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What does it mean when your Calcium is 10.7 mg/dL and your Albumin is 4.9 g/dL?

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.

There are two main issues here. First, what does a calcium of 10.7 mg/dl mean? And second, does the albumin change that?

Let’s address the calcium first. If you are over the age of 30, then that calcium level is high. The most common cause of high calcium is primary hyperparathyroidism. To make that diagnosis, we first have to look at a calcium and PTH level together. If your calcium is high, and the PTH is in the high or normal range, that is consistent with primary hyperparathyroidism. If your calcium is high, but the PTH is in the low range (under 20 pg/ml), then that is most likely not parathyroid disease - the calcium is high due to some other cause.

If the PTH is in the low-normal range, such as in the 20s to 30s pg/ml, then we need more information. This can be consistent with primary hyperparathyroidism, but you also see high calcium with PTH in the 20s and 30s with oversupplementation of Vitamin D. This is where it really helps to see Vitamin D levels and ask about Vitamin D supplementation. If you are taking a high dose of Vitamin D (such as 5,000 units or more daily) and your Vitamin D 25-OH is greater than 50 ng/ml, then the high calcium is likely due to Vitamin D. Vitamin D is a hormone that increases calcium absorption in the intestines, so taking a high dose can cause high calcium, even if you do not have parathyroid disease. The treatment is stopping Vitamin D, and seeing if the calcium goes back to normal - this may take a few months for the Vitamin D to drop back enough for the calcium to normalize. If the calcium does not go back to normal after stopping Vitamin D, then primary hyperparathyroidism is more likely.

Next, about the albumin: I get questions about albumin a lot! I’m going to refer you to some prior answers here, for more information on albumin and calcium levels:

Diagnosis primary hyperparathyroidism Vitamin D Albumin