I've got another calcium/PTH level question.

After googling the word I determined that I am not.

Look up proctologist, I'm sure you'll qualify . . . .

Why don't you just ask an actual Endocrinologist?

https://www.mayoclinic.org/diseases-conditions/hypoparathyroidism/symptoms-causes/syc-20355375

Throw it out on the table and let’s hear it. , I’m at least curious.


(That’s what she said)

I'll attempt to make it short......

After several blood tests and a CT scan (showed all clear and no cancer), all signs of my high calcium blood levels were pointing to a benign tumor and/or malfunctioning parathyroid gland or two, which were causing low kidney functions, low Vitamin D, abnormal BUN numbers, etc. In short, all pointed to hyperparathyroidism.

Then I got somewhat of a curveball today when the hematologist called and said he was expecting high PTH levels (parathyroid hormone levels) to show in the blood tests, but instead they were abnormally low. This would throw a wrench in the original prognosis. Just looking for a little insight, that's all.

Diagnosis:.... You have good insurance.


All the associated __________-ologists will make what they can from the cash cow, while they can.

I sure have seen that happen on my end.

Hope everything keeps going in the right direction for you!

N


JG, see if you can PM Etoh and maybe get his input here.

Hoping the best for you, Amigo.
Keep us posted.

Same issue with our uncle several years ago. He ended up being our aunt.

https://www.mayoclinic.org/diseases-conditions/hyperparathyroidism/symptoms-causes/syc-20356194

Hmmmm..... As was mentioned before, I was going to suggest a PM to Etoh.

My only expertise is in having had a benign growth on one parathyroid, and having it popped out. As you obviously know, PTH regulates calcium, and the reaction is very swift. A minute or two after they popped out the bad gland, my calcium was normal again. So they called it good, shot me full of Prednisone, and sewed me up.

Be of good cheer. The people who are taking care of you went to medical school and will no doubt figure it out and fix you up.

I pity the fool needin some pity from duh firah

"Then I got somewhat of a curveball today when the hematologist called"

Why did a hematologist call you with the results instead of your Endocrinologist?

I don't have an Endocrinologist. If I did I wouldn't need to ask the question here. And for the record there SCgman, I'm definitely NOT looking for pity, sympathy, or anything, just friendly advice.

Zero help, but wishing you the best. Navigating the health care system in this country in the post-obamacare era sucks. Hope you have access to competent physicians.

Stop eating nightshade vegetables especially if you are Keltic, Viking or such white decent.

Bad news is when excess calcium is found a common cause is bone cancer destroying bone cells and liberating more calcium than the body can handle. I have seen two extreme cases. Would not wish it on anyone.

Good God....you know how to [bleep] up someone's evening.....

Do you have arthritis?

I know what your going thru.

Endocrinologist cured my hyperthyroidism in 1990. Lost 60 lbs in three months and had a thyroid gland the size of a horse. Radioactive Iodine pill irradiated the thyroid gland to cure it. Have to take a daily thyroid hormone replacement pill for the rest of my life.

Scary times for sure especially as I just had gotten married that year and wife became pregnant with our first child.

Good luck buddy.

Only posting fact... my point is the situation should not be toyed with.

Thanks jack.....it's an exercise in patience that's for sure. Been feeling low for 6 weeks now, and it'll likely be at least a couple/three more before a referral. Appreciate it.

That doesn't sound fun. I'm hoping/betting the CT scan would have caught any cancer, and it came back clean.

I would do whatever it took to change their timeline.

I know of only two cases and neither showed on a CT scan for a long time.

Johnny, I used to before I got both knees replaced. I don't think I'm at an advanced stage like osteoporosis because I have zero pain anywhere associated with it yet.

JG what are last two labs on PTH? Give us (me) the number value.

Most clinicians won’t act unless pth is 10x the upper value.

Mine runs in 600s. I’m on sensipar and calctriol for it. And it’s barely dips below 300. They just give me the shrug. Like no big deal.


I think normal ranges are 40-100


Expect it to be more, obviously if you got any inkling of a compromised renal function. Thoughts I remember, you posted your GFR based on my memory of that thread it wasn’t that bad IMO.

Now you can have good GFR but your kidneys can’t still be miscommunicating the regulation of pth and calcium allocation.


I have a shîtty GFR but I have zero issue with phosphorous and potassium. Most low renal patients, K and Ph are the absolute devil to them.

Post up your lab value. On the PTH.

Rest assured, wishing you all the best.

Doctors, bless their hearts love to make diagnosis on one or two observations. They never were allowed to do that in a freshman level stats class.


You could fluke a lab and or/and or not.

Repeat the labs yet again and consult a nephrologist. They are more in tune with parathyroid issues

I tend to think endocrine docs specialize more in fat chicks and their thyroid and dumpy kids and their pituatary issues more.

Right on Sitka.

GFR 31
PTH was 6........not a misprint.......6.

Dang what’s up with your GFR?

It wasnt that bad before.

That pth has to be a lab error. unless it’s given in 10^power of some coefficient.


Typically with compromised GFR you have very elevated Pth

My GFR is bad bad bad, Stage 4 renal failure and I’m 18-22 depending on labs and hydration, and or if I’m on an antibiotic.

Are you on any antibiotics right now?

You’re stage 3 renal with a GFR like that. You need to go to a nephrologist and start seeing him/her on a regular interval and also an initial diagnosis of what’s going on in the background.

I gotta do something that's for sure. No medicine except for 20mg Lisinopril for marginally high blood pressure.

FWIW
Creatinine 2.21
BUN 31

I am IIRC you GFR was 1.5,6 last thread?

Did you get some good amount of water before that lab

Need about 24 ounces of water to do a BMP panel 2-3 hours before.
Makes veins easier to hit too


But don’t drink a gallon, that will skew.


You need a protein test with a next urinalysis they do too

You need a nephrologist. Plain and simple.

Could be something trivial like a constriction of plaque in the renal artery. Or stenosis Ultrasound those kidneys and check velocities on the vessles feeding those organs

Hoping for the best.


I hope at this point you would swear off any NSAIDS completely. Forget they exist.

Naproxen, ibuprofen, Advil. No more.

You need to freeze whatever is manifesting itself.

Don’t panic, 2.2 creat.


has zero limitations.
Neither much does 4.0

Start dialysis at 6-7 creat or 15 GFR.


Good luck.


PM me I’m glad to help any more if I can.

I’m an Endocrinologist in my spare time. I evaluated all the data, including your most recent posts, and my diagnosis is...



You’re gay.





P

Slum, from last discussion:

CREATININE 1.55
EGFR IF NONAFRICN AM 49
CALCIUM 10.2

Why thank you big boy!!!

Embrace it, and stop on by some time.



P

Be very cautious of anyone like a cardiologist wants to do ANY type arteriogram with contrast.

That will harm his GFR situation possibly irreversible

If totally unavoidable. Ask for 2 vials of Mucamist orally to lube the contrast and sheiks the nephrons from that awful chit.

Because they *may* want to do an arteriogram exploration on your renal arteries

Just in case.

Jesus Christ..... You really ARE Kingston's sock puppet.

I think he is someone who has dealt with this and has educated himself on the subject.

Slumlord is correct on seeing the kidney guy, your Ca regulatory (not so much your Para gland) is out of whack. The depression is a pretty good give away.

and correct--- no anti-inflammatory drugs.

and again correct, you are developing plaques or stones

without the rest of your labs, t3/t4 (regulates Ca channels in cellular communications) ratio, free test/estrogen, DHT, urinary (bladder emptying time and volumes) pH I would be guessing,--- just like an endo

Without a doubt. Slummy's a lot smarter than he portrays himself to be

JG,

Best of luck to you.

Good new is, once you get this fixed you'll feel much better.

Raider I hope you get better. I think Endocrinologist are good doctors most times. I have a number of weird conditions that got treated with medications and cured with diet change. It sucks.

One of my doctors told me most GP doctors are like auto mechanics, they just do a textbook diagnostic and try to diagnose. He said the research type doctors, Cancer, cardio, neuro, Endo, and some dermatologist go that extra “inquiring” mile.

Got the rest of analysis from hematologist. Along with what I posted above, my appetite has come back nicely, no nausea anymore just slight indigestion occasionally, still dry mouthed but urine is clear. Overall I feel pretty good, much better than the previous 5 weeks.

Low Vitamin D
Elevated PTHrP
Cancer free
Phosphorous good
Proteins good

Sounding good JG.

Excellent news!

Etoh, much appreciate your input as always.

Following this

Sounds good, still need to get to a neph


Phosphorus good, means you can pour the beans to that chili 😃

Ha, right on guys! Also, at least one other doctor, along with the two I've seen here, seem to "believe" that the kidney's are the victim, not the source of the problem in my case. Hope their right. Appreciate the king words and well wishes.

Thats an interesting angle. It might even prod me to follow my earlier gut instinct, a few months back I leaned on my neph about a recommended referral to an endocrinologist about my PTH

I even asked the neph if taking out my parathyroids would be a good thing (based off of what I researched) my doc shot me down and said that taking them out “in her experience” made the GFR worse and had tossed some people into dialysis.

I think I might just get myself an appt anyway to see an Endo, at least for entertainment or education purposes.

Get one that strips as a night gig - just to cover your bases.

JG,
That's great news.

Glad you are feeling a little better.

I look forward to your return to normal.

I do look at profile pics, edu and bio before I chose a doctor.

I picked a hot Indian chick to do my colonoscopy. What have I got to lose ? Right??

Better than Barnaby Jones or Marcus Welby crawling up my ass

PTL

700 Club?

Slum, you've likely already done this, but I thought at first it was a parathyroid issue with me as well. I was about sold on it actually and I still can't rule it out even though I'm obviously not a Dr. Go to this link, https://www.parathyroid.com /parathyroid.htm and read a little. It is a wealth of information from the world's foremost authorities on the subject. I think you'll at least find it interesting.

JG,
That's great news.

Glad you are feeling a little better.

I look forward to your return to normal.

/quote]


Thank you AS. I'm a big enough PITA when I fell great, and an even bigger one the past 6-7 weeks.

Praise The Lord.

Now JG can take me deer hunting.

Or vice versa there Doc........you're the only guy I know with a 250+ on the wall, bro.

By the grace of GOD, Pal. I only hunt culls and late season does now, JG.

That's what I'd do. If nothing else he could probably tell you who to talk to or see.