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I am 69. My calcium levels have run consistently 10.8 range for the past 2 years. It has been 11.9 and 11 as recently as a few days ago. My PTH was 86 in September 2021 but is normal range now. However I feel really bad. Fatigue, difficult concentration, tingling lips, constipation, absolutely no appetite with weight loss, nervous internally and eye sight changes. Could I have parathyroid issues even with a normal PTH? I have seen doctors but they just say they don't know why my calcium is high or what is causing my symptoms. My whole life has changed. I'm desperate for answers and where to find them. Please help.

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 lab results indicate primary hyperparathyroidism. You are experiencing the classic symptoms of the disease, which should improve once you get it treated.

The diagnosis of primary hyperparathyroidism is based mostly on calcium and PTH levels, but you do not need to have a “high” PTH to make the diagnosis. The important thing is the calcium and whether the PTH is appropriate given the calcium level. If your calcium level is high, then normal parathyroid glands will shut down (stop making PTH) in order to let the calcium drop back to normal. If your calcium is high (anything over 10.0 mg/dl for your age) and your PTH is in the “normal range,” that is inappropriate. An appropriate PTH for a high calcium would be something under 20 pg/ml. A PTH of 60 pg/ml, even though it is “normal range” is inappropriate for a high calcium.

**Primary hyperparathyroidism is diagnosed by a high calcium and an inappropriate (but not necessarily high) PTH. **

For example, if your calcium is currently 11.0 mg/dl, and your PTH is 45 pg/ml, then you most likely have primary hyperparathyroidism.

The only cure for primary hyperparathyroidism is an operation to remove the diseased parathyroid gland(s). For most patients, the symptoms that you are having improve in the weeks and months after surgery.

Diagnosis Hypercalcemia primary hyperparathyroidism