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Elevated Calcium, Muscle Twitching / Weakness - Hyperparathyroidism?
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Elevated Calcium, Muscle Twitching / Weakness - Hyperparathyroidism?

I am a 25 year old male.  I have been having muscle twitching and weakenss.  I first thought ALS, but neuro and GP say no way.  I recently had blood work done twice, and my red cell count and calcium levels were high.  They are doing additional tests.  I am getting a full thyroid workup, such as t3, t4...etc.  I also got a chest x-ray last night.

Is is possible that I have hyperparathyroidism...and that this could be causing the symptoms I am experiencing with my muscles?

Any feedback would be appreciated!!!

Thanks,

Tony
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Avatar_n_tn
Yes, you have symptoms of hyperparathyroidism....especially the high calcium levels.  You may want to ask Dr. Lupo (thyroid forum) for his opinion.  Ultimately, I think you just need to wait for your labs to come back and see what your doctor thinks.  Best wishes.
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Avatar_n_tn
My calcium is just mildly elevated.  It should be at 10 when it is currently at 12.  I also have a high red blood cell count and am being treated for anxiety.  

I wish I could post for the doctor...but the limit of questions gets full real quick.

I am doing a 24 hour urine sample this weekend.  I am getting an EMG next week because of my muscular symptoms.  

My main symptoms are right arm and leg weakness, muscle twitching, fatigue.  

Do you think with that coupled with mildly elevated calcium, that a dx of hyperparathyroid is possible?
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Avatar_n_tn
A person with hyperparathyroidism may have severe symptoms, subtle ones, or none at all. Increasingly, routine blood tests that screen for a wide range of conditions including high calcium levels are alerting doctors to people who, though symptom-free, have mild forms of the disorder.


When symptoms do appear, they are often mild and nonspecific, such as a feeling of weakness and fatigue, depression, or aches and pains. With more severe disease, a person may have a loss of appetite, nausea, vomiting, constipation, confusion or impaired thinking and memory, and increased thirst and urination. Patients may have thinning of the bones without symptoms, but with risk of fractures. Increased calcium and phosphorous excretion in the urine may cause kidney stones. Patients with hyperparathyroidism may be more likely to develop peptic ulcers, high blood pressure, and pancreatitis.

The list of signs and symptoms mentioned in various sources for Hyperparathyroidism includes those listed below. Note that Hyperparathyroidism symptoms usually refers to various symptoms known to a patient, but the phrase Hyperparathyroidism signs may refer to those signs only noticable by a doctor:

No symptoms
Loss of calcium from bones due to increased blood calcium levels
Mild forms of the condition have relatively mild symptoms:
Vague symptoms
Weakness
Fatigue
Depression
Aches
Severe forms have other symptoms:
Loss of appetite
Nausea
Vomiting
Constipation
Abdominal pain
Excessive thirst
Excessive urination
Bone pain
Muscle aches
High blood pressure
Confusion
Emotional behavior
Impaired thinking
Impaired memory
Delirium
Stupor
Coma
Thinning bones
Risk of fractures
Hypercalcemia (elevated blood calcium levels)
Symptoms from underlying cause
Tiredness
Mood changes
Confusion
Kidney stones
Bone pain
Constipation
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Avatar_n_tn
That post really didn't answer my question though.  Does it sound like I could possibly have hyperparathyroidism?  Also, does muscles twitching and weakness accompany the disease?
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Avatar_f_tn

Yes your symptoms comes with Hyperparathyroidism, but so does other health issues.

You would need more testing as to whether it is or sounds like Hyperparathyroidism.  Such as: Was your Serum phosphate level and Parathyroid hormone blood level high as well?  and how is your blood pressure? Blood calcium levels may be elevated in cases of thyroid disorder, multiple myeloma, metastatic cancer, multiple bone fractures, milk-alkali syndrome, and Paget's disease.

Muscle twitching and weakenss are typical symptoms of both hypo and hyper and other causes as well, and depending where on the body twitching is. Benign twitches (not caused by disease or disorders) Often affecting the eyelids, calf, or thumb. Normal and quite common, often triggered by stress or anxiety, A diet deficiency, Drug overdose (caffeine), Drug side effect (such as diuretics, corticosteroids and estrogens), and Exercise.

Weakness of muscle Symptoms suggestive of a neurological cause of fasciculations. Neurological illnesses where fasciculations are seen include: Chronic denervation of muscle due to disc compression of nerve exiting the spinal cord
ALS (Lou Gehrig's disease), Spinal muscular atrophy, Muscular dystrophy, and Myopathy.

I am wishing you the bettter outcome. If this doesn't satisfy you as to your question, I am sure the Dr can assist.

Good Luck!




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Avatar_n_tn
Man you and I are in the same boat. I too have very similar symptoms. Twitching,weak muscles, Major Fatique. Had a Thyroid test done twice. Still within Normal but TSH was always near low and I did have TSI antibodies which indicates Graves I think,but that too was below thw 125 mark for normal . It was at 92
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Avatar_n_tn
You should ask about sarcoidosis.  I am in the process of being (finally) diagnosed with this.  I have been suffering from extreme muscle twitches for a couple of months now.  High calcium levels can be an indication of this disease.  I have been feeling unwell for a couple of years now on and off and then began to have some neurological symptoms followed by all over muscle twitches that have continued for awhile now.  I also have generalized muscle weakness and some muscle cramping and extreme fatigue.  Sarcoidosis can also change your CBC.  Anyway, I am sure your chest xray will reveal something if it is, sarcoid usually starts in the lungs. Good luck.
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Hey, Just wondering if you got that diagnosis yet? I've been getting " the twitches" lately. About 6 weeks ago started as my left pinky pulling in ( twitching ) That subsided and a few days/week later I had fascillation in my right forearm/bicep area. ( just to the inside where your upper arm meet the lower arm.) Now I've got my left tricep going. But the right arm is the worst and most constant. Shoulders are kind of sore. I have been dealing with a rotator cuff problem for a long time on the left shouler. ( since spring 2006 ) Wasn't all that concerned til I got the fascillations in both arms now. Most prominent at rest, or when I try to move only slightly it will "go off" . If I tighten my fingers I can get it to stop, as soon as I relax it starts up. I'm going to the chiropractor, his initial thought was pinched nerve in neck, but that was a while ago when it was just the left pinky. I stopped going but started yesterday. I've been on the computer  ALOT lately. Could I be causing a neck thing and that's causing the twtiches. I also did a serious bicep workout yesterday and my arms were really trembling for a while. Much more than usual.

Help!
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Avatar_n_tn
I'm currently being tested for Hyperparathyroidism.  My tests have just been sent to a clinic in Tampa for review by a Parathyroid Specialist.  Now, I have to wait 7-10 days to hear from the doctor.  Every day counts now.  My symptoms are so severe I have to be on antipsychotics.  The pain is so immense there is no controlling it anymore with pain killers.

I am 31 years old.  This ordeal began when I was 5 years old with a pain in my legs that was diagnosed as Restless Legs Syndrome, and I assumed the muscle twitching was Periodic Leg Movement Disorder.  But, I have spent the last decade trying to figure out why I can't describe the sensation I am feeling as anything similar to the creepy crawly feeling described by RLS sufferers, and why my RLS is worse than anything ever reported in the history of RLS.  The pain in my legs has gotten worse with each passing year.  At 14, it was so severe, I watched my sleep fade away.  I have averaged 3-4 hours of sleep for the last 16 years.    Over the last 16 years, it has spread into my arms, hips, and pelvis.  Beginning last fall, I lost the ability to sleep altogether without the help of drugs.  The hips and pelvis is a new thing and it’s creating a very agonizing sensation in my stomach... hence the anti-psychotic.  The pain in my legs was never just at night either; I would beat my legs black and blue under my school desk all day long.

No one has ever believed me.  Doctors just laugh and throw anti-depressants at me.  As a child, my height and weight were a big concern for my parents; but, the doctor said the solution was to switch me from 2% milk to Homogenized.  That didn’t accomplish anything.  By Grade 7, I was a foot shorter than the second shortest kid in my class, and weighed 70 pounds.  Today, I’m 5’4” and am struggling to stay above 100 pounds.  I finally made it to 130 pounds; but, on September 18th, I was rushed to the ER in the middle of the night with violent abdominal pains and within just a few days, I lost 30 pounds.  Of course, there was absolutely no reason for me to be in pain, so like all the other past ER visits, pain medication was withheld.  Like all of my mysterious ER visits, I am fine by the morning and I go home.

To my horror, I sat on the sidelines in junior high and high school.  I sat and watched everyone I had grown up with grow up right before my very eyes.  Puberty kicked in at 14; but, the whole process shut down after about 6 months.  It wouldn’t be until I was 26 that puberty kicked in.  Speaking in a high voice in my early 20s was traumatizing; my University had a speech pathology department, free to students; so, with their help I learned to speak in a proper register.  A camera was put down my throat to see what was going on; but, it revealed my throat to be so inflamed and stressed that the doctor had no clue what was wrong with me and I why I spoke like that.  My voice finally changed when I was 29 and I could carry on conversations without actually concentrating on talking in a proper register.  I never made it to Graduation. My GPA collapsed practically overnight, and then after a year of having one cold after another, one of which resulted in my ear drum exploding from the pressure, and another year of Tinnitus, I dropped out.
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The cause for all my struggles has always been because of an undiscovered emotional issue that requires anti-depressants, anxiety, or stress.  None of which have ever applied.  I fought for my life, thinking I had Restless Legs Syndrome, a benign irritating problem, that was resulting in severe sleep deprivation; and it was the sleep deprivation I was blaming all my strange symptoms on.  For the last 2 years, I have been trying to fix my sleep and my health so that I could walk into my doctor’s office and get help for the main problem, which was RLS, without the doctor getting wrapped up with things not related to the real problem... my legs.  Of course, now it’s not just my legs; it’s my legs, arms, hips, and pelvis.  Plus, my back, neck, and shoulders always feel like I have thrown them out.  For the last 2 years, I have seen an acupuncturist, a massage therapist, and a chiropractor weekly.  I can never quite recover my health, and when I feel like I’m coming close, I have an episode, which puts me back to where I started.  My body will also not hold an adjustment.  My back, neck and shoulders are just as bad as they were prior to the adjustment within hours.

By the time I was 20, after being told all my life, “There’s nothing wrong with you; knock it off!” I finally did.  I stopped complaining and went on with my life.  I went on to college and began taking 40 Tylenol 1’s a day to block the pain.  It worked for a while, and even I stopped believing there was anything wrong, and with the sleep deprivation, I was really blocked from putting two and two together until this fall when everything became so bad that I could no longer hide it from the world.

I sent an SOS to every email address on The Mayo Clinic’s website.  3 hours later, I was contacted with an appointment to see the doctor of internal medicine on October 5th in Rochester, Minnesota.  I felt I needed to be honest about everything from the last 10 years... the Tylenol abuse, the DXM abuse so that I could sleep, and last winter, when my adult weight dropped to 90 pounds, I started smoking marijuana.  He wasn’t impressed with that; but, what no one seems to understand is that no medication to help the pain has ever been made available to me, and I’ve had to live, and survive, and have a good life, and be happy, and be able to crawl out of bed, and not feel like the bones in my legs are about to break in half with every step I take.
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Avatar_n_tn
The first blood test showed an elevated Calcium and a low Phosphorus.  The doctor said this cannot cause any of my symptoms; but, it’s an oddity to look into.  He said they’ll take a second blood test and this time check the Parathyroid.  I went back to my hotel room and typed in Parathyroid into Google, and learned all about it.  The website describes everything I have been through all my life.  I have nearly every single symptom on the page.

On the first blood test, my Calcium was 10.3mg/dL and my Phosphorus was 2.3mg/dL; but on the second blood test...

Calcium: 9.9mg/dL
Phosphorus: 2.7mg/dL
PTH: 43pg/mL

The doctor said all my numbers were within range.  He changed his tune.  You could see on his face he didn’t believe a word out of my mouth.  He wanted to admit me into psychiatric care, drug me up to stop the pain, and deal with each symptom as a separate emotional issue.  I was so upset that I called the clinic in Tampa and spoke with the nurse.  She said that the numbers on the second test aren’t right.  My PTH can’t be *THAT* high in correlation to my Calcium.  She gave me a bunch of tests to get done here in Vancouver over a period of 3 weeks.  To the doctors here, and the labs, Hyperparathyroidism should be ruled out.  Since my PTH is within range, another cause for my Hypercalcaema should be investigated.  However, with everything I have read, to me, the tests still point towards Hyperparathyroidism.  My Bone Density Scan revealed Osteopenia; but, since I am a 31 year old male, I shouldn’t worry about this for another 10 years.

I’ve probably made this all so much worse than it had to be.  I’m a thirsty person’ more thirsty than hungry.  from 16-21 I drank 20 gallons of milk a week.  There was a brand I loved that I couldn’t get here in Canada, so I imported 40 cartons a week from the United States.  As odd as it sounds, and hindsight is 20/20; but, at the time, even to my parents, it was quite amusing that we had to have 2 fridges, one for food and one for my milk.  I became lactose intolerant at 21, and switched to orange juice to quench my thirst.  I was advised that if I am going to avoid dairy, I still need to get my Calcium.  I switched to Calcium Fortified Tropicana with 50% Calcium and began drinking 3-4 jugs a day.  The constraints of my house were too much for how excessive my walking became.  I moved outdoors to avoid my parents questioning that I was up all night pacing back and forth to music, which acted as a tuning fork for my body.  Every time I would pass my house, I’d run inside for a glass of orange juice.  At some point, I would just grab the entire jug and take it with me as I walked around the block, excessively, at a violent pace.  Sometimes I would end up in a psychotic rage.  I couldn’t explain what was going on and I was too scared to say anything.  I would try to get to bed around 4am; but, my alarm would go off at 6am, and I left for school on maybe 30 minutes of sleep.

The last 10 years have been such a mess.  I just want all this to be over.  No one should be tortured the way I have been.  I feel so bad for that kid who believed the pain in his legs was a normal thing.
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Avatar_n_tn
Just wanted say that we have been dealing with hyperparathyroidism in my teenage son. His father(we are divorced) took him to a dr. that treated him for anxiety instead of checking his blood or anything before putting him meds. They did this behind my back.
Long story short after the meds didn't work and he was still having the problems I took him to his ped. and they found the problem very quickly. 4wks.  and many tests later after being diagnosed he had surgery to remove the bad parathyroid gland. He is doing great and is like a brand new person again.
My worry is that seeing what my son went through I wonder how many teens there are out there who might have/had this same problem and has went undetected or masked with meds. to treat symptoms and they have went on to hurt themselves or someone else because it didn't help. Please if your child is having trouble with depression, mood swings, loss of appetite, anxiety, sleeplessness. Have him or her checked for this. It is a simple blood test that can be done.  It could make a big difference in your child's life.
AJ
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Avatar_m_tn
Hi, I'm a 22 year old male. For the Last 3-4 months I have been experiencing almost all of the symptoms of hyperthyroidism : kidney stones, high blood pressure, heart palpitations, depression, etc  I recently went to Kaiser ER for an anxiety attack I was having do to "massive facial and head twitching" (my jaw and temple area on both sides twitching. (I also have little twitchs anywhere and everywhere through out the day) caused from what I was soon told to be most likely from high calcium levels in my blood (10.8) I knew there was something wrong with me for months but had to wait till I got Kaiser Insurance to find out... Do you know of anyone else having all the twitching I'm experiencing? (it happens every day) I feel better knowing whats wrong with me but I'm concerned that if I don't get this surgery soon I will be hurting myself by waiting... Honestly I'm scared to death everyday... I find myself scared to work or do anything normal in fear that I might exacerbate the problem (mainly the head and facial twitching) I have a doctors appointment Oct 13 to discuss my hyperthyroidism. The twitching is so damn scary and random I think an artery or nerve is going to explode any minute. I talked to 2 doctors that said "I was fine and experiencing normal things" I basically broke down mentally and demanded that I be checked out thoroughly at Kaiser ER and thankfully found out about the high calcium levels. DOES ANYONE EXPERIENCE THE LEVEL OF TWITCHING  I DO?
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Avatar_f_tn
I know symptoms can be scary but try to stay calm (easier said than done).  It sounds like you're in the hands of good drs.

Let us know the outcome of your appt.

Good luck.
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Avatar_m_tn
Thank you Thypatient for the kind words. Well... my Dr. said we can't do anything until we have more information regarding my health. So after a brief talk I was sent to get 9 more blood tests and a 24/hr urination test. In less than a weeks time I will have more facts and from there my Dr. and I can further evaluate my options.
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1065668_tn?1256323104
I Have muscle twitching-- look at parathyroid.com -- ANYONE with elevated calcium levers usually have hyperparathyroidism- I havnt had the surgery yet either and everyday Im a nervous wreck!!
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Avatar_f_tn
I completely agree with luvanurse777. Please check parathyroid.com. High calcium even mildly elevated or fluctuating calcium levels need to be investigated. Dr. James Norman is a phenomenal physician and a expert on parathyroid disease. I say this not only because I am a nurse but from personal experience as well. My husband is one of his patients and has a parathyroid tumor. Hopefully, all lab results complete he will have surgery no later than mid-November. He is lets just say not a very desirable person to be around. After several elevated calcium levels, horrible mood/personality changes, and almost all of symptoms that are presented we are on the road to the end of this nightmare.
I learned about parathyroid.com from one of his patients. My husband gave a customer my phone number for his wife to call b/c of gallbladder questions. In conversation with this lady, she told me about Dr. Norman, who had done surgery on her parathyroid gland to remove a tumor. I went immediately to his website and had major endocrine system continuing education. I spoke with our doctor the next day and asked for an order for additional lab test. My husband had already had elevated calcium levels for 2 years at that time. He of course asked why and said that his levels were only slightly elevated, why did I think he had a parathyroid tumor. At which point I proceeded with the reasons for each of my request. I received my orders and sent the blood to the lab.
When the results came back, indeed his calcium still elevated as was his PTH. Vit. D and B12 were both low and he has prior history of hypothyroidism.
Yes the next suggestion was he needed a sestambi scan, I politely declined and explained why. I think he thought I was insane to a point at that time but knew me well enough that I wouldn't argue unless I was sure I was right. I've worked with him for numerous years and a patient as well. He asked if I minded if he ran all by a endocrinologist at Duke and I said sure go ahead. The next day he informed me she had agreed with what I had told him.
We are surrounded by Duke, UNC, and Baptist Medical Centers, but when you compare the surgery that is performed by Dr. Norman in Tampa, FL, it is well worth the trip.
ELEVATED CALCIUM IS NOT NORMAL! My husband was at first was in denial that there was anything wrong with him b/c he at that point did not see what his children and wife were seeing. Then as months went by his fatigue, aches, pains, and not being able to sleep begin to worsen. He finally said he was ready to proceed and I sent all his information to Dr. Norman.
If there had not been an error made by the lab with the 3 additional blood tests that Dr. Norman requested, the surgery would be behind us now and he would be well on the road to his old self.
In just the last month, he has gotten much worse. He feels horrible and is a bear to live with most days. Honestly, there may be a few hours every couple days that he is not awful.
The better or worse clause really had to be tattooed on my brain for me to deal with him. Our girls try to not be around him for the most part if he is Mr. Hyde. He can't handle the over stimulation that children or a large group generate at all.
So please don't let it be overlooked and not treated. It can cause irreversible problems if not corrected.
AGAIN I STRONGLY REFER ANYONE THAT HAS QUESTIONS TO WWW.PARATHYROID.COM.
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1065668_tn?1256323104
I Have twitching all over everyday. I will be sitting like now and my calf will twitch, then my arm will twitch, then my calf will twitch again. Very rarely do I go with no twitching and it is scary. My lab work came back with an elevated calcium level of 10.4 which is only mild then I read about how any calcium levels that are elevated is not normal. Then I insisted to my MD to send me to an Endocrinologist- my lab work came back PTH of 45 and Calcium level of 11.0, he then made me do a 24 hr urine came back normal-- they say that you can have hyperparathyriodism and still have normal calcium in the urine-- soo more blood work-- PTH this time was 42 and calcium was 9.8 -- normal my endocrinologist said I'll see you in 3 months- I said wait -- dont the levels fluctuate with hyperparathyroidism-- yes but he said he will see me in 3 months. I asked my endocrinologist about the muscle twitching all over-- he said it wasnt from the hyperparathyroidism- yet the computer says it is-- I finally got all my paperwork done for the thyroid place in tampa which I found through parathyroid.com and now I am waiting on them. I sometimes wander if  my elevated calcium levels are from something else or is it because hyperparathyroidism- my aunt did have it and it can be hereditary so I try to look at the positive and not think of bad things --- after all because of the condition I am a VERY ANXIOUS person--- its truely miserable- I as well do not sleep very well- have heart palpitations- high heart rate at times- easily startled because of the anxiety. My heart usually once a day will do a funny thing that scares me half to death but then I just have to talk to myself and say everything is gonna be ok and pray... Im ready to feel normal again- I also have demineralization of my hip bones-- I guess from the hyperparathyroidism- anyhow if anyone wants to chat about this my email is ***@****
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Avatar_n_tn
Luvanurse,
Your story sounds so much like mine, I was just wondering if you have had your surgery yet? Any new developments?
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Avatar_m_tn
HI everyone, I want to say to alot of people on this forum , especially ones suffereing with anxiety issues, wether brought on by symptoms or the other way around. I started having a lot of the same problems. It started to wear my body and mind down so much I felt like i was on the verge of a complete mental breakdown. I decided to try something outside the box being that in my opinion pills and a lot of the medications that doctors will throw at you when they don't know what else to do can do more damage then help. I went and started getting acupuncture treatments. They helped more then I ever would have thought possible. It was a huge help to me and allowed me to continue on with my life. I still have symptoms every now and then but they are not as extreme and they don't terrify me to the point of dread. So that is my suggestion to anyone who is reading this. Go try Acupuncture!
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Avatar_m_tn
LUVANURSE777,

Can you please tell me what you have done to alleviate your symptoms? Reason I ask is because I have been twitching for the last 22 years non-stop. Any advice help you could provide would be great. I have had PTH tests done (and they are elevated), Calcium Serum and Ionized and it's low to normal. Please let me know. I am working with an endocrinologist, but no answers.
Thank you so much.
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Avatar_f_tn
Did you get the surgery at Norman Parathyroid?  Are you better?
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