GGT: 2 U/L; ALP: 15 U/L; TRIG: 1.9 mmol/L; Ca2+: 2.95 mmol/L; Mg: 3.00 mmol/L. What is the likely cause?

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Multiple Choice

GGT: 2 U/L; ALP: 15 U/L; TRIG: 1.9 mmol/L; Ca2+: 2.95 mmol/L; Mg: 3.00 mmol/L. What is the likely cause?

Lipid metabolism slows with low thyroid function, so triglycerides tend to rise when the thyroid is underactive. Here the enzymes GGT and ALP are both low, which argues against active liver or bone disease driving the problem. The elevated triglyceride level fits with hypothyroidism because the clearance of triglyceride-rich lipoproteins is reduced. Mild hypercalcemia and hypermagnesemia can occur in hypothyroidism due to altered renal handling and changes in bone turnover, though these findings are nonspecific. In contrast, hyperparathyroidism would usually push calcium up with more bone turnover (raising ALP), and adrenal insufficiency presents with different electrolyte patterns. Taken together, the pattern most consistent with reduced thyroid function is hypothyroidism.

Lipid metabolism slows with low thyroid function, so triglycerides tend to rise when the thyroid is underactive. Here the enzymes GGT and ALP are both low, which argues against active liver or bone disease driving the problem. The elevated triglyceride level fits with hypothyroidism because the clearance of triglyceride-rich lipoproteins is reduced. Mild hypercalcemia and hypermagnesemia can occur in hypothyroidism due to altered renal handling and changes in bone turnover, though these findings are nonspecific. In contrast, hyperparathyroidism would usually push calcium up with more bone turnover (raising ALP), and adrenal insufficiency presents with different electrolyte patterns. Taken together, the pattern most consistent with reduced thyroid function is hypothyroidism.

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