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Calcium still high, can I continue vitamin D supplements ?
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Calcium still high, can I continue vitamin D supplements ?

I'm 23 year old. Recently during a routine blood checkup, I found high calcium and low vitamin D. What is the diagnosis for it ? I followed a vegan diet for last 2 years and lost around 15 kg and I did not take any dairy products. I work on the computer and don't go out much. Can calcium levels rise if I had been living on a diet which had very low calcium for 2 years ? I'm not sure if I had gotten sufficient calcium from vegetables. Symptoms - general weakness, muscle weakness, memory problems, muscle twitches, occasional headache, heart palpitation, I had nausea for 2 days but now its okay, right shoulder pain, stomach related issues like diarrhea/constipation, my gastroenterologist said it might be irritable bowel syndrome. I do seem to not have normal bowels for months. They fluctuate from normal to abnormal.

I think before measuring my first PTH which was 150, I had taken two tablets of vitamin D3 200 IU. calcium citrate 1000 mg. I also took 2 tablets of vitamin d after the pth of 61.20, it had calcium citrate 1250 mg, vitamin D3 500 IU. So maybe that might have raised my calcium levels in my earlier reports. And now after some weeks pth has gone down but I've seen my calcium fluctuate between 10.02-10.58 in multiple reports. I took some 1000 units of vitamin d for some days. I think I took total of around 10-11k units of vitamin d. But I stopped it after seeing fluctuations of calcium in the report.

After multiple checkups PTH and calcium has been -

ca = 11 ; phosphorus = 3.5 (26/9/12)

(26-27/9/12)  Took two tablets of vitamin D3 200 IU. calcium citrate 1000 mg.

pth = 150 ; ca = 12             (27/9/12)
pth = 103.80 ; ca = 10.02    (3/10/12)
pth = 61.20 ; ca = 10.48      (10/10/12)

continued below >>>>>>
97953_tn?1193367871
This looks like primary hyperparathyroidism given the Ca in the 10-11 range with high PTH levels.  It is not unusual to see high-ish Ca levels in young adults, but typically not with high PTH levels like this.
6 Comments
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Avatar_m_tn

(11-12/10/12) took 2 tablets of vitamin d after the pth of 61.20, it had calcium citrate 1250 mg, vitamin D3 500 IU.

pth = 51.40 ; ca = 10.30      (18/10/12)
ca = 10.49                          (20/10/12)  
pth = 36.20 ; ca = 10.60       (31/10/12)
ca = 10.58                           (8/11/12)

vitamin d = 3.42 ng/ml ( > 30 ng/ml) ;
vitamin d = 28.80 nmol/L (>-=75 -250)
vitamin d = 32.80 nmol (>= 75  -250 )

magnesium
16/10/12 = 2.00 (1.80 - 2.60)
31/10/12 = 1.70

10/10/12
protein 7.34 (6-8.4)
albumin 4.67 (3.5 - 5.5)
a/g ratio = 1.75 (1.20 - 1.60)

8/11/12
protein total 7.62 g/dl (6.60 - 8.70)
albumin = 4.96 g/dl (3.50- 5)
A:G ratio 1.86 (0.90 - 2.00)

Albumin has increased from last report and is at border normal.

phosphorus in first report was 3.5 but now has been high and is fluctuating between 4.6 - 5.0
Alkaline phosphate has gone down from 353, 119 to 106 in the reports.

30/9/12
Calcium, 24 hours urine 85.50 (100-300) mg/24 hrs
total volume   4500   (800-1800)  ml/day

Sestamibi scan  = negative

Dexa scan shows osteopenia.

Is serum calcium upto 10.6 normal for a 23 year old male ?
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Avatar_m_tn
CA was 11 only the first time I measured on 26th september and ca was 12 on 27th september. Now I took 2 tablets of supracal 200 units which had 200 IU of D3 and calcium citrate of around 1000 mg. Ca can't go from 11 to 12 in one day so I think my supplements made it high. Can this raise your calcium from 11 to 12 in one day ? I'm not sure on which date I took those supplements but maybe on 26th september I took 2 tablets.

Also on 10th nov, I was having high rapid heartbeat with BP of around 140/80, strong headache, dry mouth(thirsty), When I tried to smile, the right cheeks were tremoring. My eye leds was also shaking. I also had leg twitches. I rushed to the hospital due to rapid heartbeat. I'm now taking Inderal 40, dolo 650 for headache.
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Avatar_m_tn
I also took beneficiale capsules which is a multivitamin around 26-27th September. Can ca rise due to that ? It has vitamin A 2500 IU. Here are the links for the supplement I took around 26-27th.

http://www.cimsasia.com/India/drug/info/BENEFICIALE/BENEFICIALE%20cap

http://www.mims.com/India/drug/info/SUPRACAL%20TAB/SUPRACAL%20TAB%20tab
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Avatar_m_tn
thyroid profile

t3  99.25 ng/dl  (84.63 - 201.8)
t4     8.35 ug/dl   (5.13  -14.06)
TSH    2.05 uIU/ml    (0.27  -  5.5 uIU/ml)
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Avatar_m_tn
Can you ignore the 1st pth report. Does this still look primary if you look at these reports ?

pth = 103.80 ; ca = 10.02    (3/10/12)
pth = 61.20 ; ca = 10.48      (10/10/12)
pth = 51.40 ; ca = 10.30      (18/10/12)
ca = 10.49                          (20/10/12)  
ca = 10.58                           (8/11/12)
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97953_tn?1193367871
Mark Lupo, M.D.Blank
Thyroid & Endocrine Center of Florida
Sarasota, FL
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