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Normal calcium

Parathyroid disease is characterized by abnormal calcium levels. To understand what is abnormal, we need to first define normal.

My calcium is always noted to be “high-normal” but doctors are not concerned. Could I have parathyroid disease?

<p>Great question! To figure out whether you might have parathyroid disease, I would want to see the actual calcium levels. If a calcium is "high-normal" but is in the truly normal range, then parathyroid disease is unlikely. <strong>Unfortunately, often what is called "high-normal" is actually just high, and that indicates likely parathyroid disease. </strong> </p> <p> The question then is,...

Normal calcium Primary HPT Diagnosis

Do you need to correct your calcium based on albumin levels? My doctor told me that my high calcium level was actually normal once he corrected for albumin.

The short answer is that you cannot “correct” a high calcium down to normal by looking at albumin. We use albumin to correct for low calcium levels. But this is a tricky issue, which requires a longer explanation. First, let me explain how calcium and albumin are related. Calcium in the blood can be free (not bound to anything) or bound to albumin. The free calcium is the ionized calcium, which...

Albumin Normal calcium Diagnosis

Over the last 5 months my calcium levels have been above 10.0 mg/dl, up to 10.3 mg/dl. My doctor tells me this is normal. I'm 75 years old, and my calcium levels before this were always between 9.1 and 9.7 mg/dl. Why is my calcium rising?

At your age, a calcium of 10.3 mg/dl (2.57 mmol/l) is too high. Most adults over about age 40 should have calcium levels in the mid to high 9s, up to 10.0 mg/dl (2.5 mmol/l). Sometimes adults in their 40s will still have calcium levels in the low 10s, but generally these levels drop as you age. By the time you are 75, you should not have any calcium levels above 10.0, especially if your calcium...

Normal calcium Diagnosis

My teenage daughter was recently found to have a calcium of 10.5 mg/dl. The lab says this is high, and her doctor says that she probably needs surgery to remove a parathyroid tumor. What do you think?

A calcium of 10.5 mg/dl (2.62 mmol/l) is normal for a teenager. Teenagers have higher calcium levels than older adults. While a calcium of 10.5 would definitely be high for a 50 year old, it is within the normal range for children and teenagers. Your daughter's lab is not correcting for her age. Her calcium level does not indicate a parathyroid tumor, and so she does not need surgery.

Normal calcium Diagnosis

I have been following my calcium levels for the last few years, and they seem to fluctuate a lot. I read that this could indicate parathyroid disease. My calcium levels over the last four years were as follows: 9.7, 9.2, 9.1, 9.8, 9.9, 9.1. Do you think I have parathyroid disease? I'm a 52 year old man.

As long as your calcium levels are staying in the normal range (which they are), then some fluctuation is normal. In general, your parathyroid glands do try to maintain a relatively steady calcium level, but this does not mean that the level will be exactly the same every time it is checked. Your labs appear completely normal. My answer would change if you had calcium levels fluctuating int...

Normal calcium Diagnosis

My calcium level has been high-normal for the last two years. My PTH level is high (85 pg/ml). My doctor says I do not need to be concerned because the calcium is still normal - around 10.2 mg/dl. I'm a 73 year old woman. Do I have parathyroid disease?

For your age, this calcium level is not "high-normal" - it is high. A normal calcium range for someone in her 70s would go up to about 10.0, not higher. While I cannot diagnose someone over the internet, I can say that in general, multiple calcium levels over 10.0 and a PTH of 85 in a woman in her 70s are consistent with a diagnosis of primary hyperparathyroidism. Even though your calcium l...

Normal calcium Diagnosis

Last year I was diagnosed with parathyroid disease. My doctor recommended just watching it. Last year my calcium was 10.5, but now it is 9.8 and my doctor says that I don't have parathyroid disease. Does it sometimes go away without treatment?

Primary hyperparathyroidism does not resolve on its own, but the calcium levels can fluctuate back into the normal range. This does not mean that the diseased parathyroid glands have improved. Diseased parathyroid glands act inappropriately; they often don't make a steady amount of PTH. Some days they dump out more PTH, some days less. The PTH thus fluctuates, and so the calcium fluctuates. Thi...

Normal calcium Diagnosis

What is a normal calcium level?

Calcium levels vary with age, and normal range drops as you get older. For children and teenagers, calcium levels can range from about 9.3 mg/dl (2.32 mmol/l) to 10.9 mg/dl (2.72 mmol/L). That upper range of normal drops after the teenage years. Adults in their 20s can still have calcium levels up to the mid 10s (or around 2.64 mmol/l). Adults in their 30s tend to have calcium levels in the mid...

Normal calcium FAQ

I have all of the symptoms of parathyroid disease. I'm exhausted, can't concentrate, have back pain, can't sleep at night, and just feel awful. I discovered parathyroid disease and it seems to account for all of my symptoms over the last year. My calcium level, though, was normal at 9.8 mg/dl. My doctor checked a PTH and it was 43 ng/ml. She says I don't have parathyroid disease. Could I still have it, even with normal labs?

Your symptoms are consistent with the common symptoms of primary hyperparathyroidism, but with normal calcium and PTH levels that is not likely to be your underlying problem. We diagnose parathyroid disease with labs: primarily calcium and PTH; Vitamin D is also helpful in many cases. If the calcium and PTH levels are consistently normal, then parathyroid disease is very unlikely. The one t...

Diagnosis Normal calcium

Do you have any thoughts on why there are so many varying opinions on what lab values actually confirm a diagnosis? For example many very well respected experienced surgeons and endocrinologists correct calcium for albumin even when it’s not low. This can bring a high calcium down to normal or even low and possibly miss a diagnosis.

It's a great question. It seems like we should all be able to agree on which lab values are normal. Unfortunately this is not the case, and there are a few reasons. First, when the lab gives the results, it gives a "normal range" - but this is looking at all humans in aggregate. A normal human can have a calcium of 10.5 mg/dl when she is 20 years old, but should not have that when she is 80...

Diagnosis Normal calcium Albumin

Others have said that calcium levels do not change with age. Why do you say that they do?

It is not controversial to state that calcium levels vary with age - this has been known for a long time. Studies have shown for decades that healthy children have calcium levels up into the high 10s (mg/dl) range. You are not born with a calcium level that persists for a lifetime. This is not in debate. Over time, the calcium level drops as children become young adults. There is no magic a...

My brother is 33 years old. Last year his calcium level was 10.4 mg/dl and this year its 10.3. Should we be concerned since it is above 10? Should we request the doctor to do more lab tests?

At 33 years old, a calcium of 10.3 mg/dl can be normal. It's on the higher end of normal, but still normal. It's always a good idea to look at prior labs, so the calcium from last year is helpful. If possible, it would be good to see any prior labs also. If his calcium was in the 9s throughout his 20s, but is now in the 10s, then that would be concerning for primary hyperparathyroidism. If his ...

Normal calcium Primary HPT Diagnosis

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 PTH is high (118 pg/ml), but my calcium is normal at 9.6 mg/dl. My urine calcium 24hr is 207. What would this indicate? Normal? Way weird?

Thanks for asking! The short answer is that your labs are in a gray zone, so with just this information, it is not possible to make a definitive diagnosis. To figure out what is going on, I would need to get a thorough history and would want to see more labs. I'll go through my process here. There are two possible diagnoses that could explain your labs: 1. Normocalcemic primary hyperparathy...

Secondary HPT Diagnosis primary hyperparathyroidism Normal calcium

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