I'm new here. I'm a 59 year old female who also has a diagnosis of multiple sclerosis. Two years ago I had an elevated calcium level, which my doctor has continued to monitor. It has been around 10.3 with one level of 11 in the past two years. My PTH level is 13, which is a bit low, and I have no M-spike indicated on my blood work. The rest of my test results were pretty normal. I have no symtomology of feeling unwell, and no other indications of being sick.
My doctor mentioned myeloma as the possible cause of this elevated calcium, which of course has me completely freaked out. I also take a diuretic for blood pressure problems, which I have taken for almost 20 years.
I know none of you are God, and that you can't possibly know for sure, but what are the chances it's myeloma, and not something less worrisome?
They didn't get me an appointment with a blood doctor this week; but rather three weeks from now, which I'm hoping is also a good sign? I also had total double knee replacement surgery on both my knees in April of this year and sprung back from that surgery with no problems.
Any assurances I could get would be greatly appreciated. Thanks! Freya
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Re: High serum calcium level with no M-spike: is it myeloma?
Hello Freya,
You mention that you do not have an M-spike. Is this based on results of serum protein electrophoresis (SPEP) and/or serum immunofixation electrophoresis tests?
Also, have you had your serum free light chain levels (kappa, lambda, and kappa-lambda ratio) tested? If so, what were those results?
Finally, have you had any imaging done, such as an x-ray skeletal survey, or MRIs or PET/CTs? If so, have they found any signs of bone lesions anywhere?
If you really don't have an M-spike, then the chances are lowered that multiple myeloma is the cause of your high calcium levels. The chances already are diminished by the fact that you apparently don't have any signs of anemia (low hemoglobin), kidney damage (elevated serum creatinine levels), or bone damage.
However, about 15-20 percent of myeloma patients have what is known as light chain multiple myeloma, where they either do not have an M-spike, or their M-spike is very low. These myeloma patients, however, have either an elevated kappa or lambda free light chain level at diagnosis.
There also is a very small percentage of myeloma patients, perhaps 1-3 percent, who have neither an M-spike nor elevated free light chain levels at diagnosis. That type of myeloma is known as nonsecretory multiple myeloma.
You really can't guess whether a person has multiple myeloma based on just one or two general lab results. Lots of things can cause the most common symptoms that multiple myeloma patients have at diagnosis. That's why the SPEP, serum immunofixation, and serum free light chain results are so critical for understanding whether the disease is really present or not.
This forum post summarizes the most commonly used criteria for a multiple myeloma diagnosis:
https://myelomabeacon.org/forum/criteria-for-multiple-myeloma-diagnosis-t8505.html
The criteria also are explained in this article:
https://myelomabeacon.org/news/2014/10/26/new-multiple-myeloma-diagnostic-criteria/
Good luck, and please let us know what you find out once you have further tests.
You mention that you do not have an M-spike. Is this based on results of serum protein electrophoresis (SPEP) and/or serum immunofixation electrophoresis tests?
Also, have you had your serum free light chain levels (kappa, lambda, and kappa-lambda ratio) tested? If so, what were those results?
Finally, have you had any imaging done, such as an x-ray skeletal survey, or MRIs or PET/CTs? If so, have they found any signs of bone lesions anywhere?
If you really don't have an M-spike, then the chances are lowered that multiple myeloma is the cause of your high calcium levels. The chances already are diminished by the fact that you apparently don't have any signs of anemia (low hemoglobin), kidney damage (elevated serum creatinine levels), or bone damage.
However, about 15-20 percent of myeloma patients have what is known as light chain multiple myeloma, where they either do not have an M-spike, or their M-spike is very low. These myeloma patients, however, have either an elevated kappa or lambda free light chain level at diagnosis.
There also is a very small percentage of myeloma patients, perhaps 1-3 percent, who have neither an M-spike nor elevated free light chain levels at diagnosis. That type of myeloma is known as nonsecretory multiple myeloma.
You really can't guess whether a person has multiple myeloma based on just one or two general lab results. Lots of things can cause the most common symptoms that multiple myeloma patients have at diagnosis. That's why the SPEP, serum immunofixation, and serum free light chain results are so critical for understanding whether the disease is really present or not.
This forum post summarizes the most commonly used criteria for a multiple myeloma diagnosis:
https://myelomabeacon.org/forum/criteria-for-multiple-myeloma-diagnosis-t8505.html
The criteria also are explained in this article:
https://myelomabeacon.org/news/2014/10/26/new-multiple-myeloma-diagnostic-criteria/
Good luck, and please let us know what you find out once you have further tests.
Re: High serum calcium level with no M-spike: is it myeloma?
Thanks, Cheryl, for your reply.
I have not had the SPEP test yet. I'm not going to see the blood doctor til December 27. I'm hopeful that my doctor isn't too worried or she might have had me being seen much sooner?
I don't feel weak, my bones don't ache, I've not lost my appetite, and I've not lost weight (that I didn't work on losing pre-knee surgery), I recovered from that surgery like it was a walk in the park, and although I am constantly tired, I've attributed it to my multiple sclerosis (MS), and have charged onward. Other than I am scared to death, because MS seems to me to be enough to deal with, I feel perfectly the same as I have for years.
I am concerned at my low PTH level, and wonder what role, if any, it's playing in my slightly elevated calcium level. If I have had slight increase in my calcium level for the last two going on three years, wouldn't I have some kind of symptoms showing up? Also,could the elevated calcium be a side effect of my medications or my MS? What other reasons could there be for elevated calcium?
I have a personal trainer I work out with twice a week and he keeps increasing my weights, and has not noticed any change in the year I've been working out with him.
Thanks! Freya
I have not had the SPEP test yet. I'm not going to see the blood doctor til December 27. I'm hopeful that my doctor isn't too worried or she might have had me being seen much sooner?
I don't feel weak, my bones don't ache, I've not lost my appetite, and I've not lost weight (that I didn't work on losing pre-knee surgery), I recovered from that surgery like it was a walk in the park, and although I am constantly tired, I've attributed it to my multiple sclerosis (MS), and have charged onward. Other than I am scared to death, because MS seems to me to be enough to deal with, I feel perfectly the same as I have for years.
I am concerned at my low PTH level, and wonder what role, if any, it's playing in my slightly elevated calcium level. If I have had slight increase in my calcium level for the last two going on three years, wouldn't I have some kind of symptoms showing up? Also,could the elevated calcium be a side effect of my medications or my MS? What other reasons could there be for elevated calcium?
I have a personal trainer I work out with twice a week and he keeps increasing my weights, and has not noticed any change in the year I've been working out with him.
Thanks! Freya
Re: High serum calcium level with no M-spike: is it myeloma?
Hello Freya,
I am sure it is disconcerting to have myeloma tossed at you given the many other less serious and more common causes, so don't worry that much since it is highly unlikely that anything dramatic is going to happen before your appointment.
If you look at potential causes of elevated blood calcium levels, parathyroid is often at the top of the list. Low PTH and high calcium often go together. But, I wouldn't go worrying about parathyroid tumors right now either. If your blood pressure medicine is a diuretic, that might be the problem and simply fixed.
My wife has multiple sclerosis and we're familiar with most of the medications. Your neurologist would be aware of possible side effects your MS medication.
Anyhow, if it were me, I wouldn't worry until there is some more concrete to worry about.
Let's hope it's the blood pressure medicine.
Best regards,
Steve
I am sure it is disconcerting to have myeloma tossed at you given the many other less serious and more common causes, so don't worry that much since it is highly unlikely that anything dramatic is going to happen before your appointment.
If you look at potential causes of elevated blood calcium levels, parathyroid is often at the top of the list. Low PTH and high calcium often go together. But, I wouldn't go worrying about parathyroid tumors right now either. If your blood pressure medicine is a diuretic, that might be the problem and simply fixed.
My wife has multiple sclerosis and we're familiar with most of the medications. Your neurologist would be aware of possible side effects your MS medication.
Anyhow, if it were me, I wouldn't worry until there is some more concrete to worry about.
Let's hope it's the blood pressure medicine.
Best regards,
Steve
-
Foundry738 - Name: Biclonal
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: 2016
- Age at diagnosis: 67
Re: High serum calcium level with no M-spike: is it myeloma?
Thanks so much Steve! I was quite worried, but have decided that's not helping anything, and could potentially bring on a bad spell with my multiple sclerosis. Glad I only have to wait til the 27th for a potential answer. Will keep you posted!
Merry Christmas and thanks for the time you took to respond to my post. Freya
Merry Christmas and thanks for the time you took to respond to my post. Freya
Re: High serum calcium level with no M-spike: is it myeloma?
Hi all,
I met with the hematologist last week, and had about 70 different blood tests done. He said he doubts I have cancer; but that he has to get to the bottom of what’s going on, so he can fix the calcium issue in my blood.
The calcium ionized test has come down from 1.46 to 1.30, the regular calcium in the panel has come down to 10.00 as well from 10.30. Still no M-spike, no anemia, the kappa light chain level was slightly elevated, but the lambda was normal as was the kappa-lambda ratio. All other blood levels were normal and all kidney function tests were within normal range.
He said if he thought something ominous was going on he’d tell me, and that as the test results were coming back, if he found anything of concern, he’d call me straight away. No call has come from him, and I see him for follow up next Wednesday.
My PTH level has come up too from 13 (not even registering on the low end of the test, which was 15) to 25, all thyroid, and vitamin D levels were within normal range too. So, I’m guessing there is some other reason why the calcium has been been slightly elevated.
Of note, the only thing I’ve changed is I’ve made a very conscious effort to drink 8 glasses of water every day. Not sure if that’s made a difference; but in one of the many articles I read it noted that dehydration can cause blood work to have abnormal results.
Thanks for your support and pray for good news please and thanks!
Freya
I met with the hematologist last week, and had about 70 different blood tests done. He said he doubts I have cancer; but that he has to get to the bottom of what’s going on, so he can fix the calcium issue in my blood.
The calcium ionized test has come down from 1.46 to 1.30, the regular calcium in the panel has come down to 10.00 as well from 10.30. Still no M-spike, no anemia, the kappa light chain level was slightly elevated, but the lambda was normal as was the kappa-lambda ratio. All other blood levels were normal and all kidney function tests were within normal range.
He said if he thought something ominous was going on he’d tell me, and that as the test results were coming back, if he found anything of concern, he’d call me straight away. No call has come from him, and I see him for follow up next Wednesday.
My PTH level has come up too from 13 (not even registering on the low end of the test, which was 15) to 25, all thyroid, and vitamin D levels were within normal range too. So, I’m guessing there is some other reason why the calcium has been been slightly elevated.
Of note, the only thing I’ve changed is I’ve made a very conscious effort to drink 8 glasses of water every day. Not sure if that’s made a difference; but in one of the many articles I read it noted that dehydration can cause blood work to have abnormal results.
Thanks for your support and pray for good news please and thanks!
Freya
Re: High serum calcium level with no M-spike: is it myeloma?
Hi everyone,
I had 59 blood done December 27. Some of the out of range test results are below:
Kappa light chains: 25.9 mg/L (3.3 to 19.4)
Lambda light chains: 17.5 mg/L (5.7 to 26.3)
Kappa-lambda Ratio: 1.48 (0.26 to 1.65)
No M-spike (this is the second test in a month which had no M-spike)
IgG 1993 (700 to 1600)
IgA 341 (87 to 352)
IgM 226 (26 to 217)
Gamma Globulin 2.3 (0.4 to 1.8)
Globulin 4.4 (2.2 to 3.9)
A/G Ratio 0.9 (0.7 to 1.7) (in range)
Ionized Calcium 1.30 mmol/L (1.12 to 1.35 mmol/L).
I had this same test at the end of November and the ionized calcium was 1.47. So it’s come down quite a bit in a month.
Regular calcium level 10.0 mg/dL (8.7 to 10.4 mg/dL)
All blood levels RBC, WBC, Hemoglobin, Platelets, etc are normal.
In addition, my alpha 1 & 2, and beta globulins are all within normal range.
PTH related peptide: 1.1 pmol/L normal is under 2 (within normal range).
I have multiple sclerosis and have had a tooth that was infected in November, and now needs to be extracted. Do any of these results point towards multiple myeloma?
Thanks so much!
Freya
I had 59 blood done December 27. Some of the out of range test results are below:
Kappa light chains: 25.9 mg/L (3.3 to 19.4)
Lambda light chains: 17.5 mg/L (5.7 to 26.3)
Kappa-lambda Ratio: 1.48 (0.26 to 1.65)
No M-spike (this is the second test in a month which had no M-spike)
IgG 1993 (700 to 1600)
IgA 341 (87 to 352)
IgM 226 (26 to 217)
Gamma Globulin 2.3 (0.4 to 1.8)
Globulin 4.4 (2.2 to 3.9)
A/G Ratio 0.9 (0.7 to 1.7) (in range)
Ionized Calcium 1.30 mmol/L (1.12 to 1.35 mmol/L).
I had this same test at the end of November and the ionized calcium was 1.47. So it’s come down quite a bit in a month.
Regular calcium level 10.0 mg/dL (8.7 to 10.4 mg/dL)
All blood levels RBC, WBC, Hemoglobin, Platelets, etc are normal.
In addition, my alpha 1 & 2, and beta globulins are all within normal range.
PTH related peptide: 1.1 pmol/L normal is under 2 (within normal range).
I have multiple sclerosis and have had a tooth that was infected in November, and now needs to be extracted. Do any of these results point towards multiple myeloma?
Thanks so much!
Freya
Re: High serum calcium level with no M-spike: is it myeloma?
Great news!
I saw my hematologist/oncologist today and he said I do NOT have cancer! He believes I’m developing issues with my parathyroid, which he is going to continue to monitor very closely.
You can only imagine my relief, and the belief that I won the (health) lottery today.
Thanks for all your support and I pray all your journeys are as good as can be.
Freya
I saw my hematologist/oncologist today and he said I do NOT have cancer! He believes I’m developing issues with my parathyroid, which he is going to continue to monitor very closely.
You can only imagine my relief, and the belief that I won the (health) lottery today.
Thanks for all your support and I pray all your journeys are as good as can be.
Freya
Re: High serum calcium level with no M-spike: is it myeloma?
Thanks for the update, Freya. That's great news. Good luck dealing with the parathyroid issue!
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