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How To Lower Elevated Calcium As High As 11.5 For Last 4 Years?
Question: I have a 61 yo female patient who has had elevated calcium as high as 11.5 for last 4 years. she has a normal parathyroid level. I stopped all calcium supplements, she takes atorvastatin 20 mg, fenofibrate 145 mg, and omega 3 1000 mg daily. I don't know what to do next to advise her.
Brief Answer:
Please see detailed answer
Detailed Answer:
Hi,
Elevated calcium levels, especially persistently high levels over a period of time, can indicate an underlying medical condition that needs further investigation.
It's good that you have already ruled out primary hyperparathyroidism by checking the parathyroid hormone (PTH) level.
Here are a few steps you can consider to further evaluate your patient's condition and provide appropriate advice:
Assess renal function: Impaired kidney function can disrupt calcium balance in the body, leading to hypercalcemia. Evaluate your patient's renal function through blood tests, including creatinine, estimated glomerular filtration rate (eGFR), and urine analysis, to assess kidney health. A 24-hour urine collection for calcium may also be helpful.
Investigate other causes: While primary hyperparathyroidism has been ruled out, there are other potential causes of elevated calcium levels. These may include conditions such as malignancies (e.g., parathyroid adenoma or other tumors), granulomatous diseases (e.g., sarcoidosis), or certain endocrine disorders. Additional tests, such as imaging studies (e.g., neck ultrasound), can help identify any anatomical abnormalities or tumors in the parathyroid or other organs.
Assess bone health: Elevated calcium levels can affect bone health. Consider evaluating your patient's bone density through a dual-energy X-ray absorptiometry (DEXA) scan to assess for osteoporosis or other bone-related conditions.
Monitor and follow-up: Regardless of the underlying cause, it's essential to monitor your patient's calcium levels regularly.
I Hope Your Query is clear now.
Thank You
Please see detailed answer
Detailed Answer:
Hi,
Elevated calcium levels, especially persistently high levels over a period of time, can indicate an underlying medical condition that needs further investigation.
It's good that you have already ruled out primary hyperparathyroidism by checking the parathyroid hormone (PTH) level.
Here are a few steps you can consider to further evaluate your patient's condition and provide appropriate advice:
Assess renal function: Impaired kidney function can disrupt calcium balance in the body, leading to hypercalcemia. Evaluate your patient's renal function through blood tests, including creatinine, estimated glomerular filtration rate (eGFR), and urine analysis, to assess kidney health. A 24-hour urine collection for calcium may also be helpful.
Investigate other causes: While primary hyperparathyroidism has been ruled out, there are other potential causes of elevated calcium levels. These may include conditions such as malignancies (e.g., parathyroid adenoma or other tumors), granulomatous diseases (e.g., sarcoidosis), or certain endocrine disorders. Additional tests, such as imaging studies (e.g., neck ultrasound), can help identify any anatomical abnormalities or tumors in the parathyroid or other organs.
Assess bone health: Elevated calcium levels can affect bone health. Consider evaluating your patient's bone density through a dual-energy X-ray absorptiometry (DEXA) scan to assess for osteoporosis or other bone-related conditions.
Monitor and follow-up: Regardless of the underlying cause, it's essential to monitor your patient's calcium levels regularly.
I Hope Your Query is clear now.
Thank You
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Kampana
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