What Causes Breathlessness After Walking For A While?

Brief Answer:
Please see detailed answer

Detailed Answer:
Hi XXXXX,

Welcome to HCM. I have gone through your detailed question, blood reports and understand your concerns.

Reports:
Calcium higher side
High cholesterol
Vitamin D deficiency

Couldn't find any reports of thyroid function or thyroid ultrasound scan - as your questions were regarding that. I presume that you have mis spelt "hyperthyroidism" for "hyperparathyroidism".

The answers for your questions:

Primary Question:

Do I have Hyperthyroidism related Cancer or any other Complications?

This reports are not suggestive of any cancer or hyperthyroidism. Hyperparathyroidism could be a possibility. You need to do a fasting calcium, phosphorus and albumin. If calcium is high and phosphorus is low, you can do a serum parathyroid hormone (PTH) in a good laboratory. Usually hyperparathyroidism will have very high calcium values, low phosphorus and very high PTH.

Secondary Questions:

1) Why my Calcium is on a higher end and Vitamin D on a Lower end together?

Vitamin D deficiency is very common in XXXXXXX population (more than 90%). Calcium is usually normal or lower side on vitamin D deficiency. But if you are testing calcium after food it can be on higher side.

1) Do I have cancer/tumour related to Thyroid Gland?

Hope you are referring to parathyroid. Don't worry. We will first find out if your PTH is elevated. If elevated there could be tumour (usually benign parathyroid adenoma).

2) Any Tests are required to diagnose further?

We can do a repeat calcium, phosphorus, albumin, serum PTH and urine calcium creatinine ratio to look for hyperparathyroidism. These test can be done after correction of vitamin D deficiency as PTH can be slightly high in vitamin D deficiency.

3) If no tests are required then what should be the duration of Wait-and-watch?

You can wait for 1-2 months for correction of vitamin D deficiency.

4) Is their any need to personally visit an Endocrinologist?

It's better, as these blood tests has to be done and interpreted properly. Even if you have done the investigations by own, an endocrinologist will prefer repeating the tests, as entire management and further costly investigations depends on these lab tests.

5) I am taking Vitabiotics Cardioace (Vitamin Supplement), One Capsule per day since one week which is having 20 Micro Gram Vitamin D. Still I am deficient of Vit D, Why?

You are currently on maintenance dose of vitamin D (800 iu/day = 20 mcg). For vitamin D deficiency you need higher dose (around 10,000 iu/day = 250 mcg for 8 weeks) followed by maintenance dose of around 1000 iu/day till vitamin D levels are normal.

6) What is your Overall Recommendation on the conditions mentioned above and what supplements you will suggest to relieve from the situation.

Please do a blood and urine tests, replace vitamin D and decide on further treatment based on blood tests.

Hope I have answered your question. If you have any further questions I will be happy to help.


Regards
Dr Ajish TP
Consultant Endocrinologist

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Brief Answer:
See detailed answer

Detailed Answer:
Hi XXXXXX,

Welcome back.

The elevated calcium may be due to sampling done after food. I suggest you:

1. Do a fasting calcium, phosphorus albumin immediately. If it is grossly abnormal don't delay the tests for long, do evaluation of hyperparathyroidism. If it is ok, correct vitamin D and retest after 2 months.

2. You can start on vitamin D replacement.

What we commonly treat is with vitamin D sachets or tablet - 60,000 IU as a weekly dose x 8 weeks. (Brands in XXXXXXX :
D-Rise 60k XXXXXXX Torflash 60K, Vit D3 60k tablets etc). If calcium is above normal, monitor calcium every week to look for hypercalcaemia (increased calcium). If calcium is normal, repeat calcium, phosphorus albumin after 2 months.

Hope this will clear your doubts. Wishing you good health.

Regards
Dr Ajish TP

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