Parathyroid dilemma?

[sophie50]

Dr. Lupo,  I have had past serum calcium readings ranging 9.9 (once) then 10.3, 10.1,  10.3, 10.5 (PTH 22) and 10.5 (PTH 20.7).  Ionized calcium 1.35 .  My doctor advised me to return in a year. I paid myself for further testing.  Ionized calcium came back at 1.41 H (1.17-1.32). Serum calcium 10.5 and iPTH 23.3.  24hour urine calcium was 258 (3000ml).  My Vitamin D was originally low at 19.9 but I took 50,000 IU/weekly and managed to get it up to 35.  After further testing and still taking 50,000IU/weekly it has now dropped to 27.6.  My cholesterol has also spiked quite rapidly to 269.  My DEXA scan lowest level was -0.5. TSH with meds is holding steady at 1.2.   With the other symptoms (bone pain, fatigue, GERD, thinning hair, depression (I think this is caused more because I feel I can't get anyone to "hear"me) etc.), I am reaching the end of my rope.  I have read everything available on parathyroid.com.  I cannot really afford to travel out of state to have this taken care of by a well known doctor who has said that he is 90% certain (from my labs) that this is caused by a parathyroid adenoma. How can one doctor (who I don't see) be so sure and the other is telling me to give it a year! Would it not be better to find out now rather than let things deteriorate further.  I also do not want to switch doctors so I am stuck!!  Where would you advise I go from here?

Thank you so much,
Sophie

[Trish915]

If you are near Chicago I highly reccommend Dr. Prinz at Rush Presbyterian Hospital.  My labs are similar to yours except I have -2.5 dexa scan and have insufficiency fracture due to osteoporosis.  Dr. Prinz did an ultrasound of my neck on my first visit and found a parathyroid gland that was suspicious and sent me for more tests.  He has diagnosed me with hyperpara where others did not.

Good Luck!

[Mark Lupo, M.D.]

Looks like probably early primary hyperparathyroidism.  The levels/info do not meet current guidelines for surgery, but we are trending towards earlier intervention.  The parathyroid.com site takes data from over 6000 patients to help clinicians/patients realize that numbers like yours are actually early disease (primary hyperpara).  The cholesterol is not likely related.  Your symptoms are suggestive, but may not improve after surgery -- it's up to you whether you want to pursue a second opinion...