From the Research
I strongly recommend that the patient consult with their healthcare provider to evaluate their persistently elevated calcium levels, as this could indicate primary hyperparathyroidism or other conditions despite their normal PTH, and to discuss the potential risks and benefits of treatment options, as suggested by the most recent study 1. The patient's normal PTH levels and elevated vitamin B12 levels, which are likely due to supplementation, should be discussed with their doctor, as they may be contributing to the hypercalcemia.
- The patient should temporarily discontinue all supplements that might contain calcium or vitamin A, as these could contribute to hypercalcemia.
- The improving AST liver enzyme suggests the patient's liver function is getting better, but the cause should be investigated.
- Hypercalcemia can cause symptoms like fatigue, bone pain, kidney stones, and cognitive issues, so prompt medical evaluation is important even if the patient feels well.
- Drinking adequate water (2-3 liters daily) may help prevent complications while the patient awaits medical assessment, as dehydration can exacerbate hypercalcemia, as noted in 2. The healthcare provider will likely order additional tests, such as:
- 24-hour urine calcium to assess the patient's calcium excretion
- Serum protein electrophoresis to rule out multiple myeloma or other plasma cell disorders
- Imaging studies, such as X-rays or CT scans, to evaluate for bone lesions or other abnormalities The patient's mildly elevated AST levels and normal vitamin D levels should also be investigated, as they may be related to the underlying cause of the hypercalcemia, as discussed in 3 and 4. The patient's healthcare provider should prioritize identifying the underlying cause of the hypercalcemia and developing a treatment plan to manage the condition and prevent complications, as emphasized in the most recent and highest-quality study 1.