High Calcium Normal PTH

[crockju]

Hi everyone, I've never done this before so hopefully I get a response.

I'm 25 yrs old and have been dealing with hypercalcemia for about 3 months now and my family doc is stumped. I initailly went to doc due to a high amount of anxiety and fluctuating blood pressure that would be normal one day and quite high the next (it reacehed 195/90 at one point). Generally down around the High 140's though. The doc did a bunch of blood work, which all came back normal except for the elevated calcium. Labs are as follow:

05 / 28 / 13

Calcium - 10.6 mg/dl ( 2.65 mmol/l)

06 / 03 / 13

PTH - 30 pg / ml ( 30 ng/l)

06 / 10 / 13

Calcium -10.48 mg/dl (2.62 mmol/L)

06 / 13 /13

Calcium - 11 mg/dl (2.75 mmol/l)

07 / 10 / 13

Calcium - 10.7 mg/dl ( 2.67 mmol/l) and PTH 30 pg/ml ( 30 ng/l)

08 / 13 /13

Calcium - 10.44 mg/dl (2.61 mmmol/l) and PTH 31 pg/ml (30 ng/l)

My doc suspected cancer, and had a bone scan, CT scan ( chest and abdomen), chest X-Ray, and Fecal Occult Blood Test done. All came back normal with nothing out of the ordinary.

I've also had a 24 hr. urine test done and had my Vitaman D checked....both of which also came back normal ( I'm unsure of the values here however).

Could this be hyperparathyroidism? I'm a frequent viewer to Dr.Norman's Parathyroid.com, and I've yet to be convinced one way or the other.

Any help / suggestions?

Thanks

[crockju]

Dr. Lupo,

Thanks for answering my question! I have also been having some other symptoms as well. Maybe these will help:

These symptoms are mainly irregualr bowel movements. Very loose one day and hard to get out the next, I often see the occasional thin stool as well, but this is usually followed by what i will call a normal one so I'm not sure if this is common or not? I've had a stool sample to check for blood which came back normal so I assume there isnt much to worry about here?

Also I have been experiencing "brain fog", in which I all of a sudden have trouble concentrating and feel like I have a diminished capacity to think clearly as I normally would. I have also been experienceing a continuous , mild pain / pressure in my head that seems to come on late in the morning and usually subside in the early evening. I can almost set my watch to when this pain will come and go...it's very odd.

Wondering if any of this could be related to the calcium levels? I'm obviously worried about cancer, and wondering if my head symptoms could be associated with some sort of tumor in my head or sinus cavity? I keep reaidng however that the calcium should be higher and the pth lower for this to be the case?

Also, I highly doubt a pheochromactoma would be possible. I have had a CT done of my chest and abdomen which included my adrenals. All normal!

Any further help would be much appreciated!

Thanks!

[Mark Lupo, M.D.]

It is not uncommon for young adults in their 20s to have a slightly high calcium levels.  This history is not conclusive for primary hyperparathyroidism.  If you're levels were consistently above 11, this would be more compelling.  It is something to keep track of however.  The fluctuating blood pressure spikes are something in need to be controlled.  This was not likely related to the calcium levels.  One rare endocrine cause of anxiety and labile hypertension is a pheochromocytoma and this can be screened for by your primary physician. if appropriate.