High PTH nornal calcium

I'm in a quandry. Here are my labs: 1-8-10 Calcium 8.9, 2-26-10 ionized calcium 4.77, 2-26-10 phosphorus 3.0, and 2-26-10 PTH 158. I emailed Dr. Norman and he said I did NOT have primary hyperparathyroidism. I have more than 10 of the symptoms listed on his web site. So, what do I have? What does a PTH of 158 mean?? Thanks!

[laura1967]

Please list the ranges for each of your lab results, so we can take a look at those with your results. :)

[Calicorizzo]

Here are my lab results with normal ranges in parentheses.
Calcium 8.9 (8.5-10.2); ionized calcium 4.77 (4.4-5.3); phosphorus 3.0 (2.4-4.1); .PTH 158 (10-65)

[laura1967]

To me it looks more like you are going low.....I would ask your Dr about checking your parathyroid glands for hypo.....there has to be a reason for the PTH to get so high....did your Dr just ignore that?

[Calicorizzo]

Laura, what do you mean by "going low?" Are you referring to calcium? My doctor has ordered a scan even tho Dr. Norman said it would be a waste of time. I will have it on Monday. I don't think he knows exactly what's going on with me at this point. I appreciate your input.

[laura1967]

Yes I meant that your calcium levels are looking border line low. What test did your Dr order?  Let me know how it goes.  :)

[Calicorizzo]

Laura, thanks for your help! I'm going to have a sestemibi scan at 8am on Monday. I don't understand how my calcium can be low when my PTH is so high. I read on one reputable site that if your PTH is more than twice the high end of the normal range your chance of parathyroid cancer is higher. But I just can't find any info on low to normal calcium with high PTH.

[TamraW]

I thought parathyroid cancer had to have much higher PTH than that, like 500 or above.

Here's my story and I'll try to keep it short. I actually paid for a phone consult with Dr. Norman because I had calcium that was higher than yours 10.0 and 10.4. I believe the range was below 10.2. My PTH was 67 and then jumped to 71 (range below 65). I also had several other labs that were normal and borderline high. I had LOW vitamin D levels throughout all of this. I thought my parathyroid disease was causing my low D. Dr. Norman told me I was barking up the wrong tree. I was shocked because, I too, had ALL of the symptoms. Dr. Norman told me to get checked for Hashi.

I had met a woman a few weeks earlier with Hashimoto's disease. At the time, I had myself convinced I'd had parathyroid disease. I thought how strange that parathyroid symptoms were so similar to Hashi symptoms. And they are!!!

I went back to my endo and had her run the TGab and TPOab antibody tests. Sure enough, I have Hashimoto's.

I have a new endo now. I wish I'd gone to him in the first place. He could have spared me a lot of time, misery and money.

My new endo says that Hashimoto's, which commonly causes low D levels, caused my PTH to go up. My parathyroids were doing exactly what they were designed to do. Once my D levels came up, and I mean higher than 60, then my PTH and calcium returned to normal. I am now on thyroid hormone for Hashimoto's.

Here's why the docs never tested me for Hashi in the fist place. They  said nothing was wrong with my thyroid based on one test - the TSH. If a doc runs a TSH on you and says NOTHING is wrong with your thryoid, find a doc who will run ALL the tests.
TGab, TPOab and check the thyroid levels: FreeT4 and FreeT3

My TSH was a 2.74. Current labs use obsolete ranges. My new endo says healthy thyroids average a 1.1.

:) Tamra

[Calicorizzo]

Tamra, thanks so much for your reply. I didn't mention that I had my thyroid removed in 2005 because of several goiters. My TSH is normal on 0.175mg Synthroid. Thanks!

[TamraW]

Why was the thyroid removed? Several goiters or nodules? Hashi commonly causes goiter and nodules.

If you had Hashimoto's then you might still have the antibodies and the Low D levels. Have you had the antibodies tested? D tested? Low D levels can cause sooo many terrible symptoms that mimic parathyroid disease.  I know ranges say over 30, but really try to keep it over 60.

Also, why hasn't the doc added T3 meds to your T4 Synthroid? What are your FT3 and FT4 levels? Docs should treat according to the Frees and not TSH. Without my T3 meds, I still had leg pains, foot pains, brain fog and constipation.

:) Tamra

[Calicorizzo]

I thought I'd post an update. Prior to 4/18 I was still getting tests run for my shortness of breath. I am still taking my OTC vitamin D (50,000IU). My pcp was begining to think I may have some vocal cord damage due to my vagus nerve stimulator. I was set to have a swallow test when I fell. I WAS taking 400mg Seroquel at bedtime. Seroquel drops my BP to a seriously low level - 80/47 is common. I'm 5'9" and 260lbs so that's really low! I know not to get out of bed after taking it, but I was super thirsty. It had been about 45min since I took it and I thought I could make it to the kitchen and back. I made it there OK and was leaning against the wall by the refrigerator when the dizziness hit. I didn't pass all the way out, but slid down the wall to the floor in a sitting position. A pretty gentle process. On the way down I heard my leg break. When I looked down my foot was flipped around in the wrong direction. The bottom line is that I had an oblique fracture of the distal third of my tibia. My fibula was also broken. I had to have surgery to put a rod down the center inside the tibia plus several screws holding everything together. I was in the hospital 3 days and have been in a rehab facility for 3 weeks. The injury has been devastating for me. I feel let down by the medical community. I'm the one who researched and asked for the vitamin D level. When it came back less than 6 and my calcium was low, no one ordered a bone density scan ( 3 yrs ago it showed osteopenia) or talked to me about the risk of a fall. I'm going to be off work 8-12 weeks. The bottom line? Vitamin D is very important!

[stella5349]

Ok - let me back this up a bit. - First on the parathyroid.

before I read your ranges and the Dr. Norman information - I didn't see anything specifically pointing to parathyroid as Hyperparathyroid. Not even a suspecious hypo issue either. PTH stands for parathyroid hormone. It is a protein hormone released by the parathyroid gland. PTH is the most important regulator of the body's calcium and phosphorus levels.

Release of PTH is controlled by the level of calcium in the blood. Low blood calcium levels cause increased PTH to be released, while high blood calcium levels inhibit PTH release.You mention you have symptoms based off his site. What symptoms?

might want to take a look at the court document and compare : -

http://www.phillipsandcohen.com/CM/NewsSettlements/NewsSettlements516.asp

hypocalcemia is the presence of low serum calcium levels in the blood, usually taken as less than 2.1 mmol/L or 9 mg/dl or an ionized calcium level mm of less than 1.1 mmol/L (4.5 mg/dL). It is a type of electrolyte disturbance. In the blood, about half of all calcium is bound to proteins such as serum albumin, but it is the unbound, or ionized, calcium that the body regulates. If a person has abnormal levels of blood proteins, then the plasma calcium may be inaccurate. The ionized calcium level is considered more clinically accurate in this case. In the setting of low serum albumin (frequently seen in patients with chronic diseases.

It manifests as a symptom of a parathyroid hormone [PTH] deficiency/malfunction, a Vitamin D deficiency, or unusually high magnesium levels hypermagnesemia, or low magnesium levels hypomagnesemia.

■Taking medicine that raises PTH levels. These include lithium, furosemide, rifampin, anticonvulsants, thiazide diuretics, and medicines that contain phosphate.

A high PTH level along with a high calcium level can cause problems such as osteoporosis, kidney stones, hypertension, kidney failure, peptic ulcer disease, cognitive changes, and problems with the balance of water in the body. About half of all people who have high levels of PTH and normal calcium in the blood need treatment to correct the abnormal levels. Further testing, such as bone mineral density testing or 24-hour urine calcium testing, may be needed to help make decisions about treatment. For more information, see the medical tests Bone Mineral Density or Calcium (Ca) in Urine.
An overactive parathyroid gland is often caused by a noncancerous (benign) tumor of the parathyroid gland. Parathyroid tumors tend to grow slowly and may not cause any symptoms for many years. Parathyroid tumors are more common after age 50 and are often found with routine blood tests that are done for other reasons. Treatment includes close observation, medicines, or surgery to remove the tumor.


Also you can't have several goiters... A ( one) goiter is an issue always. Nodules are multi.

Please specify exactly what the diagnoisis was to remove the thyoid gland itself.

[Lynnhere]

Hi Everyone,
I'm hoping Tamra is still here.  I wanted to pick that excellent brain of hers a bit.  I have longstanding Hashimoto's (diagnosed more than 10 years ago) and take synthroid.  Recently I've been undergoing tests for possible hyperparathyroidism.  My question, though, is about the foot pain Tamra talks about and the relationship to T3.  I've been having incredible pain in my feet for about 5 years, which can last a half-hour at a time.  It can wake me from a deep sleep...feels like the long bones in my feet are being pulled apart like a wishbone.  Any help would be very appreciated!!
Lynn