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I Recently Had My Annual Lab Work Done And Most
Question: I recently had my annual lab work done and most of it was normal. There was one test which was calcium that came back at 10.3. The normal range is 8.6-10.3 and the lab was Quest diagnostics. My doctor called with all my results and made no mention of calcium being on high end of normal. I questioned it after seeing him after this and he decided to order a PTH intact with ionized calcium. Got these results and the ionized calcium was 5.7, reference range 4.8-5.6, PTH intact was 10, reference range 14-64 and calcium was checked and it was 10.3, reference range 8.6-10.3. This test was done by Quest Diagnostics. My doctor ordered a vitamin D test and it was 31 which is normal. I am a 57 year old male and from what I have read it seems that my calcium is too high and now that the ionized is slightly higher than normal I am concerned that there is a major issue going on like cancer. Usually my calcium levels are around 9.8, once in 2017 it was 10 but otherwise it typically is in the nines. I have also read that this could be hypercalcemia of malignancy. Lot of confusing information on the internet. My doctor said if it was cancer that calcium would likely be much higher, closer to 13 or more. He doesn't seem very concerned so I am thinking I should get another cmp test and have the calcium checked since it has been 2 weeks since the ionized calcium and total calcium was checked. What is your opinion on the information I provided? I also read that ionized calcium tests can be skewed if the blood isn't drawn properly and also if the sample isn't tested within hours of collection. There were some issues when the blood was drawn because the techs couldn't find veins and there was a lot of fist clenching.
Asked by Me , 5 hours ago
Got this response from online doctor
Doctor's reply to your question above...
Brief Answer:
I agree with your doctor
Detailed Answer:
Dear sir, I have gone through your question and I understand your concerns but I agree with your doctor that malignancy is an unlikely cause as the calcium level is slightly elevated.. However, since vitamin d level is within normal range then I would recommend that you get a blood test for thyroid hormonal profile including T3,T4 and TSH together with a blood test to check on your renal functions including urea and creatinine in order to exclude more common causes of increased calcium level. I hope you find this helpful
Replied by Dr. Salah XXXXXXX Shoman , 4 hours ago
Disclaimer: The Expert's advice is provided for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, as a complete assessment of an individual has not taken place. Please consult your nearest physician before acting on it. The advice is not valid for medico-legal purposes also.
My reply:
Thanks for the response. Here are some of the results of the blood tests you suggested which weren't included in the original question. UREA NITROGEN (BUN) 34, reference range 7-25, Creatinine 1.10, reference range 0.70-1.33, Bun/creatinine ratio 31, reference range 6-22 (calc), TSH 0.92, reference range 0.40-4.50 mIU/L, T4 Free 1.2, reference range 0.8-1.8 ng/dL
As you can see the urea/bun and bun/creatinine are higher than normal. My bun is always higher than normal although these results were slightly higher than previous lab tests.
The fact that my ionized calcium is slightly elevated and PTH is so low doesn't raise concerns? Also is it true that being and adult that your calcium should really be in the nines and not above 10?
Is it possible that the urea/bun and bun/creatinine being higher than normal are causing the ionized calcium to be above normal?
Based on all the information I provided is this considered hypercalcemia?
Do I need to do any other blood tests at this point and do you think I should recheck my serum calcium?
Thanks
Asked by Me , 3 hours ago
Never got a response back so this is why I am submitting the entire thread.
Asked by Me , 5 hours ago
Got this response from online doctor
Doctor's reply to your question above...
Brief Answer:
I agree with your doctor
Detailed Answer:
Dear sir, I have gone through your question and I understand your concerns but I agree with your doctor that malignancy is an unlikely cause as the calcium level is slightly elevated.. However, since vitamin d level is within normal range then I would recommend that you get a blood test for thyroid hormonal profile including T3,T4 and TSH together with a blood test to check on your renal functions including urea and creatinine in order to exclude more common causes of increased calcium level. I hope you find this helpful
Replied by Dr. Salah XXXXXXX Shoman , 4 hours ago
Disclaimer: The Expert's advice is provided for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, as a complete assessment of an individual has not taken place. Please consult your nearest physician before acting on it. The advice is not valid for medico-legal purposes also.
My reply:
Thanks for the response. Here are some of the results of the blood tests you suggested which weren't included in the original question. UREA NITROGEN (BUN) 34, reference range 7-25, Creatinine 1.10, reference range 0.70-1.33, Bun/creatinine ratio 31, reference range 6-22 (calc), TSH 0.92, reference range 0.40-4.50 mIU/L, T4 Free 1.2, reference range 0.8-1.8 ng/dL
As you can see the urea/bun and bun/creatinine are higher than normal. My bun is always higher than normal although these results were slightly higher than previous lab tests.
The fact that my ionized calcium is slightly elevated and PTH is so low doesn't raise concerns? Also is it true that being and adult that your calcium should really be in the nines and not above 10?
Is it possible that the urea/bun and bun/creatinine being higher than normal are causing the ionized calcium to be above normal?
Based on all the information I provided is this considered hypercalcemia?
Do I need to do any other blood tests at this point and do you think I should recheck my serum calcium?
Thanks
Asked by Me , 3 hours ago
Never got a response back so this is why I am submitting the entire thread.
I recently had my annual lab work done and most of it was normal. There was one test which was calcium that came back at 10.3. The normal range is 8.6-10.3 and the lab was Quest diagnostics. My doctor called with all my results and made no mention of calcium being on high end of normal. I questioned it after seeing him after this and he decided to order a PTH intact with ionized calcium. Got these results and the ionized calcium was 5.7, reference range 4.8-5.6, PTH intact was 10, reference range 14-64 and calcium was checked and it was 10.3, reference range 8.6-10.3. This test was done by Quest Diagnostics. My doctor ordered a vitamin D test and it was 31 which is normal. I am a 57 year old male and from what I have read it seems that my calcium is too high and now that the ionized is slightly higher than normal I am concerned that there is a major issue going on like cancer. Usually my calcium levels are around 9.8, once in 2017 it was 10 but otherwise it typically is in the nines. I have also read that this could be hypercalcemia of malignancy. Lot of confusing information on the internet. My doctor said if it was cancer that calcium would likely be much higher, closer to 13 or more. He doesn't seem very concerned so I am thinking I should get another cmp test and have the calcium checked since it has been 2 weeks since the ionized calcium and total calcium was checked. What is your opinion on the information I provided? I also read that ionized calcium tests can be skewed if the blood isn't drawn properly and also if the sample isn't tested within hours of collection. There were some issues when the blood was drawn because the techs couldn't find veins and there was a lot of fist clenching.
Asked by Me , 5 hours ago
Got this response from online doctor
Doctor's reply to your question above...
Brief Answer:
I agree with your doctor
Detailed Answer:
Dear sir, I have gone through your question and I understand your concerns but I agree with your doctor that malignancy is an unlikely cause as the calcium level is slightly elevated.. However, since vitamin d level is within normal range then I would recommend that you get a blood test for thyroid hormonal profile including T3,T4 and TSH together with a blood test to check on your renal functions including urea and creatinine in order to exclude more common causes of increased calcium level. I hope you find this helpful
Replied by Dr. Salah XXXXXXX Shoman , 4 hours ago
Disclaimer: The Expert's advice is provided for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, as a complete assessment of an individual has not taken place. Please consult your nearest physician before acting on it. The advice is not valid for medico-legal purposes also.
My reply:
Thanks for the response. Here are some of the results of the blood tests you suggested which weren't included in the original question. UREA NITROGEN (BUN) 34, reference range 7-25, Creatinine 1.10, reference range 0.70-1.33, Bun/creatinine ratio 31, reference range 6-22 (calc), TSH 0.92, reference range 0.40-4.50 mIU/L, T4 Free 1.2, reference range 0.8-1.8 ng/dL
As you can see the urea/bun and bun/creatinine are higher than normal. My bun is always higher than normal although these results were slightly higher than previous lab tests.
The fact that my ionized calcium is slightly elevated and PTH is so low doesn't raise concerns? Also is it true that being and adult that your calcium should really be in the nines and not above 10?
Is it possible that the urea/bun and bun/creatinine being higher than normal are causing the ionized calcium to be above normal?
Based on all the information I provided is this considered hypercalcemia?
Do I need to do any other blood tests at this point and do you think I should recheck my serum calcium?
Thanks
Asked by Me , 3 hours ago
Never got a response back so this is why I am submitting the entire thread.
Asked by Me , 5 hours ago
Got this response from online doctor
Doctor's reply to your question above...
Brief Answer:
I agree with your doctor
Detailed Answer:
Dear sir, I have gone through your question and I understand your concerns but I agree with your doctor that malignancy is an unlikely cause as the calcium level is slightly elevated.. However, since vitamin d level is within normal range then I would recommend that you get a blood test for thyroid hormonal profile including T3,T4 and TSH together with a blood test to check on your renal functions including urea and creatinine in order to exclude more common causes of increased calcium level. I hope you find this helpful
Replied by Dr. Salah XXXXXXX Shoman , 4 hours ago
Disclaimer: The Expert's advice is provided for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, as a complete assessment of an individual has not taken place. Please consult your nearest physician before acting on it. The advice is not valid for medico-legal purposes also.
My reply:
Thanks for the response. Here are some of the results of the blood tests you suggested which weren't included in the original question. UREA NITROGEN (BUN) 34, reference range 7-25, Creatinine 1.10, reference range 0.70-1.33, Bun/creatinine ratio 31, reference range 6-22 (calc), TSH 0.92, reference range 0.40-4.50 mIU/L, T4 Free 1.2, reference range 0.8-1.8 ng/dL
As you can see the urea/bun and bun/creatinine are higher than normal. My bun is always higher than normal although these results were slightly higher than previous lab tests.
The fact that my ionized calcium is slightly elevated and PTH is so low doesn't raise concerns? Also is it true that being and adult that your calcium should really be in the nines and not above 10?
Is it possible that the urea/bun and bun/creatinine being higher than normal are causing the ionized calcium to be above normal?
Based on all the information I provided is this considered hypercalcemia?
Do I need to do any other blood tests at this point and do you think I should recheck my serum calcium?
Thanks
Asked by Me , 3 hours ago
Never got a response back so this is why I am submitting the entire thread.
Brief Answer:
Considerations
Detailed Answer:
Hello and thank you for sending the query.
I completely understand your concern regarding the calcium level and PTH - particularly in light of the fact that if one does do some research online there is an abundance of misinformation which can contribute to alot of anxiety about the significance of an abnormal blood test.
I agree - your calcium is at the upper limit of normal. This does not always indicate a disease process however. There are many things which contribute to a calcium level including dietary intake, kidney function, bone metabolism and normal endocrine function which includes vitamin D metabolism as well.
Your doctor has done a very good workup thus far.
I would not label your case as hypercalcemia - but I would followup on the lab results likely with a repeat comprehensive metabolic panel in 4-6 weeks from the prior result.
If the level is stable - would repeat it thereafter in 4-6 months.
I would like to review a copy of your entire set of labs if possible. If you have a copy of the comprehensive metabolic panel and any additional labs drawn including CBC, phosphorous level and vitamin D analysis - please upload those here and I will review those.
Having lab results readily available for review is a double - edged sword so to speak. Physicians are well aware that "normal" does not apply to the entire population. For example - there may be a set of the population that "normally" carries a calcium of 10.6 - and this is completely absent any disease process. The lab ranges of normal are simply an average range for the population. There will always be people who normally run higher or lower than that range of normal.
Thank you again for the query. I look forward to reviewing the additional lab results if you are able to upload those.
Sincerely,
Dr. Robert Galamaga
Considerations
Detailed Answer:
Hello and thank you for sending the query.
I completely understand your concern regarding the calcium level and PTH - particularly in light of the fact that if one does do some research online there is an abundance of misinformation which can contribute to alot of anxiety about the significance of an abnormal blood test.
I agree - your calcium is at the upper limit of normal. This does not always indicate a disease process however. There are many things which contribute to a calcium level including dietary intake, kidney function, bone metabolism and normal endocrine function which includes vitamin D metabolism as well.
Your doctor has done a very good workup thus far.
I would not label your case as hypercalcemia - but I would followup on the lab results likely with a repeat comprehensive metabolic panel in 4-6 weeks from the prior result.
If the level is stable - would repeat it thereafter in 4-6 months.
I would like to review a copy of your entire set of labs if possible. If you have a copy of the comprehensive metabolic panel and any additional labs drawn including CBC, phosphorous level and vitamin D analysis - please upload those here and I will review those.
Having lab results readily available for review is a double - edged sword so to speak. Physicians are well aware that "normal" does not apply to the entire population. For example - there may be a set of the population that "normally" carries a calcium of 10.6 - and this is completely absent any disease process. The lab ranges of normal are simply an average range for the population. There will always be people who normally run higher or lower than that range of normal.
Thank you again for the query. I look forward to reviewing the additional lab results if you are able to upload those.
Sincerely,
Dr. Robert Galamaga
Above answer was peer-reviewed by :
Dr. Yogesh D
Brief Answer:
Considerations
Detailed Answer:
Hello and thank you for sending the query.
I completely understand your concern regarding the calcium level and PTH - particularly in light of the fact that if one does do some research online there is an abundance of misinformation which can contribute to alot of anxiety about the significance of an abnormal blood test.
I agree - your calcium is at the upper limit of normal. This does not always indicate a disease process however. There are many things which contribute to a calcium level including dietary intake, kidney function, bone metabolism and normal endocrine function which includes vitamin D metabolism as well.
Your doctor has done a very good workup thus far.
I would not label your case as hypercalcemia - but I would followup on the lab results likely with a repeat comprehensive metabolic panel in 4-6 weeks from the prior result.
If the level is stable - would repeat it thereafter in 4-6 months.
I would like to review a copy of your entire set of labs if possible. If you have a copy of the comprehensive metabolic panel and any additional labs drawn including CBC, phosphorous level and vitamin D analysis - please upload those here and I will review those.
Having lab results readily available for review is a double - edged sword so to speak. Physicians are well aware that "normal" does not apply to the entire population. For example - there may be a set of the population that "normally" carries a calcium of 10.6 - and this is completely absent any disease process. The lab ranges of normal are simply an average range for the population. There will always be people who normally run higher or lower than that range of normal.
Thank you again for the query. I look forward to reviewing the additional lab results if you are able to upload those.
Sincerely,
Dr. Robert Galamaga
Considerations
Detailed Answer:
Hello and thank you for sending the query.
I completely understand your concern regarding the calcium level and PTH - particularly in light of the fact that if one does do some research online there is an abundance of misinformation which can contribute to alot of anxiety about the significance of an abnormal blood test.
I agree - your calcium is at the upper limit of normal. This does not always indicate a disease process however. There are many things which contribute to a calcium level including dietary intake, kidney function, bone metabolism and normal endocrine function which includes vitamin D metabolism as well.
Your doctor has done a very good workup thus far.
I would not label your case as hypercalcemia - but I would followup on the lab results likely with a repeat comprehensive metabolic panel in 4-6 weeks from the prior result.
If the level is stable - would repeat it thereafter in 4-6 months.
I would like to review a copy of your entire set of labs if possible. If you have a copy of the comprehensive metabolic panel and any additional labs drawn including CBC, phosphorous level and vitamin D analysis - please upload those here and I will review those.
Having lab results readily available for review is a double - edged sword so to speak. Physicians are well aware that "normal" does not apply to the entire population. For example - there may be a set of the population that "normally" carries a calcium of 10.6 - and this is completely absent any disease process. The lab ranges of normal are simply an average range for the population. There will always be people who normally run higher or lower than that range of normal.
Thank you again for the query. I look forward to reviewing the additional lab results if you are able to upload those.
Sincerely,
Dr. Robert Galamaga
Above answer was peer-reviewed by :
Dr. Yogesh D
Dr. XXXXXXX
I have uploaded all of my lab results from 5/20/19. Thank you for your reply. Will you review the results and let me know what you think? Also, are the ionized calcium and PTH results anything to be concerned about? I am scheduled to see my doctor this week. Do you think I should go ahead and get another CMP test or wait? I was also going to get X-rays on chest and back just to rule out any potential issues. Would you recommend that or not?
I have uploaded all of my lab results from 5/20/19. Thank you for your reply. Will you review the results and let me know what you think? Also, are the ionized calcium and PTH results anything to be concerned about? I am scheduled to see my doctor this week. Do you think I should go ahead and get another CMP test or wait? I was also going to get X-rays on chest and back just to rule out any potential issues. Would you recommend that or not?
Dr. XXXXXXX
I have uploaded all of my lab results from 5/20/19. Thank you for your reply. Will you review the results and let me know what you think? Also, are the ionized calcium and PTH results anything to be concerned about? I am scheduled to see my doctor this week. Do you think I should go ahead and get another CMP test or wait? I was also going to get X-rays on chest and back just to rule out any potential issues. Would you recommend that or not?
I have uploaded all of my lab results from 5/20/19. Thank you for your reply. Will you review the results and let me know what you think? Also, are the ionized calcium and PTH results anything to be concerned about? I am scheduled to see my doctor this week. Do you think I should go ahead and get another CMP test or wait? I was also going to get X-rays on chest and back just to rule out any potential issues. Would you recommend that or not?
Brief Answer:
Update
Detailed Answer:
I took a look at your lab results.
All results look quite normal.
A repeat metabolic panel at your next appointment may be reasonable - if only for peace of mind to verify stable levels.
Xrays may not show much and have low risk in terms of very light radiation exposure. I would be surprised if any abnormalities were found.
I am not sure what to conclude from the PTH and ionized CA results. There can be major variability in these results based on how the sample is collected and processed - as you indicated previously.
If for example the calcium level was higher - xrays would be something I would be more inclined to consider. Every physician has his own approach for this sort of thing. Your doctor is doing an excellent job and is clearly comprehensive in his approach.
Sincerely,
Dr Galamaga
Update
Detailed Answer:
I took a look at your lab results.
All results look quite normal.
A repeat metabolic panel at your next appointment may be reasonable - if only for peace of mind to verify stable levels.
Xrays may not show much and have low risk in terms of very light radiation exposure. I would be surprised if any abnormalities were found.
I am not sure what to conclude from the PTH and ionized CA results. There can be major variability in these results based on how the sample is collected and processed - as you indicated previously.
If for example the calcium level was higher - xrays would be something I would be more inclined to consider. Every physician has his own approach for this sort of thing. Your doctor is doing an excellent job and is clearly comprehensive in his approach.
Sincerely,
Dr Galamaga
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Brief Answer:
Update
Detailed Answer:
I took a look at your lab results.
All results look quite normal.
A repeat metabolic panel at your next appointment may be reasonable - if only for peace of mind to verify stable levels.
Xrays may not show much and have low risk in terms of very light radiation exposure. I would be surprised if any abnormalities were found.
I am not sure what to conclude from the PTH and ionized CA results. There can be major variability in these results based on how the sample is collected and processed - as you indicated previously.
If for example the calcium level was higher - xrays would be something I would be more inclined to consider. Every physician has his own approach for this sort of thing. Your doctor is doing an excellent job and is clearly comprehensive in his approach.
Sincerely,
Dr Galamaga
Update
Detailed Answer:
I took a look at your lab results.
All results look quite normal.
A repeat metabolic panel at your next appointment may be reasonable - if only for peace of mind to verify stable levels.
Xrays may not show much and have low risk in terms of very light radiation exposure. I would be surprised if any abnormalities were found.
I am not sure what to conclude from the PTH and ionized CA results. There can be major variability in these results based on how the sample is collected and processed - as you indicated previously.
If for example the calcium level was higher - xrays would be something I would be more inclined to consider. Every physician has his own approach for this sort of thing. Your doctor is doing an excellent job and is clearly comprehensive in his approach.
Sincerely,
Dr Galamaga
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Brief Answer:
Followup
Detailed Answer:
I was very pleased to review the results that you uploaded.
It looks like your labs are absolutely normal. I think your doctor is doing the right thing in general in terms of follow-up. The x-rays appear fine as well. Those small opacities that they described in the lower parts of the lungs are most likely nothing, possibly scar tissue but really not indicative of anything worrisome in my opinion.
Of course, ultimately your primary care physician will discuss the findings with you and any appropriate follow-up that he might suggest.
Regarding the cheese, this could theoretically affect your calcium level I suppose. I think it was a multitude of factors that probably influenced your prior lab results. This is why we often check labs on a serial basis rather than react strongly to a single abnormal result.
Thank you again for sharing your health care concerns with me on this platform. I wish you all the best and continued excellent health in the future.
Sincerely,
Dr. Galamaga
Followup
Detailed Answer:
I was very pleased to review the results that you uploaded.
It looks like your labs are absolutely normal. I think your doctor is doing the right thing in general in terms of follow-up. The x-rays appear fine as well. Those small opacities that they described in the lower parts of the lungs are most likely nothing, possibly scar tissue but really not indicative of anything worrisome in my opinion.
Of course, ultimately your primary care physician will discuss the findings with you and any appropriate follow-up that he might suggest.
Regarding the cheese, this could theoretically affect your calcium level I suppose. I think it was a multitude of factors that probably influenced your prior lab results. This is why we often check labs on a serial basis rather than react strongly to a single abnormal result.
Thank you again for sharing your health care concerns with me on this platform. I wish you all the best and continued excellent health in the future.
Sincerely,
Dr. Galamaga
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Brief Answer:
Followup
Detailed Answer:
I was very pleased to review the results that you uploaded.
It looks like your labs are absolutely normal. I think your doctor is doing the right thing in general in terms of follow-up. The x-rays appear fine as well. Those small opacities that they described in the lower parts of the lungs are most likely nothing, possibly scar tissue but really not indicative of anything worrisome in my opinion.
Of course, ultimately your primary care physician will discuss the findings with you and any appropriate follow-up that he might suggest.
Regarding the cheese, this could theoretically affect your calcium level I suppose. I think it was a multitude of factors that probably influenced your prior lab results. This is why we often check labs on a serial basis rather than react strongly to a single abnormal result.
Thank you again for sharing your health care concerns with me on this platform. I wish you all the best and continued excellent health in the future.
Sincerely,
Dr. Galamaga
Followup
Detailed Answer:
I was very pleased to review the results that you uploaded.
It looks like your labs are absolutely normal. I think your doctor is doing the right thing in general in terms of follow-up. The x-rays appear fine as well. Those small opacities that they described in the lower parts of the lungs are most likely nothing, possibly scar tissue but really not indicative of anything worrisome in my opinion.
Of course, ultimately your primary care physician will discuss the findings with you and any appropriate follow-up that he might suggest.
Regarding the cheese, this could theoretically affect your calcium level I suppose. I think it was a multitude of factors that probably influenced your prior lab results. This is why we often check labs on a serial basis rather than react strongly to a single abnormal result.
Thank you again for sharing your health care concerns with me on this platform. I wish you all the best and continued excellent health in the future.
Sincerely,
Dr. Galamaga
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Dr. Galapaga,
Thank you again for your response and confirming what I thought may have skewed the Ionized calcium and PTH. I say my doctor yesterday and per my request he ordered another CBC and CMP panel stat. The CBC was done by their lab and the CMP was done at Sarasota Memorial. He also ordered X-rays of chest and back. I have uploaded all those results. You won't believe what the calcium is now. It is much lower and rather shocking and now has me wondering about Quest Diagnostics and their testing. Maybe they have some bad equipment or maybe this confirms they aren't storing samples correctly or drawing the blood properly. The calcium dropped substantially. One thing I forgot to mention is I eat a lot of cheese but this time I purposely didn't eat any cheese within 36 hours of these tests so wondering if that would have changed the calcium level. It is almost too low now. Let me know what you think of the blood work and the X-rays. Thanks again for your help.
Thank you again for your response and confirming what I thought may have skewed the Ionized calcium and PTH. I say my doctor yesterday and per my request he ordered another CBC and CMP panel stat. The CBC was done by their lab and the CMP was done at Sarasota Memorial. He also ordered X-rays of chest and back. I have uploaded all those results. You won't believe what the calcium is now. It is much lower and rather shocking and now has me wondering about Quest Diagnostics and their testing. Maybe they have some bad equipment or maybe this confirms they aren't storing samples correctly or drawing the blood properly. The calcium dropped substantially. One thing I forgot to mention is I eat a lot of cheese but this time I purposely didn't eat any cheese within 36 hours of these tests so wondering if that would have changed the calcium level. It is almost too low now. Let me know what you think of the blood work and the X-rays. Thanks again for your help.
Dr. Galapaga,
Thank you again for your response and confirming what I thought may have skewed the Ionized calcium and PTH. I say my doctor yesterday and per my request he ordered another CBC and CMP panel stat. The CBC was done by their lab and the CMP was done at Sarasota Memorial. He also ordered X-rays of chest and back. I have uploaded all those results. You won't believe what the calcium is now. It is much lower and rather shocking and now has me wondering about Quest Diagnostics and their testing. Maybe they have some bad equipment or maybe this confirms they aren't storing samples correctly or drawing the blood properly. The calcium dropped substantially. One thing I forgot to mention is I eat a lot of cheese but this time I purposely didn't eat any cheese within 36 hours of these tests so wondering if that would have changed the calcium level. It is almost too low now. Let me know what you think of the blood work and the X-rays. Thanks again for your help.
Thank you again for your response and confirming what I thought may have skewed the Ionized calcium and PTH. I say my doctor yesterday and per my request he ordered another CBC and CMP panel stat. The CBC was done by their lab and the CMP was done at Sarasota Memorial. He also ordered X-rays of chest and back. I have uploaded all those results. You won't believe what the calcium is now. It is much lower and rather shocking and now has me wondering about Quest Diagnostics and their testing. Maybe they have some bad equipment or maybe this confirms they aren't storing samples correctly or drawing the blood properly. The calcium dropped substantially. One thing I forgot to mention is I eat a lot of cheese but this time I purposely didn't eat any cheese within 36 hours of these tests so wondering if that would have changed the calcium level. It is almost too low now. Let me know what you think of the blood work and the X-rays. Thanks again for your help.
Thanks for the detailed response. You mentioned the X-ray is probably nothing to be concerned about and my doctor didn't recommend any other testing as a result of the mild opacities. I have intermittent shortness of breath. Could the opacities be the cause of this? If this was something serious as the internet suggests would the report have been written differently or if follow up was needed would that have been suggested on the report? Since you are an oncologist you would know and I just want to be sure this isn't some major problem that requires further evaluation. Again, the doctor didn't suggest any follow up. I have had chest X-rays in the past and don't recall having opacities. Also I noticed on the report there was a comparison from 4/6/16 and no mention is made of no changes. As you can tell by now I am a hypochondriac. Thanks for all of your help and it is obvious you are great at what you do.
Thanks for the detailed response. You mentioned the X-ray is probably nothing to be concerned about and my doctor didn't recommend any other testing as a result of the mild opacities. I have intermittent shortness of breath. Could the opacities be the cause of this? If this was something serious as the internet suggests would the report have been written differently or if follow up was needed would that have been suggested on the report? Since you are an oncologist you would know and I just want to be sure this isn't some major problem that requires further evaluation. Again, the doctor didn't suggest any follow up. I have had chest X-rays in the past and don't recall having opacities. Also I noticed on the report there was a comparison from 4/6/16 and no mention is made of no changes. As you can tell by now I am a hypochondriac. Thanks for all of your help and it is obvious you are great at what you do.
Brief Answer:
Follow up
Detailed Answer:
Hello again.
First of all I would consider you far from a hypochondriac. I understand your drive to understand your lab results and imaging results as I would feel the same way.
As for the opacities - this is a very nonspecific finding. If you did an X-ray on 10 people - I would venture to guess well over half would have such a finding.
I would doubt shortness of breath would be caused by the opacities notes by the radiologist.
If you’d like peace of mind you could perhaps have a repeat X-ray some in 3-4 months to confirm stability or resolution.
Thanks again for your query.
Regards,
Dr Galamaga
Follow up
Detailed Answer:
Hello again.
First of all I would consider you far from a hypochondriac. I understand your drive to understand your lab results and imaging results as I would feel the same way.
As for the opacities - this is a very nonspecific finding. If you did an X-ray on 10 people - I would venture to guess well over half would have such a finding.
I would doubt shortness of breath would be caused by the opacities notes by the radiologist.
If you’d like peace of mind you could perhaps have a repeat X-ray some in 3-4 months to confirm stability or resolution.
Thanks again for your query.
Regards,
Dr Galamaga
Above answer was peer-reviewed by :
Dr. Yogesh D
Brief Answer:
Follow up
Detailed Answer:
Hello again.
First of all I would consider you far from a hypochondriac. I understand your drive to understand your lab results and imaging results as I would feel the same way.
As for the opacities - this is a very nonspecific finding. If you did an X-ray on 10 people - I would venture to guess well over half would have such a finding.
I would doubt shortness of breath would be caused by the opacities notes by the radiologist.
If you’d like peace of mind you could perhaps have a repeat X-ray some in 3-4 months to confirm stability or resolution.
Thanks again for your query.
Regards,
Dr Galamaga
Follow up
Detailed Answer:
Hello again.
First of all I would consider you far from a hypochondriac. I understand your drive to understand your lab results and imaging results as I would feel the same way.
As for the opacities - this is a very nonspecific finding. If you did an X-ray on 10 people - I would venture to guess well over half would have such a finding.
I would doubt shortness of breath would be caused by the opacities notes by the radiologist.
If you’d like peace of mind you could perhaps have a repeat X-ray some in 3-4 months to confirm stability or resolution.
Thanks again for your query.
Regards,
Dr Galamaga
Above answer was peer-reviewed by :
Dr. Yogesh D
Couple more questions.
The opacities aren't a possible sign of cancer are they? If cancer was suspect on report would the radiologist have noted that? Do you recommend that I get another PTH and ionized calcium test to check my parathyroid or just let it go?
Thanks
The opacities aren't a possible sign of cancer are they? If cancer was suspect on report would the radiologist have noted that? Do you recommend that I get another PTH and ionized calcium test to check my parathyroid or just let it go?
Thanks
Couple more questions.
The opacities aren't a possible sign of cancer are they? If cancer was suspect on report would the radiologist have noted that? Do you recommend that I get another PTH and ionized calcium test to check my parathyroid or just let it go?
Thanks
The opacities aren't a possible sign of cancer are they? If cancer was suspect on report would the radiologist have noted that? Do you recommend that I get another PTH and ionized calcium test to check my parathyroid or just let it go?
Thanks
Brief Answer:
Followup
Detailed Answer:
I am not really concerned about the parathyroid and calcium levels. I would not likely retest these individually. A basic metabolic panel can be checked at your next routine follow-up visit.
Regarding the chest x-ray findings, this is doubtful to represent any type of cancer but your doctor must decide about interval imaging or repeat imaging. Typically in my practice I would probably repeat a chest x-ray in about 3 months. I recommend you discuss this in detail with your primary physician. The ultimate goal of repeat imaging is to document stability or resolution of the previous x-ray findings.
Thank you again for sending the question.
Sincerely,
Dr. Galamaga
Followup
Detailed Answer:
I am not really concerned about the parathyroid and calcium levels. I would not likely retest these individually. A basic metabolic panel can be checked at your next routine follow-up visit.
Regarding the chest x-ray findings, this is doubtful to represent any type of cancer but your doctor must decide about interval imaging or repeat imaging. Typically in my practice I would probably repeat a chest x-ray in about 3 months. I recommend you discuss this in detail with your primary physician. The ultimate goal of repeat imaging is to document stability or resolution of the previous x-ray findings.
Thank you again for sending the question.
Sincerely,
Dr. Galamaga
Above answer was peer-reviewed by :
Dr. Prasad
Brief Answer:
Followup
Detailed Answer:
I am not really concerned about the parathyroid and calcium levels. I would not likely retest these individually. A basic metabolic panel can be checked at your next routine follow-up visit.
Regarding the chest x-ray findings, this is doubtful to represent any type of cancer but your doctor must decide about interval imaging or repeat imaging. Typically in my practice I would probably repeat a chest x-ray in about 3 months. I recommend you discuss this in detail with your primary physician. The ultimate goal of repeat imaging is to document stability or resolution of the previous x-ray findings.
Thank you again for sending the question.
Sincerely,
Dr. Galamaga
Followup
Detailed Answer:
I am not really concerned about the parathyroid and calcium levels. I would not likely retest these individually. A basic metabolic panel can be checked at your next routine follow-up visit.
Regarding the chest x-ray findings, this is doubtful to represent any type of cancer but your doctor must decide about interval imaging or repeat imaging. Typically in my practice I would probably repeat a chest x-ray in about 3 months. I recommend you discuss this in detail with your primary physician. The ultimate goal of repeat imaging is to document stability or resolution of the previous x-ray findings.
Thank you again for sending the question.
Sincerely,
Dr. Galamaga
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Prasad
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