Doctors Lounge - Endocrinology Answers
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Forum Name: Endocrinology Topics
|frankfrei - Mon Mar 23, 2009 4:19 pm||
I recently had my Vitamin D, Calcium, Magnesium levels checked due to recent onset of Inappropriate Sinus Tachycardia and extreme anxiety(panic attacks and generized) after going to ER 2x in one week. Had miscarriage in end of Nov then cyst on ovary in Dec that did go down in size by Jan. Had thyroid checked and a lot of other bloodwork like ACE level, B12 level and also checked for Lyme Disease-all negative. Had neuro work up bc experienced an episode of numbness on side and back of head before heartrate broke to 140. They caught on monitor and have said that right now its IST instead of SVT. I did have what they think was an SVT episode 11 years ago at age 20 bc I was around 180 resting in ER and responded to Adenosine on second round(but the strips weren't saved).
I'm pretty sure all my crazy symptoms(paresthesias, chest soreness under left collarbone, trouble getting deep breath at rest and during exercise) are pretty much cardiac(also diagnosed with MVP in past), but wanted to rule out that changes were not set off by hormones out of whack since miscarriage/ovarian cyst. Doing 24 hour urine today to rule out pheo. Anyway, my Vitamin D 1,25 Dihydroxy came back high; result was 60.7 and reference range from lab corp is 15.9 t0 55.6. My Vitamin D 25-Hydroxy was within the reference interval of 32-100 on the low side at 34.7. Calcium was 10.1 and their reference interval is 8.5 to 10.6. Magnesium within normal range at 2.1. I researched why Vit D 1,25 might be high and found that it could indicate excess parathyroid hormone, sarcoidosis, or lymphoma. Should I be worried about my level and, if so, what follow-up tests should I get to rule out the above? Current meds: now back on Atenolol 50 which controlled me before for 6 years and back on Zoloft up to 100mg, Lovaza 1 gram QD, prenatal vitamin, macrobid 100mg QHS for morning bladder pain.
|John Kenyon, CNA - Mon Apr 06, 2009 9:33 pm||
Hi there --
You've got enough factors to suggest IST and/or rare SVT without the slight deviation in D, 1, 125, which was barely over the top. I don't mean to dismiss this, as it should be rechecked later with an eye toward ruling out parathyroid problems or possible sarcoidosis, but it is an awfully small abnormality, and of course the line has to be drawn somewhere. With recent miscarriage, ovarian cyst, MVP and anxiety/panic disorder (which my just be secondary to the other stuff going on), you'd have plenty of justification for either/or. Hormones always can also play a role in all this, as a trigger or providing the little push everything didn't need, but it's not necessarily the sole underlying cause. I think, in this instance, it is just a combo of everything -- a perfect storm. All the meds seem appropriate, and hopefully the tachy stuff is quieted down. I assume the Zoloft is for GAD/PD, but if that doesn't seem to work there is always clonazepam, which is consistently effective, but which some doctors are less than enthusiastic about, because it's a scheduled drug, and because it has been associated with birth defects, it may not be for you.
Please follow up with us as needed, but I think you're back on the right track. If no one has picked up any evidence on EKG of AV nodal re-entry tract, then you should respond well to resumption of the meds you're now on. Good luck to you!
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