HIGH PTH (323)...NORMAL CALCIUM (9.3)

[juli0212]

Dr. Lupo~
I've tried to find ways to ask this question here...to no avail.  
I have had high PTH levels for over 2+years now, ranging from 323-787...normal calcium 9.3-9.4.   Parathyroidectomy in 2002/removal of one parathyroid gland and benign tumor.  Calcium levels returned to normal after being high for years.  DX:  breast cancer 5/2006...chemo/radiation/tamoxifen presently.  PTH levels have tested extraordinarily high at various labs...my endocrinologist has run a RAPID/STAT PTH, and another regular PTH level, which will be known after 3/2/09.   My question:  WHAT does a HIGH PTH level DO to the body, with normal calcium levels...NO DOC SEEMS TO KNOW...my endocrinologist has consulted with all of her colleagues and bosses...no one has a clue.   That's the bottom line:  DO I need to be worrying?  There can't be a surgical solution, as WHAT does one operate on?  For what purpose?  Remove the parathyroid glands?  Calcium is normal!
If you have any thoughts, I would LOVE to hear...or any other info I'd gladly provide. (No renal issues at all)
THANK YOU....juli

[Mark Lupo, M.D.]

I assume you don't have vitamin D deficiency...

A high PTH will leach calcium from the bone and cause increased risk for fracture.  Would look at 24 hour urine calcium and phosphate to see if this is normal.  With the normal calcium, I agree that additional surgery is not likely beneficial as it no longer appears to be primary hyperparathyroidism.

[juli0212]

Thank you for your comments.  I do not have vitamin D deficiency (I did have it before dx of IDC/Breast Cancer in 2006...take 1000ius of Vitamin D supplements daily, vitamin D levels normal now).  
A question if I may:  If a high PTH level will leach calcium from the bone, would that NOT show up as HIGH CALCIUM level in the blood?
I have done a few 24-hour urine calcium/phosphate labs and they are normal.  
Please advise on the PTH levels staying exceedingly high, with normal calcium levels.  HOW to check if calcium IS leaching from the bones (bone density is fine, bone scans are fine due to cancer screenings)...my endocrinologist and I HAD talked about taking a yearly infusion of Zometa (or like), but have NO recourse right now to do so.  Advice?   Previous parathyroidectomy in 2002 unsuccessful?
(dx of pseudogout for a year after surgery, extreme pain in all joints/urticaria developed also).   THANK YOU again for your time, and ANY of your expertise is GREATLY appreciated!  My docs are pretty clueless here, and it's frustrating...as I just want to KNOW WHAT WILL THAT HIGH PTH DO to my body?  AND how to PREVENT damage?   Thank you....juli

[queenie2003]

I have elevated PTH readings and all the test have been done, 24 hr urine test and I have been to neucular medicine a to have some kind of radiation scan done at this time they see nothing......  I have had high PTH for serveral years now and I am worried.... I do continue to have pain in my upper chest mostly on the left side to about the middle...........  I have mentioned to both to my Endo and primary doctor, but I can not get anyones attention............  I did have -7 vit ""D"" and they gave me some mega vit ""D"" pills one a week for a month......  I have taken those twice now..........  My PTH would imporve a little but still elevated..............  Yes my calcium has been checked.  I have had a bone scan and it looked o.k


Any suggestions????

Thanks

[juli0212]

Hi there,
You have posted your question to Dr. Lupo on my comments, he will not see it...you'll have to go to 'forums', under 'ask a doctor', under 'thyroid', and try to post your question there...most of the time the 'quota' is full for the day, so try to get it early!
You are, I presume, on a 50,000iu dose of Vitamin D weekly for maybe 6 weeks?   I also was Vitamin D deficient a few years ago, and had to do the same...now I maintain with daily 1000ius of Vit. D.
My PTH is over 300, with normal calcium levels.  Your scan was a Sestamibi Scan (VERY hard to find the parathyroid glands OR any tumors with this scan, but it's the best scan).   Good to have bone density/scans done (I had breast cancer, so I get checked anyway, and my bone density is fine also).  I have NO symptoms, other than fatigue...no bone pain.  My endo is bringing my 'case' up today to her colleagues, and we'll also get another urinealysis done (last one was normal)....I have no kidney/renal problems, do you?
When you write to Dr. Lupo, include your levels in your question.
GOOD LUCK....juli
****Parathyroid disease is SO insidious, NO ONE knows much about it, unfortunately***