My blood chem isn't found in textbook. What might it be?

[Maiden]

P-L-E-A-S-E - D-O - N-O-T - F-E-E-D - T-H-E - T-R-O-L-L

My blood chemistry isn't found in the textbook. What
might I have?

My calcium levels are on the high end (ranging between
9.8 & 10.4)

Yet Merck states that when serum calcium is *low*, that's when
osteomalacia (vitamin d deficiency) should be suspected.

This is inconsistent with my blood chemistry which indicates:
low 25-hydroxy D3 (23 ng/mL) - indicative of Vitamin D
deficiency, yet: *high* serum calcium (range 9.8 to 10.4)

I also have high bilirubin (1.6) and Merck states
(http://www.merck.com/pubs/mm_geriatrics/sec7/ch49.htm):

"Impairment of conversion to 25-hydroxy D3 occurs in patients
with severe liver disease...

So for all I know, perhaps the only way I'd absorb Vitamin D
is via calcidiol, which (according to Merck) is better
absorbed than ordinary Vitamin D & bypasses any defect in
25-hydroxylation in liver.

But the question remains: If Merck is correct, then why do I
have *high* calcium, if I have such low Vitamin D? Actually, I
don't quite understand Merck's reasoning, because it seems to
me that if Vitamin D deficiency causes poor calcium
absorption, this would cause calcium to remain in the
bloodstream, instead of binding to bone, and therefore should
cause *high* serum calcium levels.

[Sir John]

Why are you in a nutrition ng, Twit?

Are you lost?

Does this ng look like a Laboratory ng, Bud?

What exactly then is your problem?

"Maiden" <maidgal@yahoo.com> wrote in message
news:5be7f996.0209081900.2fb4e38e@posting.google.com...
> P-L-E-A-S-E - D-O - N-O-T - F-E-E-D - T-H-E - T-R-O-L-L
>
> My blood chemistry isn't found in the textbook. What
> might I have?
>
> My calcium levels are on the high end (ranging between
> 9.8 & 10.4)
>
> Yet Merck states that when serum calcium is *low*, that's
> when osteomalacia (vitamin d deficiency) should be
> suspected.
>
> This is inconsistent with my blood chemistry which
> indicates: low 25-hydroxy D3 (23 ng/mL) - indicative of
> Vitamin D deficiency, yet: *high* serum calcium (range 9.8
> to 10.4)
>
> I also have high bilirubin (1.6) and Merck states
> (http://www.merck.com/pubs/mm_geriatrics/sec7/ch49.htm):
>
> "Impairment of conversion to 25-hydroxy D3 occurs in
> patients with severe liver disease...
>
> So for all I know, perhaps the only way I'd absorb Vitamin D
> is via calcidiol, which (according to Merck) is better
> absorbed than ordinary Vitamin D & bypasses any defect in
> 25-hydroxylation in liver.
>
> But the question remains: If Merck is correct, then why do I
> have *high* calcium, if I have such low Vitamin D? Actually,
> I don't quite understand Merck's reasoning, because it seems
> to me that if Vitamin D deficiency causes poor calcium
> absorption, this would cause calcium to remain in the
> bloodstream, instead of binding to bone, and therefore
> should cause *high* serum calcium levels.

[Maiden]

P.S. Here's a relevant detail which I omitted above:

Two years ago, my PTH - intact was 18.0 PG/ML, while my serum
calcium was 9.8 MG/DL