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Hypercalcemia

Hypercalcemia refers to high blood calcium levels. It is most often caused by primary hyperparathyroidism.

I have had high calcium levels for over 30 years, but have never been diagnosed with parathyroid disease. I’ve never had any health problems. Do I have primary hyperparathyroidism?

In most cases, persistently high calcium levels indicate primary hyperparathyroidism. But we need more information to confirm the diagnosis. To diagnose primary hyperparathyroidism, we check the calcium and PTH together. If something else (not parathyroid disease) is causing the high calcium, then the normal parathyroid glands will be suppressed - that is, they will make very little hormone. Th...

FHH Diagnosis Primary HPT Hypercalcemia

I just found out on routine bloodwork that my calcium is 12.4 mg/dl. I know I need parathyroid surgery but I won't be able to see the surgeon until next month. Since my calcium is so high, I'm worried that my health is going to deteriorate before I get this operation. How quickly do I need to get this done?

The odds are that you have had high calcium levels for years. Your calcium did not jump from normal range to 12.4 in a day, or you likely would have noticed acute symptoms of high calcium (nausea, vomiting, confusion). Since this was found incidentally, it is very likely that you have had rising calcium levels for a while. The severity of primary hyperparathyroidism is unrelated to how high the...

Hypercalcemia Operation

Is this primary hyperparathyroidism? Over the last year my calcium levels have been: 10.5, 10.9, and 10.6 mg/dl. My PTH was 57 pg/ml. I'm 75 years old. My physician said that my PTH is normal and so this cannot be primary hyperparathyroidism.

These are classic labs for primary hyperparathyroidism. Your calcium is high for your age. PTH levels can only be interpreted in relation to calcium levels. If your calcium is normal, then you expect the PTH to be in the "normal" range listed on the lab result. But if the calcium is high, normal parathyroid glands will be suppressed, and thus the PTH should be low (under 20 pg/ml). If the PTH i...

Diagnosis Hypercalcemia FAQ

I am 69. My calcium levels have run consistently 10.8 range for the past 2 years. It has been 11.9 and 11 as recently as a few days ago. My PTH was 86 in September 2021 but is normal range now. However I feel really bad. Fatigue, difficult concentration, tingling lips, constipation, absolutely no appetite with weight loss, nervous internally and eye sight changes. Could I have parathyroid issues even with a normal PTH? I have seen doctors but they just say they don't know why my calcium is high or what is causing my symptoms. My whole life has changed. I'm desperate for answers and where to find them. Please help.

Your lab results indicate primary hyperparathyroidism. You are experiencing the classic symptoms of the disease, which should improve once you get it treated. The diagnosis of primary hyperparathyroidism is based mostly on calcium and PTH levels, but you do not need to have a "high" PTH to make the diagnosis. The important thing is the calcium and whether the PTH is appropriate given the ca...

Diagnosis Hypercalcemia primary hyperparathyroidism

I’m 67 and my Calcium is at 10.4. I’m breast cancer survivor 20 years. What should I do?

Thanks for reaching out. A calcium of 10.4 mg/dl is high for your age. Most of the time, a high calcium level is caused by primary hyperparathyroidism. Certain cancers, including breast cancer, can also cause high calcium, but this is much less common. Fortunately, it is easy to determine whether the high calcium is caused by parathyroid disease or something else, by checking the parathyroi...

Diagnosis Hypercalcemia

My blood report reads: Calcium 10.4, PTH 85.3, Vitamin D is 58.5, Albumin 5, Calcium Ionized 5.19. I am 58 years old. I have stopped taking 5000mg of Vitamin D, tho my doctor said I should have an MRI to see which thyroid needs to be removed. Does this make sense? Thank you very much.

Thanks for writing. Your blood tests indicate that you have primary hyperparathyroidism. You have a calcium level that is high for your age, with a high PTH. Most of the time, primary hyperparathyroidism is caused by a benign parathyroid tumor, or adenoma. The treatment for this is removal of the parathyroid tumor. Sometimes, imaging can show which parathyroid gland is diseased. Your doctor...

Diagnosis Imaging Hypercalcemia primary hyperparathyroidism

I'm an adult female and have had elevated serum calcium for a few years ranging from 10.4 - 10.8 (mg/dl), however my ionized calcium from the same blood draws has been either normal or only the slightest bit above normal. My PTH ranges from normal to in the 80s (pg/ml). Which calcium is more accurate in my case - the serum total or the ionized? All other serum values are normal (metabolic, phosphorus, D.) Thank you!

Great question! Usually when we check calcium levels, we are checking the total serum calcium. This is the level that is included in a metabolic panel (basic or comprehensive), one of the standard lab tests that you will have if you are simply getting "routine labs." Calcium is present in your blood in two forms: 1. Ionized, or "free" calcium, that is floating around as a calcium ion. 2. Bo...

Diagnosis Hypercalcemia primary hyperparathyroidism

I just received my test from my bloodwork and wanted to know if I should be worried about a calcium level that was 10.3 mg/dl?

If your blood calcium level is 10.3 mg/dl, it's important to consider several factors before determining if there is cause for concern: Age: Calcium levels tend to decrease slightly with age. If you are in your 20s or 30s, a calcium level of 10.3 mg/dl can be within the expected range. However, if you are 40 or older, it is less common to see levels above 10.0 mg/dl. Most of the time, persis...

Diagnosis Hypercalcemia

My calcium is 10.5 mg/dl, my PTH is 53 pg/ml, my Vit D 25-hydroxy is 21 ng/ml. My doctor wants to start me on Vitamin D daily. Everything I’ve read says not to treat the low Vitamin D, if this could be primary hyperparathyroidism. Not sure what to do! How is taking Vit D going to lower my calcium level? I am 47 years old.

Let's summarize your results: Calcium at 10.5 mg/dl is elevated for your age. PTH at 53 pg/ml is not suppressed, which is inappropriate for the elevated calcium level. Vit D 25-hydroxy at 21 ng/ml is on the lower side. These numbers strongly suggest primary hyperparathyroidism (pHPT). In the context of pHPT, taking Vitamin D supplements is not the recommended course of action. Why? Bec...

Hypercalcemia primary hyperparathyroidism Diagnosis Vitamin D Vitamin D deficiency

I am 35 yr old female. Recently I just received a slightly elevated calcium result at 10.3 mg/dl. I opted to retest 2 days later, the level dropped to 9.6. Could the higher test be a fluke? The day of the test, I did not drink much water and the test was late in the afternoon. My retake was first thing in the morning with plenty of water. My previous levels are listed below: Oct 2022-9.5 Apr 2023- 9.0 Nov 2023-9.2 Feb 2024- 9.9 Mar 2024 - 10.3 Mar (2 days later) 2024- 9.6 Thanks so much for your input.

Single instances of elevated calcium can be flukes, but they can also indicate early parathyroid disease. It is certainly possible that your calcium of 10.3 was a fluke. Whenever I get a lab result that is surprising and different from prior results, I always like to repeat it to make sure it is accurate. If all prior and subsequent results were normal, with just one weird result in the middle,...

Normal calcium Hypercalcemia Diagnosis

Hi I'm a 21 year old male my height is 6'1 and my calcium levels over last three months checked at an interval of 10-15 days have been: 10.5, 10.4, 10.0, 9.6 mg/dl.. I'm worried I might have hyperparathyroidism. My calcium levels hover between 9.6 and 10.5 whenever checked.

I understand your concerns. Calcium levels of 10.5 or 10.4 mg/dl is considered high for older adults, and so your lab may flag it as high on your results. At your age, though, it is normal to have calcium levels in the mid 10s. Most labs will adjust calcium ranges for children and won't bother adjusting with adults - but even adults in their 30s can still have calcium levels in the low 10s. Eve...

Hypercalcemia Diagnosis Primary HPT Normal calcium

My calcium is 11.9 mg/dl. Ionized calcium is 5.7. Parathyroid hormone (PTH) is 65. Random urine calcium is 11.9. I have an overwhelming overall discomfort/pain. It’s so bad I can’t work anymore. Do I have hyperparathyroidism? I am 62 years old.

Your labs are classic for primary hyperparathyroidism. A diagnosis of parathyroid disease is based on labs, specifically calcium and PTH levels. At your age, your calcium levels should be in the mid to high 9s (in mg/dl) range. A calcium of 11.9 mg/dl is definitely high. Most of the time, high calcium is caused by parathyroid disease, but not always. To confirm the diagnosis, we need to eva...

Hypercalcemia Diagnosis primary hyperparathyroidism

Hi! Is there any food you have to avoid if you have high calcium and high parathyroid levels?

Thanks for asking! Patients are often told to avoid high-calcium foods like dairy products when they are diagnosed with primary hyperparathyroidism. But in most cases, this isn't really necessary (unless you are eating absolutely insane amounts of dairy, which is not good for you anyway!). If you have primary hyperparathyroidism, your calcium is high because you have an overactive parathyro...

Hypercalcemia Parathyroid Disease Basics Primary HPT Vitamin D

Hi Dr. Boone. I have recently been diagnosed with Vitamin D deficiency and have had a lot of symptoms. I am 34 years old and my Vit D level is 21 ng/ml, PTH 52 pg/ml, Calcium range from 9.8-10.2 mg/dl. Back in 2021 my Calcium level was 9 even. Is this a cause for concern or possibly just Vit D deficiency?

Hi, thanks for writing in. First, let's look at your calcium levels. A calcium of 10.2 mg/dl is on the high end for your age. When you are in your 30s, sometimes you can have normal calcium levels in the low 10s. As you get older, your levels will tend to drop into the 9s (mg/dl). After about age 40, most adults should have calcium levels in the mid to high 9s. Typically we see the calcium ...

Vitamin D Diagnosis Primary HPT Hypercalcemia Normal calcium

I had a recent CT scan of parathyroid that was reported normal. I was put on low calcium diet for next 2 months then repeat tests. Can CTs be false negative & can diet change results and help confirm need for surgery or is it a waste of time? Seems surgery is needed now? Thank you from Ontario, Canada. Calcium is 2.83 mmol/L (11.3 mg/dl) and PTH 14.2 pmol/L (134 pg/ml). I am 68 years old.

First, these labs very clearly indicate primary hyperparathyroidism, since the calcium and PTH are both far outside normal range. We don't need anything else to make the diagnosis. A low calcium diet is not going to change this diagnosis. Your calcium and PTH levels may both fluctuate to some extent, since that happens with primary hyperparathyroidism, but the diagnosis will not change. ...

Diagnosis Hypercalcemia Primary HPT Parathyroid Disease Basics Imaging