15 Most Common Multiple Myeloma Symptoms
2. Weak Bones
Weak or fragile bones are common in multiple myeloma because the disease begins in the bone marrow, where abnormal plasma cells multiply and crowd out healthy bone-forming cells. Over time, this process weakens bone structure and increases the risk of fractures, sometimes even after minor injuries.
Bone pain is often one of the earliest signs, especially in the back, ribs, or hips. The pain may feel constant and often worsens with movement. Progressing bone damage can lead to sudden fractures without obvious causes, indicating that bones may be thin or brittle. Ongoing bone damage can lead to limited movement and difficulty with everyday activities.
In more severe cases, compression of the spinal bones may cause loss of height or a curved posture. The breakdown of bone can also release excess calcium into the bloodstream, which may contribute to symptoms such as thirst, fatigue, or nausea.
3. Chronic Fatigue
Chronic fatigue is one of the most common symptoms experienced by people with multiple myeloma. It is a deep, long-lasting tiredness myeloma that does not improve with rest or sleep and is different from normal fatigue after activity. This type of exhaustion can interfere with daily tasks such as walking, working, or even talking for long periods.
One of the main causes of fatigue is anemia, which occurs when the body does not have enough healthy red blood cells to carry oxygen. With less oxygen reaching the muscles and organs, weakness and exhaustion become more noticeable. Some treatments used to manage myeloma can also reduce red blood cell counts, which may further worsen fatigue.
Fatigue can also come from the disease process itself. As abnormal plasma cells grow in the bone marrow, they crowd out normal blood-producing cells, limiting the body’s ability to make enough red blood cells. At the same time, the immune system works harder to fight infections, which can further drain energy.
4. Low Blood Counts
Low blood counts are common in people with multiple myeloma because the cancer grows in the bone marrow, the soft tissue inside the bones that produces blood cells. As myeloma cells multiply, they crowd out healthy cells that normally make red blood cells, white blood cells, and platelets.
When red blood cell production decreases, anemia can develop. This may lead to symptoms such as tiredness, pale skin, dizziness, and shortness of breath. Low levels of white blood cells, known as leukopenia, can increase the risk of infections. Common illnesses may become more severe or take longer to resolve, and frequent fevers, sore throats, or repeated colds may occur.
A reduced platelet count, called thrombocytopenia, can result in easy bruising or bleeding. Early signs may include nosebleeds, bleeding gums, or small red or purple spots on the skin. Cuts or minor injuries may also take longer to stop bleeding.
5. Increased Infection Frequency
People with multiple myeloma often develop infections more easily and more frequently than usual. This happens because the disease affects plasma cells, which are responsible for producing antibodies that help the body fight bacteria and viruses.
When these cells become abnormal, they no longer make enough healthy antibodies, weakening the immune system’s ability to protect against germs. Respiratory infections may affect the lungs or sinuses and often cause symptoms such as cough, shortness of breath, and fever. Urinary tract infections can involve the bladder or kidneys and may lead to burning during urination or a frequent urge to urinate.
Skin infections may develop in the skin or soft tissues, causing redness, pain, and swelling. Some treatments can also lower white blood cell levels, making it easier to get sick from everyday germs.
6**. Dizziness and Confusion**
Dizziness and confusion can occur in people with multiple myeloma, often when the disease affects the blood or disrupts the body’s chemical balance. One common cause is high calcium levels in the blood, known as hypercalcemia, which can lead to symptoms such as light-headedness, disorientation, and slowed thinking.
As abnormal plasma cells multiply in the bone marrow, they interfere with normal blood cell production. This can result in anemia, where low red blood cell levels reduce the amount of oxygen reaching the brain. When the brain receives less oxygen, a person may feel weak, faint, or mentally foggy and may have trouble concentrating or remembering information.
Another contributing factor is thickened blood. Myeloma cells can release excess proteins into the bloodstream, causing the blood to become thicker than normal. This can reduce circulation to the brain and trigger dizziness, confusion, headaches, blurred vision, or difficulty with balance.
7. Nausea and Weight Loss
Nausea and weight loss can occur in people with multiple myeloma, especially as the disease begins to affect how the body handles nutrients and removes waste. When myeloma damages the bones or interferes with kidney function, toxins can build up in the bloodstream. This buildup can upset the stomach, reduce appetite, and contribute to ongoing feelings of nausea. Many people notice that food does not taste the same as before or that they feel full after eating only small amounts.
Nausea may be caused not only by the disease itself but also by certain treatments, such as chemotherapy or targeted therapies, which can irritate the stomach lining. Over time, eating less because of poor appetite or frequent nausea can lead to unintended weight loss. Kidney changes can allow toxins to accumulate, leading to nausea and loss of appetite. Treatment side effects may irritate the digestive system and cause queasiness or vomiting.
8. Cardiovascular Irregularities, Increased Thirst, and Frequent Urination
People with multiple myeloma may experience cardiovascular changes such as irregular heartbeats or shortness of breath. Abnormal proteins from the disease can thicken the blood, slowing circulation and forcing the heart to work harder. In some cases, anemia caused by low red blood cell levels adds extra strain, leading to fatigue or weakness.
Heart rhythm changes may appear as a heartbeat that feels too fast, too slow, or uneven. Swelling in the ankles or legs can also develop if the heart struggles to pump blood properly. These symptoms may not always mean serious heart damage, but they need medical attention to rule out complications linked to the disease or its treatments.
Increased thirst and frequent urination can occur when myeloma damages the kidneys or raises calcium levels in the blood. When calcium levels become too high, the body tries to flush it out through increased urination, which then leads to dehydration and constant thirst.
9. High Calcium Levels
High calcium levels, also known as hypercalcemia, can develop in people with multiple myeloma when cancer cells damage bone tissue. As the bones break down, calcium is released into the bloodstream, which can interfere with normal body functions, including those of the muscles, kidneys, and brain.
Symptoms of high calcium often develop gradually. A person may feel unusually thirsty and need to urinate more often. Nausea, constipation, and loss of appetite are also common. Some people experience weakness, fatigue, or confusion, and in more severe cases, hypercalcemia can lead to dehydration or kidney problems.
Elevated calcium levels are usually detected through routine blood tests. If calcium is found to be high, additional testing may be done to look for bone damage or related effects of myeloma. Depending on the situation, medications may be used to slow bone breakdown or support the kidneys and overall balance in the body.
10. Constipation
Constipation is a common concern for people with multiple myeloma and occurs when bowel movements become less frequent or stools become dry and difficult to pass. It can develop due to several factors related to the disease itself or the treatments used to manage it.
Reduced physical activity, lower fluid intake, and dietary changes can slow digestion and make stools harder. Dehydration, which may happen when someone feels unwell or fatigued, can further worsen the problem. High calcium levels in the blood, known as hypercalcemia, can also slow bowel movement and contribute to constipation. Pain-relieving medications and some therapies used in multiple myeloma treatment can reduce intestinal movement, making constipation more frequent or more severe.
11. CNS Symptoms
Central nervous system (CNS) symptoms in multiple myeloma occur when abnormal plasma cells or related complications affect the brain, spinal cord, or nearby nerves. Although less common, these symptoms can be serious. They often develop when myeloma spreads to areas around the brain or spine, or when weakened spinal bones collapse and place pressure on nerve tissue.
Early signs may include weakness, numbness, tingling, or loss of coordination. Changes in balance, speech, or vision can also occur. Headaches are common, especially when pressure builds up in or around the skull. Confusion, difficulty concentrating, and memory problems may develop if blood flow to the brain is affected or if calcium levels in the body become abnormal.
As nerve involvement worsens, more severe problems can develop, including ongoing pain or loss of movement in the arms or legs. Spinal cord compression is particularly serious and can lead to sudden loss of bladder or bowel control, which requires urgent medical attention.
12. Hyperviscosity
Hyperviscosity occurs when the blood becomes thicker than normal. In multiple myeloma, this happens because cancerous plasma cells produce high levels of abnormal proteins that build up in the bloodstream. Blood flow slows in small vessels, reducing oxygen delivery to tissues and impacting organs like the brain and eyes.
Because circulation is slowed, people may develop symptoms such as blurred vision, headaches, dizziness, or ringing in the ears. Some may also feel unusually tired or confused. In rarer cases, thickened blood can interfere with normal platelet function, leading to nosebleeds or bleeding gums.
Hyperviscosity can be detected through blood tests that measure protein levels and assess how easily the blood flows. When the blood becomes dangerously thick, treatment may involve removing excess proteins from the bloodstream.
13. Weak Immune Function
People with multiple myeloma often develop a weaker immune system because the bone marrow, where blood cells are produced, becomes crowded with cancerous plasma cells. These abnormal cells interfere with the body’s ability to make enough healthy white blood cells, which are essential for fighting infections.
As a result, the risk of infection increases. Common illnesses such as colds, pneumonia, and urinary tract infections may occur more often and can be more severe than usual. Infections may also take longer to improve or may return repeatedly. Cuts and wounds can also heal more slowly, and routine vaccines or standard treatments may be less effective.
14. Compression of the Spinal Cord
Spinal cord compression is a serious complication that can occur when multiple myeloma weakens the bones of the spine or when tumors form and press directly on the spinal cord. This pressure disrupts normal nerve function and can interfere with movement, sensation, and other essential body processes.
Symptoms often begin with persistent back or neck pain, which may feel worse when lying down. As pressure on the nerves increases, numbness, tingling, or weakness may develop, usually starting in the legs. Balance problems and difficulty walking can follow, and some individuals may notice trouble controlling bladder or bowel function.
These changes may appear gradually or come on suddenly and tend to worsen if the compression is not addressed. Because the spinal cord controls many vital functions, ongoing compression can lead to loss of movement or sensation in the lower body.
15. Risk and Survival Factors
Researchers have identified several factors that increase the risk of developing multiple myeloma. Age is one of the strongest factors, with most cases diagnosed in people over 60. Men are affected more often than women, and people of African ancestry have a higher risk compared with other racial groups.
A family history also matters, as having a close relative with multiple myeloma nearly doubles the chance of developing the disease. Other factors, such as being overweight or obese, may also raise risk. In rare cases, long-term exposure to radiation or certain chemicals has been linked to myeloma. Survival and outlook vary from person to person and are influenced by factors such as age, overall health, and how advanced the disease is at diagnosis.
