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Dr. Andrew Rynne

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What doe elevated calcium level indicate?

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Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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Posted on Wed, 30 Jul 2014 in Thyroid Problem and Hormonal Problems
Question: I had a blood test this week and the dr. told me that my calcium is/was 14.2 and when I look at all of the test I have had recently, I can see that it went from 9.9 on 11/2012 & 11/2013 to 14.2 MG/DL (7/10/14), ionized calcium 1.61 MMOL/L. My wbc is also high at 10.9 k/mm3 from 6 (11/2012),6.7 (11/2013 & 6.5 (6/12/14). My ast and alt are also high 76 units/L & 240 units/L. My HCT 7/10/14 was 44.3%, RDW 11.9%, neutrophil 79.9%. I had the blood test because I was having extreme stomach pain and was seen in an ER. I thought my calcium was up because my family dr. had me on weekly Vit D 50,000, but that reading Vit D 25-hydroxy was 34.37 ng/ml. I am 43 yo female on wellbutrin 150 daily for anxiety, .06% hormone gel (estrogen replacement), 50 lyrica 1 at night (herniated disk) & a topical daily medication for rosatia.
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Answered by Dr. Shehzad Topiwala 56 minutes later
Brief Answer:
Calcium

Detailed Answer:
I follow what you are saying here.

The calcium of 14 is considerably high. I suppose that is when your doctor advised you to make an appointment with an endocrinologist. I have noted the other lab results you have shared too.

You are correct in surmizing that the weekly 50,000 vitamin D can raise the calcium. So if you have not already stopped it, please do so now.

It is really important you get this high calcium assessed thoroughly and promptly.

It requires a systematic evaluation to lower the calcium first, and then determine the cause of it. This typically entails further lab testing such as :

Intact PTH
Phosphorus
Magnesium
Serum Creatinine
TSH
Free T4
Glucose
Liver function tests

The results of these will guide the next round of tests if necessary, such as

1,25 dihydroxy vitamin D
ACE levels
SPEP/UPEP
Urinary calcium excretion
Sestamibi scan

There are various causes of high calcium such as overactive parathyroid glands and each condition has to be managed accordingly to the unique cause

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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