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Medical Edge Newspaper Column from Mayo Clinic

HYPERPARATHYROIDISM MAY REQUIRE SURGERY

DEAR MAYO CLINIC: Following years of kidney stones, now increased to several per month, I’m getting an indication from my lab tests of a parathyroid problem. I had a scan two weeks ago and got a normal report, but I have all the symptoms listed for hyperparathyroidism, which I had never heard of until four weeks ago. I had laser-assisted kidney-stone surgery (again), but I still have problems. I continue to work full time, but my concentration and productivity are low. Is there anything else that can be done? — Columbus, Ga.

ANSWER: The parathyroids are four small glands located at the base of your neck that regulate the calcium in your blood. If these glands sense that blood-calcium levels are too low or too high, they secrete just enough parathyroid hormone to restore the levels to normal.

In hyperparathyroidism, the glands produce too much parathyroid hormone, causing blood-calcium levels to rise. High blood calcium often leads to high calcium in the urine, which can cause kidney stones. Fatigue, difficulty concentrating and abdominal pain are common symptoms of high blood calcium.

The scan you mention was likely a parathyroid nuclear medicine scan. This test provides information about your parathyroid glands. It doesn’t diagnose hyperparathyroidism. The fact that your scan was normal does not mean you do not have a parathyroid problem.

Hyperparathyroidism is caused by either problems with the parathyroids themselves (primary hyperparathyroidism) or problems with the way your body processes calcium and vitamin D (secondary hyperparathyroidism). To find out if you have one of these conditions, consult an endocrinologist. If you have elevated parathyroid hormones levels, the endocrinologist can use blood and urine tests to determine if your case is primary or secondary hyperparathyroidism.

Primary hyperparathyroidism may require surgery to remove one or more of your parathyroids. If you have secondary hyperparathyroidism, the first step will be treating the underlying condition that is causing problems with calcium and vitamin D processing.

— Ann Kearns, M.D., Endocrinology, Diabetes, Metabolism and Nutrition,
Mayo Clinic, Rochester, Minn.

Additional Resources:
Treating Hyperparathyroidism
Appointment Information
More Information on Hyperparathyroidism

READERS: When it comes to household safety, it pays to be proactive. In the United States, about 30,000 people die each year as a result of injuries at home. Falls are responsible for about one-third of fatal home injuries. Older adults are often more susceptible to falling because of a decline in mobility and balance.

Here are tips to minimize chances of falling at home:

— Light your way. Keep all areas, especially hallways and stairways, well lit. Use nightlights and have a flashlight handy in case of power outages.

— Keep pathways clear. Arrange furniture to allow for easy movement. Remove boxes, newspapers, cords, baskets and general clutter from high-traffic areas. Keep outdoor steps and walkways in good repair.

— Secure rugs and flooring. Secure loose rugs and carpets with tacks or a slip-resistant backing. Remove small throw rugs. Repair frayed carpet and loose floorboards.

— Safeguard stairways. Make sure all stairways have sturdy railings and that steps have a nonskid surface.

— Enhance bathroom safety. Install grab bars in your shower or tub and near your toilet. Use nonskid mats in the shower or tub.

— Keep necessities handy. Store clothing, dishes, food and other everyday items within easy reach.

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Medical Edge from Mayo Clinic is an educational resource and doesn’t replace regular medical care. To e-mail a question, go to www.mayoclinic.org, or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.