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I am a 31 year old female and my calcium level just came back at 10.4. My albumin and chloride were also slightly elevated. Should I be worried about parathyroid or what next steps should I take as precaution? I'm on 5000 units daily of Vitamin D3.

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.

At your age, a calcium of 10.4 mg/dl is borderline. Adults in their 30s can have calcium levels in the low 10s, which will tend to drop down into the 9s as they get older. A calcium of 10.4 is on the highest end of where I would expect your calcium levels to be at your age.

I am concerned about your dose of Vitamin D. 5000 units daily is a lot, and if you have been on that dose for a long time then it can cause your calcium to rise into the high range. If your Vitamin D 25-OH level is also high (above 50 ng/ml) then this may be the reason for your calcium level. One of the main roles for Vitamin D is to help your intestines absorb calcium. Since your calcium is already on the high end, I would not recommend taking so much Vitamin D.

To diagnose parathyroid disease, we need to see calcium and PTH levels. And in your case, I would also want to see your Vitamin D level. It also helps to have past calcium levels, to see if they have changed over time. If your Vitamin D is low, but your calcium is 10.4 and your PTH is in the high or high-normal range, then you likely have parathyroid disease. With borderline cases, the more results we can review, the better.

A slightly elevated albumin is usually normal. While parathyroid disease can cause a mild elevation in chloride levels, we don’t currently use chloride to diagnose primary hyperparathyroidism.

Diagnosis Vitamin D