The symptoms of multiple myeloma usually develop from the organs damaged by the disease. They can include:
- Bone pain and skeletal fractures, including compression fractures of the spine, which can cause severe pain and neurologic symptoms.
- Frequent infections, especially bacterial infections of the respiratory and urinary tracts, which occur because the immune system is weakened.
- Anemia, causing fatigue, weight loss, and general discomfort
- Abnormally high calcium levels (hypercalcemia), resulting in nausea, vomiting, altered mental states, depression, headache, and in severe cases, coma
- Loss of kidney function, leading to fatigue, a buildup of fluid in the lower limbs, and excessive thirst
- High levels of protein in the blood, causing blood to thicken (a condition called hyperviscosity), which can lead to bruising, rashes, nosebleeds, vision loss, headache, dizziness, and peripheral neuropathy (numbness, tingling, and burning pain in the extremities)
In about a third of patients, multiple myeloma is detected before symptoms appear by routine blood tests that pick up elevated levels of immunoglobulin proteins.