Does lack of estrogen raise calcium level in urine?
Patient's Query
Hi doctor,
Five years ago, I had a hysterectomy for early stage node negative breast cancer. I am 49 years old. Currently, I am on Arimidex. My prognosis was 4 percent risk of recurrence. Since my surgery, my calcium levels are at 9.7 to 10.2 and albumin are 4.7-5.0. Four years ago, a routine CT scan showed two stones. I have them followed annually by ultrasound. This month, my doctor decided to do a 24-hour urine as the stone grew a little. I have attached the reports. My 24-hour urine was 452, which I understand is elevated. Is the level very high? Does lack of estrogen raise calcium in urine and affect urine results? I did have one lobe of my thyroid removed before 16 years for 0.15 inch papillary thyroid cancer. My PTH was checked three years before and it was 22.
Hi,
Welcome to icliniq.com.
I have seen the reports sent by you (attachment removed to protect patient identity).
Yes, your 24-hour urine result shows increased calcium. The normal level is up to 300, and yours is 452. In my opinion, it is not severely raised. I will grade it as mild to moderate. Regarding the raised calcium level, I think you should reconfirm it after 15 days because these values are highly variable and one high report does not necessarily mean it is raised. So, you need to confirm it again after 15 days with a calcium-restricted diet for two days (please consult your physician for advice).
There can be three reasons for hypercalciuria: absorptive, your intestine is absorbing excess calcium, renal, your kidney is losing more calcium; and resorptive, raised PTH (parathyroid hormone). Basically, at this point, you need to reconfirm urine calcium levels and serum PTH levels as well because it was done more than three years ago. You need to remove present stones in the kidney and then you should avoid food that increases calcium in the urine. Your urologist might start you on the tablet after your stones get cleared.
I hope this helps.
Patient's Query
Hi doctor,
Thank you for your reply. I wanted to gain knowledge before I speak with my doctor tomorrow. Another concern is that due to my cancer history whether my blood work or urine alarming for bone metastasis? Am I correct in stating that my higher serum albumin causes a false higher serum calcium?
Hi,
Welcome back to icliniq.com.
As per your blood report, it does not look like any metastasis in bone. An increase in serum albumin is not of much value in increasing serum or urine calcium. But, decreased serum albumin may cause falsely decreased serum calcium.
I hope this helps.
Same symptoms don't mean you have the same problem. Consult a doctor now!
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