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My calcium is always noted to be “high-normal” but doctors are not concerned. Could I have parathyroid disease?

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.

It depends on what your actual calcium levels are. Sometimes what is called "high-normal" is actually too high. Adults over about age 40 will generally have calcium levels at or below 10.0 mg/dl (or 2.5 mmol/L). If it is persistently above that, then your calcium levels are high, not high-normal. (If you are under 40 years old, then you can have calcium levels that are slightly higher.) Repeatedly high calcium levels above 10.0 in someone over age 40 are almost always caused by primary hyperparathyroidism. To confirm that, we would need to also check a PTH (parathyroid hormone) level. If your calcium level is above 10.0, then you should have a PTH level checked.

If your results are consistently in the high 9s – they are normal. This where your levels should be. It is still possible to have primary hyperparathyroidism if you have these "high normal" calcium levels. To diagnose this, you need to know your PTH levels. If your calcium is in the high 9s, then your PTH levels should be in the normal range, somewhere between 20 and 70 pg/ml. If your PTH level is consistently much higher than this, then you may have primary hyperparathyroidism. This is called normocalcemic primary hyperparathyroidism. These cases are harder to diagnose, so you will want to have an expert review your labs. In these cases, I like to see all of the calcium, Vitamin D, and PTH levels before making a diagnosis.

If you are concerned about parathyroid disease, it is very important to know your calcium levels. Don't accept a comment of "it was normal" or "it's high-normal". You should request your lab reports from your physicians, so you can see the actual numbers. Calcium levels are usually found within a set of labs called “Basic Metabolic Panel” or “Comprehensive Metabolic Panel."

Normal calcium Primary HPT Diagnosis