Nervous about high calcium

[manders626]

For starters, I'm a 30 year old female.  I go to my PCP every six months for my thyroid check up (I have Hashimoto's disease).  She always runs extra lab work (Metabolic Panel, CBC, etc.) in addition.  Everything looked good except my TSH was a little high, so we upped my Levothyroxine.  The other questionable thing was a high calcium level of 10.5 (normal range is 8.6 - 10.2).  I went in for another draw along with my PTH.  This calcium reading was 10.4 and my PTH was 50 on a scale of 10 - 65.  She referred me to an endocrinologist.  I had my appointment with him, and he is having me tested for all sorts of scary diseases (Multiple Myeloma being on of them) with SPEP, UPEP, PTHRP, ect.  This has set me off anxiety wise.   Here are my other labs for reference:

Metabolic Panel:
Creatinine: 0.79 (.50 - 1.10)
Calcium: 10.5 (8.6 - 10.2)
Total Protein: 7.8 (6.1 - 8.1)
Albumin: 5.1 (3.6 - 5.1) *I noticed this is borderline high
Total Bilirubin: 0.2 (0.2 - 1.2)
Alkaline Phosphate: 79 (33 - 115)
AST: 18 (10-30)
ALT: 18 (6-40)
Sodium: 141 (135 - 146)
Potassium: 4.8 (3.5 - 5.3)
Chloride: 104 (98 - 110)
CO2: 25 (19-30)

CBC:
WBC: 6.7
RBC: 5.05 (3.8 - 5.10)
Hemoglobin: 13.1 (11.7 - 15.5)
Hematocrit: 41.4 (35.0 - 45.0)
Platelet: 330 (140 - 400)
Neutrophils: 65.7
Lymphocytes: 26.0
Monocytes: 5.2
Eosinophils: 2.9
Basophils: 0.2

I guess I'm looking for some reassurance that this could be something other than cancer with a negative ultrasound scan.  I had an ultrasound done last week which they didn't see anything obvious on.  Apparently they can't tell the difference between a lymph node and parathyroid tumor because of the Hashimoto's, so the Dr. at the imaging facility is suggesting a CAT scan or biopsy to see what they can find.  I don't have my appointment with my endocrinologist until June, and this is really stressful for me.  I want to note that I had this happen once before in 2008, but I think my calcium was retested and normal at 9.9.  I haven't heard of any problems since until now.  Thanks for your time!

[manders626]

Just wanted to update.  Lab testing included 11 tubes of blood, a 24 hour urine collection along with another urine collection.  I had my follow up today, and everything came back normal with the exception of a slightly low Vitamin D level (29).  My calcium is still on the higher end of normal (10.2 with a 41 PTH), but my ionized calcium level is normal and urine level is normal.  I'm thinking it may be the start of a parathyroid problem, but who knows since it has been off and on since 2008.  As of right now my doctor isn't too concerned, and I feel fine.    

[leilajax]

Your PTH seems high (even though it's in range) for high blood calcium.  This is how it was explained to me:  the parathyroid regulates blood calcium levels.  If your blood calcium is high, then the parathyroid (PTH) should compensate by going down and be in the low normal range.  If it's not compensating and high (even high normal) then it should be further investigated with a sestamibi scan.  
My blood calcium is always in the 10.2-10.8 range, not scary high, but I am on a low calcium diet, so it is abnormal.  And my PTH was only 38 the last it was checked and my doctor still wanted to investigate.  Again, I have to wait for the RAI uptake scan, so no positive diagnosis, but they definitely found something.  The waiting is the worst!
Hang in there!  If you feel that symptoms of parathyroid (you didn't mention if you had any) such as irregular heartbeat and tachycardia are too concerning see if your doc would be willing to order a sestamibi scan, that way at least it is done and available for your endo when you see him/her in June.  Or call and see if your endo can get you in on an urgent basis.

[manders626]

Thanks for the response!  I did have the PTH test done, and it was 50 (on a scale of 10-65).  So in the normal range.  The other thing I read about, but my doctor didn't even mention, was albumin relates to calcium.  With mine being almost high I'm wondering if there is a relation.  With high albumin you are suppose to correct the calcium serum.

I was just going in for my semi-annual check up, no symptoms or concerns.  Now that I know, I'm analyzing every little pain and twitch wondering if it's from whatever is going on with me.  *sigh* I do think its odd that this problem has come up twice now within the last 5 years though.  I've read the parathyroid site, and how your calcium can fluctuate.

[leilajax]

I have persistent high blood calcium.  My PTH is normal, but higher than what it should be with high blood calcium.  I have had CT scans and all looks great.  It wasn't until my parathyroid scan (sestamibi scan) that "something" was found.  They believe that I have a parathyroid tumor the size of a grain of rice, but they need to do a RAI uptake scan and superimpose the images to figure out precisely.  The test has been pushed back twice since my CT scan was with contrast and could throw off the RAI scan.  I, too, have Hasimoto's.  so far I've been told that high blood calcium could just be due to Hashimoto's or parathyroid tumor.  I am unsure as to why your doctor is investigating other "scary diseases".  Are you presenting other symptoms?  The problem with Hashimoto's is that there is a laundry list of symptoms that can be confused for other things.

You are very lucky to have doctors working diligently to investigate.  I don't have a medically trained eye, but your WBC looks great, so cancer would drop from the top of my worry list.  Have your PTH tested, your regular doc can order the blood test.  If it is in between normal and high normal, your parathyroid is the likely culprit.  Another thing to calm your fears is to know that parathyroid tumors are almost ALWAYS benign!  If your high calcium is causing symptoms such as irregular heartbeat and tachycardia, muscle cramps, and intense anxiety ask your doctor if you can start or step up your vitamin D and magnesium supplements.
I am in your boat, so I'd love it if we could keep in touch!

[courtney48]

Any chance you can be placed on a last minute call list in case the endo has a cancellation?  June seems like a long time, but I would think if your results were especially alarming and needing immediate attention that your doctor would make certain to get you in sooner.  Also, in addition to waiting for more replies here, there are a couple of other med help thyroid groups, one for thyroid cancer and another for thyroid cancer/hyperthyroidism.  Maybe someone in one of those groups has experienced similar labs.  Good luck.