Suggest A Diet Plan While Experiencing Elevated Potassium, Blood Sugar, Persistently Elevated Serum Calcium, Excessive Thirst And Low Vitamin D Level

Brief Answer:
Thoughts on this

Detailed Answer:
Hello -

I did not realize you were taking Fosamax. That wasn't part of the last question so I didn't know.

So looking at what has happened you have:
Elevated potassium
Slightly elevated blood sugar (non-fasting?)
Persistently elevated serum calcium
Excessive thirst
Low Vit. D

The elevated potassium is unlikely to be related to potassium from food as research shows normal kidneys have no trouble getting rid of that.

It's possible the elevated potassium was due to the technique of the person who handled it. This is because if red blood cells break during the transferring/handling of the specimen, potassium that is inside the cells spills out giving a false reading.

But elevated potassium could be due to other problems so it bears checking potassium level.

Your excessive thirst could be from the continued elevation in calcium. I think this is much more likely than from your minimally elevated blood sugar (which isn't particularly elevated if you were not fasting when it was drawn).

I really doubt that the premarin cream is causing the problem. It does not enter the system in amounts that oral premarin does, and the pamphlet side effect information is based on systemic premarin.

At this point what I recommend is:
1. Call the nurse practitioner and request the PTH test as well as 24 hour urine calcium test. The later requires a special container. The cause of your hypercalcemia needs to be sorted out ASAP. When you have your blood draw, your potassium should be rechecked, and I'd get an A1C if that blood sugar was not done fasting. Don't wait until you are seen by the doctor - get these tests done now so you will be able to move forward when you see him/her.

So ask for:
-PTH test
-24 hour urine calcium
-repeat potassium (to see if it was a lab error)
- possibly A1C

Other things to consider are adrenal insufficiency, but you have not detailed symptoms consistent with that.

Now to answer your question of what to eat:
That depends entirely on what the underlying cause is so that needs to be sorted out. I recommend a general healthy balanced diet until we know what the cause of the thirst and hypercalcemia are due to. Don't eat excessive amounts of any one particular thing:

Complex carbohydrates such as whole grains (basmati brown rice, etc), wide range of vegetables and fruits, chicken, turkey, lean meat, fish (as tolerated).

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Brief Answer:
Thoughts on this

Detailed Answer:
Diabetes insipidus is a possibility, but given that you have elevated calcium, I would look to that first, to sort out the reason for it. Elevated calcium can cause excessive thirst.

If the premarin is topical for intravaginal use, it would not be expected to increase serum calcium.

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Brief Answer:
Thoughts on this

Detailed Answer:
Hello -

Yes, sorry for the wait.

In doing a little research on the subject, I found this older article which states that estrogen increases calcium absorption via it's effect on vitamin D. But as your vitamin D level is actually rather low, I would not expect this to be the reason for the elevated serum calcium levels you have been having.

https://XXXX.com/0000

I also found this general article/guidelines about hypercalcemia:

https://www.XXXX.org/0000.html

And here is an article regarding the relationship of taking estrogen with a type of porphyria:

http://www.XXX.com/XXXX

I found some very old articles speculating on the mechanisms by which estrogen may precipitate porphyria cutanea tarda, but as you aren't having sun sensitive blistering, I don't think it is an issue for you.

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Brief Answer:
Thoughts on this

Detailed Answer:
Do you have diarrhea when you don't take the Vitamin D supplement?

And when did the excessive thirst start relative to the meds you've been taking and abnormal labs (the premarin cream, and elevated calcium)?

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