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Avatar universal

Frustrated!

I have had abnormal high calcium levels, mildly high glucose, low tsh, and high liver enzymes. I have many symptoms of a hyperparathyroid so I had an appointment with a endocrine surgeon. He found two nodules on my thyroid one of them near 4 cm and the second one 1.5 cm . He did a biopsy and blood tests. I got the blood test results today and my ionized calcium is elevated slightly, vitamin D is low and the,t3,t4, tsh,pth, and serum calcium are all normal. When I asked if this indicated hyperparathyroid the nurse said usually but not in this case because of the normal PTH. When I asked what it did mean she said we won't know until we have the results of the biopsy. I understand but I have also read that you can have normal PTH with abnormal calcium and vitamin D. I know I need to wait but I don't understand the thought that there isn't a problem with the parathyroid as I have so many symptoms. Feeling lousy and frustrated!
2 Responses
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97953 tn?1440865392
MEDICAL PROFESSIONAL
NO - this is an inappropriately normal PTH in the face of high calcium -- virtually diagnostic of primary hyperpara especially with the low D.
Helpful - 1
Avatar universal
Thanks Dr. Lupo for answering Since I posted this I now have further information.  My original blood work calcium levels were at a 10.5 twice and my tsh was .142 and the T4 Free was .62 and PTH 21 Other labs that were off were Glucose was 119 (fasting) and ALT was 66 and A1c was 6.2

The most recent blood work revealed
ionized calcium at 1.29
calcium 9.7
Vitamin D 28
T 4 Free .78
T 3 1.20
TSH .519
PTH 35

The Biopsy of the two thyroid growths were labeled The smears show scattered bland follicular epithelial cells with
focal oxyphilic (Hurthle cell) changes arranged in sheets.  and the second one The smears show scattered bland follicular epithelial cells arranged
in sheets and spherules. No nuclear features of papillary carcinoma
are noted. Some colloid is present. The findings are consistent
with a benign thyroid nodule.

The surgeon put me on a Vitamin D supplement of 1,000 mg a day and told me to come back in two weeks to retest blood labs and discuss possible removal of the growths as they are pushing on my vocal chords.  I am a bit concerned about the Vitamin D supplement with the increased Calcium level, but went ahead since the increase is mild.  

Just wondering what you think give these numbers??  Thanks!!
Helpful - 0

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