Please Hack My Labs-High Blood Calcium

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I feel tired, cold, and depressed all the time. Please hack my labs. Any suggestions would be appreciated. I am seeing high blood calcium and low PTH, which may be indicative of a parthyroid tumor according to this site:

http://www.parathyroid.com/Normal-Blood ... Levels.htm

 

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haidut

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If possible, please do a blood test for vitamin D, both D3 and the active form called "calcitriol" or 1,25 D. Checking serum levels of prolactin and magnesium will also be helpful. High serum calcium can also be caused by not ingesting enough calcium or high prolactin. Low calcium intake makes the body dissolve bone and teeth and dump the calcium in the blood. High porlactin does the same since milk production requires calcium and again, prolactin will get the calcium from bones/teeth and into the blood. Low magnesium levels can also cause high serum calcium.
 
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My serum magnesium was 1.8 (range 1.6-2.6)

and

my prolactin was 7.8 (range 4.0-15.2)

i have a vitamin D test scheduled next week....

thanks!
 

haidut

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lookingforanswers said:
My serum magnesium was 1.8 (range 1.6-2.6)

and

my prolactin was 7.8 (range 4.0-15.2)

i have a vitamin D test scheduled next week....

thanks!

OK, let's wait until vitamin D is tested and then discuss more. Typically, if calcium is high it is expected that PTH would be low since there is a negative feedback loop. Initially, in cases of low calcium intake or insifuccient absorption, PTH rises to stiulate conversion of vitamin D3 into the active form calcitriol in order to increase calcium absorption from intestine. In addition, elevated PTH will stimulate bone breakdown to provide calcium if intestinal calcium absorption low. Once serum calcium is elevated to certain levels this signals for PTH to drop since there is no more need to stimulate calcium absorption. This completes the feedback loop. In primary hyperparathyroidism, a dysfunction in the parathyroid (like an adenoma) prevents the PTH levels from going down once calcium is elevated. In your case PTH went down, so it is unlikely that it is parathyroid dysfunction. I am not a doctor, so this should really be discussed with your doctor and you can bring up the points that I made. There are additional tests that could show why calcium is high and only the doctor would know which of the several dozens would be appropriate for your case. Of course, it could just all be dehydration for all we know.
Keep us posted anyways.
 
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haidut said:
lookingforanswers said:
My serum magnesium was 1.8 (range 1.6-2.6)

and

my prolactin was 7.8 (range 4.0-15.2)

i have a vitamin D test scheduled next week....

thanks!

OK, let's wait until vitamin D is tested and then discuss more. Typically, if calcium is high it is expected that PTH would be low since there is a negative feedback loop. Initially, in cases of low calcium intake or insifuccient absorption, PTH rises to stiulate conversion of vitamin D3 into the active form calcitriol in order to increase calcium absorption from intestine. In addition, elevated PTH will stimulate bone breakdown to provide calcium if intestinal calcium absorption low. Once serum calcium is elevated to certain levels this signals for PTH to drop since there is no more need to stimulate calcium absorption. This completes the feedback loop. In primary hyperparathyroidism, a dysfunction in the parathyroid (like an adenoma) prevents the PTH levels from going down once calcium is elevated. In your case PTH went down, so it is unlikely that it is parathyroid dysfunction. I am not a doctor, so this should really be discussed with your doctor and you can bring up the points that I made. There are additional tests that could show why calcium is high and only the doctor would know which of the several dozens would be appropriate for your case. Of course, it could just all be dehydration for all we know.
Keep us posted anyways.

alright thanks!

also, do you think i would benefit from dessicated thyroid?
 

haidut

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lookingforanswers said:
haidut said:
lookingforanswers said:
My serum magnesium was 1.8 (range 1.6-2.6)

and

my prolactin was 7.8 (range 4.0-15.2)

i have a vitamin D test scheduled next week....

thanks!

OK, let's wait until vitamin D is tested and then discuss more. Typically, if calcium is high it is expected that PTH would be low since there is a negative feedback loop. Initially, in cases of low calcium intake or insifuccient absorption, PTH rises to stiulate conversion of vitamin D3 into the active form calcitriol in order to increase calcium absorption from intestine. In addition, elevated PTH will stimulate bone breakdown to provide calcium if intestinal calcium absorption low. Once serum calcium is elevated to certain levels this signals for PTH to drop since there is no more need to stimulate calcium absorption. This completes the feedback loop. In primary hyperparathyroidism, a dysfunction in the parathyroid (like an adenoma) prevents the PTH levels from going down once calcium is elevated. In your case PTH went down, so it is unlikely that it is parathyroid dysfunction. I am not a doctor, so this should really be discussed with your doctor and you can bring up the points that I made. There are additional tests that could show why calcium is high and only the doctor would know which of the several dozens would be appropriate for your case. Of course, it could just all be dehydration for all we know.
Keep us posted anyways.

alright thanks!

also, do you think i would benefit from dessicated thyroid?

I would refrain from thyroid supplementation until you figure out why calcium is high. Depending on the cause, thyroid may make things worse. Ray said that aspirin is helpful in hypercalcemia but he did not elaborate if aspirin lowers serum calcium directly or protects against the toxic effects of high calcium.
 
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Just to follow up, I found out my vitamin D level was 29. From my understanding, that is low, and ideally I want to be in the 50-70 range. I suspected this, because I never am in the sun. Growing up, I never wore sun block and consequently, my skin got damaged. So now, I do my best to minimize exposure. I am going to start cautiously supplementing with vitamin D again. I also started incorporating more liver.

Lastly, I began supplementing desiccated thyroid, and that, in combination with the liver seem to be the missing puzzle pieces. Someone mentioned that my T4 was a bit low, and a light bulb went off. I realized I needed to try desiccated thyroid. My dietary measures were just not enough. As long as I am eating enough calories, I feel much better on it. My temperature has come up and my mood has lifted. I'm not quite 100%, but I have seen more improvement in the past week than I have in the past 3.5 years, when I first began to feel unwell.
 

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Fabulous news lookingforanswers! :carrot
 
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:) Thanks!
 

Suikerbuik

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Are you getting your calcitriol tested?
"I am going to start cautiously supplementing with vitamin D again."
Please do so. Your first labs do not indicate that you have vitamin D shortage. And based on your first labs I am a bit worried that hypercalcemia will progress. Take care!
 

tara

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lookingforanswers said:
I suspected this, because I never am in the sun. Growing up, I never wore sun block and consequently, my skin got damaged. So now, I do my best to minimize exposure.
If you have been rigorously avoiding sunshine, you may be depriving youself of more than vit-D. We need the red light (~orange through near infrared) too for efficient metabolism. I think if you get sunlight behind a window, the glass blocks a lot of the UV and lets most of the red through.

lookingforanswers said:
Lastly, I began supplementing desiccated thyroid, and that, in combination with the liver seem to be the missing puzzle pieces. Someone mentioned that my T4 was a bit low, and a light bulb went off. I realized I needed to try desiccated thyroid. My dietary measures were just not enough. As long as I am eating enough calories, I feel much better on it. My temperature has come up and my mood has lifted. I'm not quite 100%, but I have seen more improvement in the past week than I have in the past 3.5 years, when I first began to feel unwell.
Great that you're getting such improvements. :) You may be aware that the T4 component of NDT has a long half life and its level can keep building for up to 3-4 weeks. If you get too much, it takes a while to clear the excess. So the cautious approach is to start small, and increase gradually, eg a small increment after 3-4 weeks till you get to a good level. The active T3 has a short half-life of a few hours, and this may well be what is making you feel good.
 
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tara said:
lookingforanswers said:
I suspected this, because I never am in the sun. Growing up, I never wore sun block and consequently, my skin got damaged. So now, I do my best to minimize exposure.
If you have been rigorously avoiding sunshine, you may be depriving youself of more than vit-D. We need the red light (~orange through near infrared) too for efficient metabolism. I think if you get sunlight behind a window, the glass blocks a lot of the UV and lets most of the red through.

lookingforanswers said:
Lastly, I began supplementing desiccated thyroid, and that, in combination with the liver seem to be the missing puzzle pieces. Someone mentioned that my T4 was a bit low, and a light bulb went off. I realized I needed to try desiccated thyroid. My dietary measures were just not enough. As long as I am eating enough calories, I feel much better on it. My temperature has come up and my mood has lifted. I'm not quite 100%, but I have seen more improvement in the past week than I have in the past 3.5 years, when I first began to feel unwell.
Great that you're getting such improvements. :) You may be aware that the T4 component of NDT has a long half life and its level can keep building for up to 3-4 weeks. If you get too much, it takes a while to clear the excess. So the cautious approach is to start small, and increase gradually, eg a small increment after 3-4 weeks till you get to a good level. The active T3 has a short half-life of a few hours, and this may well be what is making you feel good.

Okay so If I have been taking about 1.25 tablets a day (each tablet is 130mg), divided into .25 doses per meal, for the past week, when should I increase? My temp is typically around 97.5 to 98.0
 

tara

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I don't have personal experience of this, just going off what I've read from others here, but I wouldn't increase till you've been at that amount for 4 weeks, and then only if you need more. You may find that is enough or even too much. You can keep tracking temps and pulse as well as symptoms to get an idea of whether it's enough. They may keep rising over the next while on a steady dose.
I haven't been supplementing thyroid, and I haven't learned how to assess hyperthyroid from too much supplementation - you might want to look that up so you can tell if it happens.
 
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I think I spoke too soon. I don't seem to be responding to it like I had been originally. I've reverted back to my cold, tired, depressed state. What happened!?!?!?!?
 
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haidut said:
post 63383 If possible, please do a blood test for vitamin D, both D3 and the active form called "calcitriol" or 1,25 D. Checking serum levels of prolactin and magnesium will also be helpful. High serum calcium can also be caused by not ingesting enough calcium or high prolactin. Low calcium intake makes the body dissolve bone and teeth and dump the calcium in the blood. High porlactin does the same since milk production requires calcium and again, prolactin will get the calcium from bones/teeth and into the blood. Low magnesium levels can also cause high serum calcium.

In cases where high prolactin gives rise to high serum calcium levels (despite adequate calcium and vitamin D3 intake), what do you then look for to suggest either thyroid and/or bromocriptine?
 
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haidut

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cantstoppeating said:
post 114706
haidut said:
post 63383 If possible, please do a blood test for vitamin D, both D3 and the active form called "calcitriol" or 1,25 D. Checking serum levels of prolactin and magnesium will also be helpful. High serum calcium can also be caused by not ingesting enough calcium or high prolactin. Low calcium intake makes the body dissolve bone and teeth and dump the calcium in the blood. High porlactin does the same since milk production requires calcium and again, prolactin will get the calcium from bones/teeth and into the blood. Low magnesium levels can also cause high serum calcium.

In cases where high prolactin gives rise to high serum calcium levels (despite adequate calcium and vitamin D3 intake), what do you then look for to suggest either thyroid and/or bromocriptine?

If prolactin is high despite good calcium and vitamin D status, then it could be caused by a number of factors including liver issues, kidney issues, pituitary issues, or high estrogen since estrogen excites the pituitary and damages the normal feedback mechanism for many hormones, especially prolactin and cortisol.
The high prolactin should be enough for the doctor to prescribe a drug to lower it, but he/she may also suggest additional tests to find out potential issues I mentioned above.
 
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messtafarian

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IGF 1 is moving out of range. That's a pituitary problem. I wouldn't diagnose a tumor or anything based on that but it will cause skewed values all the way across the hypo-pituitary-adrenal axis.

As haidut advised me and pubmed illustrates, sometimes pharmacotherapy can rebalance the entire system and make the primary imbalance retreat. I'm not surprised at all that supplementing thyroid helped you. If you can afford it, you might spring for an mri of your pituitary.

What I don't like the most about your labs is that your blood sodium is slightly low, and that is not normal. Usually salt is abundant in serum and this is a really tightly regulated level with redundant and interdependent feedback loops. That's because the salts are the basis of body function. When your blood sodium is fading, something is wrong.

http://www.ncbi.nlm.nih.gov/pubmed/8810741

For the moment, watch your liquid intake and see how liquids make you feel. If you are not managing salt well then too much liquid can make you feel cold because it's diluting the blood, and you want blood that is thick enough to push through your circulatory system. So add SALT - you have room to spare here so don't be shy - keep up with the thyroid supplementation to balance whatever is happening with your pituitary, and try to get a look at your pituitary at some point because this is what also informs your thyroid. Extra salt, less liquid, adequate thyroid should make you feel better for now.
 

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