A second question about HIGH PTH/Normal Calcium

[juli0212]

Dr. Lupo~
Below I've copied and pasted my previous question, your answer, and my next question to you:
MedHelp Member's Question
HIGH PTH (323)...NORMAL CALCIUM (9.3)
by juli0212

juli0212
Female, 50 years
   Mar 01, 2009 04:42PM
Tags: HIGH PTH/NORMAL CALCIUM
Dr. Lupo~
I've tried to find ways to ask this question here and maybe get some answers:
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

..Doctor's Answer
by Mark Lupo, M.D.
Mark Lupo, M.D.  
, Mar 02, 2009 09:32PM
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.
by juli0212

juli0212
Female, 50 years
Schenectady - NY  

, Mar 03, 2009 07:34AM
To: Dr. Lupo
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
***
***  A thought:  My tumor/parathyroid gland that was removed in 2002 was found towards the LEFT BREAST in chest...while undergoign RADIATION in 2007 for 35 days, is it POSSIBLE that radiation played a part in the increased PTH levels the past 2 years (since Feb. 2007, end of radiation/chemo for 5 months before that)...my radiation oncologist didn't even realize WHERE PARATHYROID GLANDS WERE LOCATED...so he has no thoughts....it's a theory I've had since then...IF SO:  is a parathyroid gland DAMAGED and needs to be REMOVED?  HOW is that found out?  Exploratory surgery?   (Sestamibi found NO glands at all, neither did a neck/chest ultrasound)...no renal disease, phosphate/calcium normal/urinealysis normal...only high PTH.
Sorry this has been so long, wanted to give more info:  ANY thoughts would be appreciated...THANK YOU kindly...juli