Aa
Hyperparathyroidism
What is a next best step for my parathyroid concerns? My annual physical showed a calcium level of 10.2 and PTH of 68, blood in my urine and bone density scans that showed pretty severe osteopenia and osteoporosis. A thyroid scan showed a couple of nodules in thyroid gland. ( I checked the last 3 years of my annual blood work- they had been around 10.2; no PTH tests had been done.)
He sent me to an End. who said it appeared I had Hyperparathyroid, given the osteo, tests, etc.
He ran a sestambi scan and pelvic scan for kidney stones. Although the blood continued in the urine, there were no stones seen and that symptom went away. The sestambi scan didn't show anything. He also ran a test at his office for PTH, which came back much lower than the one done at Quest Labs. They didn't require me to fast for that test, which the previous one at Quest had required.
Based on these test results, he said if I had Hyperpara, it was mild and he would recommend monitoring it and starting on some kind of strong drug for osteoporosis. Nothing more was said about the nodules seen in the thyroid gland.
Having read some of the info on this, my concern is that the meds for osteo won't work if I really do have hyperpara and I am more concerned about the osteo than anything else at the moment. Neither my husband or I came away feeling very confident about the Endo's work-up, it was at a clinic where patients are kind of herded through like cattle, he was young and he didn't seem to have much experience with hyperparathyroidism.
Should I go back to my family Doc and have another test done at the original lab to see what the levels are? It has been about 3 months since I saw the End. I am concerned that even mild hyperpara will interfere with any efforts to deal with the osteoperosis, which is still not being addressed. Also, many of the symptoms of hyperpara had been noticeable for some time. Any advice about where to go from here would be welcome, and thanks.
He sent me to an End. who said it appeared I had Hyperparathyroid, given the osteo, tests, etc.
He ran a sestambi scan and pelvic scan for kidney stones. Although the blood continued in the urine, there were no stones seen and that symptom went away. The sestambi scan didn't show anything. He also ran a test at his office for PTH, which came back much lower than the one done at Quest Labs. They didn't require me to fast for that test, which the previous one at Quest had required.
Based on these test results, he said if I had Hyperpara, it was mild and he would recommend monitoring it and starting on some kind of strong drug for osteoporosis. Nothing more was said about the nodules seen in the thyroid gland.
Having read some of the info on this, my concern is that the meds for osteo won't work if I really do have hyperpara and I am more concerned about the osteo than anything else at the moment. Neither my husband or I came away feeling very confident about the Endo's work-up, it was at a clinic where patients are kind of herded through like cattle, he was young and he didn't seem to have much experience with hyperparathyroidism.
Should I go back to my family Doc and have another test done at the original lab to see what the levels are? It has been about 3 months since I saw the End. I am concerned that even mild hyperpara will interfere with any efforts to deal with the osteoperosis, which is still not being addressed. Also, many of the symptoms of hyperpara had been noticeable for some time. Any advice about where to go from here would be welcome, and thanks.
MEDICAL PROFESSIONAL
The labs you mention are consistent with hyperparathyroidism and given what I think is a young age (Fay53 meaning 53 years old or born in 1953) in combination with the bone loss, surgery could be considered. Nuclear scanning is negative at least 1/3 of the time and is NOT a diagnostic study for an over-active parathyroid. The thyroid nodules are small, the 0.7cm L area may be the overactive parathyroid gland. Would consult with an expert parathyroid surgeon -- check out parathyroid.com to learn some more.
Thanks, this site and you input is a great resource, glad I found it.
I should probably add to the info above that the thyroid ultrasound read:
"Rt. lobe: 4.2x1.0x1.9cm
Lt. lobe: 3.7x1.5x1.1cm
Isthmus: .14cm with homogeneous echo texture
Left lobe:
Upper pole: .5 cm hypoechoic nodule
Lower pole: .3 cm hypoechoic nodule
Then: located posteriorly to the left lobe of thyroid, there is a .7 cm hypoechoic density which appears to be extrathyroidal and may represent either a small node or it may be related to a parathyroid gland. Clinical correlation is suggested. Impression: 1) Probable multinodular goiter with no evidence of a dominant nodule 2) 7 mm hypoechoic density posterior to the left lobe of the thyroid. This may represent a node or may be related to the parathyroid glands. Clinical correlation is requested."
Does the sestambi scan qualify as clinical correlation? It showed no abnormal uptake. What would you consider adequate clinical correlation to be? Thanks!
"Rt. lobe: 4.2x1.0x1.9cm
Lt. lobe: 3.7x1.5x1.1cm
Isthmus: .14cm with homogeneous echo texture
Left lobe:
Upper pole: .5 cm hypoechoic nodule
Lower pole: .3 cm hypoechoic nodule
Then: located posteriorly to the left lobe of thyroid, there is a .7 cm hypoechoic density which appears to be extrathyroidal and may represent either a small node or it may be related to a parathyroid gland. Clinical correlation is suggested. Impression: 1) Probable multinodular goiter with no evidence of a dominant nodule 2) 7 mm hypoechoic density posterior to the left lobe of the thyroid. This may represent a node or may be related to the parathyroid glands. Clinical correlation is requested."
Does the sestambi scan qualify as clinical correlation? It showed no abnormal uptake. What would you consider adequate clinical correlation to be? Thanks!
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