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Hyperparathyroidism and HypoT

I have positive TPO and TGab.  I take Synthroid 62.5 and Cytomel 5mcg daily.  My latest TSH was 0.02 but my FT4 fell to .84 (.58-1.64) and my FT3 is 3.5 (2.3-4.2).  I still feel SO tired and my moods are awful.  My Endo has already tweaked my Synthroid down due to the low TSH even though I am taking Cytomel (which I THOUGHT?? negated the TSH reading).  My PTH is normal at 27 but my serum calcium has been in the 10-10.2 range and my ionized calcium came back high at 1.35 (1.17-1.32).  My Vitamin D is also low between 20-35.  I do not take any Calcium supplements. I am really suffering from hip and thigh bone/muscle pain and feel old before my time.    Any idea what could be causing this?  Thank you.
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Avatar universal
PLEASE would you let me know where you would want the PTH level to sit with a high calcium level (my post from Apr. 29).

Also I have one small hypoechoic nodule measuring 4x4x6mm.  What is the time frame for rechecking this and what is the meaning of "hypoechoic?  I saw in another post that you suggested FNA for a .7cm nodule and I was told nothing under 1cm is checked???

Thank you!
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Avatar universal
PLEASE would you tell me where you would expect to see PTH when calcium is 10.3 (8.5-10.2).  I know the range is 12-88 but I have "heard" that PTH should be almost non existant.  I am 50. What kind of a ball park range is "non existant"?  

Also have you EVER heard of a parathyroid adenoma at the carotid bifurcation?  

Thank you, in advance, for taking the time to reply.

Sophie
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Avatar universal
Hi Val,  I must say that I really do appreciate your responses!  

I do not want to make the trek to see Dr. N because this MAY not be the problem BUT IF this IS the problem, I need to know that for sure first.  I just could not afford to get there and be turned down (both physically and emotionally).

Yes, I have already paid for quite a few blood tests on my own.  It is what started the whole ball rolling and what clinched the deal for finding and dealing with the HypoT and the Hashimotos. I was seeing a different GP whom I stopped going to because he just kept upping my antidepressant.  It is a shame, a darn shame, because I have great insurance and when I KNOW there is a problem and I keep being put off....then it is me that ends up paying for tests.  When I am right, I still cannot get reimbursement or even an "I'm sorry, we should have checked that".  Instead I am looked at as a hypochondriac.

I have had other issues like this in the past.  Three different times already in my life when I knew there was a problem only to be put off numerous times.  Each time I have had to fight and be persistant and...each time I was correct.  That is a HORRIBLE thing to be proud of!  I guess I just don't know how to address things properly at the doctor's office! I wonder how many men get offered anti depressants!!

I will go to my GP this week.  I really need something to help with the bone pain and the tight muscles!  Ibuprofen is not working for me.  The more I try to stretch and exercise, the worse it is getting!  I am sleeping all afternoon and my family is just not happy!  I am just so tired!  Every time I go to the doctor, I have gained a couple more pounds!

I WAS under the impression that ionized calcium is important.  Apparently numerous things can alter the result?  So they are just testing calcium and PTH.  Since my PTH is 27, they are not at all concerned.  They did say that levels do fluctuate with both PTH and Ca.  So they will wait 2 months and test again.

I am just tired.  Tired of trying to get help and/or figure this out.  Sometimes I feel like just slinking down into a corner and giving up!  Then I get mad.  It's a vicious circle.   I am, unfortunately, at the ready to give up stage again. Thank you for caring and sorry for such a long winded post!  I really do appreciate you writing to me and if anything comes of my appointment, I will let you know. Maybe the doctor will just up the antidepressants once again!  Sophie
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Avatar universal
I always understood that ionized calcium was key.  You know you can get your own tests at www.****.com ?
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Avatar universal
Have you considered just going to see him.  He will do the proper scan and tests.
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Avatar universal
I have already sent a message and he said "we humans do not, in general,  like living with calcium in the 10's. You need PTH checked SEVERAL more times as well as serum calcium and ionized calcium.   GET MORE LABS.  You may not have Hpth but it is NOT a certainty at this time".

He also said ionized calcium is absolutely THE MOST IMPORTANT lab test.  My ionized calcium was high. 1.35 (1.23-1.32) but I had asked the receptionist to add this and the Endo said no more as it is unreliable. At least I managed one!

Sophie
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