hypercalcemia and flimmer

A few weeks ago I read the pages of parathyroid.com and noticed that hypercalcemia often induces arrhythmias, eg. atrial fibrillation. Last year I had persistent flimmer for six months, until an electric cardioversion after one week's medication with Multaq took it out.

I have elevated levels of calcium and PTH in my blood. When I read about the symptoms of primary hyperparathyroidism on Parathyroid.com, I found that my symptoms during several years fit well to primary hyperparathyroidism (although I have other diseases, too). Maybe I have had higher than normal calcium level even for many years. Nobody knows.

Last year I thought that there must be a strange cause for the flimmer. Now I suspect hypercalcemia. Infections have also been suspected.

[is_something_wrong]

Hello.

By the way: "Flimmer" (Scandinavian) is "Fibrillation" in English.

First; if you have elevated PTH and (ionized) calcium, this is diagnostic of hyperparathyroidism, and I don't understand why you don't get this condition treated. How high are your Ca (total and ionized) and PTH levels?

Yes, disturbances in Ca levels may cause various arrhythmias (though, according to my cardiologist, low is worse than high regarding arrhythmias). Do you have sustained A-fib or just occationally?

Stay in close touch with your doctor (preferrably internist, endocrinologist or cardiologist) and of course avoid food rich in calcium if your Ca levels are elevated.

[helyanna]

Ok fibrillation. I had it last year persistently for six months. Then electric cardioversion with premedication with Multaq returned sinus rhythm. Nowadays I only have slight increasing of the rhythm in some mornings but not af. at all.

I read your journal and saw that your ejection fraction is 55-60 %. How does this affect your performance? I have slightly enlarged left atrium, a slight leakage in mitral valve and pulmonary pressure at the upper reference limit. Before the atrial fibrillation my blood pressure in a clenching test with hand (to study autonomic nervous function) was at the highest 260/140. There may be some dysfunction of my autonomic nervous system. I think I have sympaticotony, and this may cause false results in the tests.

I eat similar foods as before knowing the hypercalcemia, because I want to resist osteopenia, which I already had in 2008. I have not yet received any eating advice from doctors. One doctor said that I can decrease taking vitamin D for the summer. When vit. D level was measured in this August, it was below the lower reference value 37 ( should be over 40). Therefore I returned my vit. D dose to the before summer level (50 microg.)

It was late in last year,  when my ionized Ca was measured. It was at the upper reference value. Doctors did not take it into consideration. Then in January 2011, ionized Ca and PTH were measured, because I had tremors and other strange symptoms. They both were above the reference. Then both values have been elevated repeatedly. I don't yet have the diagnosis on hyperparathyroidism but it is suspected.

Tomorrow I shall travel to another town to see an endocrinologist. I think that I'll not fill the criteria for parathyroid operation. My parathyroids were not seen in MRI but I have some tumour (?) in my left lung. As I have read, any extra parathyroids cannot be in the lateral upper part of the lung. Usually they are in the mediastinum. The cardiologist control is in next year.

[is_something_wrong]

First thing first, my EF is not 55-60%. This was measured when I was lying at the bench with a heart rate of 120 due to nervousness and my heart didn't fill properly. My correct EF is 70-75%.

My calcium (actually recently measured) is 2,52 (borderline) but no doctor seems to care. My PTH is fairly low. Doctors seems to believe it's due to my omega 3 supplements. On occation the Ca normalizes down to 2,35 or so. I have no clue why.

Calcium levels that are borderline high will not cause AF, I'm pretty sure of that. Maybe your enlarged left atrium is the cause (or caused by, this is why they say "AF causes AF"). What I think is more concerning (though I'm no healthcare professional) is your tumor in the lung (which definitely may cause high Ca but usually low PTH) and a blood pressure increasing to 260/140. I would definitely see an endocrinologist and maybe some other doctors as well.

Keep us updated and best wishes!

[helyanna]

A couple of days ago I was at the Endo doctor's. He said that I have shortage of vitamin D. I am confused because lack of vitamin D cannot cause elevated calcium. I have both ionized calcium and PTH elevated, which suggest primary hyperparathyroidism (see patrathyroid.com).

Yesterday I was called by a lung specialist. My latest TT scan showed that the lung tumour has not increased in size during the last three months. The next control is after one year. The tumour could not be specialized.

When the AF began, I was dehydrated (thirsty but did not go to drink immediately). I often have serum sodium above the upper reference value.

I had the blood pressure 260/140 in a test, not in normal life.

[helyanna]

Yesterday I possibly had a short episode of atrial fibrillation. I was working in the garden. Ten months had alapsed without AF. Even the past warm summer (with sweating) did not cause any episodes of AF.

I was working with my upper body bent down when I noticed exrtrasystoles. I tested my rhythm on my wrist and found it irregular for some time. I also had flatulence. Possibly gas in my transverse colon caused the irregular rhythm. I remember that in spring 2010 when the AF began for first time, I had abdominal pain and often excess gas in intestines.

There may be several possible causes of  my AF to be taken into consideration. They are: infections, hypercalcemia, hypernatremia, thyroid over- or undermedication, gas in intestines, gastroparesis, working upper body bent down.

When someone has hyperparathyroidism, the symptoms may be bad even when calcium is only slightly elevated (parathyroid.com). Thus, I think, also this can cause atrial fibrillation. Nobody has told me why my AF began last year. It is sure that I was dehydrated. I did not go to drink in time although I was thirsty. I don't know when my left atrium has dilated, it has not been very long, at most about two years or the enlargement happened due to the the AF.