TPO & Calcium elevated -- is it related somehow?

[nenjbn]

Hi Dr. Lupo,
I have mildly elevated serum calcium (5 high readings over the past four months).  Since November I've been even more fatigued than normal, have increased arrhythmias, aching neck (left side of throat - developed over past two months), etc., etc.  I also have a history of kidney stones -- quite a few.  After reading the parathyroid.com site, I urged my doc to test my PTH.  He said it was mid-range normal and the ionized calcium was in the normal range, so he does not think that's the issue.  He called yesterday and gave results of thyroid tests.  TSH, T3 & T4 fell in normal range and the TPO was elevated.  Wait and recheck in six months is his approach.

Can this all be parathyroid related?  Could it be the thyroid alone, even though I have normal numbers?  Is it possible/common to have thyroid and parathyroid problems at the same time?  My dad and one sister have had thyroid problems.  My father had his thyroid "killed" with iodine (not certain if that means an autoimmune problem) and my sister is dealing with Graves disease.  Are there any other test to consider at this point?

I am a 36-year-old woman in otherwise good health.  I feel like I am in some diagnostic gray area right now.  I appreciate any insight or direction you can give.

Thank you.

[Mark Lupo, M.D.]

You have primary hyperparathyroidism with inappropriately normal PTH levels.  You need parathyroid surgery - check out parathyroid.com -- this will clear-up any questions.

This is a separate problem from autoimmune thyroid disease (Hashimoto's) -- positive TPO -- with currently normal thyroid function but increased future risk of developing hypothyroidism.  That's assuming TSH 3 w/TPO & fatgue -- it may be time for a trial of thyroid hormone.

[mosesgt]

Great answer! I like it when something is definitively answered. I do not understand how Dr Lupo derived this, but he certainly is clear on what the problem is. How did you do that Dr Lupo?