Thyroid UK
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Primary hyperparathyroidism? T3,D3, too high? Disappointing Endo visit

Hello, I had posted before. My thyroid had been removed 1996, ever since I was on L-Thyroxine and miserable, last two years on Novothyral 100 (100mcg T4, 20mcg T3). I took it in the morning and from noon , I felt very weak and had pains. So from Sept.1,2017 I slowly switched to T3 and am now on 90 mcg daily in 4 doses.Some symptoms have improved, others not. I have more energy, but it is a rough and bumpy ride and I want to change to NDT now. Furthermore, I have high calcium and high Parathormone levels and am afraid this is possibly due to primary hyperparathyroidism, for which my symptoms also fit. Yesterday I had my first Endo visit. He was not pleased of my self medication and suggested I should go back to T4 ,or, maximum, Novothyral again, and feel miserable again!! ( this were not his words). For the parathyroid problem, he was not at all concerned because calcium and PTH were just still within the range. He said this was due to my too high D3 and I should stop taking D3 until the end of year.

From Oct.19, 2017: about noon

Krea 0.76 mol/l. (0.5 -0.9)

TSH 0.01 (0.27-4.2uIU/ml)

FT3. 5.6 pg/ml (2-4.4)

FT4. 1.2 ng/l. (9.3-17)

TPO-AK. 14.4. kIU/l. (-34)

TRAK. 0.99. IU/l. (<1.75 < 1.22l)

CA. 2.52. mol/l. (2.15-2,58)

Parathormon mit 6.7 pmol/l. (1.6-6.9)

25-OH D3. 142,3 nmol/l. (13.2-118) This calculates as 56.9 ng/ml which I think is optimal?!

alkal. Bone phosphatase 26,2ug/l. (4.7-27.1)

an organic phosphate. 1.06 mmol/l. (0.81-1.45)

ACTH. 21.5 ng/l. (7.2-63.3)

Cortisol basal. 62,8 ng/ml. (6-10 o'clock: 48)

In February 2017,with Novothyral 100:

FT3. 2.38 ng/l. (1.80-4.60)

FT4. 12.05 ng/l. (8.00-17.00)

25-OH-D3. 52.4 ng/ml. (30.0-100.0)

1.25-dihydroxy -D3 80.9 pg/ml (25.0-86.5)

Ferritin was high, 225.1. ng/ml. (15.0-160.0)

Iron, magnesium , vitamins etc are filled up since I have been in orthomolecular treatment for years.

What do you think of it, esp. the hyperparathyroidism? I have slight osteopenia, the scan and szintigram showed nothing clear.

13 Replies
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Your calcium and parathyroid are within range, vitd is over range and phosphate is fine so they don't indicate hyperparathyroidism.

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Thank you! This is what Endo says . I wonder why PTH and Calcium are both high. I think that with high calcium should PTH be low.

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Normally if calcium is high pth will be low but as your vitd level is high and your thyroid levels possibly a bit over they may be causing an imbalance. Phosphate is fine which is good.

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I'm sure you've taken a look at the main parathyroid site and the calcium calculator that adjusts for age: parathyroid.com/Normal-Bloo...

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Thank you! No, I didn't know the site, will go there

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I just see it should be maximum 2.495 mmol/l for my age. My figure was 2.52 mmol/l. So it is too high. What do I do now?

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Maybe read around the parathyroid site for some ideas? They seem to recommend a series of tests to monitor calcium, PTH, vitamin D, phosphate etc. over time and have a (commercial) app. for this tracking.

I haven't read the relevant pages but if you're supplementing vitamin D, maybe reduce that supplementation as other members have suggested and see if it normalises the calcium etc.? renawaltdr

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You can't compare USA and UK results as the assays are different, your calcium is within the range used for your test. You need to have both adjusted calcium and pth tested at the same time and pth is time critical so must be in the lab as quickly as possible after taking the sample, if they are high/over range then further testing needs to be done. Going on your latest results nothing will be done until one or both go over range, as I said before you need to normalise your other results to see if that brings levels down.

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Calcium increases in blood when supplementing vitamin D. This is why vitamin K2 is recommended as cofactor, to direct excess calcium into bones rather than blood and arteries

How much vitamin D were you taking

Did you take Vitamin K2 or magnesium as well

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Thank you. I was at 52ng/dl D3 in February, then was advised to reduce supplement to 2000Iu/d D3 ( with K2)which led to 30 ng/dL by the end of July. Since then I took 5000IU/d together with K2 and Mg. Now I think I try 2..3000IU/d and test again in January 2018

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Hi - did you take a t3 dose on the morning of your Oct test? How long between last dose and test?

Your vit d is at an optimum level (you have an unusual lab range!). If you have been supplementing you should reduce to a maintenance dose and re-check in a few months time.

As you have osteopenia, have you been taking vit k2-mk7 and magnesium? These help with bone density via redirecting calcium uptake to bones.

Gillian

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Thank you! Yes, I take magnesium and Vit. K-MK 7. Will reduce VitD3 uptake. Last T3 dose before Test in Oct. was 4 am, so about 8 hrs in between. I can't go longer without new T3.

Today I felt overdosed for the first time and will start NDT now.

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Hi - well in that case you have probably been slightly over- medicated which can be as bad as being under for symtoms. But see how you go on ndt.

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