Is Calcium Level Of 11.0 A Cause For Concern?

Posted on Fri, 11 Sep 2015

Question: What does it mean (or what possible causes) are related to intact PHT levels but high calcium levels. My calcium is 11.0 but my PHT levels are intact. Are the types of nodules (either kind) usually cancer? I have a biopsy scheduled soon... but I wanted to know the likelihood of this, given the information I know.

Answered by Dr. Binu Parameswaran Pillai (1 hour later)

Brief Answer:
INTACT PTH dosent necessarily mean normal PTH

Detailed Answer:
Good day,
Noted your concern. We expect the PTH to go high when calcium is elevated. PTH molecule has 3 diferent split products. Intact PTH just means we are measureing the whole PTH molecule, not just the split product. Please do not confuse the term " INTACT" PTH as normal PTH.

Could you please attach the actual report ? I would like to see your Intact PTH levels . That would be a very valuable information to decide the next step.

Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (32 minutes later)

I uploaded the test results I have. I hope it is the correct information. Thank you, XXXXXXX

Answered by Dr. Binu Parameswaran Pillai (50 minutes later)

Brief Answer:
High calcium independent of PTH

Detailed Answer:
Thank you. Your PTH seems to be norml ( high normal). If the calcium remains high, but PTH is not elevated, then we have to do few other tests,
1) 24 hour urine calcium and creatinine.
2) Vitain D and 1, 25 hydroxy vitamin D levels
3) CBC, ESR

And based on these, we may have to plan further. Your calcium elevation seems to be independent of PTH. Thyroid nodules are different and we need to evaluate the thyroid nodules and high calcium seperately. I hope your endocrinologist is planning few tests.

By the way, do you know of any family ember having high calcium ( father/mother/kids/siblings?)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (19 minutes later)

I do not know any information about other family members related to high calcium. I do know that my calcium levels have been up to 11.5 before and then dropped to 10.?..... so over the years, I have been up and down (over the range of 10.7 at times, then back down). I do know that my biological mother had multiple nodules in her thyroid and had a large tumor and part of the thyroid removed. It was not cancerous and her thyroid functions normally without medications. She had thyroid surgery when she was 40 and she is now 74. can you tell me if you think cancer is a serious concern? My mother had benign nodules.... ? I want to know if this calcium elevation with PTH being normal is a significant concern???

Answered by Dr. Binu Parameswaran Pillai (2 hours later)

Brief Answer:
Very less chance of thyroid cancer.

Detailed Answer:
Please do not worry about cancer in thyroid nodules. the small nodules just need observation. The 1 cm x 0.7 x 1 cm nodule need an FNA ( needle test) to exclude cancer. Most thyroid cancers are curable and easy to treat. There is less than 5% chance of cancer in a thyroid nodule.

But we need to get to the bottom of high calcium. Your endo must be working on it. You need a 24 hour urine calcium and creatinine, vitamin D test, 1,25 hydroxyl vitamin D test etc. You may also need a chest Xray to start with.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar