High Blood Calcium Levels
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Thanks for all the posts. I found a second source (article by a Dr. from Albert Einstein school of medicine and two others) which mentions that parathyroid hormone should not be in the "normal" range when calcium is high and that the combination of elevated calcium and normal PTH points toward parathyroid tumor. I'm going to hope the two sources I've found are correct, because it would explain my situation and seem to make finding mets in my bones a less likely scenario.
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Hello EClaire
If I were you I would deal with my medical team rather than articles on the Internet. We are all different and it is difficult to generalise.
All I can say from my own experience is my oncologist was checking my blood tests before I began treatment for breast cancer, and discovered high calcium levels. She was concerned that my cancer had already gone to the bones. She decided to check my PTH for hyperparathyroidism and discovered it was high. From that, she concluded that this was the problem and not mets to the bones. My team decided to get me through the BC treatment before dealing with the hyperparathyroidism. Subsequently, I had a parathyroidectomy and was cured.
In your case, you said your PTH is normal, but calcium is elevated. If I were you I would ask to be tested ofr hyperparathyroidism for peace of mind. If you do not have hyperparathyroidism and it is mets to the bone, there is always treatment. It is important not to delay. My own general doctor kept telling me that my calcium levels were only slightly elevated and not a problem! He would not do a PTH blood test, telling me that they did not do them. Because of this, I delayed having a parathyroidectomy, even though I knew I had hyperparathyroidism and the delay was a big part of my ending up with osteoporosis.
I think the worst thing is not knowing one way or the other. I sincerely wish you all the best.
Sylvia
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Hi Sylvia,
Thanks for your reply. I appreciate your concern. I think you make a great point about getting tested for hyperparathyroidism for peace of mind. I'll get through the bone scan first and then, if it's clear, I'll talk to my doctor about pursuing the parathyroid issue.
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My mom was diagnosed with stage 1 breast cancer this past christmas. She had a lumpectomy and radiation and is doing well. However, last week her Dr. told her she has a high blood calcium level and they tested her PTH level and it is not elevated. We're are hoping it is just a Parathyroid issue and not due to more cancer. I keep reading that a high calcium level and normal pth are more likely due to a malignancy. Does any one have any experience with high calcium and normal/ non elevated pth level?
Her Dr. has also said that he doesn't believe this has anything to do with her breast cancer. I feel like it is too much of a coincidence. I'm kind of freaking out and I know my mom is becoming worried as well. Any advice helps..
Thanks.
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Hello devonh5377
I have just read your posting and wanted to say that I was sorry to hear about your mum and her breast cancer. I was glad to know that she is doing well.
With regards to your mother's high level of calcium but not elevated PTH, and when you refer to her Dr., are you talking about her GP? If I were you, I would advise your mother to talk with her consultant breast surgeon and/or oncologist. They can test her and find out what is going on. It is best to deal with the hospital. You have to be sure that they agree with your doctor about the PTH being normal, and indeed about the calcium being high. Your mother should also get a DEXA scan to test for osteopenia or osteoporosis, which cancer treatment can cause. Parathyroid problems can also osteoporosis.
I hope this may help you.
Sylvia
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Hello devonh5377
You did not mention what kind of breast cancer your mother was diagnosed with. She should know whether it was hormonal, that is oestrogen and/or progesterone positive. She should also know whether she is HER2+. If she is positive for the first two she should be on something like tamoxifen. If she is HER2+ she should be on herceptin. If she is triple negative breast cancer she will not be offered anything to take post-treatment. If she is taking anything this might have affected her calcium level.
If either you or your mother needs support, there are other forums where you might like to look, such as a forum for older women with breast cancer, a forum for those 40 to 60 with BC, Calling all TNBCs, Calling all TNBCs in the UK,Triple positive breast cancer, etc.
Hoping you will let us know what happens.
Sylvia
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Devonh5377
I had elevated blood calcium, and parathyroid levels on the border of normal/abnormal.
My endocrinologist tested my Vitamin D levels - they were insanely low. When they get like that, they pull calcium out of the bones, and cannot restore it properly.
This is a good thing to get tested - they all work together. Other things that your mom may be deficient in that are important for bone health are magnesium and vitamin K2.
Stage 1 cancer is very unlikely to be associated with high blood calcium levels. That's usually something that occurs when disease has progressed significantly.
Treating these deficiencies has made my blood calcium normal, and is pulling back my bones from osteoporotic (well, all except my hip).
Hope this helps
Sue
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Hello Sue
I think that you have given very good advice to Devonh5377 about the importance of vitamin D and the problems associated with low levels. I have read quite a few times about a possible connection with low levels of vitamin D and the development of breast cancer. I have been taking vitamin D supplements for a few years and when I was tested my endocrinologist/consultant breast surgeon sent me a letter congratulating me on having such high levels of vitamin D, on behalf of the person who carried out the testing.Yesterday I read an article about vitamin D (the sunshine vitamin) and how it may have a bigger impact on extending the survival of cancer patients than very expensive drugs. An oncologist and professor in one of the big London hospitals has said that he tests all of his cancer patients for the level of vitamin D and prescribes supplements when they are low. It would be well worth Devonh5377 knowing if she has low levels of vitamin D.
I also agree with you about the importance of vitamin K2 and magnesium.
Sylvia
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I am pleased to have stumbled on this forum as the experiences of many of you ladies seem to be so similar to mine. I had a mastectomy for BC last week, after having breast cancer treated in the other breast 16 years ago. I was told at that time I may get it in the other one but thought I might be out of danger now. Also I was investigated for hyperparathyroidism over a period of 3 years because of fluctuating calcium levels, osteoporosis, and other symptoms but although the PTH level was always raised the calcium was not always high so the endocrinologist was not very impressed.
In both of my cancers the mamograms showed widespread collections of calcium, I had already been suspicious there might be a connection and this Forum has more or less confirmed it. Last week before the op the Anaethetist pointed out high calcium in my blood and suggested I looked into it so I will mention all this when I go for my review next week. Parathyroid.com is a very good site and it seems to me that the condition is recognised more in the USA. I should be pleased with any feedback.
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Ladies the fear monster strikes again. I just got my labs back from my onc and she noted a high ALP level 145 U/L. My serum calcium level is 10.1. I checked my labwork from back from 4 months ago and my ALP was 152 U/L and my calcium was 10.1. I'm terrified that I might have bone or liver mets. Please tell me of any experiences with high ALP and upper range of normal calcium levels.
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Cynthia - raised PTH levels and normal calcium can still be hyperparathroidism; it is known as 'normocalcaemic hyperparathroidism'.
This was my experience and I had it corrected by surgery to remove a (benign) adenoma on one parathroid gland.The levels are now back to normal and I am hoping that the osteoporosis will also improve over time now that the other 3 parathyroid glands are working again.
According to parathyroid.com, high PTH is always indicative of hyperparathyroidism.Maybe you should find another endocrinologist? I think there may be a connection between this and bc (abnormal calcium deposits??)
Best to you,
sam
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Thanks for posting Sam. My PTH level wasn't checked. The labwork was done at my three-month onc visit. I am going to have her check my PTH in the hope that it is something like hyperparathyroidism. My ALP level was increased and my calcium level has remained on the high end of normal for some time.
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Sam Thank you for replying to my post, you have given me more confidence to push a bit harder. Its very frustrating when an expert dismisses the evidence.
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There are a couple of thoughts circulating in this thread that seem not quite right to me (but I'm a doctor, so what do I know). First of all, just because you run doesn't mean you won't get osteoporesis. I am a runner, training for my second marathon, and I have had bone loss in the past year and I'm only 49. It is largely genetic. Second, some people just blip high on calcium levels and it isn't the parathyroid at all. I had elevated levels years before bc, had my parathyroid checked and it was fine, and the calcium levels went down to normal within a year. Again this was well before bc so I don't think there is a connection. Finally, calcifications that appear on mammograms are very different from calcium levels in the blood. if the calcium in our blood was that large we'd all be having heart attacks.
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Well, yes, precisely......and actually the likelihood of a stroke is quite a bit higher with someone who has parathyroid disease and therefore calcium which is deposited in the arteries rather than the bones.
I think you might have misread the facts about hyperparathyroidism in some of the above posts - it is the high levels of PTH (parathyroid hormone) which indicate the disease....not high levels of calcium, which may or may not be elevated in parathyroid disease.
There are many people on these boards who have a dx of both bc and hyperparathyroidism, so I would speculate there may be a link between the two diseases.Hyperparathyroidism is very under-diagnosed, by the way, since the hormone levels are rarely checked by a PC doctor, who may well dismiss osteoporosis as due to age factors.
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When you are saying high calcuim levels,How high is bad.Mine has been high a couple times but only by a little.I am not sure how high is considered bad.Mine was high in June but normal this month.Just wondering how high it gets to cause worry.
Thanks Dee
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I meant I'm NOT a doctor. Whoops, typo.
Mine was somewhere between 10 and 11 and that was considered only slightly elevated. DFC, it doesn't sound like you should worry.
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Since diagnosis, I have had two high normal calcium levels (10.2 during chemo and 10.4 just a couple months ago). I have some elbow, hip, and knee pain issues that my oncologist thinks may be left over from chemo and/or caused by the Arimidex I am on now. Should I be worried about bone mets or seeing an endocrinologist to check for hyperparathyroid? My alkaline phospatase is normal, but I don't think anyone has looked at my PTH.
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Hi, I pulled up this thread so I could follow-up on my earlier posts. Just wanted to say that the bone scan I had in the spring was clear. After that, I was retested for parathyroid hormone twice. Out of the three PTH tests I had, only one was above normal (although I understand now that the tests in the normal range were very telling, when matched with the elevated calcium tests). My doctors disagreed about whether it meant I had parathyroid disease. Meanwhile, I had a second kidney stone, which, along with the osteopenia, really should have been a red flag for someone.
I finally self-referred to the surgeons in Tampa who specialize in parathyroid surgery. They were confident from my labs that I had an adenoma. In Tampa, it was confirmed with a scan. I had an adenoma removed in September and the other three parathyroid glands tested (all normal). The nausea and fatigue I had previously been blaming on taking Arimidex cleared immediately after the surgery, so they were actually symptoms of hypercalcemia.
I have learned through this experience that a lot of doctors aren't familiar with how to interpret the calcium and PTH tests. If I hadn't insisted on having the PTH repeated and then self-referred based on what I'd read, I'd still be feeling sick and probably developing more kidney stones and losing more calcium out of my bones. Like others, I would suggest anyone with mysterious elevated calcium levels dig through the parathyroid.com site and consider asking for parathryoid testing. I would be skeptical of being told, as I was, that elevated calcium levels were from taking supplemental calcium until a doctor very familiar with diagnosing parathyroid disease had ruled it out.
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EClaire........well done for your perseverence! Just goes to show that the patient is often more clued-up than the docs.
There is a lot of confusion concerning parathyroid disease - I was overjoyed to find Parathyroid.com, though some people say that not all the information on there is accurate.
There seems to be some correlation between hyperparathyroidism and breast cancer.There are quite a few of us on here who have had both.
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Thanks for your kind words, Sam52.
I was told by the surgeon in Tampa that parathyroid disease can cause breast cancer. However, the stuides I've read say that, while there can definitely be a correlation, it's less clear whether one causes the other, or if perhaps something else causes both. I would love to know more about the connection between the two since, as you said, a lot of us seem to have both.
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Hello Everyone,
I just wanted to say that I was diagnosed with TNBC breast cancer and hyperparathyroidism in 2005. I was told that I had had the parathyroid problem before the breast cancer.I am convinced there is a connection and feel that the hyperparathyroid problem played a part in the developement of my breast cancer. Every one should be tested for their parathyroid hormone level as part of regular blood tests.
Sylvia
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Hello everyone
I was re-reading this thread and refreshing my mind about hyperparathyroidism and breast cancer. I was wondering what has happened to the women who used to post here. I was wondering in particular whether those who had had parathyroidectomies had remained cured or whether anyone had had the adenomas regrow, as I know they sometimes can. I keep a check on my parathyroid hormone and calcium levels, both have remained normal since my surgery in 2009.Does anyone have any more recent research about a possible connection between hyperparathyroidism and breast cancer? I remain convinced that somehow my undiagnosed for years hyperparathyroidism was a factor in the development of my breast cancer.
A special hello to sam52, as we went through all this together.
Sylvia
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Hi Sylvia,
My calcium levels have returned to normal but my ALP continues to be elevated when it is tested by the lab associated with my Onc's office. I decided to ask my endocrinologist to check my ALP, calcium, and parathyroid homone level. He found all to be normal. So I'm not stressing about the ALP level anymore as ovbiously it can fluctuate. i have heard that Arimidex, which I'm taking, can increase the ALP level in some women. I must be one of them. I believe there is very possibly a connection between BC and hyperparathyroidism because there seems to be a lot of women with both. I do not know the specific literature however. Sorry.
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Hello Rocket,
I am convinced there is a connection between breast cancer and hyperparathyroidism but I am not sure which one comes first. My consultant told me she thought my hyperparathyroidis came first, judging by the size of the benign adenoma that she removed.
Best wishes, Sylvia.
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I had breast cancer and a lumpectomy in 2009 at the same time I was found to have high calcium levels in my blood As I posted on another message board, I had an ultrasound and a scan after my radiation therapy and they saw a shadow on one of my parathyroid glands. We have been monitoring my blood and PHT levels and had another scan about 6 months ago which found a small (7mm) tumour on the right lower gland. Not sure if it is related but my breast lump was also on the right side.
Last week I had a minimal invasive parathyroidectomy. For those who are concerned about the surgery, can I assure you that it is a walk in the park compared to a lumpectomy! I was released the following morning after an afternoon surgery and while I wasn't feeling 100% I was able to shower and move around and mostly just needed Paracetamol (Tylenol) for the pain. I'm not a stoic here; I am actually a wuss about pain so many of you would probably deal with this even better than I.
When I was reading up my condition, I read that if you have parathyroid ism and you take calcium supplements, it will exacerbate your condition and will shoot up the calcium levels in your blood. Initially I thought that if I took the supplements while waiting for the surgery it would help--wrong! What it does is trigger the parathyroid to seek MORE calcium out of your bones. It felt counter intuitive but I stayed away from the supplements but upped my weight bearing exercise regime to try and compensate.
As for the surgeon who claims they need to do the full surgery to check the other parathyroid glands, I am skeptical. The scan I had where they inject some radioactive stuff very clearly showed what was happening on all the glands. I would think that this surgeion could do the same. There was never any mention of anything more than minimal invasive surgery. However, my specialist did insist that I go to Sydney (I live in Canberra, Australia) for the surgery so that it would be done by a guy who specialises in this surgery as it can be a little tricky and you want someone who does this all the time.
I am intrigued about this correlation betwen breast cancer and parathyroid problems. I have a long family history of breast cancer (every women in my family for 3 generations has had it) so it wasn't a surprise to me and have never considered that there was any other trigger beyond family connection (yes, have done the BRAC 1 and 2 tests and while there are some variations they are considered normal or benign. Something is going on there but it's not on those two genes).
Someone mentioned that they have read research on this topic. Could someone post me to a ink or two? Thanks!
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Hello everyone
I think we need to keep this thread going and up to date.Please post if you have been diagnosed with breast cancer and also have been diagnosed with hyperparathyroidism, before or after diagnosis of breast cancer. I would also be interested to know whether you had positive or negative receptors with the breast cancer diagnosis. I think there is a connection between hyperparathyroidism and breast cancer, but the big question is which one causes the other or is there a different common cause?
Remember the most important factor for a diagnosis of hyperparathyroidism is high parathyroid hormone (PTH). The calcium level may be in the normal range or only slightly raised. It is important to know what is happening to rule out metastases to the bone.
Best wishes.
Sylvia0 -
I was just diagnosed with high calcium 10.9. I already had an appointment with my endocronologist so I told him about all of my pain and he ran tests. He was not convinced it was all caused by the arimidex. My tests came back with high calcium and I think normal PTH levels and very very low vitamin D. My tissue expander exhange surgery was cancelled because my plastic surgeon would not do it until we found out the cause of my high calcium. I have had DEXA and bone scan. Only showing osteopencia no bone mets (thank God). I am just waiting now to see the next step so see if I need to have parathyroidectomy. I want my expanders out so I am willing to do whatever so I can have the exhange surgery done. I had radioactive iodine about 7 years ago for graves disease. I have had alot of back pain and elbow pain. My endocronologist has put me on 50,000 ius of vitamind d, it is for 6 weeks. Glad this post has been reopened.
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Hello Busymom0413
I have just read your interesting post. I think your calcium level is very high at 10.9. Even when I had problems with my parathyroid gland my calcium level was only just above the normal range. I have been told by my consultant that the normal range for calcium is 2.05 to 2.55. However, high calcium levels are apparently not the deciding factor in hyperparathyroidism. It is the level of parathyroid hormone (PTH). Mine was way above normal. The range for PTH is 1.2 to 7.6.I was interested to know that you had very low vitamin D and I hope the supplements will help. There has been a lot of information around about low vitamin D and development of breast cancer.
I think it is probably prudent that your surgery for tissue expander exchange has been delayed until you find out the cause of your high calcium.
I was glad to know that you have had a DEXA scan and that so far you have only osteopenia, but that is a forerunner of osteoporosis. I am assuming that when you speak of a bone scan you mean a bone nucleide scan and that this has shown no mets to the bones.
If I were you I would ask to have the special scan for the parathyroid, which will show any growth on these tiny glands, the size of a pea, that sit on the thyroid gland. This special scan is called a Sestamibi scan. You can get non-malignant adenomas growing on these glands, of which there are usually four. I had one large one on one gland and this was removed through a parathyroidectomy. I had a full parathyroidectomy but you can get minimal invasive surgery. I have no scar whatsoever on my lower neck. I would not rush into this without being positive that there is a problem with the parathyroid.
I have heard that Arimidex does cause problems with the bones and indeed osteoporosis.
Breast cancer treatment also causes bone problems and osteoporosis.
I am one of those who thinks there is a connection between hyperparathyroidism and breast cancer. My consultant has told me that by the size of the adenoma removed, the hyperparathyroidism came before the breast cancer, so I have always wondered whether it caused it. My breast cancer was IDC with triple negative receptors.
I was interested to know that you had radioactive iodine seven years ago for Graves disease. I think I have read that this treatment can have all kinds of side effects. It could well be that there is a connection between this, your aches and pains and bone problems.
I am assuming that you have had hormonal breast cancer. Did you have IDC with oestrogen and progesterone positive receptors? What about HER2? Have you had Tamoxifen?
I hope you will get a definite diagnosis.
Best wishes.
Sylvia0 -
Hi Sylvia. 10.9 is not too high based on the scale that oncologist's lab uses. The upper end of the normal range is 10 .6 or something like that. My onc is only concerned if he sees large leaps up or down in my blood work.
I had a slightly elevated calcium last month but then stopped taking the vitamin d3 and calcium supplements and am back to normal range.0
