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High Calcium normal HPT

Dr. Lupo,

This is going to be long, and a apologize for that.  I do appreciate that you are willing to read and answer these questions.

I am a 52 year old active woman.  I suffered a very painful insufficiency fracture of my sacrum this winter.  I have since learned that I have osteoporosis of my pelvic region and osteopenia of my lumbar spine.  My calcium ranges around 10.9, HPT around 30, Vitamin D around 39.  I have seen several doctors who have ranged in opinion from I am fine, do not worry about the calcium to doctors who tell me I have bone cancer, but cannot locate the cancer.  None of the blood work supports cancer, multiple myeloma and kidney and liver are all completely normal.  

On April 17th,  I was given an infusion of pamidronate to control bone pain and hypercalcemia.  Two weeks after the infusion my calcium was 9.7 and 6 weeks after the infusion my calcium was 10.3.  I am being treated by a endocrinologist at a prestigious Chicago University and she tells me that I cannot have hyperparathyroidism because my HPT is too low and my vitamin D is too high.  According to parathyroid.com, I could have hyperparathyroidism, but my vitamin D is too high.  (It should be noted that I take 500 mg of calcium and 200IU of vitamin D 3x per day.)

I started taking the calcium and vitamin D supplements in April of 08, but my calcium has been in the 10.3-10.9 range since January of 2005.  The first vitamin D blood was not taken until after I had been on the supplements.  I also take a thiazide diuretic, but didn’t start that until April of 2008 so docs do not think that is causing the elevated calcium.

I am ever so curious as to what your opinion is as to my current situation.

1 Responses
97953 tn?1440865392
Looks like primary hyperparathyroidism with inappropriately normal PTH.  Vit D levels vary, but usually are a bit lower.  With Ca levels of 10.9 PTH should be lower if the parathyroids were completely normal -- my best guess is primary hyperpara, particularly in the absence of other identifiable cause.
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