Family Doctor: Hyperparathyroidism to be taken seriously

Family Doctor: Hyperparathyroidism to be taken seriously
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By Peter Gott, M.D.
United Media
Posted Apr 26, 2009 @ 12:00 PM

Q: I was recently diagnosed with hyperparathyroidism. I went several years without a diagnosis. My family doctor referred me to an endocrinologist, who did nothing to help me.

I am a 78-year-old woman. During routine blood tests in 2004, I was found to have elevated blood-calcium and parathyroid-hormone levels, which were basically ignored. At that time, my calcium level was 10, but my doctor told me that it wasn’t anything to get excited about and that he would just watch it. My latest test showed a level of 11.6.

Because nothing was being done, I did some research online and found out about hyperparathyroidism. I took it upon myself to send copies of my results and symptoms to a specialized clinic in Florida. I was then scheduled for surgery to remove the gland but fell and broke my hip before I could leave California. I opted to fully recover before making the several-thousand-mile trip and have just recently found a surgeon close to home who performs the same surgery I was prepared to cross the country to get.

Please inform your readers, including any doctors who may read your column, about this disorder. Thanks.

A: Hyperparathyroidism occurs when the parathyroid glands secrete too much hormone. This is often the result of a benign tumor known as an adenoma.

Symptoms are often mild and include feeling fatigued and weak, having aches and pains and depression; more severe symptoms include nausea, vomiting, loss of appetite, constipation, increased thirst and urination. Confusion and impaired thinking and memory may develop. Regardless of whether symptoms are present or not, sufferers may have thinning bones.

Routine lab tests to check phosphorus and blood-calcium levels are now alerting physicians about people who may have mild hyperparathyroidism without symptoms.

The primary treatment is to remove the parathyroid gland(s). This cures about 95 percent of cases. There is a class of drugs called calcimimetics that turn off the secretion of parathyroid hormone, but they are Food and Drug Administration-approved for only two types of hyperparathyroidism: that secondary to kidney failure with dialysis and primary disease caused by parathyroid cancer.

For those with mild disease, immediate treatment may not be necessary, according to the National Institutes of Health. This is true for only those with no symptoms, whose bones and kidneys are normal and blood-calcium levels are only slightly elevated. If a patient prefers to wait, he or she will need close monitoring to check calcium levels, kidney function, bone loss and more.

Your physician was correct to refer you to an endocrinologist; however, I am disappointed in both their reactions. You needed to be told what the results could mean and what steps could be taken. I applaud you for taking matters into your own hands and getting a proper diagnosis.

Write to Dr. Gott c/o United Media, 200 Madison Ave., 4th fl., New York NY 10016.

http://www.cantonrep.com/lifestyle/x718269595/Family-Doctor-Hyperparathyroidism-to-be-taken-seriously