Can Hyperparathyroidism cause diabetes?

[1280]

I have recently been experiencing the following symptoms anxiety, fatigue, aching bones, nausea, and tiredness (tiredness especially after eating).

I have had the following lab results:

Ionic Calcium of 1.35 mmol/L (normal upper range to 1.25 mmol/l)
on a seperate day:
Serum calcium of 2.57 mmol/L (normal up to 2.55 mmol/L)
PTH = 3.3 pmol/L (normal range up to 6.4)
Phosphorous = 1.20 mmol/l (range=0.8-1.4)
Chloride = 107 mmol/l (range=98-106)

Is this hyperparathyroidism? if so could this cause diabetes (or glucose intolerance). I seem to have varying symptoms from day to day and feel like I'm losing my mind.  I haven't felt this terrible since I had a bowel obstruction and resection from my crohn's disease and my GP doesn't seem to think it is Primary hyperparathyroidism, but am I seeing an endocrinologist next month.  I have also had a Sestamibi scan that was negative.  I have done some research and discovered that these scans aren't always reliable and actually shouldn't be used as diagnostic tools for this disorder.

[Anita Ramsetty, MD]

Hi,
You could have hyperparathyroidism because the PTH was not low(which it should be in normal cases when the serum calcium is high), however you likely will nede your PTH, phosphorus and Calcium levels repeated, as well as a 24 hour urine for calcum excretion.  Sestamibi scans are useful but not 100%, as you have read. Many endocrinologists do not use them at all as first line tests to look for primary hyperparathyroidism, but instead often use them in complicated cases after surgeries etc.
Until you see the endocrinologist next month, stay well hydrated(drink lots of water) and stop taking any extra calcium supplements or TUMS if you do that regularly. Stay on a normal diet though, and try not to exclude regular calcium sources(this could make things worse if you have hyperparathyroidism).

[1280]

Thanks for the advice, I have been staying well hydrated and when I heard that this could be from hyperprathyroidism I actually did cut out almost all of my calcium.  The result was that I did indeed feel worse (bone aching especially).  I am back on a normal diet and feel better for sure.  Is it ever normal to have slight hypercalcemia?  I did have a 24 hr urine collection and it did come out in the normal range (from what I read this also doesn't exclude hyperparathyroidism).  I was also on synthroid for 6 years and stopped it because I had developed hyperthyroidism.  My thyroid problems seem to be stable now, could these two be related?  I understand calcitonin (from the thyroid) has the opposite effect as TSH.  Could being on unneccesay thyroid medication (possibly for years) be a cause for hypercalcemia?

Thanks

[1280]

Sorry I meant to say PTH not TSH.

[Anita Ramsetty, MD]

Hi,
Yes, hyperthyroidism can be the cause of mild elevated serum calcium, but often it is with significant hyperthyroidism and not mild cases.

Some folks can have mild hypercalcemia show up on labs when they are a bit dehydrated, so there is not other disease process going on but otherwise it is not considered "normal"--our bodies really do a great job of keeping calcium within a specific range outside of something being amiss.

Definitely keep up with the hydration and the normal diet. It may take some repeat testing to determine what is the diagnosis and best course of action for you.
Take care.

[1280]

Dr. Ramsetty,
I have had 2 more lab test results, I was wondering what you thought.
March 5th:
Serum Calcium: 2.54 mmol/L (normal up to 2.55)
Ionized calcium:1.43 mmol/l (normal upt to 1.35)
PTH: 2.4 pmol/L (normal up to 6.4)

March 11th:
Serum calcium 2.49 mmol/L
Ionized calcium 1.37 mmol/L
PTH 3.6 pmol/L

[Bren249]

A related discussion, Type2 Diabetes and Hyperparathyroidism was started.