Is it hyperparathyroidism or something else?

[sjnigro]

Hi Dr. Lupo,
My husband recently had fasting blood work done to check Thyroid and glucose levels.  His glucose, A1c, calcium and triglyceride levels all came back high.  HDL Cholesterol low and TSH was normal.
TSH is 1.42
Calcium 10.4 mg/dL
Glucose 120 mg/dL
A1c 6.4% of total HgB
Triglycerides 184 mg/dL
HDL 36 mg/dL
He is currently takes levothyroxine 150 mcg for hypothyroidism (TSH was 16.42 in April 2009), lisinopril and hydrochlorothyazide for high BP, 81mg Aspirin 1 x day, multivitamin, and Advair 2 x day.
His test results in April 2009 were (I'll just post the out of range results) A1c not done at this time. Not sure if he was fasting for this either.
TSH 16.42
Calcium 10.2 mg/dL
Glucose 105 mg/dL
Triglycerides 302 mg/dL
HDL 31 mg/dL
Hemoglobin 18.7 g/dL
Hematocrit 54.7%
MCV 100.7 fL
MCH 34.4 pg
My concern is the doctor wrote to him on the recent lab report that "overall the labs look good.  The blood sugar levels are in good range" (which I question) "Recheck lab in 6 months" "Calcium level is a little high on this lab.  Previous level was normal.  We should recheck the calcium level in 1 month."  I believe he had blood work done about 6 months ago as well, but I don't have those results.
Never having had high calcium levels, I began researching it on the internet for him.
My concern is that I read on parathyroid.com that high calcium levels should be addressed immediately.  A wait and see approach isn't a good thing. I guess I was wondering if his thyroid issues have anything to do with this and should we go ahead and have him see an endocrinologist since his sugar and calcium are high and he is hypothyroid which is currently under control.  Sorry for the long post and thank you for your time!
~Susan

[Mark Lupo, M.D.]

The hypothyroidism is appropriately treated and independent from the calcium
Would test PTH and calcium to evaluate for parathyroid disease.
Hydrochlorothiazide may increase blood calcium slightly, but if that is the only cause the PTH should be in the low-mid normal range.

[katima]

Update - saw endocrinologist and daughter is now being treated for graves. No uptake scan because the doc said that is the definitive diagnostic tool but only needed if rai is being considered and she doesn't do rai in young girls.  Started propanolol and tapezole.  Another episode of blinding headache and dizziness last night but were able to treat with tylenol and ibuprofen. It breaks my heart that she will have to deal with graves for possibly a lifetime.  I know there are many worse things to get and I keep telling myself this is manageable and treatable and we'll al be fine.
2nd child saw endo.  She does not feel there are thyroid issues.  Her feeling is that there is something whonky with the adrenal gland. She has ordered the following tests:
glucose, HbA1C, TSH, Creatinine, sodium, potassium, cloride, VB12, Ferrutub, CBC, thyroid antibodies, am cortisol, ACTH, DHEAS, Free T3 , Free T4, prolactin, and a 24 hour unrine for free cortisol.
She was pretty vague in what she was looking for.  Is the adrenal gland associated with the thyroid gland? Any idea what she might be looking for based on these tests?  I will be so happy when we stop having to navigate the medical world.  We've been lucky to have great people helping us.