Appt.with Endo. Regarding high PTH...
SIGH......
If you remember from a previous post
I had bloodwork for my 2yr VSG checkup
my PTH level came back high..
(40@ 1yr checkup...102 @ this yrs..)
my bariatic surgeon was not concerned in the least...
my vita.D, calcuium and kindney function all came back normal..
after extensive reading
and the worry that comes after googling the **** out of it
I posted here and had my fears squashed...
just had an appt. w/ my Endo thinking he could give me a clue
as to how much I should up my calcium..
I got the right one citrate,
not the gummy crap I was using
and upped myself from about 250mg a day to 4,000...
well he was no help at all..
he said all your other labs are fine,
WHY would they even test for this..
its not relavent to you at all....everthing else is normal...
sigh... I am just going to keep on keeping on
with the upped calcium and get my G/P (whom I love and adore)
to order me follow up bloodwork in 3 months and hope the PTH has come down...
Sorry this is so long..
can you think of anything I'm doing wrong?
My Vita D is normal, not low
I take 5,000 of it a day...my BP is still normal in morning...
then when testing in afternoon and nite...
top # high/ bottom # anywhere from 50/65 (normal)
could all this be related to (oh Jesus I'm gonna say this)
the start of menopause????
once again I apologize for the book I just wrote!
No doctor here, but from what I understand this is what can happen:
PTH level goes up, but calcium level stays within normal range because your body is leeching calcium from your bones. The body does this when you don't ingest enough calcium in your diet. Once you are getting adequate calcium, your PTH level will return to normal IF that was the reason for the PTH level to be high. The return to normal can take months!
Of course, there are other reasons for high PTH levels (all of which I guess you've already read about!).
question: Are you taking dry Vitamin D3 or taking an liquid/oil based D3? I ask because it has been found that VSG, DS, LapBand patients do better on the liquid type of D3, whereas RNY do better with a dry D3. Something to consider.
ok, will try to keep my story as brief as possible. But, we have some similarities so maybe it will be of interest to you.
At 3 month check, calcium was normal, PTH normal, Vitamin D high (too high to for the lab to put a number on it.) I was relieved that PTH was normal because I had a lot of nausea that first few months and didn't get all my calcium in which I know is terrible.
At 6 months, I was getting my calcium citrate in consistently but PTH now elevated (like about 120 if I remember right), vitamin d still high and calcium normal. I was offered the option of seeing endo now, or waiting for 9 month lab work to see what that showed.
I could only imagine that my bones are being dissolved by PTH so I wanted to see endo.
I saw endo this week. He said it is possible that it is an absorption issue but that is really very unlikely with a vsg. He drew a little picture of how calcium is absorbed in intestine and since VSG patients still have all their intestinal "real estate" the risk of low calcium absorption is minimized. (For what it is worth, in contrast, he says he sees 1 RNY patient per week with pth/calcium/vit D issues)
His hypothesis is that I might be a "calcium overexcreter." In other words, I pee out calcium at a higher rate than normal. In his hypothesis, this did not show up at the 3 month labs because I was on a thiazide diuretic for blood pressure at that time. One thiazide side effect it to DECREASE the amount of calcium excreted in urine. So, while I was on the thiazide, my calcium excretion would be normal.
But, I stopped the thiazide at the 4 month mark because of excellent blood pressure. So, according to his hypothesis, I was no longer protected by thiazide and I went back to being a calcium hyperexcreter, which caused my calcium levels to drop and then PTH went up in response in time for 6 month lab work. Of course, the "low" calcium isn't going to show up as long as I have bones to dissolve.
If I am a calcium hyper-excreter, according to the endo, it isn't related to VSG. I have to do a 24 hour urine collection so he can see what's there before a diagnosis can be made. I will probably do that this weekend. WHOOHOOO!
This is all so convoluted. Sorry. Hope you get some answers!
~Shel
HW:361 SW:304 (VSG 12/04/2014)Mo 1:-32 Mo 2:-13.5 Mo 3: -13.5 Mo 4 -9.5 Mo 5: -15 Mo 6: -15 Mo 7: -13.5 Mo 8: -17 Mo 9: -13 Mo 10: -12.5 11/3/2015 Healthy BMI Reached! Mo 11: -9 Mo 12: -8 12/27/2015 Goal Weight Reached!
Thank you for sharing your story with me..
I only came up with this problem at my 2 yr bloodwork
but something is definitely going on..
Im sluggish and weak, not feeling myself at all
but I'm also healing from a frozen shoulder with nerve issues
that effect the left side of my neck, head and eye..
this could also be contributing to my tiredness...
Who knows...
I wonder if they will put you on thiazide again
to combat the calcium excruciation...
I hope everything works out for you...keep me posted.
You are exactly right, if his hypothesis is right, he will put me back on a thiazide! (The nerdy pharmacist in me finds this fascinating!)
Tho our labs are similar, I don't have any symptoms at all. Not feeling yourself is a pretty crummy feeling on its own. I hope you feel better soon!
~Shel
HW:361 SW:304 (VSG 12/04/2014)Mo 1:-32 Mo 2:-13.5 Mo 3: -13.5 Mo 4 -9.5 Mo 5: -15 Mo 6: -15 Mo 7: -13.5 Mo 8: -17 Mo 9: -13 Mo 10: -12.5 11/3/2015 Healthy BMI Reached! Mo 11: -9 Mo 12: -8 12/27/2015 Goal Weight Reached!
