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Elevated calcium 10.8, tiny neck mass, neurological symptoms, feeling ill

Hello,

Let me start by saying this is my first post – hopefully I can get some answers along with following up with my medical professionals. I’m a 20-year-old male, college student, and I’ve actually had to take a leave of absence because of how unwell I recently became. I should also say that my issues are various and might be interrelated, but I’m posting in this subsection first because I think my most recent blood report of an elevated calcium (10.8) is a direct symptom. I will also probably post in neurology/migraines.

To first outline all my ailments:

- For several years I’ve complained about pulsations and tightness around the bottom left occipital of the head (where the head meets the neck) – these were sensations that were enough to obtrude in day-to-day life. I have had head trauma, (1) accidentally hit in the head with a baseball bat in youth, (2) fell and hit the back of my head on cement – both were in my youth and I didn’t pass out for either. I had a voluntary CT (non-contrast) after the 2nd incident, which came back negative. This tightness since then was off/on, but since I entered college it became an issue again. Sometime last year they came back and I opened a case with a neurologist, who did blood work which came back OK, all but an elevated calcium of 10.5. We also did an MRI (non-contrast), which also came back negative. She deemed at the time that it must be neurological, and I was going to have nerve-blocking injections, but eventually dropped following up as the issue subsided.

NOW—fast-forward to a week before New Year’s 2016, they came back with a vengeance—the whole left side of my head was numbed. I immediately felt a change in my body-sensation. I started feeling nauseous, unbalanced, difference in cognition, and a change in my vision. Several times I’ve felt faint and nearly fainted, although numerous EKG’s are normal. I also had fluctuations in my pulse (more below). The best way to describe it is that I just felt/feel unwell and generally ill.

The head tightness/pulsation went away when I started to take an OTC herbal called MigRelief. A week or so after New Year’s I made it in to my primary, who ran blood work and referred me to another neurologist. The blood work JUST came in, and serum calcium is elevated at 10.8 and protein at 8.4 – BUT TSH is normal at 2.65. Simultaneously, the neurologist sent me in for MRI (WITH contrast) last week, the results of which have not come in yet. I in fact ended up in the emergency room after the contrast IV was administered – as soon as I stood up I felt ill, like vomiting, my heart rate dropped, and my vision went black/blurry.

- I have severe social anxiety, as of yet undiagnosed and untreated because of other health issues. This is the kind that can send my heart racing in seconds. Can this affect symptoms?
- I’ve seen my optometrist and had an exam – no vision changes and physiological issues w/ my eyes.

- **** RE: Thyroid: Another thing that happened in the course of the past 6 months/year is that I randomly discovered a tiny pea-sized lump in my neck, above my Adam’s apple, followed by a 2nd one next to it. We also went at this vigorously. I saw an ENT who had an ultrasound-guided biopsy done on the mass, which came back negative. He recommended against excision, but said we would monitor it. Haven’t seen the ENT again yet.

Final notes:

- What I’m wondering at this point is what symptom can be related to what. In 10/2013 my calcium was reported at 10.5, and this week at 10.8 – my primary has NOT suggested hyperparathyroidism yet – she wants to wait a month and do another blood test for the calcium. I’m starting to get alarmed of underlying issues.

- MY TSH in 10/2013 was 1.80, and this week at 2.65. I have although noticed hormonal changes in my body (hair, etc). Can this be hyperparathyroidism without abnormal TSH, and most importantly, will those masses in the neck be related to this?

- Can the elevated calcium (I.e, hyperpara) be causing my symptoms of feeling ill and unwell – and can it also be causing my neurological head symptoms? I have to wait on the MRI results next.
1 Responses
1756321 tn?1547098925
Excerpt from Physiopedia - Hypercalcemia...

"Characteristics/Clinical Presentation

Musculoskeletal:

* Muscle pain, tenderness, and weakness
* Muscle spasms
* Bone pain (worse at night and with weight-bearing)
* Pathological fracture

Central Nervous System :

* Drowsiness, lethargy, coma
* Irritability, personality changes
* Confusion
* Headaches
* Depression, memory loss, difficulty concentrating
* Visual disturbances
* Balance/coordination problems
* Changes in deep tendon reflexes (hypo/hyperreflexia)
* Change in muscle tone (in individuals with pre-existing neurological condition)
* Positive Babinski and/or clonus reflex
* Changes in bowel/bladder function

Gastrointenstinal:

* Anorexia (loss of appetite)
* Nausea/vomiting
* Constipation
* Dehydration
* Excessive thirst

Cardiovascular:
* Hypertension
* Arrhythmia
* Cardiac arrest

Associated Co-morbidities:

Hypercalcemia can lead to many other complications such as:[3]

Osteoporosis: if the bones continue to release calcium into the blood, it could lead to this disease.

Kidney stones: this could be caused by too much calcium accumulation in the urine, leading to crystal formation in the kidneys.

Kidney failure: Severe hypercalcemia can lead to damage in the kidneys and possibly cause permanent loss of kidney function.

Nervous system deficits: Severe hypercalcemia can lead to dementia and confusion.

Arrythmias: Hypercalcemia can affect the electrical impulses of cardiac muscle, causing irregular heartbeats.

Primary Hyperparathyroidism: This is often associated with hypercalcemia because it causes an increased release of parathyroid hormone (PTH) which raises serum calcium levels."

***

Excerpt from American Family Physician - Adverse Reactions to Contrast Material: Recognition, Prevention, and Treatment...

"Conditions Associated with Adverse Reactions to Contrast Material:

* Preexisting renal [kidney] insufficiency
* Previous anaphylactoid reaction to contrast material
* Asthma
* Food or medication allergies, or hayfever
* Multiple medical problems or an underlying disease (e.g., cardiac disease, preexisting azotemia)
* Treatment with nephrotoxic agents (e.g., aminoglycosides, nonsteroidal anti-inflammatory agents)
* Advanced age"

***

Excerpt from Hypothyroid Mom - Top 5 Reasons Doctors Fail To Diagnose Hypothyroidism...

"Mary Shomon, author of the book that changed my life Living Well With Hypothyroidism, shared this important list of recommended lab tests.

Thyroid Tests "Normal" But You Don't Feel Well?

If you're undiagnosed, or a thyroid patient taking thyroid hormone replacement medications, being in the "normal" range does not mean you feel well, or that your treatment is optimized. What levels are considered "optimal*" by many integrative physicians?

~ TSH - Typically less than 2.0
~ Free T4 - Top half of the reference range
~ Free T3 - Top half - top 25th percentile of reference range
~ Reverse T3 - Lower end of normal range
~ Thyroid Peroxidase Antibodies (TPO) - Within reference range
~ Vitamin D - Above 50
~ Ferritin - Above 60 (Above 80 if experiencing hair loss)

* we are all different, one size doesn't fit all, so these are guidelines. Your optimal levels may vary."

Optimal vitamin D range: 40 - 60 ng/mL (100 - 150 nmol/L).  
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