What Are Signs and Symptoms of Multiple Myeloma?

Multiple myeloma's signs and symptoms are very generic and may be easy to ignore. What symptoms or signs could indicate you have multiple myeloma? What should you be on the lookout for experiencing side effects? Throughout this article, you can learn answers to these important questions.

Myeloma specialist Suzanne Lentzsch, MD of Columbia University, shares common signs and symptoms caused by multiple myeloma.

Common Side Effects, Signs and Symptoms of Myeloma

Common side effects, signs and symptoms of multiple myeloma include:

Bone pain
Bone lesions/fractures
Fatigue
Anemia
High blood calcium
Neuropathy (numbness and tingling)
Decreased kidney function
Kidney failure
Infections

Learn more about these symptoms below.

How Are Bone Problems and Bone Pain Related to Multiple Myeloma?

Bone lesions or fractures can be a sign of multiple myeloma.

Normally, two major kinds of bone cells work together to keep bones healthy and strong. These are osteoblasts, which lay down new bone, and osteoclasts, which break down old bone. Myeloma cells make a substance that tells the osteoclasts to speed up the dissolving of bone. The osteoblasts do not get a signal to put down new bone, so old bone is being broken down without new bone to replace it.

This can cause painful areas of bone weakness. Any bone can be affected, but back, hip, and skull pain is most common. These changes also increase the chance that the bones will break, often from a minor stress or injury.

Bone pain, in general, can also be a sign of multiple myeloma. Pain in the spine or ribs is common, as myeloma lesions are commonly found in these areas. Bone pain from normal daily activities or persistent bone pain in one area can indicate bone fractures.

Bone pain is a tricky symptom because it is more common with advanced age, so it's easy to write it off to age, a muscle pull, or even the need for a chiropractor. Listen to your body and ask for an X-ray or other imaging to see if you have any bone damage that could be caused by myeloma.

How Are Fatigue and Anemia Related to Multiple Myeloma?

Anemia and fatigue come hand in hand due to how multiple myeloma can affect your body.

When mutated myeloma cells grow out of control, they can crowd out normal red blood cells and white blood cells. Without adequate levels of healthy blood cells, your muscles fatigue faster, and you have less energy.

It's easy to shrug off being "extra tired" and attribute it to a lack of sleep, older age, or being out of shape, but anemia can be a sign of multiple myeloma. It's a good idea to get blood tests yearly to see if your blood levels are in normal ranges.

Low levels of red blood cells mean that your body's tissues aren't receiving the oxygen they need. This is called anemia. Anemia usually results in muscle weakness, reduced ability to exercise, shortness of breath, and dizziness.

How Is High Blood Calcium Related to Multiple Myeloma?

As myeloma damages the bones, the bones release calcium into the blood. High calcium levels in the blood, or "hypercalcemia," can be a symptom of multiple myeloma.

High blood calcium can result in unexpected side effects like severe constipation, lack of appetite, nausea, or vomiting. It can also cause persistent, unquenchable thirst or a high increase in urination. You may feel weak, drowsy, or confused if you have high blood calcium.

A simple blood test can indicate if your calcium levels are higher than normal. If your doctor has not performed this test and you are experiencing one or more of the side effects listed above, consider asking them to do so.

What Are Nervous System Symptoms of Multiple Myeloma?

When myeloma weakens the bones in the spine, they can collapse and press on spinal nerves. This can cause sudden severe pain, numbness, and/or muscle weakness. If you experience this, get medical help immediately.

In some patients, large amounts of myeloma protein can cause the blood to “thicken.” This thickening is called hyperviscosity. It can slow blood flow to the brain and cause confusion, dizziness, and stroke-like symptoms. These are also serious symptoms that should be medically addressed as an emergency.

Removing the protein from the blood by plasmapheresis can rapidly reverse this problem.

Is Neuropathy a Symptom of Multiple Myeloma?

Sometimes, the abnormal proteins produced by myeloma cells can be toxic to the nerves. This damage can lead to weakness and numbness, known as neuropathy. This can also present as a tingling sensation and most often occurs in the hands and the feet, although it can occur throughout the entire body.

Neuropathy can also be caused by diabetes, which can be more common as we get older. If your hands or feet feel "fuzzy" or have "pins and needles" sensations, ask your doctor to test for a monoclonal protein.

Are Infections a Common Presentation of Myeloma?

Leukopenia, or low levels of white blood cells, occurs when myeloma cells take over the bone marrow and crowd out the "healthy" blood cells meant to protect your body. Multiple myeloma patients become more susceptible to infection without proper levels of immune-protecting white cells.

Multiple myeloma patients are ~15 times more likely to get infections, such as pneumonia, because the body is unable to make the antibodies that help fight infection. Once sick, it may take myeloma patients longer than the standard amount of time to recover and the infection can be slow to respond to treatment.

While getting sick may not seem like a major concern without multiple myeloma, infections as simple as the common cold can be a serious risk to your health, so let your doctor know if you are feeling sick.

How Are Kidney Problems Related to Multiple Myeloma?

Mutated plasma cells that have become myeloma cells excrete a protein known as monoclonal immunoglobulin, often called M-spike or M-protein. This protein can damage the kidneys. Initially, it can be asymptomatic but can be found with a blood test.

However, if the multiple myeloma goes undetected for some time, it can cause a large decrease in kidney function and even kidney failure. As the kidneys start to fail, they lose the ability to dispose of excess salt, fluid, and body waste products, which can lead to symptoms such as weakness and leg swelling.

How Can I Talk to My Doctor About My Myeloma Symptoms?

Many myeloma patients report that they went months or years with these types of symptoms listed above, brushing them off or even having a doctor ignore their thoughts that something was wrong.

If you think something is not quite right, or if you are experiencing similar symptoms, talk to your doctor and insist they run simple blood tests and an x-ray to rule out multiple myeloma. The longer you wait, the more end-organ damage can occur.

As Dr. Lentzsch says in the video above, "The patient is always right!"

You know your body better than anyone and should feel confident that you can track the symptoms down with the help of a doctor.

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