High Calcium, but low Parathyroid. What now?
October 15, 2017 7:17 PM   Subscribe

You are not my doctor, but perhaps you've been found to have high calcium levels in your blood and can offer some insights into my situation. My calcium serum levels are high, but my parathyroid hormone level is NOT - it's very low.

I went to the doctor with a list of complaints that I later found to be potentially symptomatic of Hypocalcaemia - drowsiness, extreme muscle weakness (esp. in legs and lower back), soreness, and twitching ; digestive/elimination difficulties ; occasional vomitting ; loss of appetite; low mood, mental fogginess and decreased mental capacity -- easily confused, surprisingly forgetful. (I'm a mid-forties male in otherwise OK shape: not much overweight, non-smoker. My cholesterol is pretty high and she just prescribed lipitor.)

The doctor ordered a battery of blood tests and everything came back normal except for calcium at 10.6 mg/dL - "very high" according to her. (Thyroid, TSH, was at 1.40 uIU/mL - maybe low but within the normal range of values.) She ordered another round of tests, about 1 week later, for calcium, parathyroid (PTH), phosphate and albumin. Calcium was slightly lower at 10.0 mg/dL . Parathyroid was not found at an elevated level, but instead was at the *low* end of the scale, at 14 pg/mL . Phosphate and albumin levels were inside the 'normal' values; the phosphate on the high end of the range at 4.2 mg/dL and the albumin at 4.8 g/dL . After those most recent tests being done, I haven't been back to the see the doctor yet, but will probably be hearing from her in the next few days.

So at this point I'm trying to understand :
1. what might be behind the high calcium, if it's not high parathyroid hormone.
2. what I might expect the Doctor to say about the plan for getting my calcim levels down

I don't take calcium supplements ; I do take magnesium regularly. I'm pretty sure my diet doesn't take in more than the usual USRDA of calcium. I have gone through periods where I might take 1-2 antacid tablets a day every day for days on end, but that was a long time ago, not now. Other than that.... I recently cut down my nightly beer consumption to close to nil, after a long stretch of 2-3 beers most nights of the week.

Thanks in advance for any ideas you have.
posted by armoir from antproof case to Health & Fitness (5 answers total) 1 user marked this as a favorite
 
You can have a low or normal PTH reading and still have hyperparathyroidism that needs to be fixed. Your calcium reading will vary a bit naturally.

Source.

I had high calcium due to renal-related PTH issues (this is not likely the source for you if your creatinine is normal, but I'm mentioning it here because it feels the same and it's awful). At 10.2 calcium, I was super foggy and distracted with all of the symptoms you described.
posted by mochapickle at 8:01 PM on October 15, 2017


It's almost always hyperparathyroidism per the health care professional sitting in the room. However, taking a LOT of VItamin D can elevate it too.
posted by fshgrl at 10:28 PM on October 15, 2017


When this happened to my girlfriend, it was a benign tumor in the parathyroid. The parathyroid helps calcium and magnesium disperse throughout your system as they ought to, so low parathyroid can equal too-high calcium because that calcium is not going where it needs to go. She had the specific gland with the tumor removed (there's more than one parathyroid gland, and any one can do the job if the others aren't actively blocking it), and was basically fine instantly.

However, the way she found out about the benign tumor was an intestinal obstruction, because all the calcium that wasn't being absorbed clumped into one place in her gut and basically turned into chalk. This was Not A Good Time for anybody, and I recommend bothering your doctor until they find out what is up with your current levels.

AFTER bothering your doctor, take as much Vitamin D as medically allowed and hopefully it will help with absorption and allay some of the effects.
posted by Rush-That-Speaks at 11:40 PM on October 15, 2017


Is the calcium measurement ionised calcium? For a total calcium your level would slightly high on the first reading and at the high end of normal on the second reading and not what I would call "very high".

It's possible to have hyperparathyroidism with an inappropriately normal PTH but if your PTH is below the reference range or at the low end it's likely to be appropriate response to the high calcium and therefore not consistent with hyperparathyroidism.

Other potential causes of high calcium that your doctor should hopefully be considering are granulomatous disease ( tuberculosis or sarcoid which is an autoimmune disorder that can be helped by steroids) and unfortunately cancer. I stress that it's unlikely hypercalcaemia would be the only sign of cancer but it's on the list. Hyperthyroidism can also cause hypercalcaemia but not in this case as your TSH was fine.

Vitamin D toxicity almost never causes high calcium by itself in adults but since you already have a high calcium you should only take it if advised to by a doctor. Renal (kidney) problems have hopefully already been checked for but are unlikely to be the cause of your high calcium as mochapickle says that would be with a high PTH.
posted by *becca* at 1:47 AM on October 16, 2017 [1 favorite]


Update : two subsequent blood tests found calcium had decreased to 10.0 mg/dL (same value both times), and the doctor is no longer concerned about it and is half-heartedly pursuing some other avenues (low cortisol). The pleasures of modern Western medicine.....
posted by armoir from antproof case at 3:13 PM on October 31, 2017


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