Calcium, D, PTH . .. & Phosphorous??

Lisey
on 5/20/12 4:37 am - Milwaukee suburb, WI
I had my vite labs drawn 3/26/12. As some of you might remember, I stopped taking my vites during chemo & had started them up again about 2 weeks prior to 3/26 draw. Of course, a lot of them were on the low side, but thankfully all on the low side of normal. They used to tend towards the high side of normal & that's my ultimate goal again.

I saw an endocrinologist b/c I had a bone density scan done that showed I had osteopenia. I had a scan done in 2006 & was normal. Given multiple risk factors, PCP sent me to endocrinologist.

The endo ordered another PTH panel & D to see how they might have changed since by that time I had been on my full vit regimen for 2 months. I had this drawn this past Mon.

My confusion is, intuitively, you would think since I've now been on my full vites for 9 weeks vs the 2 weeks at the 3/26 draw, if anything, my PTH should be lower, yes? Well, it wasn't, it was higher. Yet, my D was higher. So was calcium, but apparently that's b/c it's been leeched from my bones vs what I was taking.

3/26 labs:
A 34 (18-77)
E 12 (6-20)
K .31 (.28-1.78)

B6 >100 (2-22)
B12 803 (211-911)
B4 701 (468-1258)
Zinc 83 (70-150)
Copper 96 (70-175)
Selenium 148 (79-326)

Ferritin 151 (10 - 150)
Total Iron 80 (50-170)
TIBC 230 (250-400) LOW
% Saturation 35 (15-50)
Unsat IBC 150 (112-347)

D 38 (30-100)
Calcium 8.2 (8.6-10.2) LOW
PTH 60 (14-72)
Phosphorous 3.6 (2.5-4.5)

Total Protein 6.1 (6.6-8.7) LOW
Albumin 3.7 (3.5-5.2)

Magnesium 2.3 (1.5-2.6)
Potassium 3.6 (3.4-5.1)
Glucose 84 (65-99)
Sodium 138 (136-145)

5/14 Labs:
Calcium 9.1 (8.6-10.2)
PTH 84 (15-72)
D 55 (30-100)
Phosphorous 4.7 (2.5-4.5) HIGH
Albumin 4.4 (3.5-5.2)

Note: I also had labs drawn 5/9 (when saw oncologist) &:
Calcium 8.5 LOW
Phosphorous 3.6
Albumin 4.2
Glucose 83
Sodium 136
Potassium 3.7


Big question is why would PTH go UP when I've increased my blood level of D to just about middle of the range? I would have expected it to go down if anything.

I researched this as best I could & the only thing I came up with is a link b/w calcium, PTH, D, & phosphorous. Research has been underway to understand the role of phosphorous in the calcium, D, PTH pathways in the last 10 years. It's VERY complex info, heavy duty reading & I'm just starting to read about it - I don't think I know enough about it to actually write the crux of how they work together, except to say that it appears very high levels of vit D can cause high levels of phosphorous. Excessive phosphorous levels cause an INCREASE in PTH. The other key point in this is that this process starts with high D levels in the INTESTINE, not the blood . . . & if that's the case, could it be that the super high levels of D actually start this process in the common channel of the small bowel? Here's a couple of links:

http://ndt.oxfordjournals.org/content/20/10/2032.full

http://www.rndsystems.com/mini_review_de....aspx#phosphorus

There's more info/ other links out there. What do people think of this or are there any other suggestions as to why my PTH would increase with a better, but still normal D?

---------------------------------------------------------------------------
Here's what I have been taking for vites for last 2 months:
Sublingual:
10k A, 100 K1, zinc gluconate - all every day
B12 every other day

Dose 1:
K1 1000mcg, dry
K2 100mcg, dry
multivitamin
Bcomplex, high potency
probiotic

Dose 2:
calcium citrate 630mg
D 50k IU, dry
magnesium citrate, 500mg
boron citrate
A 25k IU, dry
E, 400mg, dry
potassium citrate/ gluconate, 99mg
omega 3

Dose 3:
polysaccharide iron 150mg
Vit C, 500mg
Copper lysinate, 5mg

Dose 4:
calcium citrate 630mg
D 50k IU, dry
magnesium citrate, 500mg
boron citrate
A 25k IU, dry
E, 400mg, dry
potassium citrate/ gluconate, 99mg
selenium

Dose 5:
calcium citrate 630mg
D 50k IU, dry
magnesium citrate, 500mg
boron citrate
A 25k IU, dry
E, 400mg, dry
potassium citrate/ gluconate, 99mg
milk thistle

 

HW / SW / CW / GW      299 / 287160 / 140     Feb '09 / Mar '09 / Dec '13 /Aug '10          

Appendicitis/Bowel Obstruction Surgery 8/21/10
Beat Hodgkin's Lymphoma!  7/15/2011 - 1/26/2012 


Ran Half-Marathon 10/14/2012

First Pregnancy, Due 8/12/14                             I LOVE MY DS!!!
 

beemerbeeper
on 5/20/12 4:41 am - AL
I don't know nothin but ask if you are taking 3 doses of Calcium a day?  Because I take 6.  And my PTH is still rising.

~Becky


Lisey
on 5/20/12 4:45 am - Milwaukee suburb, WI
I'm taking 3 doses of calcium a day (2 pills per dose) of citrate.  I'm going to up to 4. 

HW / SW / CW / GW      299 / 287160 / 140     Feb '09 / Mar '09 / Dec '13 /Aug '10          

Appendicitis/Bowel Obstruction Surgery 8/21/10
Beat Hodgkin's Lymphoma!  7/15/2011 - 1/26/2012 


Ran Half-Marathon 10/14/2012

First Pregnancy, Due 8/12/14                             I LOVE MY DS!!!
 

MajorMom
on 5/20/12 5:08 am, edited 5/20/12 5:09 am - VA
My understanding is that PTH lags behind the D and calcium. I do think it's a good idea to increase your calcium citrate. I also take 6 doses of 600mg a day. With each calcium dose I also take magnesium citrate and boron. Be ready to counter with a constipation ritual if you're taking calcium tablets rather than capsules. Are you taking potassium?

--gina

I see the postassium now. You might want to increase that with input from your doc. I'm taking 8 - 99mg tablets a day to keep mine up.

5'1" -- HW 195/SW 187/GW 115 July 08/CW 121 Dec 2012
                                 ******GOAL*******

Starting BMI between 35 and 40ish? 
Join us on the
Lightweights Board!
DS on Aug 9, 2007 with Dr. Hazem Elariny

Lisey
on 5/20/12 7:00 am - Milwaukee suburb, WI
Thanks, Gina.  I take potassium chelated/ gluconate 99mg, 3 X daily.  I've already decided to up my calcium to 4x daily & ultimately will add more if I need to.

HW / SW / CW / GW      299 / 287160 / 140     Feb '09 / Mar '09 / Dec '13 /Aug '10          

Appendicitis/Bowel Obstruction Surgery 8/21/10
Beat Hodgkin's Lymphoma!  7/15/2011 - 1/26/2012 


Ran Half-Marathon 10/14/2012

First Pregnancy, Due 8/12/14                             I LOVE MY DS!!!
 

JazzyOne9254
on 5/20/12 1:17 pm, edited 5/20/12 1:18 am
I am struggling with bouts of osteopenia myself

When your PTH (parathyroid hormone) is high, that means your parathyroid glands have kicked in. It is their job to pull calcium from your bones to maintain the correct blood calcium level for body functions. If you are getting enough calcium from diet and supplements, according to my lab sheet a normal PTH range is 15-72 pg/mL

Go over your labs with your doctor to be sure.

HW 405/SW 397/CW 138/GW 160  Do the research!  Check the stats!
The DS is *THE* solution to Severe Morbid Obesity!

    

Lisey
on 5/20/12 2:25 pm - Milwaukee suburb, WI
Thanks . . . I know that PTH pulls the calcium from your bones to regulate your blood calcium levels if they're not sufficient.  What I'm driving at is there's a lot of newer research that suggests calcium is highly regulated by D & that PTH is influenced by phosphorous as well.  I think it's more complicated than we realize.  It occurred to me to start digging for info when my PTH got worse when I had signicantly increased my calcium (b/c I was taking it for 9 weeks by that point as opposed to 2 weeks in the 3/26 draw), as well as Vit D . . . & as evidenced by the D increase in my second draw.  I think there's another mechanism at work.  I'm hoping someone else who has heard of phosphorous' s role in the calcium-D-PTH triad can give me some insight, either b/c they know or b/c they read the links I gave & understand it better than I did the first time around.  I'll reread them again this week, just don't have time in next couple of days.

HW / SW / CW / GW      299 / 287160 / 140     Feb '09 / Mar '09 / Dec '13 /Aug '10          

Appendicitis/Bowel Obstruction Surgery 8/21/10
Beat Hodgkin's Lymphoma!  7/15/2011 - 1/26/2012 


Ran Half-Marathon 10/14/2012

First Pregnancy, Due 8/12/14                             I LOVE MY DS!!!
 

MajorMom
on 5/20/12 7:44 pm - VA
One of our DSrs is a head nurse in a dialysis center and she speaks of phosphorous and vitamin D3 quite a bit. I'll point her to this thread.

--g

5'1" -- HW 195/SW 187/GW 115 July 08/CW 121 Dec 2012
                                 ******GOAL*******

Starting BMI between 35 and 40ish? 
Join us on the
Lightweights Board!
DS on Aug 9, 2007 with Dr. Hazem Elariny

JazzyOne9254
on 5/20/12 7:53 pm
It is more complicated. 

All those chemicals work together to deliver absorbable calcium to your bones through your bloodstream.  Taking Iron with Vitamin C works in a similar fashion.  I don't have the diagrams in my computer to post, but my prof drew the diagrams on the  board to illustrate the reactions that make it happen. .  I'll dig around for my handout.  All my stuff is so disorganized since I've been mostly dealing with Mom's decline and passing this semester.  Didn't take classes because of it.  

HW 405/SW 397/CW 138/GW 160  Do the research!  Check the stats!
The DS is *THE* solution to Severe Morbid Obesity!

    

JazzyOne9254
on 5/21/12 1:36 am

I have had a hell of a time with calcium myself right out of the gate, and the fact that I'm post-menopausal, and was prior to surgery, doesn't help.  Estrogen plays a role in helping all these other chemicas work together, too. 
That's why you hear so much in the news about post-menopausal osteoporosis.

At this point, I'm not sure what else I can do nutritionally to get my calcium levels up, short of infusion.  I recently had a Reclast infusion, which gets its name from "osteoclast".

I should look like a stick of chalk by now!

HW 405/SW 397/CW 138/GW 160  Do the research!  Check the stats!
The DS is *THE* solution to Severe Morbid Obesity!

    

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