Parathyroid Errors

I often see patients from across the UK and a number from overseas - the record distance travelled was from Sydney, Australia!

There seems to be a common theme from these patients usually resulting in delays in diagnosis and generally getting sorted out.  I thought it might be helpful to list some of the issues:

1. Calcium only slightly elevated

As a result of only tiny elevations in calcium it is often said that there is not a problem.  This is incorrect.  Calcium levels should be in the normal range - if not you need to work out why not and only then can a decision be made as to what to do.

2. PTH level normal

PTH levels should be almost zero if the calcium is high as the glands are supposed to switch off and stop making PTH.  If PTH levels are normal we term this 'inappropriately elevated' and it suggests primary parathyroid disease.

3. Mildly elevated calcium and parathyroid disease is OK

No it is not.  Calcium levels and indeed parathyroid hormone levels are completely unrelated to symptoms so some patients have terrible symptoms even with mildly elevated calcium.

Calcium levels do not make a difference to osteoporosis.  So if you have the disease you can develop osteoporosis and it makes no difference how high the calcium level is

4. Surgery is not good

This may be the case if you go to an inexperienced surgeon.  You should ask your surgeon how many cases they undertake a year.  If this number is low (<50) you may wish to consider an alternate surgeon.


www.bucksendocrine.com

www.thyroidsurgeon.org.uk

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