Hyperparathyroidism doesn't seem to be a disease but an adaptation to acidosis in ckd, or just low calcium intake. Metabolic Acidosis of Hyperparathyroidism, 1974 5:18 Calcium and vitamin D supplementation lower PTH (in hyperparathyroidism) as would be expected, since the body doesn't need to get the calcium from the bones. Effects of a Short-Term Vitamin D and Calcium Supplementation on Body Sway and Secondary Hyperparathyroidism in Elderly Women, 2009. The effects of calcium supplementation to patients with primary hyperparathyroidism and a low calcium intake, 2002 Also, the extreme effects of hyperparathyroidism in the picture seems to say hypercalcemia from pth can't be that bad if the one thing that happened to the man is dissolution of his skeleton (vs nothing if he had gotten calcium supplements) 6:20 underscoring what I just said, the calcium level is barely above the normal range in hyper patients, and vitamin d storage is deficient 10:00 symptoms are fatigue and weakness, same as acidosis (and bone problems if you don't take in calcium) 10:56 sure, since the only specific symptom is bone loss, if you reduce pth you reduce bone loss, ignoring low calcium intake. Pretty sure that results in more acidosis symptoms 14:36 so basically anyone with ckd and who listened to he guidelines to reduce calcium intake should get surgery. 28:51 normo calcium PHPT with normal calcium excretion indicates insufficient calcium intake, why else would pth try to get calcium from the bone. Rats fed a calcium deficient diet have PTH levels rise to over 10 times normal in a few weeks. It's really baffling there is no discussion on dietary calcium. 47:34 drug induced kidney stones from e.g. diuretics to manage kidney bp (horrible idea) tend to be ignored 48:05 PHPT doesn't seem to have anything to do with kidney stones, or rather it prevents them: after surgery removal of parathyroid to treat PHPT, the risk of kidney stones almost doubled from 18% to 30%. The base risk has more to do with comorbid ckd and probably the drugs used in ckd. Kidney Stone Events Following Parathyroidectomy vs Nonoperative Management for Primary Hyperparathyroidism, 2022. 58:38 it seems biphosphonate may be sold in combination with calcium, so again brushing over the importance of calcium intake. Wouldn't make a lot of sense for serum calcium not to go down with bisphosphonate otherwise
This is very interesting information. It means that perhaps, psychiatrists should be routinely screening for PTH because we may have an epidemic of people with 'normocalcaemic' primary hyperparathyroidism that are mistakenly being treated with antidepressants and therapy rather than parathyroid surgery.
I have been diagnosed with primary hyperparathyroidism. My calcium is elevated and my parathyroid level is low. You didn’t mention it in your video so I was just curious what you think about that ??
I fractured my spine last year and have this,what I want to know is how long will it take for the associated osteoporosis to go away?And will it totally go away?as I have heard that it can,I have primary hyperthyroidism.I have high calcium levels.
Can blood and urine testing of the parathyroid hormone levels in men after a vasectomy and suspected to have contracted HPV help test and treat HPV related cancers and hormone imbalances caused by HPV and or vasectomy in men?
I wonder why no one talks about the relationship between prior head/neck irradiation (like I had roughly three decades ago after Keloid surgery) and the development of Parathyroid adenoma, like I was recently diagnosed with! Dexa shows osteopenia. Going for my parathyroidectomy in another week. My own research online lead me to a couple of articles that points to this and one said (the average latency is 30 years between radiation exposure and tumor development!!!). 58 yr old male with one tumor found on the same side as the Keloid and radiation treatment! Never smoked, used alcohol or drugs of any kind and I'm generally in good health. Diagnosed a few years ago with "reduced" kidney function (stage 1), most likely related to the tumor that has been developing over the years 🤔
If it's a benign tumor, why would they recommend surgery? I suppose they recommend surgery in all cases of hyperparathyroidism so this would not be an exception. I would prefer to keep my functioning parathyroid tissue and let the body regulate my calcium cause that seems daunting without. It's almost funny that post operation, they give you IV calcium, to now manually manage blood calcium, but before, they never mention calcium intake.
@@Rene-uz3eb You fail to realize that the body can't properly regulate your serum calcium as long as you have an overactive gland/tumor pouring excessive amounts of PTH into your bloodstream! The tumor is the cause of the excessive calcium, not the other way around. Surgery is the only cure, according to the experts. Fortunately in my case, it appears to be only one adenoma. I'll know for sure after I wake up from anesthsia tommorow evening 😂 So the remaining three glands will do exactly as you suggest. They will regulate my calcium once they stabilize and readjust after years of underactivity. The calcium that they give post surgery, is needed because once the overactive tumor is removed, your calcium level drops too low (below normal levels). It's like popping a water baloon after slowly filling it up with water over several minutes, lol.
@@redtailpilotthe presenter did not mention adenomas at all. In their mind, hyperparathyroidism is just an overacting gland. If they are leaving you with functional tissue then probably nothing to worry about, but the underlying cause seems to be there's less solvable calcium in the bones so that the parathyroid needs to work overtime to get calcium balance needed. But I'm not going to take on the experts in this one comment.
I'm not going to take on the experts either 😂 My question was, why none of them seem to mention the link between head/neck irradiation and late effect parathyroid tumor development? I discovered multiple articles (including one in published by the New England Journal of Medicine) that talk about this in detail! More than one mention that the average latency period between radiation exposure and parathyroid tumor manifestation is...30 years!!! Well guess what, my radiation treatment was 29 years ago and my parathyroid adenoma was diagnosed two months ago 😮
@@redtailpilot yes you seem to be correct about radiation causing parathyroid tumors. That being said, if it is secondary hyperparathyroidism due to kidney disease, then a benign adenoma can also develop. Also, when they induced tumors in rats with radiation, they didn't wait 30 years. So the patients in that study receiving radiation might have been a more compromised health population in general. Then, hyperparathyroidism can also occur due to calcium deficiency, but no doctor ever talks about that. "The condition can occur because of vitamin D deficiency or low calcium intake" Hyperparathyroidism, 2004, American family physician
Excellent presentation
Hyperparathyroidism doesn't seem to be a disease but an adaptation to acidosis in ckd, or just low calcium intake.
Metabolic Acidosis of Hyperparathyroidism, 1974
5:18 Calcium and vitamin D supplementation lower PTH (in hyperparathyroidism) as would be expected, since the body doesn't need to get the calcium from the bones.
Effects of a Short-Term Vitamin D and Calcium Supplementation on Body Sway and Secondary Hyperparathyroidism in Elderly Women, 2009.
The effects of calcium supplementation to patients with primary hyperparathyroidism and a low calcium intake, 2002
Also, the extreme effects of hyperparathyroidism in the picture seems to say hypercalcemia from pth can't be that bad if the one thing that happened to the man is dissolution of his skeleton (vs nothing if he had gotten calcium supplements)
6:20 underscoring what I just said, the calcium level is barely above the normal range in hyper patients, and vitamin d storage is deficient
10:00 symptoms are fatigue and weakness, same as acidosis (and bone problems if you don't take in calcium)
10:56 sure, since the only specific symptom is bone loss, if you reduce pth you reduce bone loss, ignoring low calcium intake. Pretty sure that results in more acidosis symptoms
14:36 so basically anyone with ckd and who listened to he guidelines to reduce calcium intake should get surgery.
28:51 normo calcium PHPT with normal calcium excretion indicates insufficient calcium intake, why else would pth try to get calcium from the bone.
Rats fed a calcium deficient diet have PTH levels rise to over 10 times normal in a few weeks. It's really baffling there is no discussion on dietary calcium.
47:34 drug induced kidney stones from e.g. diuretics to manage kidney bp (horrible idea) tend to be ignored
48:05 PHPT doesn't seem to have anything to do with kidney stones, or rather it prevents them: after surgery removal of parathyroid to treat PHPT, the risk of kidney stones almost doubled from 18% to 30%. The base risk has more to do with comorbid ckd and probably the drugs used in ckd.
Kidney Stone Events Following Parathyroidectomy vs Nonoperative Management for Primary Hyperparathyroidism, 2022.
58:38 it seems biphosphonate may be sold in combination with calcium, so again brushing over the importance of calcium intake. Wouldn't make a lot of sense for serum calcium not to go down with bisphosphonate otherwise
My calcium is 11.4, has been consistently climbing every year since 2017. Just had PTH checked, it`s 198.3. I have MANY symptoms. The VA does nothing.
This is very interesting information. It means that perhaps, psychiatrists should be routinely screening for PTH because we may have an epidemic of people with 'normocalcaemic' primary hyperparathyroidism that are mistakenly being treated with antidepressants and therapy rather than parathyroid surgery.
I have been diagnosed with primary hyperparathyroidism. My calcium is elevated and my parathyroid level is low. You didn’t mention it in your video so I was just curious what you think about that ??
I fractured my spine last year and have this,what I want to know is how long will it take for the associated osteoporosis to go away?And will it totally go away?as I have heard that it can,I have primary hyperthyroidism.I have high calcium levels.
Can blood and urine testing of the parathyroid hormone levels in men after a vasectomy and suspected to have contracted HPV help test and treat HPV related cancers and hormone imbalances caused by HPV and or vasectomy in men?
Dear doctor, is it means that in normocalcemic PHPT patients always have adenoma on the neck or in a chest? We always can locate it?
I wonder why no one talks about the relationship between prior head/neck irradiation (like I had roughly three decades ago after Keloid surgery) and the development of Parathyroid adenoma, like I was recently diagnosed with! Dexa shows osteopenia. Going for my parathyroidectomy in another week. My own research online lead me to a couple of articles that points to this and one said (the average latency is 30 years between radiation exposure and tumor development!!!).
58 yr old male with one tumor found on the same side as the Keloid and radiation treatment! Never smoked, used alcohol or drugs of any kind and I'm generally in good health. Diagnosed a few years ago with "reduced" kidney function (stage 1), most likely related to the tumor that has been developing over the years 🤔
If it's a benign tumor, why would they recommend surgery? I suppose they recommend surgery in all cases of hyperparathyroidism so this would not be an exception. I would prefer to keep my functioning parathyroid tissue and let the body regulate my calcium cause that seems daunting without.
It's almost funny that post operation, they give you IV calcium, to now manually manage blood calcium, but before, they never mention calcium intake.
@@Rene-uz3eb You fail to realize that the body can't properly regulate your serum calcium as long as you have an overactive gland/tumor pouring excessive amounts of PTH into your bloodstream! The tumor is the cause of the excessive calcium, not the other way around. Surgery is the only cure, according to the experts. Fortunately in my case, it appears to be only one adenoma. I'll know for sure after I wake up from anesthsia tommorow evening 😂
So the remaining three glands will do exactly as you suggest. They will regulate my calcium once they stabilize and readjust after years of underactivity. The calcium that they give post surgery, is needed because once the overactive tumor is removed, your calcium level drops too low (below normal levels). It's like popping a water baloon after slowly filling it up with water over several minutes, lol.
@@redtailpilotthe presenter did not mention adenomas at all. In their mind, hyperparathyroidism is just an overacting gland. If they are leaving you with functional tissue then probably nothing to worry about, but the underlying cause seems to be there's less solvable calcium in the bones so that the parathyroid needs to work overtime to get calcium balance needed. But I'm not going to take on the experts in this one comment.
I'm not going to take on the experts either 😂
My question was, why none of them seem to mention the link between head/neck irradiation and late effect parathyroid tumor development? I discovered multiple articles (including one in published by the New England Journal of Medicine) that talk about this in detail! More than one mention that the average latency period between radiation exposure and parathyroid tumor manifestation is...30 years!!! Well guess what, my radiation treatment was 29 years ago and my parathyroid adenoma was diagnosed two months ago 😮
@@redtailpilot yes you seem to be correct about radiation causing parathyroid tumors. That being said, if it is secondary hyperparathyroidism due to kidney disease, then a benign adenoma can also develop. Also, when they induced tumors in rats with radiation, they didn't wait 30 years. So the patients in that study receiving radiation might have been a more compromised health population in general.
Then, hyperparathyroidism can also occur due to calcium deficiency, but no doctor ever talks about that.
"The condition can occur because of vitamin D deficiency or low calcium intake"
Hyperparathyroidism, 2004, American family physician
Thankyou very much for this valuable presentation÷))