Parathyroid pth and calcium problem

[jayhealth]

Hello I have added my details below, can tell me if this is primary hyperparathyroid

Age - 23, male
Computer programmer - 8-10 hrs/day, don't go out in the sun

Past history
Following a low carb vegan diet 2-3 years (no dairy sources in the diet)
irritable bowel syndrome
Seizure around age 9-10

Symptoms
obvious - muscle weakness, osteopenia
subtle/occasional - memory problems, general weakness, anxiety, problems passing urine(no urine problems currently)

1st blood test (from Lab company A)

Calcium 11 mg/dl (8 - 10.5)  
Potassium  5 nmol/L  (3.5-5.5)
Serum iron 101.0 ugm/dl (59-158)
Total iron binding capacity 303 ugm/dl         (274-385)
Vitamin D 25 Hydroxy    3.42 ng/ml  (> 30 ng/ml)
Alkaline Phosphatase   353 U/L   (108-306)

Next day (From lab company A)
Calcium ionized 4.8 mgm/dl  (4.0 - 4.8 mgm/dl)
serum magnesium 1.8 (1.70 - 2.70)

I think after 1st blood test I took 2 small vitamin D supplements
which had 200 IU units in each and calcium citrate of 1000 mg.
I took it even before I got the lab results.

I had an 4-5 month old liver function test report which had
Alkaline phosphate 136 units/l (39-117)

2nd Blood test the very next day (From lab company A which outsourced my blood to company B)

PTH, intact   150 (10-65)  pg/ml
Calcium  12 (8.5 - 10.3)  mg/dl

Endo doctor said Lab A and B might be wrong, so let's check it again after 1 week.

3rd Blood test (From lab company C) after 1 week

Calcium, Serum  10.02 mg/DL  (8.10 - 10.40)
Calcium, ionized  1.26 nmol/L (1.16 - 1.32)
PTH, intact     103.80 pg/DL (15.00 - 68.00)

After this test I think I ate some dairy products like milk, eggs etc

4th Blood test (From Lab company C) after 2 weeks

PTh     61.20  pg/ml   (15-68)
Calcium, Serum      10.48   mg/DL (8.10 - 10.40)
Calcium, ionized    1.28   nmol/  (1.16 - 1.32)
Alkaline Phosphate   119.00 U/L  (30 - 120)
Phosphorus           5.00 mg/DL  (2.70 - 4.50)

Sodium 140 meg/L (137-150)
Potassium, serum 4.30 meq/l(3.50-5.30)
Chloride, serum 103 meq/l  (99 - 111)

5th blood test today  (From Lab company C)

Vitamin D, 25 hydroxy   28.80 nmol/L  (> 75 nmol/L)
converts to 11.53 ng/ml (>30 ng/ml)

Phosphorus, serum   4.66 mg/DL (2.70 - 4.50)
Potassium, serum   4.30 meq/l   (3.50- 5.30)
Magnesium serum   2.00 mg/dl  (1.80 - 2.60)

Other tests:

Calcium, 24 hours urine 85.50 (100-300) mg/24 hrs
total volume   4500   (800-1800)  ml/day

Sestamibi scan  = negative

Complete Haemogram

Haemoglobin   13.5   gm%   (13 - 17)
Total leucocyte count  5800  /cumm (4000- 11000)

Different Leucocyte count

POlymorphs  63 %  (40 -80)
LYMPHOCYTES   31 %  (20-40)
EOSINOPHILS     05 %  (1-6)
MONOCYTES   01  %  (2-16)
BASOPHILS      00  %  (1-2)
RBC   4.19  million/cumm   (4.50 -5.50)
platelet count   193000 /cumm  (150000 - 450000)
pcv     39.1 % (40-50)
mcv     93.4 femto litres  (83-101)
mch    32.2 pico grams   (27-32)
MCHC    34.5  G/DL (31.5 - 34.5)
ESR (We stergren)     05   mm/1 hr (5-30)

Peripheral Smear

RBC series        RBCs are normocytic normochromic
WBC series    TLC, DLC Within normals limits NO immature cells seen
PLatelets               Platelets are adequate
Haemoparasites                  No haemoparasites seen
Opinion                  Peripheral blood picture is unremarkable

Liver function test:

Total protein 7.34 g/dl (ref range 6.0 - 8.4)
albumin 4.67 g/dl (ref range 3.5 - 5.5)
globulin 2.67 (1.20 -1.60)
a/g ratio 1.75 (ref range 1.20-1.60)
total bilirubun   0.53  mg/dl  (0.10 - 1.20)
conjugated bilirubin  0.27  mg/dl (0 - 0.70)
unconjugated bilirubin  0.27  mg/dl (0 - 0.70)
sgot (ast)   17 u/L   (5-34)
alk phosphatas  119 U/L   (53-128)
gamma gt  18    u/L  (12-64)

Lipid profile

Cholestrol     136  mg/dl  (ref range 140 -220)
TRIGLYCERILE   70 MG/DL  (20 -150)
HDL - CHOLESTROL   39  mg/dl  (30 - 65)
LDL CHOLESTROL  85   mg/dl  (0-130)

(calculated parameter)

VLDL CHOLESTEROL   14  mg/dl  (ref range 5 -40)
LDL / HDL RATIO   2.18              (0 - 3.55)
CHOL/ HDL RATIO  3.49            (0 - 4.97)

Biochemistry

Blood sugar fasting   91  mg/dl  (ref range 70 -110)
urine sugar fasting    N.R

Blood sugar PP   95 mg/dl (ref range 80 -140)
urine sugar PP   N.R

Blood urea   17 mg/dl   (17 -55)
serum creatinine   0.65   mg/dl  (0.30  -1.30)
uric acid     4.73 mg/dl   (3.50 - 7.20)

[Red_Star]

Vitamin D uses magnesium to convert to active vitamin D. If you are not eating enough magnesium in the diet, you may develop "side effects" of vitamin D supplementation that are actually symptoms of magnesium deficiency.  There are many possible magnesium deficiency symptoms but they include constipation, headache, heart rhythm problems, anxiety, panic attacks, acid reflux/heartburn.

[jayhealth]

New reports

calcium, serum    10.54   mg/dl   (8.10 - 10.40)
phosphorus    4..93  mg/dl  (2.70 - 4.50)
magnesium   1.70 mg/dl  (1.80 - 2.60)

[jayhealth]

I think after eating oats, my magnesium levels go down. Oats have phytic acid.

"Studies suggest that we absorb approximately 20 percent more zinc and 60 percent more magnesium from our food when phytic acid is absent. This is bad news because phytic acid strongly inhibits mineral absorption in adults – especially iron and zinc." [1]

I don't know why calcium again is high. I've only been eating mostly eggs but no dairy or butter. I occasionally eat butter. But I try to avoid dairy because I get acne. I eat vegetables. I think I'm going to switch to Tahini sauce for calcium.

[1] http://chriskresser.com/another-reason-you-shouldnt-go-nuts-on-nuts

[jayhealth]

Tahini paste is high in calcium but its high in oxalic acid which inhibits calcium absorption. [1]

Where do you get calcium in vegan diet ? Is there something which can be just used like in teaspoon format, I hate cooking. Getting calcium using cooking in not sustainable in my home. I would rather pay for some food which is high in calcium, low in sugar.

[1] www.ohf.org/docs/Oxalate2008.pdf

[jayhealth]

31/oct/12

calcium = 10.6  (8.10 - 10.40)
pth = 36.20 pg/ml  (15 - 68)
vitamin d 25 hydroxy = 32.80 nmol/l   (75-250)

[matee89]

I know that this is quite old thread, but I´m intressted if you did solve your health issues? I have been diagnosed with hyperparathyroidism, but still unknown if it's primary or secondary. My serum calcium are always in the upper normal range or slightly elevated (up to 10.7 mg/dl), ionized calcium is always in the upper end or slightly elevated as well. My PTH, intact levels bounce around 40-112 pg/ml. D 25 hydroxy are always low (< 25 nmol/l) and vit D supplements makes me very anxious. My symptoms are exacly like yours (anxiety/racing heart, abdominal discomfort, bowel problems, fatigue). Did you get a correct diagnosis? I am going to meet an endocrinologist in two weeks. I´m in my mid 20´s