Question

I have all of the symptoms of parathyroid disease. I'm exhausted, can't concentrate, have back pain, can't sleep at night, and just feel awful. I discovered parathyroid disease and it seems to account for all of my symptoms over the last year. My calcium level, though, was normal at 9.8 mg/dl. My doctor checked a PTH and it was 43 ng/ml. She says I don't have parathyroid disease. Could I still have it, even with normal labs?


Answer
Deva Boone
Answer authored by Deva Boone
Deva Boone, MD is the founder of the Southwest Parathyroid Center. As one of the most experienced parathyroid surgeons in the U.S., she has treated thousands of patients with parathyroid conditions.

Your symptoms are consistent with the common symptoms of primary hyperparathyroidism, but with normal calcium and PTH levels that is not likely to be your underlying problem. We diagnose parathyroid disease with labs: primarily calcium and PTH; Vitamin D is also helpful in many cases. If the calcium and PTH levels are consistently normal, then parathyroid disease is very unlikely.

The one thing that you should do is check your prior calcium levels. Sometimes with parathyroid disease the calcium levels can fluctuate from the high range to the normal range, and back again. You can “catch” the calcium in normal range one day, and have a high calcium level the next day. If I am not sure about the diagnosis, the first thing I do is recheck labs. I like to see a series of calcium and PTH levels over a few weeks. This will often clear up the diagnosis. If the calcium and PTH stay perfectly normal during that time, then we can rule out parathyroid disease.

Diagnosis Normal calcium