When Professor Google Does Not Know…

Something weird is happening at Eurofins the lab which analyses the blood tests. On Saturday they sent me the results of my alpha-1 antitrypsin survey. This came back normal, so there is no genetics causing a suppression. Yesterday evening they resent me the results twice!! This kind of thing is not normal, so it caught my attention.

The really weird thing is the low parathyroid hormone level.

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“Hypoparathyroidism is the combination of symptoms due to inadequate parathyroid hormone production (PTH) (Hypo-parathyroid-ism).  This is a very rare condition, and almost always occurs because of damage or removal of parathyroid glands at the time of parathyroid or thyroid surgery. This bears repeating: When people have too little parathyroid hormone (PTH), it is almost always because they had thyroid or parathyroid surgery and all four parathyroid glands were removed or injured.”

Source parathyroid.com

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I have the low hormone level BUT not the reduced calcium levels. I used to get cramps and have had neuropathy in my fingers. This neuropathy being probably down to the cervical spine injury ~2008 and the hernias therein. Calcium levels are however normal.

I have asked Professor Google about the PTH low Calcium normal using different sets of key words. He/she/it does not have much to say on the subject. There was one case of a Māori woman with similar numbers. It was weird enough to ask the laboratory to check the parathyroid hormone data. It was not wrong. They made a “special” report.

The endocrinologist may yet comment.

Using the above logic it perhaps makes sense to re-test the hormone level.

Because I am asymptomatic, this does not seem like a big deal. It could be a harbinger of problems yet to come. The hormone level is low; it has not dropped the calcium yet…

Like me it is a bit of an anomaly an outlier. The question is, is it safe to ignore and chalk up as just one of those things or does it need further investigation?

Low Parathyroid Hormone – Hypoparathyroidism?

The results for the three different mutations of HFE gene are in. I don’t have any of these. Which excludes the vast majority of the diagnoses for hereditary haemochromatosis. The footnote from the lab suggests contacting the centre for rare iron related disease in the big university hospital 150 km away. They may just talk with me as an ex-boffin.

I do feel a tad rusty these days, like the tin man my joints could use some oiling.

That means the polycythaemia primary or secondary question is in focus. Is there a malignancy or did my blood just adapt to smoking tabs?

My parathyroid hormone (PTH) is low, it is 26 pg / mL.

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“The iPTH reference interval of a healthy blood donor population was measured as 25.2–109.1 pg/mL (2.7–11.6 pmol/L) at 2.5 and 97.5 distribution percentile. The iPTH reference interval from data stored in the laboratory database was 19.3–112.5 pg/mL (2.0–11.9 pmol/L). Furthermore, 60% of the whole population had prevalently insufficient vitamin D concentration (<30 ng/dL; <75 nmol/L).

Mineri et al., Clinica Chimica Acta Volume 521, October 2021, Pages 1-8.”

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So it is at the rare end of a distribution yet just within the 2.5-97.5 percentile range. It is probably within experimental error out of the range. The error bars on 26 picograms must be big in a small sample!!

“PTH is secreted primarily by the chief cells of the parathyroid glands. The gene for PTH is located on chromosome 11. It is a polypeptide containing 84 amino acids, which is a prohormone. It has a molecular mass around 9500 Da”

My results for Calcium and Phosphorus were very normal, this latter statement is a bit weird. Low PTH levels are very rare and usually come with low Calcium levels. That pathway is messed up. Low parathyroid hormone screws with the Calcium concentration and bone turnover.

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Symptoms of hypoparathyroidism

Hypoparathyroidism often starts if glands in your neck are damaged during surgery.

Symptoms include:

  • a tingling or burning sensation in your fingers, toes and face
  • muscle pain, stiffness and spasms

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I have these two but these are caused when Calcium is too low!! So I do not have hypoparathyroidism.

We have another “contradiction” of sorts so the GP has asked advice from an endocrinologist. My guess would be re-test and if the value is still low maybe do something.

I am going to have an Alpha 1 Antitrypsin assay tomorrow which may add a piece to the jigsaw puzzle, concerning my lungs.

I’ll wait to hear from the GP as to what the endocrinologist suggests. It could be more tests, or not.

On the GP front we are probably good until September now…fingers crossed…

The working notion is that whatever it is that may be going on, it is just not manifesting in a sufficiently serious way, yet…

It could just go away or it could develop.

I am a bit of an anomaly, so it is no surprise that my blood results are a tad skewed from the normal.