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Desperate for help - "normal" PTH
Dear Dr. Lupo,
I really need your help. I was tested for calcium and PTH. My calcium came back 10.6 and my PTH came back as 21. My doctor says he's "not concerned." However, I am. My mother has been researching a lot and it seems many people have a "normal" PTH reading but still have parathyroid disorder. I have every symptom and I'm tired of feeling sore and achy, depressed, tired and run down, having trouble getting up the stairs, lack of energy to do daily routines (i.e. shower, shave, laundry) and a boat load of other symptoms. There really isn't any symptom of parathyroid that I DON'T have. I'm tired of feeling like crap and I'm needing your expert opinion. Is it possible (or likely) that I have parathyroidism with a PTH level of 21 and a calcium level of 21? Also, my protein was slightly elevated and my albumin was slightly elevated. My calcium was checked over a year ago and was high as well but nothing was ever done about it. I have felt like crap for a long time and I know not many doctors are aware of this disorder or how to treat/diagnose it. Any help or feedback you could provide would be greatly appreciated. I feel helpless because my doctor sticks with his theory of "everything is fine" but I don't feel it is. One more thing. He's re-testing me upon my request. My mother read it is best to be tested in the morning so I'm getting up early to be there around 8 or 9. I'm also fasting just to be sure I have an accurate reading. There is some discrepancy on what time of day to test, and whether or not to fast so I'm going to fast just to be safe. I wonder if this will change the reading, dramatically or at all. My main question though is - is it likely I have parathyroid disorder with those levels in my blood. Thank you so much for your time.
Sincerely,
Gary
I really need your help. I was tested for calcium and PTH. My calcium came back 10.6 and my PTH came back as 21. My doctor says he's "not concerned." However, I am. My mother has been researching a lot and it seems many people have a "normal" PTH reading but still have parathyroid disorder. I have every symptom and I'm tired of feeling sore and achy, depressed, tired and run down, having trouble getting up the stairs, lack of energy to do daily routines (i.e. shower, shave, laundry) and a boat load of other symptoms. There really isn't any symptom of parathyroid that I DON'T have. I'm tired of feeling like crap and I'm needing your expert opinion. Is it possible (or likely) that I have parathyroidism with a PTH level of 21 and a calcium level of 21? Also, my protein was slightly elevated and my albumin was slightly elevated. My calcium was checked over a year ago and was high as well but nothing was ever done about it. I have felt like crap for a long time and I know not many doctors are aware of this disorder or how to treat/diagnose it. Any help or feedback you could provide would be greatly appreciated. I feel helpless because my doctor sticks with his theory of "everything is fine" but I don't feel it is. One more thing. He's re-testing me upon my request. My mother read it is best to be tested in the morning so I'm getting up early to be there around 8 or 9. I'm also fasting just to be sure I have an accurate reading. There is some discrepancy on what time of day to test, and whether or not to fast so I'm going to fast just to be safe. I wonder if this will change the reading, dramatically or at all. My main question though is - is it likely I have parathyroid disorder with those levels in my blood. Thank you so much for your time.
Sincerely,
Gary
MEDICAL PROFESSIONAL
This needs retesting of both Calcium and PTH.
With the high-ish albumin, we sometimes also ionized calcium (although this is not always accurate).
Fasting may help if phosphorous is being tested (which may help make the diagnosis).
My feeling is that with a Ca of 10.6 the PTH should be < 20 in most cases - so this is suspicous for primary hyperparathyroidism but needs more evaluation before considering treatment (surgery).
With the high-ish albumin, we sometimes also ionized calcium (although this is not always accurate).
Fasting may help if phosphorous is being tested (which may help make the diagnosis).
My feeling is that with a Ca of 10.6 the PTH should be < 20 in most cases - so this is suspicous for primary hyperparathyroidism but needs more evaluation before considering treatment (surgery).
Hi Bella - thank you for responding. Our symptoms are unbelievably similar. I have bone pain, muscle pain, pounding heart beat, severe anxiety (horrid anxiety), I choke on my spit all the time, crave water at night really late, I urinate a lot too..lower back pain, pain under my right breast or whatever its called on a guy lol. They thought it was my gallbladder but its not.Now my stomach muscles hurt on the left and right..exactly where your kidneys are at..irritable and moody, angry..driving worse (anger coming out in my driving) palpatations and the list is endless. I really hate the choking on my spit - that bothers me a lot since I sing a lot on youtube etc. Very frustrating but so are my other symptoms. I have this weird issue going on in my lower left abdomen. It only happens in bed at night for the most part and its like something is churning around but its not gas and passing gas (if I can which is rare) doesn't help it. Its like it just goes in circles..whatever it is moving around. I also have twitching nerves all over my body and horrid acid reflux. I'm so glad you are feeling better. I don't feel like I'll ever get a diagnosis. What part of IN are you in and what is your Endo's name? I'm in I'll but wouldn't mind traveling if I could get answers and a DX. Thanks for your response. Hope you continue to feel better!
My phone thought I meant I'll and it changed it..I meant Illinois..I'm in Illinois.
Omg! We have the same symptoms! I got cold chills and goosebumps reading about your leg pain, thinking you have cancer and your kidneys bothering you. I don't think you have cancer and I don't think I do either but it makes you worry. I have pain from my lower back on down..my thighs, calves, even my feet hurt. I am really tired, sore..bone/muscle pain, choke on my spit, have a raspy voice..all typical parathyroid symptoms. My calcium was 10.6 and pth was 21 both times I was tested. This is a horrible way to live. 10 days seems like forever but its better than 3 mths. Don't give up..its not your potassium..it doesn't sound like it. I have severe anxiety..I mean severe and my heart pounds severely and I get this feeling go throughout my body..I can't describe it but it almost feels like volcano lava going through my body..kind of warm and it feels like it rises higher and higher. Just thinking about the fact that I might get upset can make my heart pound and cause that feeling. My anxiety couldn't be any worse. Good luck to you Lucy and please keep us updated. Hang in there.
My blood calcium has been elevated for years. Two years ago, it was 11.1, but my doctor never mentioned it other than to tell me not to take calcium supplements. My PTH is 5. That's not a typo. It is 5. My latest calcium lab-as of three weeks ago- was 10.9. My internist sent me to an Endocrinologist who told me to stop taking the 25 mg tablet of HCTz daily. After ten days, she retested my blood and got no change. Then she said I have to wait a month and retest. I am having heart palpitations, serious cramping and pain in the calves and upper legs. My BP has risen to as high as 175 over 110. I avoid table salt and try to eat low salt foods. I am drinking more water too. I have pains in my back - more like an ache in area of my kidneys. I still have more than a week until the Endo will retest me and my legs hurt badly. I called her and she told me to talk to my internist. I called there and got the Nurse Practitioner who said it is probably low potassium. So I have been taking potassium pills and the pains are still there. They are worse at night. I am scared that this is cancer. I am scared that this is a kidney problem. Will waiting another ten days be OK? This leg pain really is difficult to live with. Probably the "not knowing" if it is cancer is even harder. Having to wait ten days for the results of another blood test is frustrating - especially since I am pretty sure that the blood test results after waiting 10 days from the cessation of the HCTz were probably right. I don't see how waiting for a month after cessation of the HCTz will make a difference and she is ignoring that my legs really hurt! All of the Endocrinologists in my area are scheduling new patients three months after they call for a first appointment. I can't wait that long. I worry that waiting 10 days with this leg pain and the kidney pain might be a mistake but I don't know where to go. My internist says to tell the Endo and the Endo tells me to tell the internist.
Hi, I had lots of symptoms. I had severe muscle and bone pain, depression, frequent urination, heart palpations, irritability, and I mean severe on that issue. I could fly off of the handle in a split second. My family didn't know what to think! I was tired all the time, and my hair was coming out, and I also could not sleep through the night. I would wake up after a couple of hours, and then just be awake. Now, after my surgery of the removable of 2 parathyroid glands, I feel better. I sleep all night, and people can't believe how calm I am!!! I still have lots of fatique, but nothing like before. My muscles are up and down, and it has been 3 weeks. The Dr. did say, that after having high blood calcium for so very long, that it will take time. Also, the nervous anxiety is completely gone. AMAZING!!!! That was awful for me. I still have days I urinate quite often, but it is starting to get better, and my constant diarreah is gone. I did have that also. So, I see my Dr. the Endo, in 10 days and the surgeon in 3 weeks for a final check, and to see how my blood calcium levels are doing. I feel better than before, and I see changes weekly. They say, 1 to 3 months. So, I am hoping for the best!! What kind of symptoms are you having?? Look for you later!!
Thank you for your response. What kind of symptoms did you have if you don't mind me asking? Whatever the symptoms, do you feel better after surgery? I'd really like to know what you dealt with as far as symptoms/problems from the parathyroid issue. I have too many to name but I'd like to see if there are any similarities to our symptoms. Thanks for your response and I look forward to hearing from you soon hopefully.
My blood calcium levels were always in the mid to upper 10's, with high ionized calcium, and a PTH level anywhere from 17 to 49. Never any higher. All my other tests were always fine. Finally a MRI showed one adenoma on the right parathyroid, and they found the second one durning surgery. My surgeon was suprised that I had such normal PTH levels. I should say, that the average PTH level was around 35 most of the time. I also had testing done to rule out the other causes of high blood calcium, and saw a great endocrinologist in Indiana. Hope this helps.
Hi Dr. Lupo,
I wrote to you before telling you my calcium level was 10.6 and my PTH was 21. I also told you my albumin was high and you suggested getting my phosphorous tested and to be retested for my calcium and PTH. I was retested and my level was 21 again for the PTH. I was recently in the ER and had blood work done for a third time. My calcium this most recent time was 9.4 and my ALK PHOSPHOROUS was tested but I'm not sure if thats what you were looking for. If it is, that level read at 54. Not sure if the ALK is what you wanted tested. Also on the print out of my results, my SGOT was low at 5. It says "L" beside it which I'm assuming means "low?" Also, my glucose was 105 and it has an "H" beside it which again, I assume means "high." I WASN'T fasting. Does it sound like I have hyperparathyroidism? If so, can you recommend any good endocrinologists in my area? I live in Peoria, Illinois.
Thank you so much for your time. I truly appreciate it.
I wrote to you before telling you my calcium level was 10.6 and my PTH was 21. I also told you my albumin was high and you suggested getting my phosphorous tested and to be retested for my calcium and PTH. I was retested and my level was 21 again for the PTH. I was recently in the ER and had blood work done for a third time. My calcium this most recent time was 9.4 and my ALK PHOSPHOROUS was tested but I'm not sure if thats what you were looking for. If it is, that level read at 54. Not sure if the ALK is what you wanted tested. Also on the print out of my results, my SGOT was low at 5. It says "L" beside it which I'm assuming means "low?" Also, my glucose was 105 and it has an "H" beside it which again, I assume means "high." I WASN'T fasting. Does it sound like I have hyperparathyroidism? If so, can you recommend any good endocrinologists in my area? I live in Peoria, Illinois.
Thank you so much for your time. I truly appreciate it.
Thank you for your response Dr. Lupo. I was retested this morning around 9:30 AM and I did fast. I didn't eat for 25 hours total because of my schedule. Unfortunately my Phosphorous was not tested. The only test on the lab slip was "parathyroid hormone" and a DX of Hypercalcemia. I should have contacted you sooner I guess. Thank you very much for your valuable feedback. I will print this and show this to my new doctor when I move in 3 weeks and get set up with someone in my new state. Thank you so much.
Gary
Gary
I'm sorry. I made a typo. I meant calcium level of 10.6 and a PTH level of 21. I know I said 21 for both things. That's NOT correct.
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