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Avatar universal

Calcium and vit d, with ANA

I also posted this in the thyroid forum but you all were so helpful and knowledgable, I wanted to get your input as well!

I haven't been on in a while...life has been so busy.

I finally had my appt with the rheumatologist and he doesn't think I display any physical symptoms of lupus (rash, lupus hair) he did run the ANA and some additional tests to be sure.  I got some results but not the ANA yet.

Of course there are new questions and I knew you all would have the best information.

So my serum calcium is at 10.0, which is borderline high.  What I've read is that for over 30 is should be 10.1 or lower (the lab range says 10.4, but from what I've read that is for teens and possibly twenties, neither of which I am!).
Couple of months ago it was 9.6.

My urine calc ox was >5 flagged HIGH.

Also a test called eGFR-Afr Am >59, eGFR-Non-Afr Am >59

The range says >60, so I assume that >59 is the same and just weird they have it so close but different.  But throwing it out b/c it has to do with kidneys and so does the urine calc ox.

So here's where I'm confused, and want to make sure b/c think the docs may just brush this off, so just want to make sure I understand.

Did the vit d supp cause the rise in calcium, both serum and urine?  

I've read that pth levels can lower vit d and you shouldn't supp vit d if you have a parathyroid disorder until it is identified and resolved.  And that pth regulates how much calcium is in your blood etc.  and that high levels of calcium are bad.

So chicken or egg?  Is the vit d causing the rise in calcium?   My vit d with full supp has only gotten to 50, then dipped to 30 again and now is at 45.  When I started the supp it was 9.

Should my pth have been checked then, and my calcium levels?

Can they be checked now or has the supp skewed the results?

Should I stop the d supp since my calcium now seems to have gone overboard?  I don't want calcium deposits.  
7 Responses
1530171 tn?1448133193
Hey GG7714, the eGFR Afr. Am is an estimate of how well your kidneys filter creatine ( a muscle waste byproduct)- for African American people- and your result is just border line low. Chances are that most Nephrologists will not consider this level for diagnosis yet, and will take a wait and see approach.
Note that there are many limitations with this test.
Age,  being overweight, muscle weight, gender are all factors which may influence the findings.

The calcium oxalate for men is higher than women's, however can you
tell me if the test was a direct measurement of CaOx or was it an indirect calculation using a logarithm according to the Bonn Risk Index (BRI) to assess your risk? Please supply also the Lab's unit of measurement, if it has to do with the former.
The BRI range from 4-8 is considered very high.
The risk doubles from range limit to range limit.
This has to do with CaOx crystallization risk.

No, my opinion is NOT to stop normal 1000-2000 UI supplementation of vitamin D3, but to:
1. Take vitamin K2 so calcium gets directed to teeth, bones and joints
instead of soft tissues
2. Limit vitamin C, OJ and oxalate foods , but  note that the risk in these is only 10-15% and the balance has to do with other bodily mechanisms.
3. Drink ample amounts of spring water 1H away from meals.
4. Potassium and magnesium supplementation helps limit the risk.
5. Rule out parathyroidism, re: high serum Ca

Hope this helps.

Avatar universal
Hi Lightseeker,

Thank you for the reply.  I do take magnesium and k2 with the vit d.  My PCP cautioned me with the k2 b/c of potential bleeding issues.  I got the protocol form the vit d council but didn't notice the potassium, so will add some as well.  I do get leg cramps sometimes and try to eat a banana, which does seem to help, but sometimes it's hard to know how much you're getting of what.

So my ANA has bounced around but the most recent is 1:640.  The rheum hasn't called yet so I'm not really sure what to make of it.  The other tests are negative (dsDNA,C3, etc.).

Could kidney stones cause an elevated ANA?  Could hyperparathyroid cause elevated ANA?

What else would high normal serum Ca and the high urine CaOx indicate?

Lastly, so sorry if I don't understand, but does the high urine CaOx mean there are kidney stones or just increases the chance of developing?  Anything besides water I can take to help reduce/prevent?

Thanks for shedding the "light"!
1530171 tn?1448133193
The immune system makes antibodies to fight foreign intruders like
infectious pathogens (it attacks the nucleus of their cells, thus the term antinuclear), but sometimes it attacks the body's own cells
erroneously, considering them as foreign and that's where this may lead to autoimmune diseases.
So we have antinuclear antibodies (ANAs), which are not necessarily an indication of autoimmune disease, on their own.

If unresolved kidney stones or hyperparathyroid cause elevated ANAs, it would likely be an indirect involvement. Not easy to link.

The high urine CaOX indicates a higher level of particles associated with a higher risk of forming kidney stones.

The overwhelming cause of high serum Ca (yours is borderline high) is hyperparathyroidism and if you're that concerned, you should discuss this further with your doctor, instead of worrying about it until next time you get tested again.

Hope this helps.

Wishing you well.

Avatar universal
Thanks Niko,

Since the ANA is higher again now and the two calcium tests were either high or in the case of the serum calcium higher than it had been and right on the border, I was hoping there was one thing linking them all.

I don't know that I've ever had my urine calc ox tested before, and it was certainly never high, so I was just surprised by this since I was only hoping to rule out autoimmune but now have a separate issue.  Not sure if it's new or if it just was never tested before.

Do I understand correctly that the urine calc ox isn't definitive for kidney stones and perhaps there are preventative things I could do to try to keep from developing them?

And, with a bouncing ANA (1:160, 1:40, 1:640) over a few months, but so far all other tests are negative, what would you do?  Monitor every 6 months absent new/any symptoms?

And I apologize if I sounded overly concerned, not sure where I am.  Sadly, I was just trying to put the slightly elevated ANA to bed, and then the calc ox and being over 30, my understanding that serum Ca should not be over 10.1 and all of sudden my Ca that had been in mid-9s was higher.  I thought I'd done it to myself with the vit d.

Thanks again for your advice.  I'll let you know what the rheum says.
1530171 tn?1448133193
No need to apologize. It is good to be overly concerned (at first only) than
not concerned enough.

Should you be able to implement some gradual improvements (things you can control), like optimizing your diet according to your body's specific needs consuming fresh natural & chemical free foods, getting some physical activity everyday, adequate rest & sleep, drinking ample spring water (as I mentioned already before),etc. will help tremendously in the long run.

Labs are just labs. My opinion is to rely more on how our bodies relay information to us, and less to what the labs are telling us.

Medicine would serve us much better if doctors would treat us mainly according to medical history, clinical examination and how we feel
instead of putting most of their focus on what  tests results look like.

Keep me posted.

Avatar universal
Thanks again. Do you know of a good rheumatologist in the Dallas area?  Or know how to find one?  

The one I went to said all the tests were normal and to come back in 6 months to run tests again and then discharge if remains the same.

Wondering if I should get a second opinion.

1530171 tn?1448133193
If I were you and paying out of pocket is not a huge burden, I would opt for
a reputable Holistic/Functional Medicine or Naturopathic Doctor.

In a way, it is nice that your doctor is not overly concerned at the present time, but the issue with his/her attitude is not being proactive enough,
which is unfortunately considered normal in conventional medicine.

A friend of mine, has developed a gazillion symptoms and conditions in the last couple years- has also severe photosensitivity, so he totally avoids the sun - so when I asked how much vitamin D3 he takes, he said:
"What's that for?"
His doctor, who sees him every month and prescribes various meds for his symptoms, never bothered to have this checked!
norance, not within their treatment protocol, who knows?
The fact remains that this patient has a serious vitamin D deficiency, which went undiagnosed, untreated and resulted in a complete deterioration of his health, which may never return back to normal!. Poof! I'm ranting now.

You'd rather have a Doctor who will help you prevent something potentially serious-which might be subclinical now- instead of waiting for your condition to worsen to reach a level when it MUST be treated!
And of course there are no guarantees in medicine, so what if there's significant sustained damage, beyond the ability of your doctor to treat effectively at that time?

I guess, that's why I have gravitated towards studying Naturopathic Medicine which is not limited by "established" procedures, recommended protocols and internal politics, which usually govern most conventional medicine specialties.

Unfortunately,I don't know any Rheumatologists who are holistic minded in Dallas.
I live in Northern Ontario presently, but I'll do a search for you and let you know , should I find one in Dallas who meets the criteria.

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