High calcium levels & Hashimoto's Thyroiditits

I am a 57 year old female and was diagnosed with Hashimoto's disease several years ago. My family practice doctor noticed thyroid enlargement at a routine visit and sent me to an endocrinologist. I have been treated with synthroid for several years. My thyroid gland was also nodular and two years ago I had the right lobe and isthmus removed because the benign nodules were continuing to enlarge and swallowing was becomining a little difficult. Recently my endocrinologist reduced the synthroid from 150 to 137 mcg because my TSH levels were borderline and a had a couple of episodes of heart palpitations. A week later I saw my family practice doctor for annual bloodwork and my calcium level was 10.2. I was taking 2000 mg of calcium with vitamin D in split dosages and was told to decrease to 1000 and have my blood calcium levels rechecked in a couple of months. Last month I had an annual ultrasound of my thyroid to track the growth of a nodule in my remaining left lobe and it had decreased in size. If there was a parathyroid problem, would it have shown up on the ultrasound? Also, is the wait and recheck calcium levels in a couple of months the proper way to go? In addition to the synthroid, I am also taking Maxzide 75/50, Zocor 40 mg, Cymbalta 60 mg. and percocet 30 mg/day (both for lumbar neuropathy), and Robinul 1 mg twice a day (for the excessive sweating caused by the Cymbalta). OTC supplements, in addition to the calcium, are multivitamins, glucosamine/chondroitin, and omega 3 fish oil capsules. Some symptoms I've noticed over the past 9-12 months are memory problems and difficulty in concentrating, bone pain (mainly hips and legs), lack of energy, some feelings of depression, excessive thirst and frequent urination. I know some of the meds I'm taking can cause some of the symptoms, especially the excessive thirst. I am just tired of feeling bad. Can you offer any suggestions?

[Mark Lupo, M.D.]

The calcium is high-normal but may be due to HCTZ in the Maxzide.  A test of PTH (with calcium) would help determine if this is parathyroid related.  Ultrasound does not always show the parathyroid abnormality, the blood testing is the key.