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Q: 

I’m 77 my Calicum is 10.3 does this sound like I need parathyroid surgery?

By Anonymous June 27, 2018 - 4:26pm
 
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HERWriter Guide

Hello Anon

Thank you for writing!

Adults should generally have calcium levels that are "in the 9s" in mg/dl. Most labs will give a normal calcium range from about 8.8 to 10.5 mg/dl, but this is not correcting for age. A value of 10.5 in a teenager is perfectly normal, but 10.5 in adult over age 35 is high – this can be considered hypercalcemia.

High blood calcium (hypercalcemia) is like it sounds -– too much calcium in the blood. Some persons have slightly high levels of calcium with no symptoms. This is no cause for alarm. Your doctor will just monitor this area for any changes at your annual check-ups. However, there are times when the calcium levels are so high that it causes damage to the body.

Symptom and Causes

Symptoms for severe hypercalcemia are as follows:

Nausea and vomiting
Loss of appetite
Excessive thirst
Frequent urination
Constipation
Abdominal pain
Muscle weakness
Muscle and joint pain
Confusion
Lethargy and fatigue

Normally, when calcium decreases, the body knows to produce more parathyroid hormone and when calcium increases, it knows to produce less. The parathyroid hormone is responsible for stimulating the bones to produce more calcium, the digestive system to absorb it, and the kidneys to produce less of it while producing more vitamin D. Vitamin D helps in calcium absorption as well.

When the calcium levels reach a very high point, the thyroid gland releases the hormone, calcitonin. This hormone slows the rate of calcium being released from your bones. However, with hypercalcemia, this process is disrupted. This can be caused by a number of factors, such as:

Overactive parathyroid gland – this is the main cause of hypercalcemia.

Cancer - with some cancers (breast, lung and multiple myeloma) the malignant tumor actually produces a protein that mimics the parathyroid hormone and tricks the body to produce more calcium than needed.

Other diseases – such as, tuberculosis and sarcoidosis, cause inflammation where tissue is injured and as a result, raises vitamin D levels. Elevated vitamin D (calcitriol) makes your digestive system absorb more calcium, causing the body to produce more at a faster rate.

Sick people who have to spend a lot of time resting – inactivity produces a risk of calcium buildup because bones will eventually release calcium into the blood.

Certain medications – excessive or long use of medications/supplements such as lithium, thiazide diuretics, calcium or vitamin D.

Dehydration – although not permanent and mild in most cases, when dehydrated (less fluid present in blood) calcium level rises.

If hypercalcemia is not treated accordingly, there are health risks that can develop too. Osteoporosis, kidney stones and/or failure, nervous system dysfunction and abnormal heart rhythm are all listed by the Mayo clinic.

Tests and Treatment

Severe hypercalcemia will be more than likely treated while hospitalized. It will be very important to bring calcium levels down so no further damage will develop. When doctors have stabilized calcium levels, further treatment will depend on what the core problems is. For example, if the problem is severe primary hyperparathyroidism, your doctor may recommend removal of the parathyroid gland(s). However, the patient has to be able to withstand surgery. If surgery will be too risky, the attending doctor will try certain medications.

Anon - we cannot ascertain if you need surgery - but we want to give you as much information as possible. Talk to your doctor about your options.

Best,
Susan

June 27, 2018 - 4:56pm
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