What causes tiredness and vomiting inspite of having calcium meds?
Please see the label for elemental calcium
The calcium levels are just high and i wouldnt beleive that would be the only cause of her symptoms. Would like to know her serum albumin levels and we will have to do a corrected calcium levels based on albumin levels. I hope the blood was drawn at fasting state.
There are many reasons for rise in calcium. IS she he taking 1200 mg total calcium or elemental calcium ?? ( please look at the label of calcium tabletes for the amount of elemental calcium). Hypercalcemia can be PTH dependent or PTH independent. Only in the PTH dependent cases, the levels of PTH rise. Since her PTH levels are normal, whiile having a rise in calcium, it is likely a PTH independent cause.
PTH independent causes of high calcium include, excess calcium intake, excess vitamiin D intake, certain infections like tuberculosis, other conditions like sarcoidosis etc. Lastly, certain cancers like lymphoma, breast cancer, lung cancer, multiple myeloma etc can rise calcium levels which are all PTH independent causes. Other causes include dehydration and addison's disease.
I would be very interested to know her ESR and Urine calcium levels as well as serum albumin levels. Any kidney tets like creatinine? LISINOPRIL is unikely to cause this.
For now, she need rehydration with oral fluids and with hold calcium and vitamin D. She could repeat a fasting calcium, PTH, phosphorus, alkaline phophatase, creatinine and albumin after few days. However, in the interim, if she is symptomatic, please take her to a hospital for IV fluids. Because hypercalcemia can cause dehydration and that is dangerous in a 86 year old women. It can cause kidney prolems.
At his point then, you think I should ask for an ESR...and go from there if it is out of range?????? My sister does have SLE.
What is the significance of the Albumium at this point?
Also, should I request a bone density test at and how will that direct me into further treatment that would help with the blood calcium levels.
I live in a very small community where we must travel to see an ENDO...so any assistance you can give is appreciated.
Good day. Great to know that you are a nurse .
The calcium you mentioned was total calcium and not ionized calcium. Total calcium has to be calculated based on the albumin level. So if she had a total calcium of 10.5 and albumin of 3.9, then the corrected calcium will be 10.58. ( we keep normal level of albumin as 4 for this calculation and in her case since albumin level was good, no much change in corrected calcium)
ESR is important. It will indirectly tell us if there is any inflammation or active cancer. It is not 100% accurate, but can surely give a clue.
If it is > 100, at this age, I seriously would be worried and would like to get a serum protein electrophoresis for multiple myeloma which is one of the cause of hypercalcemia.
In fact, her calcium levels are not terribly high. Could you please tell me how much total elemental calcium she took each day ??
Yes, in a 86 year old lady, getting a bone density is a good idea. However, since the PTH is normal, no need to get a forearm bone density. Hips and lumbar bone density would suffice.
Keep her rehydrated. I hope you will write back to me with the amount of elemental calcium she took each day
The User accepted the expert's answer
Get personalised answers from verified doctor in minutes across 80+ specialties
- What causes tiredness or guidyness in the body
- What causes tiredness after jogging
- What causes fatigue and tiredness
- What causes severe tiredness
- What is the cause for tiredness when on loratab
- What could cause persistent vomiting along with weakness and tiredness
- What is the cause for dark urine and tiredness
- What are the causes for lightheadedness and tiredness
- What could be causing tiredness
- What causes pain in abdomen vomiting and tiredness
- What causes sore throat inspite of having a treated thyroid cancer?
- What does low troponin value indicate?
- What causes extreme body heat with no fever?
- What causes spike in blood sugar level?
- What causes tingling around the mouth and tremor on chin?
- What causes pink blood discharge?
- What causes shortness of breath,confusion and depression when on thyroid...
- Suggest treatment for dry and cracked penis skin
- What does "eGFR is 57,sodium 129 and chloride 90" indicate?
- What causes nausea inspite of having diabetes, acid reflux disease and...