Typically, hypercalcaemia is discovered by routine laboratory testing in patients without obvious illness. Primary hyperparathyroidism is the most common cause of hypercalcaemia among adult patients; among hospitalized patients, malignancy is the most common cause. (7,9 In primary hyperparathyroidism, parathyroid hormone is secreted inappropriately, despite an elevation in the ionized calcium level. Signs and symptoms of hyperparathyroidism include nausea, vomiting, anorexia, constipation, proximal muscle weakness, polyuria, polydipsia, impaired renal function, hypertension, short Q-T interval, bradycardia, and a number of neuropsychiatric symptoms. The latter include lethargy, drowsiness, impaired concentration ability, and confusion. In severe cases, there may be stupor or coma.

There are no studies utilizing criteria-based diagnoses of psychiatric illnesses in patients with hyperparathyroidism. (63) Several case series, however, suggest that the severity of psychiatric symptoms intensifies as the level of hypercalcaemia increases. Delirium, psychosis, and cognitive impairment are common in patients who have serum calcium levels above 16 mg/dl. Depressive symptoms, but not cognitive symptoms, tend to resolve with treatment.(71> Cognitive symptoms may improve, but residual symptoms usually remain. The diagnostic considerations in patients with multiple vague non-specific symptoms that suggest fibromyalgia and depression should include hyperparathyroidism.(72) Therefore it is important to check calcium levels early to identify hyperparathyroidism in such patients or in refractory psychiatric disorders with this symptom complex.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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