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Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
Follow-Up Answers
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.
Follow-Up Answers
by jenlj1, Nov 20, 2006 12:00AM
Thank you for your answer and time; below are the answers to your questions:
If the 10.4 Ca was before HCTZ (a med known to increase serum Ca as it decreases Urine Ca) then you may have primary HyperPTH but would like to see more testing to be conclusive. The thyroid tests are normal - this is not likely the cause of your symptoms. What was the Vit D level? Is there a family history or personal history of kidney stones (ie the high urine Ca).
1)The 10.4 Ca was before starting the HCTZ; as were the high 24 hour urines (545 and 261).
2)Vit D levels were 48 (20-100 ng/mL)
3)I haven't had any kidney stones, nor is there a family history; as far as I know.
Basic blood work is pretty normal nothing too far out of range; I've starting taking a multi-vitamin recently but don't suppliment Ca as I am pretty sure I get plenty in my diet. My fatigue began after starting the HCTZ a couple of weeks ago; perhaps I just need to adjust to taking the medication or it's something totally unrelated(cold or flu)???
Thanks again for your time.
If the 10.4 Ca was before HCTZ (a med known to increase serum Ca as it decreases Urine Ca) then you may have primary HyperPTH but would like to see more testing to be conclusive. The thyroid tests are normal - this is not likely the cause of your symptoms. What was the Vit D level? Is there a family history or personal history of kidney stones (ie the high urine Ca).
1)The 10.4 Ca was before starting the HCTZ; as were the high 24 hour urines (545 and 261).
2)Vit D levels were 48 (20-100 ng/mL)
3)I haven't had any kidney stones, nor is there a family history; as far as I know.
Basic blood work is pretty normal nothing too far out of range; I've starting taking a multi-vitamin recently but don't suppliment Ca as I am pretty sure I get plenty in my diet. My fatigue began after starting the HCTZ a couple of weeks ago; perhaps I just need to adjust to taking the medication or it's something totally unrelated(cold or flu)???
Thanks again for your time.
Doctor's Answer
by Mark Lupo, M.D., Nov 20, 2006 12:00AM
, Nov 20, 2006 12:00AM
Would recheck Ca to see if further elevated on HCTZ.
The two urine tests are discordant -- one is practically half of the other -- the 545mg is concerning but the other is normal. It would make since if the 261 were after HCTZ started. Was the calcium intake that different during the two separate tests?
Still tough to conclude HyperPTH, but this would be the most commin cause of elevated Ca in an otherwise healthy person.
The two urine tests are discordant -- one is practically half of the other -- the 545mg is concerning but the other is normal. It would make since if the 261 were after HCTZ started. Was the calcium intake that different during the two separate tests?
Still tough to conclude HyperPTH, but this would be the most commin cause of elevated Ca in an otherwise healthy person.
