Hyperparathyroidism FAQs | Dr. Babak Larian Facebook Live

Every month I host a Facebook LIVE event and answer frequently asked questions about parathyroid disease. You can find the time stamps to questions in the first comment below.
I am a renowned for my expertise in minimally invasive parathyroid surgery. At the CENTER for Advanced Parathyroid Surgery, our goal is to provide every patient with customized and compassionate care because parathyroid disease affects everyone differently. If you or a loved one is suffering with parathyroid disease, please contact our office today so we can give you the care you deserve.
LEARN MORE ABOUT PARATHYROID DISEASE AND TREATMENT - www.hyperparathyroidmd.com/
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[@LarianMD]

kzbin.info/www/bejne/l6vWm3ucbLFpg7M - Surface of Parathyroid Cells (Calcium Sensing Receptor) kzbin.info/www/bejne/l6vWm3ucbLFpg7M - Corrected calcium versus serum calcium kzbin.info/www/bejne/l6vWm3ucbLFpg7M - High calcium/hyperparathyroidism genetics in family kzbin.info/www/bejne/l6vWm3ucbLFpg7M - Can hyperparathyroidism be cyclic? kzbin.info/www/bejne/l6vWm3ucbLFpg7M - Is it possible parathyroidism and ultrasound coupled with high PTH but normal calcium and vitamin D a reason to operate or watch/wait? kzbin.info/www/bejne/l6vWm3ucbLFpg7M - Hyperparathyroidism diagnosis #1 (alkaline phosphatase) kzbin.info/www/bejne/l6vWm3ucbLFpg7M - Can you take too much calcium? Do hungry bones go away? kzbin.info/www/bejne/l6vWm3ucbLFpg7M - Hyperparathyroidism diagnosis #2 (post-op; bone loss & hyperplasia) kzbin.info/www/bejne/l6vWm3ucbLFpg7M - Hyperparathyroidism and mental health problems kzbin.info/www/bejne/l6vWm3ucbLFpg7M - surgical and pathology reports kzbin.info/www/bejne/l6vWm3ucbLFpg7M - does scar tissue from thyroid removal make surgery higher risk for possible failure? kzbin.info/www/bejne/l6vWm3ucbLFpg7M - family history and surgery (Sensipar) kzbin.info/www/bejne/l6vWm3ucbLFpg7M - Hyperparathyroidism diagnosis #3 (Normohormonal PHPT) kzbin.info/www/bejne/l6vWm3ucbLFpg7M - Cure with simple operation? kzbin.info/www/bejne/l6vWm3ucbLFpg7M - Hyperparathyroidism diagnosis #4 (Ultrasound; elevation in PTH levels) kzbin.info/www/bejne/l6vWm3ucbLFpg7M - support group appreciation kzbin.info/www/bejne/l6vWm3ucbLFpg7M - correlation between hyperparathyroidism, hyperthyroid and/or cortisol levels? kzbin.info/www/bejne/l6vWm3ucbLFpg7M - what are options when we have hyperplasia? kzbin.info/www/bejne/l6vWm3ucbLFpg7M56 - Can Sensipar be a long-term solution? kzbin.info/www/bejne/l6vWm3ucbLFpg7M - Event ends

[@patangel1652]

You are such an incredibly compassionate Doctor. It’s very apparent how much you really care for your patients.

[@carolmartin6137]

You are correct health care is in the toliet. My last 3 drs appointments were with pa’s. No more

[@leeking6185]

Excellent information!! I am having a para-thyroidectomy in 2 days for normocalcemic hyperparathyroidism. Thank you!

[@sandan2358]

My PTH is 263. I’m so tired, have depression, and the brain fog is terrible. My thyroid ultrasound was normal and so was my nuclear medicine scan.

[@yemiadenubi5997]

Hi doc, i wish i had come across you before now. I had the traditional surgery for pry hyperparathyroidism just November gone due to only one parathyroid enlarged; the lower left. My thought had been only the affected parathyroid was taken out; only for me to visit an endocrinology who wasnt at the surgery today and in the process of asking questions i got told 2 parathyroid were removed in order to test the functioning of the other parathyroid. Does this sound right doctor and is that a normal practice.

[@lisaann9120]

Can you have low calcium and then it go.sky high? I had pins and needles through out body and numbness in limbs and face. My pth is thru the roof and calcium now. This has been happening for 9ms. Plus I've always had severe kidney stones

[@lesliesteinhauser2595]

Do you know if taking diatomaceous earth can raise your calcium levels?

[@lindamitchell7836]

Hi Dr Larian. My last PTH level was 150 and 141, and my vitamin was 26, and presently 29.3. My question is should I continue taking 50.000 once a week of vitamin D???? I have been diagnosed with secondary hyperparathyroidism, with Stage 3a CKD. What would yo think is the next step in treatment!?!

[@MariaGrobler-fh3kt]

Hi Dr. Larian My name is Maria and I live in South America Hello docter. I got very sick in 2013 and was misdiagnosed for a long time. My PTH was 533. My one parateriohide was removed. After 10 years it is back. It is now PTH 103 and CA 2.57. Scan show that 2 parateriohide are enlarge and third one is inactive. Is surgery my only option?

[@Foraging4you]

Does sensipar stop bone pain 😢 i can't sleep or function properly

[@saloncentricmagic1]

I am on my second round of test ...When I took vit D to get my level up , my PTH go up as well to 138 was my PTH , the calcium in blood ranges 10.8 to 11.3 .... My calcium in my urine was okay but the calcium free floating in my blood was high ....Dr. Appt. Are space out 6 month due to shortage of Endocrinologist...so frustrating...I have all new test ...but now to wait till February to see Doctor

[@babaklarian1408]

It sounds like you have primary rather then secondary hyperparathyroidism. You may want to ask your primary doctor to order a parathyroid ultrasound in the meanwhile.

[@saloncentricmagic1]

@@babaklarian1408 ty !!! I will...

[@ishaali7151]

I have primary hyperparathyroidism and i feel like my dr knows much of its, i dont feel myself and my dr its keep tell me that i have depressoin and everytime i test the blod text he is keep tell me hyperparathyroidism high calsumine as its normal. Iam now wait fir surgery and iam srecead of it and i Ask my dr can i have medisine he say they dont have it medisine for making the calsumine low and i dont know if that is true.

[@carolmartin6137]

My pth andcalium levels normal spiked to higher levels twice. Major kidney stone problems adenoma shows on scan. I dont know what to do. Endo wants surgery?

[@babaklarian1408]

If the last 2 levels show an elevation or if the calcium & PTH are not following an inverse relationship then that confirms hyperparathyroidism. You already have identified an abnormal parathyroid on scan, which makes you a candidate for a minimally invasive parathyroidectomy.

[@carolmartin6137]

Thank you for the reply. A rather famous expert facility tells me with high normal calcium levels i would not be eligible for surgery

[@michaelknight2721]

How long does it take for osteoporosis from this to totally go away.

[@babaklarian1408]

Once treated, I would say that you would start to notice bone density improvement probably at one and a half years, but that continues for several years. And it does have to do with your level of weight bearing exercise.

[@lesliesteinhauser2595]

Is it true that primary hyperparathyroidism shortens your life by six months? In what effects does this have on your heart and muscles?

[@babaklarian1408]

Some reports indicate that. Makes sense that if your body is running inefficiently then it can create problems in several organ systems that can shorten your lifespan.

[@jayjaychadoy9226]

Is that your hair behind you?

[@kathywood1571]

It a picture of a horse I think

[@Rene-uz3eb]

20:30 you forgot to account for calcium loss in urine. If that loss is abnormally high (>200mg/day), like in ckd, and you don't compensate with diet, then pth may permanently be high to get more calcium from the bones to keep calcium levels normal. Similarly, if your dietary intake is insufficient or due to lack of absorbtion from low vitamin d or high age, again a permanently elevated pth results to get the balance from bones. Another case, if bone stores are low, even more PTH is needed to extract a given amount of calcium for daily maintenance of calcium levels. Finally, in ckd, ph is acidic which is compensated by higher calcium levels (either from the diet or the bones via PTH). Which is why I say hyperparathyroid is a pseudo disease and does not need correction at all by the parathyroid, but by increased calcium intake. Adenomas are simply a reflection of increased need for PTH output. 21:17 that's a unfounded theory 23:30 the body can easily get rid of elevated calcium via urine 28:10 hereditary NSHPT is rare, shouldn't even be a factor in diagnosis unless it's extreme 29:07 that is simply wrong. Most hyperparathyroid is secondary. Also note why does hyperparathyroid occur with age: because as children we are able to retain much more calcium. As adults the urinary calcium per day goes up significantly, resulting in a potential mismatch of accustomed calcium intake in the diet. 34:29 since this lady has both elevated pth and active vitamin d, at normal serum calcium and urinary excretion for her age, that's an indication that she doesn't take in enough calcium in the diet to make up for that 200mg daily loss. This paper sketches out what's going on with pth and calcium in ckd: Pathophysiology of Calcium, Phosphorus, and Magnesium Dysregulation in Chronic Kidney Disease, 2015 47:40 calcium without phosphorus just gets peed out (and without good vitamin d levels just causes constipation)

[@cindylauritzen4016]

What are your qualifications to say this doctor is wrong? How long have you studied this disease? Where are the studies to support your claims, especially the one about secondary HPT? Your claim about more secondary is the opposite of the research I saw after being diagnosed with this disease. Also other doctors who treat this disease agree with this doctor! I have normocalcemic HPT which means my calcium levels are always normal with high PTH. My urine calcium is also normal. So no my PTH was not elevated because my body was eliminating the calcium in the urine. It was elevated because all 4 of my parathyroid glands were enlarged and producing too much PTH.

[@cindylauritzen4016]

Also HPT is not just diagnosed in older people. There are children who have this disease, but not very often. Also younger adults are diagnosed with this disease. I have this disease and I am in a support group. There are younger adults there being diagnosed, unfortunately many discuss how they are delayed treatment because some uninformed doctors think only older people have this.

[@Rene-uz3eb]

@@cindylauritzen4016 most hyperparathyroid is from ckd, so secondary. But hyperparathyroid isn't even a properly defined disease. They just claim high output is a sign of disease, 'abnarmal'. Even though in almost no case, there is a problem with high calcium levels. They even introduced normo calcemic hyperparathyroid for that reason, even though it makes no sense, if the high pth output results in normal calcium, clearly pth is not the problem but that you are losing calcium somewhere, or are extremely low in bone calcium. Endicronology is a career. They are a society, they fit things the way it suits their peers, not the patients. They are in competition for patients with other specialists (here the nephrologists), so the bigger the diagnosis fish net the better. That's what happens in health care as a for profit business.

[@Rene-uz3eb]

To your point, you have low bone calcium. If you didn't, the elevated pth would dissolve too much bone, and that extra calcium would be found in the urine, since you are normo calcemic. Instead, the high pth output is just enough to maintain your blood calcium levels, clearly. Normal urinary calcium loss is about 200mg per day, doesn't come from nothing, and supplementary calcium only sticks if you take it with phosphorus (check baby formulas, they always add phosphorus to the calcium exactly because it doesn't work without)

[@cindylauritzen4016]

When he was discussing hereditary HPT he was answering a question and was helping that particular person understand their situation. He wasn't saying anything about the rarity of it or even implying it's not rare. Listen and understand the context of the discussion before trying to make a useless point.