Low PTH

[maria19609]

I've posted to you once before and here I am again! Four years post thyroidectomy (low stage follicular/papillary carcinoma) I've had multiple symptoms arise since the thyroid came out.
After several blood test and a doctor they found out that my PTH is slightly low at 11 however my ionized calcium is at 9.5.
Can I be hypo or hyper? Numbness, tingling, muscle weakness, spasms/twitching in the back (rib cage area) thiegh & calve areas. fatigue etc.. Vitamin D Deficient and suppose to be taking 1000 IU spring & summer and 2000 IU Fall & winter.
My New Doctor is sending me to an Endo. Would you know possibly what the treatment could be and maybe what other types of tests they may want to perform?

[maria19609]

A few more questions:
Before those blood test, the TSH was 0.25, a few months before that it was .02 with T4 at 1.41. I know theres a lot of factors that affect the levels but 4 yrs. in one would think that the hormone levels would be somewhat level. Everytime my blood is checked they're either raising my levels or lowering them. My magnesium was 2.0 around this time last year. (Normal)
Is it also possible to have Graves disease after thyroidectomy? My new doc. is wondering if this is one of the problems. My left eye is protruding out only about 3mm.
If I'm somewhat hyperthyroid why am I not having the palpatations or losing weight?
Just wondering??

[Mark Lupo, M.D.]

0.06 and 0.03 TSH levels are very similar, ie not "jumping" - both suggest high dose of levothyroxine and if you are low risk in terms of cancer, the dose may need to be decreased a bit.

PTH 11 and Ca 9.5 are normal -- would retest Ca and ionized Ca as well as Magesium to be certain.  Getting vitamin D back to normal will be helpful -- 25-OH-D levels ideally should be >40.

Otherwise the symptoms may not be thyroid/parathyroid related.

[maria19609]

I forgot to mention that last month my TSH was 0.06 and now 0.03 as well. My TSH keeps jumping around. I also just found out that I have a history of thyroid eye disease. Would the thyroid eye disease have anything to do with the tsh and pth?
Thank you !