Parathyroid Disorders Archive Questions

Below are Dr. Streeten’s answers to Parathyroid Disorders questions
received through the Ask the Expert feature.

This content is provided for informational purposes only, and is not intended
to be a substitute for individual medical advice in diagnosing or treating a
health problem. Please consult with your physician about your specific health
care concerns.



Now displaying records 1 to 6 of 6.

1

---

Q : 1 12/19/2008	What will happen if all parathyroid glands was removed? When all parathyroid glands are removed, this causes hypoparathyroidism. This causes the blood calcium to drop very low but can very effectively treated with high dose vitamin D. Vitamin D has some of the same effects as parathyroid hormone (PTH) and is therefore able to take the place of the action of PTH. I hope this answers your question. EAS
Q : 2 03/14/2008	Do surgeons at the University of Maryland use MIRPS? Yes, our surgeon who specializes in parathyroid surgery does minimally invasive radioguided parathyroid surgery in those who are candidates for it.
Q : 3 03/13/2008	When one PTH is in the 300 range, is surgery necessary? The decision for parathyroid surgery depends on a complete history (age, symptoms, presence of kidney stones and/or osteoporosis, whether there is any kidney disease), on how high the blood calcium is. The PTH alone does not make the decision.
Q : 4 03/05/2008	I am a long standing hypothyroid patient, due to radioactive iodine in 1986. I've just learned that my RX dose has been too low for some time. Also, my cholesteral is elevated. I am essentially vegan so this is suprising to me. Can my low thyroid be affecting this? Hypothyroidism can, indeed, raise cholesterol. I'm sure your doctor is planning to repeat your cholesterol studies after your thyroid levels are normalized.
Q : 5 02/24/2008	Can you tell me about the Secondary hyperparathyroidism pathology? In secondary hyperparathyroidism, all four parathyroid glands are stimulated by something (eg. vit D deficiency) to overfunction. The parathyroid glands are usually enlarged but do not contain "tumors" or "adenomas".
Q : 6 02/14/2008	I am trying to decide if I should push a little more to see an endocrinologist, and I would like your opinion if possible. I am a 34-year-old female with a 14-year history of calcium kidney stones. I have passed at least 20, and a recent CT shows at least 9 more dispersed through both kidneys. I began feeling bad in October 2007. Along with that feeling, my serum calcium levels began increasing. In my blood and urine tests, the calcium is the only elevated number. It was high-normal (normal being up to 10.2) in October, 10.4 in November, 10.3 in December and 10.5 in January. I don't take vitamins, and I consume very little dairy -- 1/4 cup milk and perhaps a serving of cheese 5 days/week. My PTH was checked in January, and it was 36.8 (normal range 15-65). I guess I'm perplexed about this -- my calcium began increasing at the exact time I began feeling worse -- fatigue, weight loss, sleep problems, palpitations, anxiety, etc. -- but my doctor says the numbers are not high enough that I should be symptomatic, and he is pretty cut and dry concerning normal vs. abnormal lab values. I'm wondering if my PTH might be considered abnormal for an elevated serum calcium. Have you encountered patients that are very sensitive to changes in calcium levels? Would a mid-level PTH and a history of kidney stones raise a red flag to an endocrinologist? In situations like this, is a wait and see approach more prudent, or is an appointment with an endocrinologist warranted? When the blood calcium is elevated, the normal response of the parathyroid glands is to suppress their output of PTH (eg. to below the lower end of normal). Your PTH is inappropriately normal, most likely due to underlying primary hyperparathyroidism. It is well known now that with primary hyperparathyroidism (which causes kidney stones), the PTH can be normal. I agree that it is important for you to see an endocrinologist to help make this diagnosis.

1