Elevated parathyroid hormone (PTH): How is it treated?

Posted by ladybugmg @ladybugmg, Sep 27, 2018

After I had a nonfasting blood test yesterday my doctor tells me that I have elevated PTH. Is anyone else dealing with PTH and if so would appreciate learning about their experience and how it was treated or is untreatable. Thank you for sharing.

@ladybugmg

Yes, I have elevated PTH as well. Here is a link to a Mayo website about elevated PTH, please click on the link to get more information,
https://www.mayoclinic.org/diseases-conditions/hyperparathyroidism/symptoms-causes/syc-20356194
As a result of the PTH being elevated, I also have osteopenia. Do you have bone density problems or kidney stones as well?

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@hopeful33250

@ladybugmg

Yes, I have elevated PTH as well. Here is a link to a Mayo website about elevated PTH, please click on the link to get more information,
https://www.mayoclinic.org/diseases-conditions/hyperparathyroidism/symptoms-causes/syc-20356194
As a result of the PTH being elevated, I also have osteopenia. Do you have bone density problems or kidney stones as well?

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Thank you for the information. I have had osteoporsis for many years which was once controlled by medication but it caused digestive problems so don't take anything to combat it.

The latest primary care doctor (I have had four different ones in the past ten years who either dropped out of the profession or left the clinic) who is treating me is also a geriatric specialist and at the first visit with him he ordered the first test I have ever had for PTH. The followup test a couple of months later showed the elevated parathyroid hormone.

I am now taking 1 weekly 50,000 IU vitamin D2 and 1 daily 2000 IU D3 vitamin as the latest test results shows a D reading of 21.8 ng/mi.

How is your doctor treating the PTH and what is the prognosis?

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I too have elevated PTH but my calcium levels are normal. Apparently this is called normocalcemic hyperparathyroidism. My primary care doc is an endocrinologist and after a bone density test showed that my bones were losing density (despite doing a lot of weight bearing exercise), he wanted to do the blood test and the 24 hour urine catch which showed the elevated (but not scary) PTH and normal calcium. That was at the end of November and I'm to have a retest early February. A parathyroidectomy may be in my future. I've been scouring the internet to find info about hyperparathyroidism and surgery seems not unusual, even with normal calcium. BTW my D3 is normal.

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@ladybugmg

Thank you for the information. I have had osteoporsis for many years which was once controlled by medication but it caused digestive problems so don't take anything to combat it.

The latest primary care doctor (I have had four different ones in the past ten years who either dropped out of the profession or left the clinic) who is treating me is also a geriatric specialist and at the first visit with him he ordered the first test I have ever had for PTH. The followup test a couple of months later showed the elevated parathyroid hormone.

I am now taking 1 weekly 50,000 IU vitamin D2 and 1 daily 2000 IU D3 vitamin as the latest test results shows a D reading of 21.8 ng/mi.

How is your doctor treating the PTH and what is the prognosis?

Jump to this post

@ladybugmg It has been a while since you last posted. How are doing? I hope your Vitamin D levels have improved

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@crankyyankee

I too have elevated PTH but my calcium levels are normal. Apparently this is called normocalcemic hyperparathyroidism. My primary care doc is an endocrinologist and after a bone density test showed that my bones were losing density (despite doing a lot of weight bearing exercise), he wanted to do the blood test and the 24 hour urine catch which showed the elevated (but not scary) PTH and normal calcium. That was at the end of November and I'm to have a retest early February. A parathyroidectomy may be in my future. I've been scouring the internet to find info about hyperparathyroidism and surgery seems not unusual, even with normal calcium. BTW my D3 is normal.

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Hello @crankyyankee

I would like to welcome you to Mayo Connect. I found your story about normocalcemic hyperparathyroidism to be very interesting as it parallels a lot of my problems with elevated PTH, (sometimes) elevated calcium levels (sometimes) and continual low bone mass despite treatment with meds. My D3 is below normal and just doesn't go up no matter how much Vit D3 supplements that I take.

While I had never heard of normocalcemic hyperparathyroidism, I did a little investigation online and found this information from the National Institute of Health. I found it very interesting and I thought that you would as well. Here is the link, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3564219/.

This seems to be a relatively new diagnosis in that it does not fit the primary hyperparathyroidism.

I would certainly be interested in hearing how you are following up on this matter. Will you post again?

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@hopeful33250

Hello @crankyyankee

I would like to welcome you to Mayo Connect. I found your story about normocalcemic hyperparathyroidism to be very interesting as it parallels a lot of my problems with elevated PTH, (sometimes) elevated calcium levels (sometimes) and continual low bone mass despite treatment with meds. My D3 is below normal and just doesn't go up no matter how much Vit D3 supplements that I take.

While I had never heard of normocalcemic hyperparathyroidism, I did a little investigation online and found this information from the National Institute of Health. I found it very interesting and I thought that you would as well. Here is the link, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3564219/.

This seems to be a relatively new diagnosis in that it does not fit the primary hyperparathyroidism.

I would certainly be interested in hearing how you are following up on this matter. Will you post again?

Jump to this post

The doctor is still experimenting using D2 and now D3 to see if this makes a difference. The D is now up to 27 and we are hoping for at least 30, the absolute minimum. My calcium is still a little high. I wonder if fatigue is associated with PTH.

REPLY
@hopeful33250

Hello @crankyyankee

I would like to welcome you to Mayo Connect. I found your story about normocalcemic hyperparathyroidism to be very interesting as it parallels a lot of my problems with elevated PTH, (sometimes) elevated calcium levels (sometimes) and continual low bone mass despite treatment with meds. My D3 is below normal and just doesn't go up no matter how much Vit D3 supplements that I take.

While I had never heard of normocalcemic hyperparathyroidism, I did a little investigation online and found this information from the National Institute of Health. I found it very interesting and I thought that you would as well. Here is the link, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3564219/.

This seems to be a relatively new diagnosis in that it does not fit the primary hyperparathyroidism.

I would certainly be interested in hearing how you are following up on this matter. Will you post again?

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I saw that nih piece. I've been collecting info since my diagnosis in early December. (I like to be as informed as possible when talking to my doctor, which may drive him nuts, but makes me feel like I'm a collaborator in my medical care.) I will post after my February retests and doctor visit.

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@crankyyankee

I saw that nih piece. I've been collecting info since my diagnosis in early December. (I like to be as informed as possible when talking to my doctor, which may drive him nuts, but makes me feel like I'm a collaborator in my medical care.) I will post after my February retests and doctor visit.

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@crankyyankee

I'm sure your doctors will get used to you being prepared. My doctors are now disappointed if I don't have a list of questions and a packet of research that I've done. I know that they are busy people and can't take time to research everything. So keep advocating for yourself. It is important to you and your medical team as well!

Good work~

I look forward to your posting again with an update.

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@ladybugmg

The doctor is still experimenting using D2 and now D3 to see if this makes a difference. The D is now up to 27 and we are hoping for at least 30, the absolute minimum. My calcium is still a little high. I wonder if fatigue is associated with PTH.

Jump to this post

@ladybugmg

That is interesting that your doctor is experimenting with D2 and D3. I have just been using D3. I have an appointment with my endocrinologist later this month and I may ask about that. I cannot get my D level above 17, no matter how much D3 supplement I take.

I may ask for some more testing on the Parathyroid. Have you had any nuclear tests on the Parathyroid?

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My tests have just been included in the overall blood testing that the primary care doctor has been doing every four momths. The mg/dl calcium is not signifigantly elevated at 10.4 By the way, he has had surgery for the condition and showed me the scar. I have had edema in my ankles recently and now have to wear compression socks during the day which seems to reduce the swelling.

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High PTH is caused by your parathyroid gland releasing too much PTH. PTH and calcium work together to keep each other in balance. If the PTH is high, the calcium should be very low. Or vice versa. If both are high or even at the high normal, you need to get it checked out. You should get the both the PTH and calcium tested in the same blood draw. Sometimes if the Vit D is low, it will cause the calcium to be high. My calcium ranged from 9.9 – 11.2 over 5 years before I was diagnosed with Hyperparathyroidism. They didn't check my PTH until my calcium was finally flagged as high. The only "cure" for this is to have the parathyroid gland removed that has the adenoma (tumor) on it. You need a surgeon who performs at least 50 of these a year as it is highly specialized. There are many symptoms of Hyperparathyroidism but most can be blamed on something else. I had about half of them. I went to Mayo in Rochester for final diagnosis, surgery consult and surgery. I was VERY happy with the drs and treatment. They ran all the necessary tests within 24 hours that confirmed the diagnosis. They range from blood tests, 24 hour urine, bone density scan and a nuclear scan. It was an outpatient surgery. I was in the hospital for 6 hours total. They removed one adenoma. They use interoperative PTH testing and that is how they know that the correct parathyroid gland was removed. A person has 4 glands and they can all be affected. They have to leave 1/2 of one. In my case, my PTH dropped from 77 to 15 so they knew the one gland that showed up on the nuclear scan was the only one. I started to feel better immediately, my symptoms all went away within a week. I was lucky because I had very limited bone density loss and when I get it rechecked, they feel it will be normal again. I also did not have any kidney stones which are very common with this disease. Good luck.

REPLY
@sennertd

High PTH is caused by your parathyroid gland releasing too much PTH. PTH and calcium work together to keep each other in balance. If the PTH is high, the calcium should be very low. Or vice versa. If both are high or even at the high normal, you need to get it checked out. You should get the both the PTH and calcium tested in the same blood draw. Sometimes if the Vit D is low, it will cause the calcium to be high. My calcium ranged from 9.9 – 11.2 over 5 years before I was diagnosed with Hyperparathyroidism. They didn't check my PTH until my calcium was finally flagged as high. The only "cure" for this is to have the parathyroid gland removed that has the adenoma (tumor) on it. You need a surgeon who performs at least 50 of these a year as it is highly specialized. There are many symptoms of Hyperparathyroidism but most can be blamed on something else. I had about half of them. I went to Mayo in Rochester for final diagnosis, surgery consult and surgery. I was VERY happy with the drs and treatment. They ran all the necessary tests within 24 hours that confirmed the diagnosis. They range from blood tests, 24 hour urine, bone density scan and a nuclear scan. It was an outpatient surgery. I was in the hospital for 6 hours total. They removed one adenoma. They use interoperative PTH testing and that is how they know that the correct parathyroid gland was removed. A person has 4 glands and they can all be affected. They have to leave 1/2 of one. In my case, my PTH dropped from 77 to 15 so they knew the one gland that showed up on the nuclear scan was the only one. I started to feel better immediately, my symptoms all went away within a week. I was lucky because I had very limited bone density loss and when I get it rechecked, they feel it will be normal again. I also did not have any kidney stones which are very common with this disease. Good luck.

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Thank you.

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