Case
We have a patient who has been the the VLCD for 5 weeks and her calcium levels continue to rise, from 10.3 up to 10.7 now 11.7. Is there any concern there? There had been mention of concern with potential kidney stone. What should we do?
Treatment Recommendations
Serum calcium can have some fluctuations, but it is generally not a concern related to the VLCD. Serum calcium is not a great marker of true calcium. If calcium comes back mildly abnormal, I usually watch it. If it drops or remains stable it’s probably just fine.
However, steadily rising calcium like you describe needs a medical evaluation. I presume this is something done by her PCP. She can remain on the diet. Of major concern is some sort of malignancy or parathyroid tumor--so important that it be evaluated.
No evidence that VLCD increases risk of nephrolithiasis. Obviously, good fluid intake is important, as dehydration is a risk for kidney stones. —John Hernried, MD