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Hyperparathyroidism?
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Hyperparathyroidism?

Sorry this has been posted more than once - I couldn't figure out how to post in the expert question forum.
I am only 31, but for a few years I have had symptoms of pHPT (problems with memory, sleep, fatigue, headaches).  Osteoporosis has worsened from -2.5 spine, -1.5 Hip to -2.9 spine -1.9 hip in 2.5 years.That whole time, I have done everything right. Weightlifting 3-4 x a week, exercise every day. Have a phenomenal diet, organic, grassfed, 8+ sev of vegetables a day, no soda, caffeine, coffee - 3 L of water a day, take plenty of Ca, Vit D, multivit,  total bonafide health nut weirdo.  My PCP agreed there must be something else wrong. Investigating revealed:  

9/21:  Ca = 9.8, Ca++ 5.1, PTH 65, ALP 133,         (ALP a year ago was <100 consistently)
10/14: Ca =10.3, PTH =36, Ntelopeptide= 104
10/17:  Ca = 10.0, Ca++ 5.4, PTH =57.1, ALP= 133, 1,25 Vit D = 58, 25OH D=49
11/7:   Ca = 10.2, PTH= 49, ALP = 143, 1,25 Vit D = 43, 250H D = 64
calcitonin and osteocalcin high-normal
24hr urine Calcium 520

my creatinine has also been climbing over the last few months, is now 1.2,  and my est GFR is now 59.
Recently realized decreased kidney function could be a result of PTH (not just a cause)
No kidney stones, but I've had cloudy urine for years.

2 wks ago, I stopped taking Ca suppements bc I thought I would feel better, but instead feel much worse.  (PTH not being suppressed by suppl anymore? Higher PTH= more Ca being taken up into cells?)
Urinary sympt have been getting worse, too I have drinking 3L H20 for a long time just to be healthy, and used to just pee more volume. The last couple months, I can't get by with less or go anywhere w/o my waterbottle, and have to pee every 20 min.

What would you think based on that?  I know it is borderline - but I am young and otherwise in excellent health... and at least used to have good kidneys that maybe could keep up with the Ca efflux?  but there doesn't seem to be any other explanation.

Thank you
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97953_tn?1193367871
Tough case, this may be a borderline case of primary hyperparathyroidism.  In your next post, he mentioned a 3 cm neck mass.  In my mind the next step would be ultrasound with possible biopsy both for cytology and PTH washout .
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Thyroid & Endocrine Center of Florida
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