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Old 12-19-2008, 09:11 AM   #1
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Question Calcium metabolism! Can someone explain?

I haven't been on for a while as I have been told by my Endo that my HypoT (Hashimoto's) has been stabilized with my current meds (Synthroid 62.5mcg Cytomel 5mcg). Last test results were:

TSH 0.88
FT4 0.95 (.58-1.64)
FT3 3.9 (2.3-4.2)

The problem that I am having is that I am just SO fatigued and my hip bones are so painfully sore! Something is off and I can't figure it out. Doctor says calcium is not high enough to worry about.

Calcium 10.5 Previous readings 10.5, 10.3, 9.5, 10.1 (ranges 8.5-10.2 or 10.5)

Ionized calcium 1.35, 1.41, 1.42 (1.17-1.32) Every test has been highDoctor says this test is unreliable!

Vitamin D 24 (40-100) Have taken 2x weekly initially to increase from 19. Levels fell from 45 when on 1x weekly supplements.

PTH 27, 22, 14, 12.4 (12-65)

Phosphorus 4.5 (2.5-4.5) I do NOT drink soda.


Doctor prescribed Vitamin D supplements(50,000IU) to be taken twice a week again. My concern is the discrepancy between the below normal Vitamin D and the calcium level My understanding is that the purpose of Vit. D is to help absorb calcium. If my calcium is at a high normal level, do I really need to increase absorption and an increase in Vit. D? The follow up question is, with a low level of Vit. D how is my calcium so high? Where does the calcium come from if it is not being absorbed in the intestines? I do not supplement. Is the blood measurement of calcium the measurement AFTER it has been absorped by the gut? (Duh! When is it measureable in the blood?)
I have had inappropriately normal to low/normal PTH levels. So it is apparently NOT a parathyroid issue. The doctor says not to worry....just take the Vitamin D.

In adults, deficiency can lead to bone pain and delayed healing of fractures. I have BOTH of these but have high calcium levels!
Calcium is supposed to normalize the growth of cells in the intestinal wall thus protecting the colon. I have just had 5 polyps removed...one was precancerous!

Increased calcium supports normal cholesterol levels. Mine are HIGH 252 (<200) and LDL is also high140 (<100)

Something is causing the Calcium to do the opposite of what it should be doing. Any thoughts would be appreciated. Hoppy

Last edited by hopalong_too; 12-19-2008 at 09:22 AM.

 
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Old 12-19-2008, 12:18 PM   #2
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Re: Calcium metabolism! Can someone explain?

I am in a similar situation - trying to figure out where my high calcium comes from. I also have low PTH (11). My calcium was last 10.2 in a range where 10.2 is the highest end of normal. I am awaiting blood test results from last week to repeat the calcium test.

In the research I have done, it seems that high calcium levels in your blood can come from your bones (what can cause osteoporosis) and also from your diet (from supplements and food/drink consumption). I'm sure it can come from other places too, as I have had a bone density scan (which came back excellent according to the doc) and I do not supplement calcium nor do I consume many dairy products. My doc also says high calcium can happen due to dehydration.

I would be glad to share my high calcium symptoms if only I knew what they were (still recovering from hypoT problems - 8 wks now on synthroid) and I can't figure out what's what. My doc has not said anything about supplementing Vit D, so I would be interested to know if that helps you.

 
Old 12-19-2008, 01:34 PM   #3
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Question Re: Calcium metabolism! Can someone explain?

Thanks for your reply, Radar! Is your Vitamin D level low as well? Is your doctor willing to look farther with a 10.2 calcium? I cannot even get my doctor to retest the level, I have had to pay myself. (So much for great insurance). Usually with high calcium, the Vitamin D level will be higher. That is the dilemma!! Calcium is regulated by several things, one of which is Vitamin D. It helps the body absorb calcium and deposit it in the bones. I don't think I need and more help unless I am making calcium and losing it before it is going to the bones. I had a fusion done in my foot and it is not healing and there has been no change in the xrays in the last month (12 weeks total so far). I thought maybe it is slow because of HypoT issues (i have read that thyroid and growth hormones contribute to the regulation of calcium) but am wondering if it is calcium issues.

I am wondering now if it is a Calcitonin issue? I have never seen that mentioned by anyone. Calcitonin enhances the ability of the bones to store calcium by transferring calcium from the blood to the bones and inhibiting release. I do not have osteoporosis so I know I cannot have this tested. I believe the other reason it is tested is for medullary carcinoma?

Also PTH (parathyroid hormone) regulates the transfer of calcium from the bones to the blood. So if it is low.....what is it regulating?

I would really appreciate it if anyone could explain the calcium, vitamin D, PTH negative feedback loop. I can only find low Vitamin D, AND low calcium issues. Searching for reasons of high calcium with low PTH and low Vitamin D. Hoppy

Last edited by hopalong_too; 12-19-2008 at 02:20 PM.

 
Old 12-22-2008, 12:51 PM   #4
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Re: Calcium metabolism! Can someone explain?

My Vitamin D level (25-OH, Total) was 34 in mid-November. The labwork states that optimal levels are greater than 30. I am still waiting to get my bloodwork back from 12/12, so I will post the new results when I get them (if ever...!).

My doctor did seem concerned about the 10.2 calcium level last month, so I think if it is still high, he will want to do some more tests to find out why. I don't know anything about calcitonin.

If your PTH is low, it is trying to tell your body to stop releasing calcium. If your calcium remains high even while PTH is low, then there is a problem somewhere else. Unfortunately, that's all I know at this point. Good luck!

 
Old 12-22-2008, 02:24 PM   #5
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Re: Calcium metabolism! Can someone explain?

Some meds such as HCTZ (diuretic) cause one's body to retain more calcium than usual. Fam

 
Old 12-22-2008, 06:05 PM   #6
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Re: Calcium metabolism! Can someone explain?

I don't take any meds other than Synthroid and Cytomel for the HypoT and the Vitamin D 50,000IU twice weekly. I was at the doc today. She is concerned about the extremely high cholesterol/LDL and triglycerides (she says the non fasting high triglyceride number is a warning sign for something) so I need to get fasting levels checked in two weeks. Total cholesterol has been 252 and 269 with fasting previously but the HDL is good. I asked if the high numbers could be thyroid related and she said Yes, so I am having the thyroid levels tested again. I also had PTH/calcium, Vitamin D, CBC, iron (plus ferritin) and a bunch of other tests. She says the hip pain may lessen if I can get the Vitamin D number higher and the fatigue may still be thyroid related.

Radar, Please let me know if you get any more info. There are not many around with high calcium and low PTH with low Vitamin D.

Last edited by hopalong_too; 12-23-2008 at 09:04 AM. Reason: clarification

 
Old 12-23-2008, 03:40 AM   #7
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Re: Calcium metabolism! Can someone explain?

Before I started on Synthroid, my vitamin D levels kept plummeting, even after taking the 50,000ui. It was because my thyroid levels were messed up. It's all related. I had normal calcium, but very low vitamin D. My bone scans were also low, so even though I had normal calcium levels, for some reason it wasn't getting to my bones due to the low vitamin D. Once my thyroid levels were better (temporarily, they're off again now), my vitamin D was stable and my bone scans improved.

My cholesterol has gone up too (high total and LDL). That's a sign of a low thyroid. So you're not balanced even though your doctor says you are.

 
Old 12-23-2008, 08:30 AM   #8
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Re: Calcium metabolism! Can someone explain?

I did get my calcium lab results yesterday - my serum calcium is now 9.4 (down from 10.2 in Nov.). My calcium in Oct was also 9.4, so I must have had a false reading or been dehydrated in November?

However, ionized calcium is a bit high - 5.3 with a ref range of 4.8-5.6. I have read several things about ionized calcium that says the highest end of normal is actually 5.3.

My doctor signed off on the lab work, so he must not think it's anything to be concerned about. Still waiting to get back the Vit D report.

 
Old 12-23-2008, 09:02 AM   #9
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Re: Calcium metabolism! Can someone explain?

Thanks Tigger67, That is about the only thing that makes sense to me and I am hoping this is thyroid related and my GP will catch it!

Radar, My ionized calcium levels were always above range.

Ionized calcium 1.35, 1.41, 1.42 (1.17-1.32) The conversion rate is x4 so

Ionized calcium 5.4 5.64 5.68 (4.68-5.28)

Your lab does have a slightly higher range. My lab it is 5.28. My Endo says this test requires expertise in handling and therefore he says it is unreliable. My thought was why bother or find a reliable tester!

Vitamin D testing does take a while to come back. My GP told me yesterday that she wants my Vitamin D level up to 90 (range 40-100)!! Hoppy

Last edited by hopalong_too; 12-23-2008 at 09:04 AM.

 
Old 12-23-2008, 12:15 PM   #10
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Re: Calcium metabolism! Can someone explain?

Although I'm afraid I can't help much with the calcium issue, I can about vitamin D. You probably would be better taking D3, instead of 50K of synthetic D, as you were prescribed. Doctors who don't know the best way to supplement D tend to use the prescription form, which is just a patented, high-dose, version of synthetic D.

D3 is the more natural form of D, the type we get from the sun. And you can supplement with it every day. Using 50K to correct a deficiency (which it will eventually do), isn't really how the body normally gets D. You get more spikes in levels, and once you stop taking it, D will of course go down again.

Ask your doctor about switching to D3 instead. You can pick it up at most vitamin stores inexpensively. Go for a gel formulation, as it requires some fats to be absorbed. Typically 1K-5K is needed daily to correct a deficiency.

 
Old 12-23-2008, 03:13 PM   #11
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Re: Calcium metabolism! Can someone explain?

Namelessme, Thank you. I did switch to D3 2000IU/day once I got my levels up to 45 and it ws expected to continue climbing. Instead, it dropped like a rock back down to 20 so we are trying again with the Rx. Hoppy

 
Old 01-06-2009, 09:55 AM   #12
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Re: Calcium metabolism! Can someone explain?

Just an update - I got my Vitamin D results back. They only tested for Vitamin D, 1, 25-Dihydroxy. It was 56 with a range of 15-60.

As a reminder, my last ionized calcium was 5.3 (range: 4.8-5.6) and my last two serum calcium tests were 10.2 (Nov) and 9.4 (Dec) (range: 8.5-10.4).

Can anyone explain if my Vit D levels are normal as they relate to my calcium? And what is the difference between Vitamin D, 1, 25-Dihydroxy and Vitamin D, 25-OH, TO (last tested at 34 in Nov)? Thanks for any help.

 
Old 01-06-2009, 04:54 PM   #13
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Re: Calcium metabolism! Can someone explain?

Hopalong_too;

When I was first diagnosed I took the generic version of synthroid and did fine on it. Later on down the road, my doctor all but insisted that I take the real synthroid and I did. After being on it a month or so I was suffering with excruiating pain in my hips and pelvis area. I had to put a real soft pillow in my car just to sit without suffering.

Someone on the board suggested it might be the synthroid.

Taking their advise I went off of it for about 3 days. The very first day I experienced relief and had no pain the second or 3rd. Then I went back on the real synthroid on day 4 and the pain started within 24 hours. I had to stop taking it and go back to the generic version.

 
Old 01-15-2009, 05:26 PM   #14
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Re: Calcium metabolism! Can someone explain?

Some meds such as hctz cause ones body to retaind more calcium than usul. 0_o

 
Old 01-15-2009, 06:14 PM   #15
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Re: Calcium metabolism! Can someone explain?

I was in the archives trying to find some things out myself. I came across something interesting ...

Do you perhaps think it may be a magnesium issue? I read "Never take Calcium without Magnesium but you can take Magnesium without Calcium.

Apparently Magnesium deficiency can cause all sorts of problems, I also read there too much calcium will cause bones to ache.

I'll post back when I go back and find out where that article is for you.

At the top post go to "Information Archive" click then Symptoms of Magnesium...

tup

Last edited by imtupp; 01-15-2009 at 06:28 PM. Reason: add info

 
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