Hyperparathryoidism

[1280]

Hi Dr. Lupo,
This is a very similar question to one I posted before but I have yet another blood tests. Here is a summary of all of my tests:
Dr. Lupo, I posted a similar question earlier but have received another lab test result and wanted some advice.

I have had the following lab results:

January 4th: Ionic Calcium of 1.38 mmol/L (normal upper range to 1.35 mmol/l)

February 5th:
Serum calcium of 2.57 mmol/L (normal up to 2.55 mmol/L)
PTH = 3.3 pmol/L (normal range up to 6.4)
Phosphorous = 1.20 mmol/l (range=0.8-1.4)
Chloride = 107 mmol/l (range=98-106)

March 5th:
Serum Calcium: 2.54 mmol/L (normal up to 2.55)
Ionized calcium:1.43 mmol/l (normal upt to 1.35)
PTH: 2.4 pmol/L (normal up to 6.4)

March 11th:
Serum calcium 2.49 mmol/L
Ionized calcium 1.37 mmol/L
PTH 3.6 pmol/L

March 19th:
Serum calcium 2.62 mmol/l
Ionized calcium 1.47 mmol/l
PTH: 5.9 pmol/l
Is this hyperparathyroidism? I seem to have varying symptoms from day to day and feel like I'm losing my mind(anxiety, fatigue, aching bones, nausea, and tiredness).  I have also had a Sestamibi scan that was negative and a normal result for urine calcium.  I had an ultrasound of my neck which revealed a hyperplastic nodule as well.
Thanks

[Mark Lupo, M.D.]

sounds like a parathyroid problem - phosphate does not have to be low.  Would test PTH levels.

[Lori707]

My calcium serum levels have been consistantly high for about 4 yrs. They have been between 10.6-11.6  A couple times it was 10.2   My Alkline Phosphate is normal and the doctors state that my parathyroids therefore are normal and there would be no tumor. My vitamin D is okay.  Last month I had two doctor appointments within 3 hrs.apart. Both had drawn blood and sent it out to the same lab. One result came out with a calcium level of 10.6 and the other result came out 11.6  How is this possible? Eventhough my phosphate is okay, could it be possible that I still may have a parathyroid problem or a tumor on it? I read on the web from www.parathyroid.com that any level in the 10's and especially with my symtoms, is a tumor. They were really sure of themselves. So now I don't know what to think.
Could really use your help and guidence.
Thank you.

[Mark Lupo, M.D.]

The most recent set of labs is consistent with primary hyperparathyroidism.  The sestamibi scans are negative in about 1/3 of cases - this does not mean you don't have hyperparathyroidism.