What is Low-Normal and Normal PTH?

[Maria80386]

First, thanks much for everyone's time in reading and in advance for any responses!

My questions:
What is the definition of low-normal versus normal on the PTH INTACT blood tests?  My level came up as 17 with a normal range of 10-65. My calcium topped 11 last week, but has been 10 and above with possibly related symptoms and worsening GERD for the last two years.

Also, if one has a parathyroid tumor (benign or otherwise), can the area swell intermittently, thus one would have an intermittent "lump in the throat" feeling?

Finally, how many rounds of tests with high calcium levels are needed before doctors finally get down to business in solving the problem versus "watching it"?

Any ideas would be appreciated.

[Mark Lupo, M.D.]

The calcium of 10-11 (high) with a "normal" PTH is concerning for primary hyperparathyroidism with an inappropriately normal PTH.  Usually these are 20-30 or higher, but have seen cases like this when PTH is 10-20, calcium is high and the answer is primary hyperparathyroidism.  These adenomas do not usually cause a lump or intermittent swelling sensation.

Would recheck PTH and check urine calcium excretion (24hour urine collection).  Would also do neck ultrasound (by a good thyroid/parathyroid doc) to see if there is an adenoma.

[Maria80386]

Thanks for your super-fast response. It is greatly appreciated.