CureusJun 2, 2026

High Blood Calcium Linked to Tirzepatide and Calcium Supplements: A Case Report

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Jun 3, 2026

Abstract

A 70-year-old female developed symptomatic moderate hypercalcemia after three months on tirzepatide for obesity.

Common side effects of tirzepatide include gastrointestinal symptoms, pancreatitis, and acute kidney injury.
Hypercalcemia is rarely reported with tirzepatide, particularly in patients also taking calcium supplements.
This case involved a patient with osteoporosis who experienced nausea, vomiting, and electrolyte imbalances.
Moderate hypercalcemia was associated with hypokalemia and metabolic alkalosis, which corrected with intravenous hydration.
The proposed mechanism may involve tirzepatide's effects on bone turnover and increased calcium absorption.

Simplified

Tirzepatide is a glucagon-like peptide-1 receptor (GLP-1R) agonist and glucose-dependent insulinotropic polypeptide receptor (GIPR) agonist that is used for diabetes mellitus and weight loss. Common adverse effects include gastrointestinal symptoms such as nausea and vomiting, pancreatitis, and acute kidney injury. Hypercalcemia is rarely reported in the literature and has previously been reported in patients taking GLP-1R agonists with concomitant thiazide diuretic or exogenous calcium supplement. We report a 70-year-old female with obstructive sleep apnea started on tirzepatide three months prior to presentation, osteoporosis on calcium supplements, and obesity, who developed nausea and vomiting. She was found to have symptomatic moderate hypercalcemia with hypokalemia, metabolic alkalosis, and acute kidney injury that corrected after intravenous hydration. No prior literature describes hypercalcemia from tirzepatide use and calcium supplementation. The mechanism most likely involves tirzepatide's effect on bone turnover and concomitant increased absorption from calcium supplement ingestion. Clinicians need to closely monitor patients' electrolytes, especially calcium, when initiating patients on tirzepatide. Further research is warranted to reveal tirzepatide's mechanism regarding calcium metabolism.

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Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

PubMed

High Blood Calcium Linked to Tirzepatide and Calcium Supplements: A Case Report

Abstract

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