Kidney Stones, Elevated Serum Calcium . . . parathyroid?

[janeeth]

I am a 34-year-old female with a 15 year history of calcium oxalate kidney stones.  I have passed at least 15, and according to a recent CT scan, I have at least 7 more (several in each kidney).  For several years I have been fatigued and have had sleep issues, which I attributed to having children who didn't sleep through the night.  I realized that sleep was an issue when they began sleeping through and I could not make it more than 4-5 hours.  Also have experienced increased heart palpitations over past 6 months which have led to anxiety.  I am taking Lexapro for the anxiety.  (Palps were evaluated and determined to be PVCs.)

I recently went through tests due to the presence of kidney stones.  Blood tests revealed mild elevation in serum calcium (10.3 with 10.2 being the upper limit).  All other urine and blood tests were within normal range.  I met with my urologist yesterday, who says calcium level is not THAT high, so we should just wait and check in 6 months.  I'm not certain how to proceed, because I don't feel well and haven't for quite a while.  But I don't want to waste my time or another physician's if the "wait and see" approach is the best one available.

I am very fatigued and have frequent headaches.  I am a runner and noticed last May that I wasn't able to run as far or as fast.  I really want to feel good again!  Am I wasting energy worrying about nothing, or would you suggest further evaluation given the elevated calcium and presence of kidney stones?  

Thanks so much for your opinion.

[vic_m]

dietary changes can help in most people:

limit sodium
limit vit c
limit oxalate

increase fluid intake
increase calcium intake (contrary to intuition)

[Enoch Choi, MD]

those collections are to see how the kidneys are functioning, which i suppose are normal in her case

[LukeL]

Have you had a 24 hour urine collection. I suffered from kidney stones and had a couple of those done, it is not fun (espeically because you can eat no dairy for 72 hours) but it can help. Also if your stones are calcium in composition you may want to ask your doctor about a low dose water pill, it seemed to help me a lot

[Enoch Choi, MD]

Your calcium level is below what's average for asymptomatic hyperparathyroidism, 11.1

That is to say, for people without symptoms related to hyperparathyroidism have an average calcium higher than yours.

It's not high enough to say that you have hyperparathyroidism even though you have stones, which can be related to hyperparathyroidism.

Often, with minimal elevations, "wait and see" is the most prudent since it most often comes back normal when rechecked