Your Blood Work Results and Parathyroid Tumors
Channel: BioBalance Healthcast
Date: 06/07/2020

See all the Healthcast at https://www.biobalancehealth.com/healthcast-blog/
I evaluate my new patients with a battery of blood tests before I ever see them.  This gives me the advantage of the time I need to think about them and how their symptoms fit with their labs.   This combination of information gives me clues about their hormone status and other diseases that will affect their hormone replacement and or impair their ability to be healthy as they age. 

Recently, both Dr. Sullivan and I had a patient each who had low testosterone but also had symptoms that were not due to low testosterone, and that did not get better after they had testosterone replacement with pellets.  This is unusual for us, and we both had waited to see how the testosterone would affect the symptoms of severe fatigue, muscle weakness, bone pain and kidney stones.  We put that together with their lab work that showed unusually high blood calcium levels.

Blood calcium can increase a bit when women lose their estradiol with menopause—it is a sign of their bones dissolving faster than they build them back.  This is how osteoporosis happens.  More bone is removed than is built up because of the lack of estradiol and testosterone in women, and lack of testosterone in men.  We both considered this as the cause of their high calcium until we replaced their sex hormones, and it did not get any better!

We decided that a history of kidney stones and muscle weakness as well as bone pain and severe weakness as well as exhaustion and sleepiness were all signs of hyperactive parathyroidism.  

So, what are Parathyroid Glands? 
There are 4 tiny glands situated behind the thyroid gland in the neck.  These tiny glands hold the power to make bones thick or thin depending on how much hormone is secreted from them.  If these glands are hyperactive, usually from a benign tumor, then they break bone down and thin the bones, and increase the calcium blood level liberating calcium from the bones. Too much calcium causes muscles to be weak and lax.  Too much calcium also makes people tired and sleepy.  The calcium dissolved from the bones must get out of the body some way,  so the kidneys kick up the excretion in the urine.  This results in calcium forming stones in the kidney. 

Calcium kidney stones are the most common type of kidney stone  and are  the only type of stone that can be seen on X-ray.  

How do you diagnose a parathyroid tumor?  They are small and hard to see on radiological scans, so the first test is blood work for high Parathyroid hormone and high ionized calcium.  If both are elevated, then we look for the gland that is the problem.  Often times, surgery to take out 2 of the 4 glands and part of the thyroid is curative.  If all of the glands must be removed, and one is healthy, they can transplant the parathyroid gland to a place that can be “followed” easily.  This place is usually in the forearm.  Parathyroid hormone is absolutely essential to life and calcium balance, bone health, brain and muscular health.  

Your symptoms will guide us into checking if you have hyperthyroidism. We check the following
Symptoms of Hyperparathyroidism (High Blood calcium)
• Low energy
• Feeling tired (fatigue)
• Loss of appetite
• Muscle weakness
• Bone or joint pain
• Constipation
• Anxiety or depression
• Kidney stones
• Bone loss
• Broken bones
• Hypertension
Once we have the information, we need to attempt a diagnosis, we use some or all of the following tests and procedures to Diagnosis.
Diagnosis:
• Ct scan of the neck
• MRI scan
• Ultrasound of the neck
• Bone density test
• Xray of the kidneys

If we have done these tests and determine that you have an issue with hyperthyroidism the various treatments are:

Treatment is surgical:
• Removal of just the parathyroid tumor 
• Removal of ½ of the thyroid and parathyroids
• Radiation