[February]

My calcium labs show normal or high normal blood calcium and low ionized levels.

I'm trying to figure out if it's because of kidneys which have taken a hit because of ivig. I have had low gfr in the past that has returned to normal.

It could be parathyroid too.

Is there any way to tell the difference?

Is there anything more I should test for?

[kiwi33]

Originally Posted by February

My calcium labs show normal or high normal blood calcium and low ionized levels.

I am not sure that I understand this - as far as I know all blood calcium is ionised as Ca2+.

Would you like to post the test results here? I would be happy to comment on them - I know a fair bit about metal ion biochemisty.

[February]

The ionized calcium has been low 2 times within 8 months and the cbc calcium is trending higher than my norm

The last tests were

Ionized 1.07 1.12-1.32

cbc 9.2 8.3-10.5

I know they are not seriously out of range but there is a trend I'm concerned about because of the low gfr. I think 59

My b-12 levels have sat over 1800 but I haven't taken it in a year almost because I think the levels are high and wanted to see if they lowered

I take calcium citrate regularly

I think a pth level test next?

Thanks for taking a look

[kiwi33]

"Ionized 1.07 1.12-1.32"
Assuming this is free (not protein-bound) Ca2+ in units of mmol/L, it is just outside the normal range.

"cbc 9.2 8.3-10.5"
If this is total (free and protein-bound) blood Ca2+ in units of mg/dL, it looks fine to me.

"there is a trend I'm concerned about"
If there are trends in total and/or free blood Ca2+ then this is worth discussing with your doctor.

"the low gfr. I think 59"
A glomerular filtration rate of 59 suggests mild to moderate loss of kidney function.

"I think a pth level test next"
Good idea. If you have not already done so, getting your doctor to check your Vitamin D level is also an idea - Vitamin D is important in Ca2+ metabolism.

The info in this (long...) link might help you to ask your doctor informed questions; http://www.kidney.org.uk/help-and-in...osphate-index/ .

[glenntaj]

--what are your albumin levels?

Much of the calcium in the blood is bound up in albumin. If your albumin levels are high--approaching 5--your total calcium levels may be reading as factitiously high compared to your ionized calcium levels.

The usual conversion factor is that for every tenth of an albumin point over 4.0, one must subtract .08 from the calcium level to get a true (or truer) actual total calcium reading. So, for instance, if one has an albumin level of 4.8 and a total calcium reading of 9.6, one should subtract .64 from that level (.8 times .8), giving an actual total calcium level of 8.96.

I deal with this quite often, as I tend to run high albumin levels (high protein, low carb diet), and my calcium levels need to be interpreted in light of that.

[February]

Thank you both so much.

I'm not concerned the calcium is a little low. My main concern is the health of my kidneys. I have malabsorption issues. I have to get the nutrients from supplements. I couldn't eat enough to keep deficiencies away. The supplements are hard on kidneys. I am trying to maneuver to balance the two. A problem is that I have no access to gfr to look for trends. The level may be sitting at 60. I can tell by my fluid intake and outtake. The trends on the labs are indicative of how I feel. I don't want to worry unnecessarily either.

I will check on D level. I'll ask for a phosphorous test too. I take it that's a different test than ALP which trended higher as well.

The albumin levels are consistently in proportionate levels just higher.


I do take b12 when I feel more sensory motor symptoms. Will it be a problem even though blood levels are high?