Dr. Zulfiqar Ahmed
Diabetology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am afraid that I have hypercalcemia. I cannot sleep, my head hurts and my throat feels tight. I have heart palpitations and my muscles feel weak. I lie on the bed and feel like I am lying in stone. My right ear has been ringing. I had an electrolyte test five days ago. My calcium was 10.1 mg/dl, within the normal range. Potassium, magnesium, and sodium were normal too. Should I go to the emergency room? I cannot sleep a bit and I am so sleepy.
Thank you.
Hello,
Welcome to icliniq.com.
I can understand your concern. Your calcium levels are in the high-normal range: however, it is total calcium which might not be accurate until we know albumin levels as well. In the presence of your symptoms, it is advisable to either check corrected calcium levels if available in your area, or assess albumin levels. Since much of the calcium is bound with albumin, variations in albumin levels may affect corrected calcium levels. So if your calcium is high, you must do parathyroid levels to see why calcium is high. Your blood pressure and sugars are within the normal range. Heart rate is acceptable. These symptoms may be due to high sugar, but since it is normal, diabetes is ruled out. How do you feel psychologically? Sometimes extra stress can lead to the symptoms you have as well. It is not very urgent to go to the emergency room right now if you can arrange blood tests on your own.
I hope this helps you.
Thank you.
Regards.
Patient's Query
Hello doctor,
Thank you for the response. I can get the blood tests done tomorrow morning. I feel a bit dizzy and blurry in my vision. However my vitals remain good, blood pressure, oxygen, heart rate, and blood sugar are also normal. I think I can manage for today. I do not have any severe pain besides my legs feeling a bit numb and weak. Would it be better if I get tested my blood for ionized calcium and total calcium instead of albumin? I have been facing anxiety disorders this past year so stress could play a part too.
Thank you.
Hello,
Welcome back to icliniq.com.
Corrected calcium is the same as ionized calcium. You can do that it is fine. Are you taking any medication for the anxiety disorder that you are having? As I mentioned, it might be anxiety causing these symptoms. If that is so, better to see and talk to a psychiatrist or psychologist.
Thank you.
Regards.
Patient's Query
Hello doctor,
Thanks for your response.
I have a psychiatrist appointment in a week because I understand that my anxiety is getting bad. But at the same time, I am scared right now that something bad will happen until tomorrow because of my calcium. I am in a pitiful state.
In your opinion what change should I be on notice in my symptoms that I should get up and visit the emergency department? Am I good as long as my vitals are good? I read that constipation is also a sign of hypercalcemia but I had motion twice yesterday so I would say I am good.
Thank you.
Hello,
Welcome back to icliniq.com.
Your reported calcium levels were high and normal. The only thing I want to exclude is whether it is higher than what is reported. If that is correct, further investigation is necessary. However, this much calcium will not do anything harmful to you. It is only when calcium levels are very high that one may experience worrisome symptoms but those levels would be quite high and definitely over 15. You do not need to worry and try to relax. In my opinion, your current symptoms are due to ur worsening anxiety. Take deep breaths by opening your mouth and counting until seven and then blow out it from ur mouth counting until ten. Repeat it for three to four minutes. Hopefully, your appointment is near with ur psychiatrist and you can discuss it with him. Be assured your calcium levels will not put you in any danger.
Thank you.
Patient's Query
Hello doctor,
Thank you for the advice. So I will take a full exam tomorrow, calcium and ionized calcium, albumin, pth, creatinine and urea, crp. As of today, please tell me, are there any symptoms that I should look out for if I need to go to the emergency room?
Thank you.
Hello,
I think you can just do ionized and total calcium and if it is high, then you can do parathyroid. You can do urea creatinine and CRP (c-reactive protein). I do not think you need to worry about anything tonight. Just relax everything is fine. If I will tell you of one symptom you will concentrate on it and it will disturb you more. There is nothing to worry about until your vital signs are fine. Your heart rate is good and oxygen levels are fine. Just take deep breaths relax and rest.
I hope it makes sense.
Thank you
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Diabetology
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