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Hyperparathyroidism and neck weakness
I am a 63-year old woman and have mild hyperparathyroidism. I have had some muscle weakness since 2002 (eg. sitting weakness). In 2009 I had fluid and electrolyte disturbances and leg weakness. My ADH deaceased in water deprivation test. I have periodic polyuria and hypernatremia. At the same time my S-Osmol wass upper normal. I have hypothyroidism, the reason is not known. Treated first with thyroxine and then with Armour and now with Thyroid Erfa. I had cognitive problems, which have become milder with thyroid medication. I have also lost 16 kg during four years. I have atenolol for rhytmh and blood pressure (when younger, I had often tachycardia). I have been diagnosed with CFS/ME.
In 2010 I had several sinusitis an then it became chronic, is still lasting. I had antibiotic diarrhea two times. I got atrial fibrillation - it lasted six months and then was changed to sinus with Multaq and electric cardioversion. I had abdominal problems and then in December 2010 my gall bladder was taken off. I had tightness of chest in excercise and had periods of leg muscle cramping.
In late 2010 I suffered mild morning nausea (from MUltaq ?), attacks of neck and left shoulder and arm pain and weakness. Then in January 2011 I began also have tremor, muscle twiches and many other symptoms. I had neck and shoulder weakness every now and then till tthe spring. I had also sometimes ringing or humming of ears. My sight one time became as pixelled and a few times slightly smoggy.
My neck symptoms have become worse in Autumn. My neurologist thaugth that I may have TIA attacks. My internal medicine specialist says that my neck symptoms do not result from my mild hypercalcemia. Diagnoses suggested by Doctors: polymyalgia, vasculitis, myasthenia, TIA. otosclerosis etc. Sorry I had to shorten the story from late summer not to exceed the allowed length...
Can hyperparathyroidism be excluded from possible causes of my neck muscle weakness?
In 2010 I had several sinusitis an then it became chronic, is still lasting. I had antibiotic diarrhea two times. I got atrial fibrillation - it lasted six months and then was changed to sinus with Multaq and electric cardioversion. I had abdominal problems and then in December 2010 my gall bladder was taken off. I had tightness of chest in excercise and had periods of leg muscle cramping.
In late 2010 I suffered mild morning nausea (from MUltaq ?), attacks of neck and left shoulder and arm pain and weakness. Then in January 2011 I began also have tremor, muscle twiches and many other symptoms. I had neck and shoulder weakness every now and then till tthe spring. I had also sometimes ringing or humming of ears. My sight one time became as pixelled and a few times slightly smoggy.
My neck symptoms have become worse in Autumn. My neurologist thaugth that I may have TIA attacks. My internal medicine specialist says that my neck symptoms do not result from my mild hypercalcemia. Diagnoses suggested by Doctors: polymyalgia, vasculitis, myasthenia, TIA. otosclerosis etc. Sorry I had to shorten the story from late summer not to exceed the allowed length...
Can hyperparathyroidism be excluded from possible causes of my neck muscle weakness?
Thank you for your reply. I am very glad to get your assessment.
My osteopenia (2008) has improved to normal first with Ca and vitamin D and then with high vit-D treatment (50-80 mcg). Now I am not allowed to use more than 25 mcg of vit-D daily.
My blood calcium will not be corrected. Any parathyroidectomy is not planned. Criteria for the operation are high. Serum Ca++ should be repeatedly over 1,50 mmol/l. My S-Ca++ has only been 1.34 at its highest (upper reference limit 1.30). Urine calcium excretion should be over 10 mmol/l, mine is normal.
My situation is otherwise very complex, I have many disorders, even sarcoidosis has been suggested due to a tumor in my lung. When an MRI was made for parathyroids, they were not seen, only the lung defect was found by chance. It cannot be an extra parathyroid due to its location. I have fluid and electrolyte disorders (periodic polyuria, hypernatremia, dehydration, low antidiuretic hormone), chronic sinuitis, rhythm and blood pressure problems, immune deficiensy and so on. My symptoms are periodic.
Today I saw an endocrinologist. He said that my neck symptoms cannot result from the hyperparathyroidism, as you also said that the neck weakness may have another cause. He said that clearing of my situation is challenging.
Another internal medicine specialist said that my facette joint arthrosis does not cause such symptoms. An ENT specialist said that the cause could be attributed to some internal medicine problem. An ultrasound scanning of my neck vessels did not reveal any cause.
Because no parathyroidectomy has been planned, I cannot get Sestamibi scanning. ANCA antibodies, ACE, Ach-R antibodies, IgG subclasses have been measured recently, but I have not yet the results.
Five days ago I increased my Thyroid Erfa dose by one quarter pill. The dose is now 1.75 + 1 pills. In August my thyroid labs were TSH 0.023, FT4 13.3 (ref 12-22), FT3 5.3 (ref. 2.8-7.1). I think that this increase has improved my general condition a little.
My osteopenia (2008) has improved to normal first with Ca and vitamin D and then with high vit-D treatment (50-80 mcg). Now I am not allowed to use more than 25 mcg of vit-D daily.
My blood calcium will not be corrected. Any parathyroidectomy is not planned. Criteria for the operation are high. Serum Ca++ should be repeatedly over 1,50 mmol/l. My S-Ca++ has only been 1.34 at its highest (upper reference limit 1.30). Urine calcium excretion should be over 10 mmol/l, mine is normal.
My situation is otherwise very complex, I have many disorders, even sarcoidosis has been suggested due to a tumor in my lung. When an MRI was made for parathyroids, they were not seen, only the lung defect was found by chance. It cannot be an extra parathyroid due to its location. I have fluid and electrolyte disorders (periodic polyuria, hypernatremia, dehydration, low antidiuretic hormone), chronic sinuitis, rhythm and blood pressure problems, immune deficiensy and so on. My symptoms are periodic.
Today I saw an endocrinologist. He said that my neck symptoms cannot result from the hyperparathyroidism, as you also said that the neck weakness may have another cause. He said that clearing of my situation is challenging.
Another internal medicine specialist said that my facette joint arthrosis does not cause such symptoms. An ENT specialist said that the cause could be attributed to some internal medicine problem. An ultrasound scanning of my neck vessels did not reveal any cause.
Because no parathyroidectomy has been planned, I cannot get Sestamibi scanning. ANCA antibodies, ACE, Ach-R antibodies, IgG subclasses have been measured recently, but I have not yet the results.
Five days ago I increased my Thyroid Erfa dose by one quarter pill. The dose is now 1.75 + 1 pills. In August my thyroid labs were TSH 0.023, FT4 13.3 (ref 12-22), FT3 5.3 (ref. 2.8-7.1). I think that this increase has improved my general condition a little.
MEDICAL PROFESSIONAL
No, it can not be excluded though usually the severity of symptoms is proportionate to the degree of hypercalcemia, so if it is mild, the neck weakness may have another cause, but this is difficult to know until the calcium is corrected.
I aimed the previous question to Doctors. Did I act on the instructions?
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