New Results Are In - Confused!

Good morning a on this wet rainy day.

I picked up my blood results that I had done yesterday and these are the results. I'm not sure if anyone can go back through my posts and see my other results and compare.

Calcium: 2.33 (Range 2.20-2.60)
CA Corrected: 2.21 (Range 2.20-2.60)
PTH: 4.8 (Range 1.1-6.9)
Magnesium: 0.75 (Range 0.7-1.0)
Albumin: 51 (Range 35.0-50.0)
Phosphate: 1.02 (Range 0.8-1.05)
Alkaline Phosphatase: 47 (Range 35-105)

This is the first set of results my Calcium has been in the lower end but my PTH has risen every time I've had it tested in the past 6 months. My Magnesium is low and my Albumin is just outside thereference range. I've had low Magnesium levels for a year that I know of.

May 2014

Calcium: 2.51 (Range 2.20-2.60)
CA corrected: 2.45 (Range 2.20-2.60)
PTH: 3.5 (Range 1.6-6.9)
Albumin: 49 (Range 34-50)
Alkaline Phosphatase: 45 (Range 35-105)

Urine Calcium Volume: 2.282 Litres
Urine Calcium: 3.28
Calcium/24hrs: 7.48 (2.5-7.5)

Urine Volume: 1.666 Litres
Urine Creatinine: 5.6 (Range 8.0-12.5)
Creatinine/24hrs: 9.3

Can anyone comment? I have poets all my results on here since being a member. I'm just so confused    The GP also did a DNA Antibody on me yesterday for Lupus but my symptoms done relate to half as much as they do for HPTH.

I have a contact email for FP - I think I am going to email and see if he can help? I need to know what is going on!

Thank you xx

Hi Lucie

This is just a flying visit to the forum as I'm on my way out so don't have time to fully analyse your results but the first thing that jumped up and bit me on the nose is that with a corrected calcium almost falling out of the bottom of the range your PTH should be almost non-existent! I'm thinking normocalcaemic primary hyperparathyroidism as the relationship between your calcium and PTH just doesn't add up, what does everyone else think? Lucie there's a paper on normocalcaemic pHPT in the reference section. 

Jasmine x

Just to add to this. 

January 2014
Calcium: 2.49 (Range 2.10-2.55)
PTH: 61.7 ng/L (Range 15-68)

Sorry - not sure what the UK conversion is for the PTH reading as was in Oz at the time but that is the result the Endo said "I'm not ruling out HPTH"

Xx

I'm also on a quick visit as work beckons.

They all look pretty normal to me, the albumin level being high in range in 99.9% of people will be down to dehydration so you maybe are not drinking enough.

Not up on normo phpt so can't comment on that one.

Nelly

Hi Lucie

I can see why your Oz Endo wouldn't rule out HPTH from your Jan 2014 results. A highish-in-its range calcium at the same time as a high-in-the-range PTH is an indicator of normo-calcaemic hyperparathyroidism.

Good that your current GP has thought of Lupus, as it would be useful to rule that out.

I also have high albumin most of the time and Nelly is right that it could be due to dehydration, especially  this weather. My GP told me that a high-ish albumin level was a good sign normally.

Any GP looking at your May results would probably say that they are "fine, because both Ca and PTH are within range". And if they then looked at your most recent results they would say "look, the calcium has dropped and the PTH has risen - that is what they are supposed to do". And they might also conveniently ignore the fact that you are excreting calcium in your urine (24 hr result is top of the range).

I'm no expert, but these results probably indicate those times that Dr Norman mentions on his website (parathyroid.com) when levels look as if they've dropped back to "normality". But if you have your levels tested in another few weeks, they may be back to the Oz levels.

I've been diagnosed with "mild" normo-calcaemic HPT and my calcium levels hover around 2.5. But my PTH has reached 12 at times. So if my case is "mild", yours is possibly also quite subtle.

I consulted FP privately (£250) and I consider it money well spent in order to talk to someone (within 2 weeks of my request to see him) who knows about PHPT! I have now transferred to his NHS list and will be seeing his team next week. You do normally need a GP referral letter to consult him even if you go privately, which seems odd to me. But the GP letter doesn't have to be anything other than a request for him to see you. My GP's letter was merely that and I myself provided all the blood test results, etc.

In your case I would email him to ask his opinion. I'm not sure if he'll reply at length by email, but if he suggests it would be a good idea to consult him, then I would be guided by that.

Let us know how things turn out, Lucie - you have nothing to lose by sending him an email.

Love from Tigerlily xx

Thank you all.

Tigerlily - This is what I get confused about, if my PTH were working as they should and not grown into any Tumours, would my CA & PTH levels always be consistently low? I get confused by Endo's when they say "I'm not ruling out HPTH" and then GP's who say "Calcium & PTH will fluctuate"

I just never know where I stand. My Calcium has been as high as 2.66! I know my levels are not through the roof, but have been high normal but I just don't know whether that is normal for me, a 31 year old, who up until a year and a half ago, felt normal.

Sometimes I feel like I'm chasing the correct diagnosis of HPTH and then I have days when I think, put the HPTH business to rest, you don't have it! I just do not know and I'm worried that if I invest more of my healthcare into another Endo, I'll be left scratching my head again   for the foreseeable future! But I will email FP and see what his advice is, if he replies that is LOL and hopefully he can enlighten me.

Xx

I agree Tigerlily, the PTH may have risen in response to the calcium falling which would be a normal response, but you're right, values do fluctuate and when there is a consistently inconsistent relationship between the two it's worthy of further investigation by experts who know their stuff. I would agree with Tigerlily, Lucie - it wouldn't hurt to give FP a shot.

Jasmine x

Thank you Jasmine.

That's what I try and explain when I'm sitting in the GP office, should my levels just be low all the time, not up and down consistently, I just want a definitive answer but nobody can seem to give me one. My feeling is that if all was normal, I wouldn't have all the symptoms, wouldn't feel so blerghhh and me levels would be consistent.

Better begin the email - poor FP   

Xx

Hi Lucie
I'm sorry I don't know enough about normo-calcaemic PTH disease to help but just sending good luck with email to FP.
Amanda xxxx

Great Link

http://blog.parathyroid.com/parathyroid-hormone-pth-levels/

Yep, says it all and Dr Politz is a wonderful doctor, he assisted Dr Norman with my surgery. However, if and when you contact FP I wouldn't advise using this paper as a reference to what's happening to you Lucie as the Norman Parathyroid Centre is not held in high regard in the UK, they think he's a bit gung-ho and self important. Have a look on Dr Larian's site (he's based in California and very well respected) to see if you can find something similar. In fact I'll take a look myself .....

Jasmine x

Thanks Jasmine, very useful link!

I have emailed FP, tried to keep it brief and to the point. Keeping fingers crossed he will get back to me soon enough.

Xx

Thanks Jasmine, very useful link!

I have emailed FP, tried to keep it brief and to the point. Keeping fingers crossed he will get back to me soon enough.

Xx

Really interesting link.
A xxxx

Lucie, I hope you an encouraging response from FP, good luck. 

I found that link really interesting, Jasmine. Thanks for putting it up here. 

Love 
Brigitte xx

Hi Lucie

I hope you get a positive response from FP, I look forward to hear his response as I might try emailing him too. 

I`ve noticed that your serum calcium levels are always higher than your corrected serum calcium mine is the other way around.  Is there a reason for this?

Thanks 

Mel

This can happen if your albumin level is low, Mel.

My albumin is always top of the range and so they adjust my serum calcium downwards when they "correct" it.

If your albumin level is not so high (say, lower than 40) your corrected calcium will be corrected upwards, because the correction is based on the albumin level.

Love Tigerlily xx

As much as I visit this Forum I am still easily confused   

Still no response from FP - I emailed yesterday afternoon. I will let you know his response (if I get one)

Just to add to my symptoms, I was told last year by a Physiotherapist that I could possibly have Occipital Neuralgia, which is basically to do with the nerves in your neck and when I looked into this, there are a few possible reasons why you have this but one of them was a tumour in your neck? Could this be related to HPTH also, who knows!


Lucie xx

Thanks Tigerlily that's interesting x

Well, that's really interesting, Lucie. I have also been looking at occipital neuralgia today and wonder if it could be linked with an HPT adenoma in the neck.

Do let me know if you get any further with this.

Love from Tigerlily xx

Lucie & Tigerlily
After reading about this I'm wondering if this is what I've been suffering with when I have blinding head and neck ache for months on end.
I don't have it at present but I will definitely take thus up with GPwhen it comes back.
All I can say is if this FHH test comes back negative I'm going to be so angry that I've put up with these headaches for over a year because it could be related to another adenoma !!!
Amanda xxxx

Amanda and TigerLily

I too go through spells of this , sometimes for days on end but it all starts in the back of my neck and if I press on certain areas, the tingling sensation is horrendous! It would explain a lot as this has only been an issue for me since  all my symptoms came about, as well as the tight shoulders, which while typing are giving me jip!

Have a word with your GP Amanda! I think between us all we could run our own Parathyroid Centre   

Lucie xx

Fascinating stuff ladies! You're all real gems and I learn something new from this forum all the time   

Love
Brigitte xx

I'm with you on that one Brigitte, the Forum has some wonderful people with great knowledge, it's such a comfort.

Lucie xx