Possible hyperparathyroidism? Lab results.

[sle07]

Hello everyone! I was going to write out a long detailed post but in the interest of not having a long read, I just decided to list my symptoms and a portion of my lab results to see if anyone can point me in the right direction. For reference I'm a 27 year old male 5' 11" and around 180lbs. The last few months have been the absolute worst for me and it's been very hard to determine what's health related, diet related or stress related (I've been under tremendous stress lately.) One of the more concerning things related to labs is the frequent finding of elevated calcium and high blood pressure. I've suspected hyperparathyroidism for awhile now and I've been trying to incorporate a more "Peat" way of eating for the last 2 years or so but context is everything so instead of just applying everything I read, hopefully, someone more knowledgeable could point me in the right direction and help me minimize damage until I'm able to follow up with my PCP and whomever I'm referred to for whatever it is I may or may not have. :?


Symptoms:

High Blood Pressure (varies all over the place, it's been elevated more often than not though)
High Calcium (most recent test was 10.5, the lowest I've seen in 3 tests, 11, 10.6, then 10.5)
Felling like I'm going to pass out
Hair loss
Digestive issues (lots of gurgling, usually after milk consumption)
Cold hands and feet (temps are low 96.6 when waking, maybe 97.2-97.7 after eating)
Erectile difficulties (started the last few months)
Fatigue
Muscle twitches
Irritability and anxiousness
Brain fog/memory issues/generally feeling "slow"

I've definitely been underrating lately but my diet is pretty much eggs, coconut oil, some fruit, cheese and milk, coffee with milk and sugar, white rice, icecream (have since cut that back because I realized I've used this diet as an excuse to binge on it) shrimp, chicken/pork/beef/liver and occasionally some junk food thrown in (maybe once a week, if that). I've tried OJ but noticed some kind of weird inverse relationship with it. If I feel "ok" and have it I feel weird, if I feel "weird" and have it I feel better.)

Lab tests:

CBC w/ diff/plate was normal (if anyone thinks this would be relevant I will post)

Basic Metabolic Panel:

Glucose, Serum 95 mg/dL
BUN 19
Creatinine, Serum 1.07
eGFR 95
BUN/Creatinine ratio 18
Sodium, Serum 141
Potassium, Serum 4.3
Chloride, Serum 101
Carbon Dioxide, Total 25
Calcium, Serum 10.5

TSH 2.040

C-Reactive Protein, Quant 0.3

My PCP did not order PTH with this test but a prior test with calcium level at 11, the PTH was "normal" at 32.8.

Any help would greatly be appreciated.

 

[tara]

sle07

Others here are better at reading labs, so hopefully some of them will chime in.

Have you run your average diet through cronometer or similar to see if it is low in anything? In cooey of 3000 cals, at least 80-100 g protein?
Salting to taste?

I'm wondering if there is enough magnesium in there.
If you feel dgestive distress from milk, may be worth experimenting with different forms/brands, or giving it a miss for a bit and seeing if that is better (need to get some calium form elsewhere if you drop the milk).

The TSH looks highish (but not extreme). May be worth trying a little cautious thyroid supp at some stage in the future, but I favour checking nutrition and other factors first, in case things can be improved by those means. You need to have nutrition in place to support supplementary thyroid anyway.
Are you getting regular sun and enough sleep? Is you breathing relaxed, nasal, diaphragmatic?

 

[haidut]

post 112119 Hello everyone! I was going to write out a long detailed post but in the interest of not having a long read, I just decided to list my symptoms and a portion of my lab results to see if anyone can point me in the right direction. For reference I'm a 27 year old male 5' 11" and around 180lbs. The last few months have been the absolute worst for me and it's been very hard to determine what's health related, diet related or stress related (I've been under tremendous stress lately.) One of the more concerning things related to labs is the frequent finding of elevated calcium and high blood pressure. I've suspected hyperparathyroidism for awhile now and I've been trying to incorporate a more "Peat" way of eating for the last 2 years or so but context is everything so instead of just applying everything I read, hopefully, someone more knowledgeable could point me in the right direction and help me minimize damage until I'm able to follow up with my PCP and whomever I'm referred to for whatever it is I may or may not have. :?


Symptoms:

High Blood Pressure (varies all over the place, it's been elevated more often than not though)
High Calcium (most recent test was 10.5, the lowest I've seen in 3 tests, 11, 10.6, then 10.5)
Felling like I'm going to pass out
Hair loss
Digestive issues (lots of gurgling, usually after milk consumption)
Cold hands and feet (temps are low 96.6 when waking, maybe 97.2-97.7 after eating)
Erectile difficulties (started the last few months)
Fatigue
Muscle twitches
Irritability and anxiousness
Brain fog/memory issues/generally feeling "slow"

I've definitely been underrating lately but my diet is pretty much eggs, coconut oil, some fruit, cheese and milk, coffee with milk and sugar, white rice, icecream (have since cut that back because I realized I've used this diet as an excuse to binge on it) shrimp, chicken/pork/beef/liver and occasionally some junk food thrown in (maybe once a week, if that). I've tried OJ but noticed some kind of weird inverse relationship with it. If I feel "ok" and have it I feel weird, if I feel "weird" and have it I feel better.)

Lab tests:

CBC w/ diff/plate was normal (if anyone thinks this would be relevant I will post)

Basic Metabolic Panel:

Glucose, Serum 95 mg/dL
BUN 19
Creatinine, Serum 1.07
eGFR 95
BUN/Creatinine ratio 18
Sodium, Serum 141
Potassium, Serum 4.3
Chloride, Serum 101
Carbon Dioxide, Total 25
Calcium, Serum 10.5

TSH 2.040

C-Reactive Protein, Quant 0.3

My PCP did not order PTH with this test but a prior test with calcium level at 11, the PTH was "normal" at 32.8.

Any help would greatly be appreciated.

Definitely talk to a doctor first, but quite likely hyperparathyroidism. Whether it is primary or secondary would have to be diagnosed by the endocrinologist. With calcium at 11, PTH should have been very low. The PCP should be aware of the golden rule of endocrinology called "inappropriately normal", which is what your past PTH was.
If you can, ask for tests for vitamin D3, calcitriol, prolactin. Could be secondary hyperparathyroidism due to vitamin D deficiency. Elevated prolactin can also raise serum calcium.

 

[sle07]

Thank you both for replying. I've read many of your posts here and I greatly appreciate your input.

sle07

Others here are better at reading labs, so hopefully some of them will chime in.

Have you run your average diet through cronometer or similar to see if it is low in anything? In cooey of 3000 cals, at least 80-100 g protein?
Salting to taste?

I'm wondering if there is enough magnesium in there.
If you feel dgestive distress from milk, may be worth experimenting with different forms/brands, or giving it a miss for a bit and seeing if that is better (need to get some calium form elsewhere if you drop the milk).

The TSH looks highish (but not extreme). May be worth trying a little cautious thyroid supp at some stage in the future, but I favour checking nutrition and other factors first, in case things can be improved by those means. You need to have nutrition in place to support supplementary thyroid anyway.
Are you getting regular sun and enough sleep? Is you breathing relaxed, nasal, diaphragmatic?

I have occasionally been using cronometer to track calories but haven't been very rigorous with the recording. I believe on a good day I'm probably taking in around 1300 calories which I know is extremely low but with everything going on I've had going on at work and home I just haven't been hungry or ensuring proper nutrition. It's definitely going to be a priority moving forward.

I haven't gotten much sun exposure the last few years now thinking about it, maybe 3-4 days this summer. Sleep has been an issue and I often wake up 2-3 times a night. Breathing is pretty relaxed as far as I've noticed.

Definitely talk to a doctor first, but quite likely hyperparathyroidism. Whether it is primary or secondary would have to be diagnosed by the endocrinologist. With calcium at 11, PTH should have been very low. The PCP should be aware of the golden rule of endocrinology called "inappropriately normal", which is what your past PTH was.
If you can, ask for tests for vitamin D3, calcitriol, prolactin. Could be secondary hyperparathyroidism due to vitamin D deficiency. Elevated prolactin can also raise serum calcium.

I have an appointment tomorrow and I'll bring those up to my doctor. He's easy going and I'm sure if I can work out a justification he will probably order those tests. Do you have any input on specific things I should be doing as far as diet or supplementation go?

Thanks again!

 

[haidut]

post 112381 Thank you both for replying. I've read many of your posts here and I greatly appreciate your input.

sle07

Others here are better at reading labs, so hopefully some of them will chime in.

Have you run your average diet through cronometer or similar to see if it is low in anything? In cooey of 3000 cals, at least 80-100 g protein?
Salting to taste?

I'm wondering if there is enough magnesium in there.
If you feel dgestive distress from milk, may be worth experimenting with different forms/brands, or giving it a miss for a bit and seeing if that is better (need to get some calium form elsewhere if you drop the milk).

The TSH looks highish (but not extreme). May be worth trying a little cautious thyroid supp at some stage in the future, but I favour checking nutrition and other factors first, in case things can be improved by those means. You need to have nutrition in place to support supplementary thyroid anyway.
Are you getting regular sun and enough sleep? Is you breathing relaxed, nasal, diaphragmatic?

I have occasionally been using cronometer to track calories but haven't been very rigorous with the recording. I believe on a good day I'm probably taking in around 1300 calories which I know is extremely low but with everything going on I've had going on at work and home I just haven't been hungry or ensuring proper nutrition. It's definitely going to be a priority moving forward.

I haven't gotten much sun exposure the last few years now thinking about it, maybe 3-4 days this summer. Sleep has been an issue and I often wake up 2-3 times a night. Breathing is pretty relaxed as far as I've noticed.

Definitely talk to a doctor first, but quite likely hyperparathyroidism. Whether it is primary or secondary would have to be diagnosed by the endocrinologist. With calcium at 11, PTH should have been very low. The PCP should be aware of the golden rule of endocrinology called "inappropriately normal", which is what your past PTH was.
If you can, ask for tests for vitamin D3, calcitriol, prolactin. Could be secondary hyperparathyroidism due to vitamin D deficiency. Elevated prolactin can also raise serum calcium.

I have an appointment tomorrow and I'll bring those up to my doctor. He's easy going and I'm sure if I can work out a justification he will probably order those tests. Do you have any input on specific things I should be doing as far as diet or supplementation go?

Thanks again!

The doctor will need to find the cause if he agrees it is hyperparathyroidism. Could be related to the gland, could be vitamin D deficiency, could be kidney issues, could be other things as well. Other than avoiding PUFA, Ray said that even a low dose of aspirin (100mg) can protect from the negative effects of hypercalcemia. So, you can ask the doctor about trying that in the meantime.

 

[tara]

post 112381 I have occasionally been using cronometer to track calories but haven't been very rigorous with the recording. I believe on a good day I'm probably taking in around 1300 calories which I know is extremely low but with everything going on I've had going on at work and home I just haven't been hungry or ensuring proper nutrition. It's definitely going to be a priority moving forward.

I'd make this a priority. Your endocrine system can be expected to be affected by severe prolonged undereating, and probably can't recover well without addressing it. There may be other contributing factors, but it seems likely to be a key one. Maybe increase by a couple of hundred calories every couple of days till you are up at reasonable amounts, and allow yourself more if you get hungry for it. At least to begin with, food that is as easy as possible for you to digest. I'd let your dr know about this too, so they can take this into account when trying t figure out what's going on. Also, there are some specific hazards in the early stages of refeeding that can require urgent attention, so good if the dr has it on their radar.

More expanded thoughts on this here: viewtopic.php?f=11&t=4028&hilit=youreatopia

 

[sle07]

Thanks for the replies.

Well i followed up with my PCP. He's no longer concerned about the calcium for some reason. After doing an EKG I believe he's concerned about left ventricle hypertrophy. He prescribed an ACE inhibitor (it starts with an E, I will be picking it up later today.)

Not really sure where to go from here.

 

[haidut]

post 113372 Thanks for the replies.

Well i followed up with my PCP. He's no longer concerned about the calcium for some reason. After doing an EKG I believe he's concerned about left ventricle hypertrophy. He prescribed an ACE inhibitor (it starts with an E, I will be picking it up later today.)

Not really sure where to go from here.

If possible, ask him for losartan or telmisartan. These are also ACE inhibitors but they also reverse mitochondrial aging.
http://www.natap.org/2011/newsUpdates/081811_13.htm
"...Researchers at the Johns Hopkins University School of Medicine have found a protein normally involved in blood pressure regulation in a surprising place: tucked within the little "power plants" of cells, the mitochondria. The quantity of this protein appears to decrease with age, but treating older mice with the blood pressure medication losartan can increase protein numbers to youthful levels, decreasing both blood pressure and cellular energy usage. The researchers say these findings, published online during the week of August 15, 2011, in the Proceedings of the National Academy of Sciences, may lead to new treatments for mitochondrial-specific, age-related diseases, such as diabetes, hearing loss, frailty and Parkinson's disease."

 

[sle07]

post 113372 Thanks for the replies.

Well i followed up with my PCP. He's no longer concerned about the calcium for some reason. After doing an EKG I believe he's concerned about left ventricle hypertrophy. He prescribed an ACE inhibitor (it starts with an E, I will be picking it up later today.)

Not really sure where to go from here.

If possible, ask him for losartan or telmisartan. These are also ACE inhibitors but they also reverse mitochondrial aging.
http://www.natap.org/2011/newsUpdates/081811_13.htm
"...Researchers at the Johns Hopkins University School of Medicine have found a protein normally involved in blood pressure regulation in a surprising place: tucked within the little "power plants" of cells, the mitochondria. The quantity of this protein appears to decrease with age, but treating older mice with the blood pressure medication losartan can increase protein numbers to youthful levels, decreasing both blood pressure and cellular energy usage. The researchers say these findings, published online during the week of August 15, 2011, in the Proceedings of the National Academy of Sciences, may lead to new treatments for mitochondrial-specific, age-related diseases, such as diabetes, hearing loss, frailty and Parkinson's disease."

Thanks for that haidut I will look into it!

Just an update:

I've started the Enalapril, hoping to reduce my BP and minimize any further damage to my heart. However, I still believe my doctor is missing the mark in trying to treat symptoms rather than finding the underlying cause of them. So today I saw an endo and she very much believes my symptoms could be parathyroid related. I'm having some further testing done tomorrow.

 

[Simatta]

Thanks for that haidut I will look into it!

Just an update:

I've started the Enalapril, hoping to reduce my BP and minimize any further damage to my heart. However, I still believe my doctor is missing the mark in trying to treat symptoms rather than finding the underlying cause of them. So today I saw an endo and she very much believes my symptoms could be parathyroid related. I'm having some further testing done tomorrow.

Did you ever get resolve surrounding this issue?

 

[davidgraham]

Did you ever get resolve surrounding this issue?

I'd like to know also