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abnormal labs: elevated serum calcium, elevated 24 hour urine calcium levels

I am age 50, and have a 12 year history of Borderline high serum calcium levels usually around 10-10.2(range 8.6-10.3), and on a few occasions several years ago a 10.3.  My pcp has never commented it as abnormal.  However, on my most recent labs, the calcium level came in at 10.4, and she finally commented.  A repeat labs done 13 days later revealed a calcium level of 11.1 with a pth intact of 18(range 16-77), and then a referal to endo.  Endo ordered a large amount of tests with s suspicion of non parathyroid related hypercalcemia.  His test results done 10 days later are:  serum calcium down to 10.2(8.6-10.3), ionized ca= 5.4(4.8-5.6), 24hr urine high at 469(55-300), intact pth 19(16-77),serum creatine 1.36 (0.7-1.36) w egfr  63(,60 abnormal), cystatin c 0.92(0.52-1.23) w egfr=90(<60 is abnormal), Vit D, 25-oh  38(30-100), calcitrol says vitd1,25(oh)2  68 (18-72), VitD3 1,25(OH)2 68, and VitD2 1,25(0H)2 ,< 8.  serum phosphorus 3.5(2.5-4.5), normal cbc, urine immunofixation is nml, blood immunofixaiton is nml, blood epg is normal, random urine protein electrophoresis nml,  kappa/lambja ligght chain nml, no M spikes, sreum proten is 6.8(6.1-8.1), albumin(4.6(3.6-5.1), globulin 2.2(1.9-3.7).  I dont have the parathyroid like protein test, but I am very concerned I have cancer for that was on top of differential.   Any help would be apprecaited
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Avatar universal
I’ve had elevated calcium since January and my PTH is in the normal range although higher than yours. I’ve also been worried about cancer. The parathyroid specialist I’m seeing ran some cancer tests but not nearly as thorough as your tests.  I had a 4D CT scan of the parathyroid and it did show an adenoma. I think you should see a parathyroid specialist if you can. You can still have hyperparathyroidism with a normal PTH.
Helpful - 1
Thank you for the comment, and your personal journey.  I did just get back the parathyroid like protein test after 2 weeks which was normal.  It is hard to wait for all the results when a doctor's initial suspicion is cancer.  And my primary care Dr just keeps telling me" see the endocrinogist.  I wish it was that easy.  
I totally understand. My primary doc said I had hyperparathyroidism but didn’t recommend surgery and didn’t refer me to an endo. Since my insurance requires referrals I went to a parathyroid specialist on my own but he doesn’t take insurance so I’ve been paying out of pocket. I know not everyone can do that. My urine calcium was also high by the way. I still worry about cancer so it’s good your doc did run those tests. Since they were all negative I think hyperparathyroidism is definitely a possibility. It’s hard when the docs pass you around
649848 tn?1534633700
Parathyroid glands control the amount of calcium in the blood.  Even though your doctor has said it doesn't seem to be parathyroid related, your test results indicate you could have a parathyroid adenoma.  Although this isn't cancer, the parathyroid(s)  containing the adenoma(s) (if there is one) would have to be removed, since this won't resolve on its own.

Although your Vitamin D at 38 (30-100) is within the normal range, it's still on the low side.  It's typically recommended to have Vitamin D levels around 50-60; however, I wouldn't recommend adding Vitamin D to your supplement regimen as it isn't necessarily the proper thing with high calcium levels.  

Here's a link to a website that will give tons of info on parathyroids (most of us have 4 of them).   https://www.parathyroid.com/

Although the only connection the parathyroids have to the thyroid gland is their location in the body (parathyroids are located just behind the 4 corners of the butterfly shaped thyroid gland), it would be a good idea to ask for thyroid testing, as well.  A complete panel, including TSH, Free T4 and Free T3 are needed to determine a thyroid condition.  
Helpful - 0
134578 tn?1693250592
Several things can cause hypercalcemia, as it sounds like you know. All you can do is keep testing. Why did the second doctor identify it as non-parathyroid related if you didn't have the test?
Helpful - 0
because my pth level was low with high blood calcium levels, high urine calcium levels and normal vit d levels
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