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Desperate for help - "normal" PTH

Dear Dr. Lupo,

I really need your help. I was tested for calcium and PTH. My calcium came back 10.6 and my PTH came back as 21. My doctor says he's "not concerned." However, I am. My mother has been researching a lot and it seems many people have a "normal" PTH reading but still have parathyroid disorder. I have every symptom and I'm tired of feeling sore and achy, depressed, tired and run down, having trouble getting up the stairs, lack of energy to do daily routines (i.e. shower, shave, laundry) and a boat load of other symptoms. There really isn't any symptom of parathyroid that I DON'T have. I'm tired of feeling like crap and I'm needing your expert opinion. Is it possible (or likely) that I have parathyroidism with a PTH level of 21 and a calcium level of 21? Also, my protein was slightly elevated and my albumin was slightly elevated. My calcium was checked over a year ago and was high as well but nothing was ever done about it. I have felt like crap for a long time and I know not many doctors are aware of this disorder or how to treat/diagnose it. Any help or feedback you could provide would be greatly appreciated. I feel helpless because my doctor sticks with his theory of "everything is fine" but I don't feel it is. One more thing. He's re-testing me upon my request. My mother read it is best to be tested in the morning so I'm getting up early to be there around 8 or 9. I'm also fasting just to be sure I have an accurate reading. There is some discrepancy on what time of day to test, and whether or not to fast so I'm going to fast just to be safe. I wonder if this will change the reading, dramatically or at all. My main question though is - is it likely I have parathyroid disorder with those levels in my blood. Thank you so much for your time.

11 Responses
97953 tn?1440868992
This needs retesting of both Calcium and PTH.
With the high-ish albumin, we sometimes also ionized calcium (although this is not always accurate).
Fasting may help if phosphorous is being tested (which may help make the diagnosis).
My feeling is that with a Ca of 10.6 the PTH should be < 20 in most cases - so this is suspicous for primary hyperparathyroidism but needs more evaluation before considering treatment (surgery).
Avatar universal
I'm sorry. I made a typo. I meant calcium level of 10.6 and a PTH level of 21. I know I said 21 for both things. That's NOT correct.
Avatar universal
Thank you for your response Dr. Lupo. I was retested this morning around 9:30 AM and I did fast. I didn't eat for 25 hours total because of my schedule. Unfortunately my Phosphorous was not tested. The only test on the lab slip was "parathyroid hormone" and a DX of Hypercalcemia. I should have contacted you sooner I guess. Thank you very much for your valuable feedback. I will print this and show this to my new doctor when I move in 3 weeks and get set up with someone in my new state. Thank you so much.

Avatar universal
Hi Dr. Lupo,

I wrote to you before telling you my calcium level was 10.6 and my PTH was 21. I also told you my albumin was high and you suggested getting my phosphorous tested and to be retested for my calcium and PTH. I was retested and my level was 21 again for the PTH. I was recently in the ER and had blood work done for a third time. My calcium this most recent time was 9.4 and my ALK PHOSPHOROUS was tested but I'm not sure if thats what you were looking for. If it is, that level read at 54. Not sure if the ALK is what you wanted tested. Also on the print out of my results, my SGOT was low at 5. It says "L" beside it which I'm assuming means "low?" Also, my glucose was 105 and it has an "H" beside it which again, I assume means "high." I WASN'T fasting. Does it sound like I have hyperparathyroidism? If so, can you recommend any good endocrinologists in my area? I live in Peoria, Illinois.

Thank you so much for your time. I truly appreciate it.

Avatar universal
My blood calcium levels were always in the mid to upper 10's, with high ionized calcium, and a PTH level anywhere from 17 to 49.  Never any higher.  All my other tests were always fine.  Finally a MRI showed one adenoma on the right parathyroid, and they found the second one durning surgery. My surgeon was suprised that I had such normal PTH levels.  I should say, that the average PTH level was around 35 most of the time.  I also had testing done to rule out the other causes of high blood calcium, and saw a great endocrinologist in Indiana.  Hope this helps.
Avatar universal
Thank you for your response. What kind of symptoms did you have if you don't mind me asking? Whatever the symptoms, do you feel better after surgery? I'd really like to know what you dealt with as far as symptoms/problems from the parathyroid issue. I have too many to name but I'd like to see if there are any similarities to our symptoms. Thanks for your response and I look forward to hearing from you soon hopefully.
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