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Report showing low vitamin D and isoechoic nodule behind left parathyroid. What is the further course of action?
Question: I had a follow up test and it shows normal calcium serum level, ionize calcium and PTH levels. My Vitamin-D is very low : 14.7ng and also history of high cholestrol.. I do have 7mm isoechoic nodule behind left parathyroid. I have lots of muscle cramps, probably depression too.. What should be my next line of action..?
Brief Answer: Vitamin D Detailed Answer: When I see blood levels of 14.7 in a patient of mine along with normal calcium and PTH, I generally recommend daily supplementation with over the counter vitamin D3 (cholecalciferol) 5000 IU. Levels should be rechecked in 2 months to see there is still a deficiency, and also to ensure too much is not given. The goal is to keep blood vitamin D levels in the range of 30-50. The daily supplementation can be adjusted between 1000 - 3000 IU daily to keep blood levels in this target range. Low vitamin D has been linked to a variety of symptoms. If your complaints improve after a few weeks of treatment, then it is likely they were due to vitamin D deficiency. If not, then you should see your primary care physician to determine the next course of action. Vitamin D will not affect the cholesterol levels. The 7 mm isoechoic nodule is statistically benign. You may wish to perform an ultrasound 6 months after the previous one to look for growth/change in characteristics of the nodule, if any. If you have risk factors for thyroid cancer (like past or first degree family history of thyroid cancer, or exposure to ionizing radiation to your upper body) then performing a fine needle aspiration biopsy of the thyroid nodule is recommended. But first, the radiologist needs to confirm if it is indeed a thyroid nodule or not
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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