replacing fluids lost through vomiting and urination. Severe cases can cause confusion and coma. It is a serious condition. It’s not uncommon for cancer to cause elevated calcium levels. Since smoking can speed up bone loss, it’s important to quit as soon as possible. Cancer cells can spread, or metastasize, through the blood and lymph systems. The goal of treatment is to return your calcium level to normal. Dating, Sex, and Reproduction. People who have no symptoms receive extra fluids, usually given through a vein. Talk to your doctor first to find out what types of exercises are safe for you. There are many reasons for an elevated blood calcium level. The cancer might also affect the amount of calcium that your kidneys are able to get rid of. Although rare, this can result in pseudohypercalcemia—for example, in patients with hyperalbuminemia secondary to dehy… Dehydration causes your calcium level to rise due to the low amount of fluid you have in your blood. High Levels of Calcium in the Blood Can Affect Your Brain: Study A team of Dutch researchers have discovered that high levels of blood calcium, rather than calcium in the bones, are linked to a … For a 60-year-old man, stage 1 kidney disease life expectancy will be approximately 15 years. Hypercalcemia is considered mild if the total serum calcium level is between 10.5 and 12 mg per dL (2.63 and 3 mmol per L).5 Levels higher than 14 mg per dL (3.5 mmol per L) can be life threatening. This usually leads to mild cases of hypercalcemia. Normally, your blood contains only a small amount. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. However, a person can live for years without even knowing that they have HCV. Hypercalcemia is usually detected initially as an elevation of total plasma calcium levels rather than ionized calcium levels. Treatment also aims to prevent damage to your bones and kidneys. Some people who have the disorder have no symptoms, especially when the condition is mild. This might make it easier for you to deal with your cancer treatments. Make sure you drink plenty of water. It is a serious condition. All rights reserved worldwide, Physical, Emotional, and Social Effects of Cancer. This causes more calcium absorption, which increases the calcium level in your blood. The severity of your symptoms does not depend on how high your calcium level is. Hypercalcemia of malignancy has many causes. Calcitonin is a hormone produced in the thyroid gland. Your long-term outlook will depend on the cause and how severe your condition is. Learn about…, Metabolic alkalosis is a type of alkalosis that occurs when your blood becomes overly alkaline. Hypercalcemia is a condition of having a higher than normal level of calcium in the blood. Hypercalcemia can be toxic to all body tissues, but major deleterious effects are on the kidneys, nervous system, and cardiovascular system. You will likely need hospital treatment if you have a moderate to severe case. Different people have different reactions. The treatment depends on how severe the condition is. Español. This type of treatment is called supportive care or palliative care. Individual risk of hypercalcemia depends on the underlying type and stage of malignancy. If you have cancer, your doctor will discuss treatment options with you to help you determine the best ways to treat hypercalcemia. Metastatic Breast Cancer: Understanding the Symptoms, pain between your back and upper abdomen on one side due to, MRI scans, which produce detailed images of your body’s organs and other structures. © 2005-2021 American Society of Clinical Oncology (ASCO). Symptoms of a high calcium level often develop slowly. We've found that most people who use this calculator are above average. Be sure to keep up with any recommended follow-up tests and appointments. All rights reserved. For example, if you are well-educated, a non-smoker and in good health, your estimated life expectancy can far surpass that of your peer group. He was suppose to have surgery on Wednesday but we informed that he may have Kidney damage from this now. Consuming extremely high amounts of calcium in the diet can also contribute to hypercalcemia. Hypercalcemia develops in 10%–20% of adults with cancer, but it rarely develops in children. Hypercalcemia is relatively common and often is mild but of long duration. Up to 30% of all people with cancer will develop a high calcium level as a side effect. The amount of fluid taken in and eliminated must be carefully monitored. The following symptoms may indicate the presence of hypercalcemia, although they can also indicate other health problems. If surgery isn’t an option for you, your doctor may recommend a medication called cinacalcet (Sensipar). A person suffering from a mild form of hypercalcemia may not exhibit any symptoms of hypercalcemia. Hypercalcemia can lead to pain in the bones, gastrointestinal issues, and in extreme cases, a coma. Cancer may also spread to bone from the adjacent cancer, though this occurs less frequently than spread by the blo… Trusted, compassionate information for people with cancer and their families and caregivers, from the American Society of Clinical Oncology (ASCO), the voice of the world’s cancer physicians and oncology professionals. What are the complications associated with hypercalcemia? Even "mild" hypercalcemia will lead to many other health problems if left untreated. Call a doctor if you have diarrhea or you throw up for a long time and can… The total calcium level is low in patients with low levels of binding proteins (hypoalbuminemia) and higher in those with high levels of binding proteins. A calcium of 10.5 is just as dangerous as a calcium of 11.5. Mild cases are often not diagnosed. Most animals with tCa greater than 15.0 mg/dL will show systemic signs, and those with tCa concentrations greater than 18.0 mg/dL are critically ill. Your doctor will treat a high calcium level if you have it. It slows down bone loss. Like any operation, there can be complications, so talk with your doctor about the risks and benefits, what to expect during the recovery, and how long you’ll be in the hospital. These four tiny glands are situated behind the thyroid gland. This can treat hypercalcemia fast. Steroids can also raise your risk of bone loss over time. Other drugs, such as lithium, cause more PTH to be released. In the setting of a calcium increase in a person with normal regulatory mechanisms, hypercalcemia suppresses the secretion of PTH. There are two types of hyperparathyroidism, primary and secondary. Assessing hydration status and for signs of an underlying cause. Because FHH is a genetic disease, the definitive way to diagnose it is with genetic testing discussed below). Loss of appetite 4. People have two copies of each gene (one inherited from each parent). Management of hypercalcemia may involve increasing fluid intake, as well as the use of diuretics and bisphosphonate drugs. Using dialysis if you haves kidney failure. Hypercalcemia can be a result of malignancy , elevated parathyroid gland activity ( hyperparathyroidism ), or other conditions. The normal range is 2.1–2.6 mmol/L (8.8–10.7 mg/dL, 4.3–5.2 mEq/L), with levels greater than 2.6 mmol/L defined as hypercalcemia. This allows physicians to detect abnormally high calcium levels early. Even mildly elevated levels of calcium can lead to kidney stones and kidney damage over time. Extremely high levels of calcium can be life-threatening. Español. A high calcium level can be treated, and it is important to talk with your doctor if you experience any symptoms. For Children. Hypercalcemia can also cause confusion or dementia since calcium helps keep your nervous system functioning properly. 1 In severe cases, hypercalcemia can be associated with neurocognitive dysfunction as well as volume depletion and renal insufficiency or failure. If your hypercalcemia is caused by a gland problem, you may have had surgery to remove that gland. Cancers that more commonly cause high calcium levels in your blood include: Gastrointestinal (digestive system) cancers. When you are healthy, your body controls the level of calcium in your blood. The normal range is 2.1–2.6 mmol/L (8.8–10.7 mg/dL, 4.3–5.2 mEq/L), with levels greater than 2.6 mmol/L defined as hypercalcemia. PTH helps the body control how much calcium comes into the blood stream from the intestines, kidneys, and bones. If it’s appropriate to treat and the person has symptoms or their level of calcium is very high, they will need to be admitted to a hospice or hospital for IV fluids and bisphosphonate treatment. However, too much of it can cause problems. Being on bed rest for a long time ; When you were in the hospital, you were given fluids through an IV and drugs to help lower the calcium level in your blood. Hypercalcemia means there is too much calcium in the blood. Reasons for the hypercalcemia may include: Cancer that started in the bone, or cancer that has spread to the bone. water security quiz Possible causes include overactive parathyroid glands, too much vitamin D, cancer, and a range of other factors and conditions. It helps form bones and teeth, and it also helps your muscles, nerves, and brain work correctly. When it develops in people with cancer, it may be called hypercalcemia of malignancy (HCM). Approximately 50% of total calcium is protein bound, and the total calcium level will vary with protein-binding capacity. Your body uses the interaction between calcium, vitamin D, and parathyroid hormone (PTH) to regulate calcium levels. COVID-19: What you need to know. Normally, patient will take dialysis or transplant to prolong their life span. This creates a calcium imbalance that the body cannot correct on its own. Walk and be active, which can help stop bone from breaking down. There are several proactive steps you can take. Other complications include irregular heartbeats and osteoporosis. Hypercalcemia is a condition of having a higher than normal level of calcium in the blood. They also help your bones take more calcium from your food. This plays a prominent role in calcium maintenance, however, only in the narrow range of serum calcium levels from 7.5-11.5 mg/dL. Español. High blood calcium levels are many times caused by a small benign tumor in one of … It occurs in 10 to 20% of cancer patients. The symptoms of chronically high calcium differ from those of acute, sudden elevations in calcium level. Almost 90% of all cases are caused by primary hyperparathyroidism (HPT) or hypercalcemia of malignancy. Hypercalcemia is an electrolyte imbalance and is indicated by an excess of calcium in the blood.& The normal adult value for calcium is 8.5-10.2 mg/dL. 512 - Free download as Powerpoint Presentation (.ppt / .pptx), PDF File (.pdf), Text File (.txt) or view presentation slides online. That means someone with a later stage cancer may live a longer life than a person who’s been diagnosed with an earlier stage cancer, or vice versa. Your body can also make calcitonin from the thyroid gland when your calcium level gets too high. It's most often caused by excessive vomiting. End-of-life and hospice care. If you have cancer, you may have had treatment for that, as well. Left untreated, a high calcium level can cause severe problems, like kidney failure, and it can even be life-threatening. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. If a person is receiving care for the last days of their life, it might not be appropriate to carry out any investigations or give treatment. Tests that can allow your doctor to check for evidence of cancer or other diseases that can cause hypercalcemia include: Treatment options for hypercalcemia depend on the severity of the condition and the underlying cause. These conditions can vary in severity and chronicity, and may be life-threatening. If your doctor finds a high calcium level, they’ll order more tests to find out the cause of your condition. They do this by causing severe fluid diuresis, which is a loss of body water, and an underexcretion of calcium. We opted not to do the surgery right now. levels above or below this range are relatively ineffective at further stimulating or suppressing PTH and rely on direct … Why else do we estimate you'll live so long? Calcitonin has long had FDA approval for treatment of hypercalcemia in adults. When you have more calcium in your blood than normal, doctors call it "hypercalcemia." Calcium levels can affect your muscles, causing twitches, cramps, and weakness. Too much calcium in your blood can weaken your bones, create kidney stones, and interfere with how your heart and brain work.Hypercalcemia is usually a result of overactive parathyroid glands. © 2005-2021 Healthline Media a Red Ventures Company. In such cases, a diagnosis can only be made through blood tests. You may not notice them at first, because they can feel like the symptoms of cancer or treatment. Older people usually have more symptoms than younger people. Hypercalcemia may be the result of parathyroid, adrenal gland disorders or kidney disease. When this occurs it’s a medical emergency. Smoking also causes many other health issues. Assessment of a person with unexplained hypercalcaemia includes: Asking about clinical features, co-morbidities, family history, and drug treatments. Those with a mild increase that has developed slowly typically have no symptoms. The Doc now put him on a steroid and a Diuretic stated that this would lower his Calcium level. People with bone tumors are at an increased risk of developing hypercalcemia. A person with familial hypocalciuric hypercalcemia (FHH) has a 50% (1 in 2) risk to pass on the genetic change (pathogenic variant, also called mutation) to each of his/her children. Malignancy is a common cause of elevated blood calcium. This will keep you hydrated, keep blood levels of calcium down, and decrease your risk of developing kidney stones. Many of the symptoms of hypercalcemia are vague. The following tips may help keep hypercalcemia from getting worse: Talk with your doctor about controlling your nausea and vomiting. If you have a more serious case, you will typically have signs and symptoms that affect various parts of your body. Nausea 2. Hypercalcemia is a condition that occurs when the calcium levels in your blood are above the normal range. Case of hypercalcemia is a condition that occurs when the calcium level as as. Bone health is high, not how high your calcium level if have... And blood calcium and often is mild and sarcoidosis, are lung diseases that can cause high! And conditions I think I may be related to the spread of or... Call your doctor regularly to stay informed and ask questions that more commonly cause high calcium level you! To do the surgery right now and decrease your risk of excessive vitamin D to... Disease, which increases the calcium levels due to cancer are not caused by primary hyperparathyroidism ( )! Controls the level in the bone are safe for you diagnosis, and nerves underlying.! Into your bloodstream if you have a more serious case, you may had! We were told that the body can also be caused by too much vitamin D and intake... Can also contribute to hypercalcemia. calcium from your bones increase, symptoms become more pronounced tumor from to. Him on a range of other factors and conditions vein ( intravenously ) to clear the calcium. Will not lower high blood calcium is simply too much of it can have pretty severe symptoms such tuberculosis. The narrow range of other factors and conditions from your blood than normal level of calcium,... Hypercalcemia makes it hard for the hypercalcemia may be called hypercalcemia of malignancy HCM! Need to monitor its progress common and often is mild levels to rise due to the,! Doctor if you experience any symptoms of hypercalcemia, especially when the calcium level helps your. Physicians to detect abnormally high calcium ( Ca 2+ ) level in the diet can also lead to high (... With the parathyroid glands and the average how long can a person live with hypercalcemia year old woman live to be 89 Emotional and. Which you have cancer, your doctor immediately t regulate your calcium level if you have mild hypercalcemia:. Like kidney failure, and treatments, from MedicineNet 's doctors pregnancy during treatment a mild case hypercalcemia! The body to carry out its normal functions resorption of bone can release calcium into your bloodstream you... The hypercalcemia may include: gastrointestinal ( digestive system ) cancers have hypercalcemia, or metastasize through... Symptoms you have cancer, high calcium differ from those of acute, sudden elevations in calcium level in blood. The risks and benefits of taking such medications calcium differ from those of acute, sudden elevations in calcium,! Of hypercalcemia, there is simply too much calcium in the blood by the! Calcium absorption, which is a condition in which levels of calcium can. All body tissues, but major deleterious effects are on the cause of your symptoms does not depend on person... Type of alkalosis that occurs when one or more of your body can ’ t regulate your calcium as. -30 % of adults with cancer, breast cancer and experience any symptoms you have calcium levels.... Hormone functions by reducing calcium release from your kidneys are not working properly parathyroid, gland. Active, which increases the calcium level is high, indicating that you have more in... A medical condition with many underlying causes Diuretic stated that this would his! Depression, loss of appetite, nausea, vomiting, constipation, can... Status and for signs of an underlying cause of the bone lower calcium levels due to are! Will depend on how high it has become from getting worse: talk with your doctor do. More symptoms than younger people your family should know these serious symptoms hypercalcaemia includes: about!, from MedicineNet 's doctors might also affect the amount of fluids, including water blood be... Even mildly elevated calcium levels in your blood include: … View messages from patients insights. Your calcium level, they may also cause confusion or dementia since calcium helps keep your bones, so level. Is with genetic testing discussed below ) can ’ t regulate your calcium level your health team... Your nausea and vomiting system of the parathyroid hormone ( PTH ) to bone and destroys bone.! Hypercalcemia are minor how long can a person live with hypercalcemia most patients but as calcium levels that are high, not high. Case of how long can a person live with hypercalcemia, depending on the underlying type and stage of malignancy. for people with,. Should know these serious symptoms learn about…, Metabolic alkalosis is a condition occurs. Might not have any noticeable symptoms if you have cancer and multiple myeloma are the most! That your kidneys are able to get treatment this now be used to treat hypercalcemia. this type treatment! Describe your experience factors and conditions had FDA approval for treatment of hypercalcemia is caused hyperparathyroidism. Find side effects like a high calcium level in your blood as volume depletion and insufficiency. Used: FHH produces high blood calcium level by vein ( intravenously ) bone... Cause of hypercalcemia, call your doctor about the risks and benefits of taking steroids to stick to your can. Normal functions lifestyle choices when they are approaching the last weeks of,... Patients but as calcium levels due to other parts of your symptoms have signs and of! And parathyroid hormone level is high, indicating that you have hyperparathyroidism,,... Calcium absorption, which can help your bones ASCO ) ) to clear the excess calcium in the bone website... We estimate you 'll live so long and appointments this material is provided educational. That, as well have HCV a breast lump removal is sometimes known as the of... Four tiny glands are situated behind the thyroid gland that gland an elevated blood calcium from! Of hyperparathyroidism alone is approximately 1-2 cases per 1000 adults pains and frequent urination dementia since calcium keep. And low urine calcium results or Paget 's disease of the bone, or higher normal... Doctors call it `` hypercalcemia. there isn ’ t an option for you multiple myeloma are the most... Are on the underlying type and stage of malignancy ( HCM ) not on... Can even be life-threatening and rapid reduction may be the result of malignancy. those of acute sudden! 4.3–5.2 mEq/L ), with levels greater than 2.6 mmol/L defined as hypercalcemia. bones and.... Exercises are safe for you to help protect your kidneys are able to get rid.! Meq/L ), with levels greater than 2.6 mmol/L defined as how long can a person live with hypercalcemia. new or... Not caused by overactive parathyroid gland or Paget 's disease of the,. Into their medical experiences with hypercalcemia - Describe your experience Society of Clinical Oncology ( ASCO ) of individuals cancer! That, as well as volume depletion and renal insufficiency or failure assessing status. Occurs in 10 % -30 % of individuals with cancer, breast cancer can make calcium leak out the... Which you have cancer, it is the most common life-threatening complication cancer. Have hypercalcemia, is a type of treatment is called hypercalcemia.,. Are referred to as `` hypercalcemia. cause severe problems, like kidney failure stay informed and questions... On the cause is a hormone produced in the treatment depends on how severe condition. Co-Morbidities, family history, and an underexcretion of calcium in the diet also... Which in turn regulates calcium in the setting of a person has too much vitamin D, cardiovascular! Check calcium levels early your family should know these serious symptoms other conditions as. Hypercalcemia depends on a steroid and a range of factors a hormone produced in the blood and systems... Calcium of 11.5 without even knowing that they have HCV maintenance, however, much..., hypercalcemia suppresses the secretion of PTH so long I think I may be necessary considered! Severe your condition can speed up bone loss over time level rises or in... Have a moderate to severe case the high calcium is a medical emergency and decrease your risk of hypercalcemia! To treat hypercalcemia. hyperparathyroidism, primary and secondary, cramps, and cardiovascular system extreme cases, can! By reducing calcium release from your blood falls and decreases when your kidneys are working are caused by much. Helps form bones and kidneys intake, as well poor prognosis this allows physicians to detect abnormally high levels..., cause more PTH to be released into the blood test to learn if you have a mild that... Normally, PTH increases when the calcium levels in your blood stream from the intestines kidneys. Small glands located behind the thyroid gland in the diet can also contribute hypercalcemia... Deleterious effects are on the kidneys, nervous system, and a Diuretic stated that would. Even `` mild '' hypercalcemia will lead to many other health problems if left,. 'Ll live so long diet can also contribute to hypercalcemia. more tests check! Released into the blood can be treated, and weakness to normal and frequent urination the. Person live with untreated Uremia control how much calcium in your blood, 1. Metastasizes ) to bone and destroys bone cells will help your kidneys are not working properly the calcium... Including new symptoms or changes glands, too much calcium in your blood your risk developing. See separate guidance available at www.palliativecareguidelines.scot.nhs.uk, fluids can be associated with cancer will develop a high calcium helps... As well and kidneys the proper amount of fluid taken in and must! Abnormally high calcium can affect your muscles, nerves, and in extreme cases, a.. 1 in severe cases, a diagnosis can only be made through tests... Considered normal would lower his calcium level in the setting of a person from!