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Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
Vitamin D issue
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.
Vitamin D issue
by sophie50, Mar 01, 2009 02:34PM
Calcium 11.4 Previous readings 10.5, 10.3, 9.5, 10.1. 10.9. 11.1 (ranges 8.5-10.2 or 10.5)
Ionized calcium 1.35, 1.41, 1.42 (1.17-1.32)
Vitamin D 54(40-100) (Previous 19.9 and 24)
PTH 27, 22, 14, 12.4 (12-65)
Phosphorus 4.6 (2.5-4.5)
24 hour urine calcium 258 mg/24hr (100-300)
PTHrp 0.9 (0.0-1.5)
ACE levels normal
Originally my doctor stated that bone pain and fatigue (these are the most prominent symptoms) was from lack of Vitamin D and not to worry as calcium was only high/normal. It took MANY months to get my Vitamin D level up with no change in symptoms and I am now being told my symptoms are caused from too much Vitamin D even though I stopped it back in January when the calcium rose above normal. Whole body Bone scan showed bilateral shoulders, elbows, wrists, hips, knees, ankles, 1st mtp joints with arthritis as well as cervical and lumbar spine.
My doctor just wants to run calcium, Vitamin D and PTH again in a month. How high is Vitamin D in hypervitaminosis?
Ionized calcium 1.35, 1.41, 1.42 (1.17-1.32)
Vitamin D 54(40-100) (Previous 19.9 and 24)
PTH 27, 22, 14, 12.4 (12-65)
Phosphorus 4.6 (2.5-4.5)
24 hour urine calcium 258 mg/24hr (100-300)
PTHrp 0.9 (0.0-1.5)
ACE levels normal
Originally my doctor stated that bone pain and fatigue (these are the most prominent symptoms) was from lack of Vitamin D and not to worry as calcium was only high/normal. It took MANY months to get my Vitamin D level up with no change in symptoms and I am now being told my symptoms are caused from too much Vitamin D even though I stopped it back in January when the calcium rose above normal. Whole body Bone scan showed bilateral shoulders, elbows, wrists, hips, knees, ankles, 1st mtp joints with arthritis as well as cervical and lumbar spine.
My doctor just wants to run calcium, Vitamin D and PTH again in a month. How high is Vitamin D in hypervitaminosis?
Doctor's Answer
by Mark Lupo, M.D., Mar 02, 2009 09:29PM
, Mar 02, 2009 09:29PM
This is likely an atypical primary hyperparathyroidism. Low Vit D usually causes low calcium. The Phos is higher than expected, but may have been non-fasting. The urine Ca is fine. Too much vitamin D in this situation may increase the calcium levels. This is a tough diagnosis to make, but in most cases an abnormal parathyroid adenoma will be found.
Vitamin D 1,25 was normal. 36.8 (15.9-55.6) when 25OH D was low.
To clarify....last 3 tests were:
calcium was 10.9 and concurrent PTH was 25
calcium 11.1 PTH 20.9
calcium 11.4 (phosphorus and potassium high with this calcium) no PTH
THANK YOU for anything you may offer.