But if too much is made, it can cause your blood calcium levels to get too high hypercalcaemia. If you have high levels of calcium in your blood, it can lead to problems if not treated. Hyperparathyroidism affects people differently. Some people have mild or no symptoms, while others have many. The symptoms may not relate to the level of calcium in your blood. For example, some people with a slightly raised calcium level may have symptoms, while others with high calcium levels may have few or no symptoms at all.
A diagnosis may be missed or delayed because there are no symptoms or they are vague, like feeling tired, and thought to be caused by another condition. If hyperparathyroidism is not treated, it can lead to high blood calcium levels hypercalcaemia , which may cause:.
In very severe cases of hyperparathyroidism, high calcium levels can lead to rapid kidney failure, loss of consciousness, coma , or serious life-threatening heart rhythm abnormalities. But hyperparathyroidism is usually diagnosed at an early stage in the UK, and these complications are extremely rare. It's important that hyperparathyroidism is diagnosed as soon as possible.
Without treatment, it can gradually get worse and may lead to complications. But in most cases, the condition is mild to moderate and remains stable for years. A DEXA scan a bone density X-ray can help detect bone loss, fractures or bone softening, and X-rays , CT scans or ultrasound scans may show calcium deposits or kidney stones. Tertiary hyperparathyroidism is often associated with very advanced kidney failure usually requiring dialysis. People with tertiary hyperparathyroidism are almost always under the care of kidney specialists.
In 4 out of 5 cases, primary hyperparathyroidism is caused by a non-cancerous tumour called an adenoma on one of the parathyroid glands. You and your family should know these serious symptoms.
Ask your doctor what you should watch for and when to get treatment. Your doctor can do a blood test to learn if you have a high calcium level. You may also have blood tests to check how well your kidneys are working. Your doctor will treat a high calcium level if you have it.
The treatment depends on how severe the condition is. People who have no symptoms receive extra fluids, usually given through a vein. This will help your kidneys remove extra calcium from your blood.
Taking medication to stop bone from breaking down. You may be prescribed a bisphosphonate, such as zoledronic acid Zometa , pamidronate Aredia , or ibandronate Boniva , or denosumab Prolia, Xgeva. Talk with your doctor about the risks and benefits of taking such medications. Taking medicine called steroids.
These can help stop bone from breaking down. They also help your bones take more calcium from your food. Steroids can also raise your risk of bone loss over time. Talk with your doctor about the risks and benefits of taking steroids. Taking a hormone called calcitonin. This hormone functions by reducing calcium release from your bones and increase calcium secretion from your kidneys. Using dialysis if you haves kidney failure. Dialysis is a machine-based process that cleans your blood when your kidneys are not working properly.
Treating a high calcium level helps relieve your symptoms. When you feel better, it is easier to continue your cancer treatment. Cancer causes hypercalcemia in two ways. The first is easiest to understand. Occasionally certain cancers will spread from their site of origin to other parts of the body. Some cancers all those listed above have a propensity to spread to the bone. This is called metastasis - the spreading of a cancer from the place it started to another place in the body.
When the metastatic cancer spreads to the bones it grows there and slowly eats away at the center of the bone, and this releases calcium into the blood. The second way that some cancers can increase your blood calcium is via hormones and proteins that the tumor can secrete.
One of these hormones is called " parathyroid-related-peptide ". These hormones can circulate in the blood and cause the bones to release calcium just like parathyroid hormone does. Some of our patients will have had a PTHrp test done prior to them being sent to us for parathyroid surgery. This is your doctor's way of checking to make sure that your high calcium is not caused by a cancer.
We do not require this test to be done, nor should you ask your doctor for it. In our opinion, this test is over used but at least you understand what it's for. Multiple Myeloma. Multiple myeloma is a cancer it is in the list above , but we write more about it here because it is the most common cancer cause of high calcium. Nearly half of all people with myeloma have hypercalcemia at some stage during their disease.
Multiple myeloma is a cancer of the plasma cells a type of white blood cell that are found in the bone marrow. Plasma cells develop from B lymphocytes a different type of white blood cell and they produce antibodies that help the body fight infection bacteria and viruses.
When a plasma cell becomes malignant it will divide many times and produce many copies of itself that form tumors in the bone marrow. Over a period of years these tumor erode the inside of the bone, producing holes in the bones called "lytic" lesions. Since the malignant cells are clones they all act exactly alike and they all produce the same antibody molecule that is secreted into the blood this is what your doctor will measure. Multiple myeloma is often detected during routine wellness testing where it shows up as an abnormally high amount of protein in the blood, a high calcium level, and often increased amounts of protein in the urine.
To make the diagnosis your doctor will order a protein electrophoresis to be done. This test will examine the proteins in your blood to see if there is a large amount of one type of antibody present Some of the patients that we see for parathyroid disease have had protein electrophoresis test performed to make sure they don't have multiple myeloma prior to them coming for treatment of their parathyroid disease.
We believe that this is almost never necessary and this test is performed way too often. This is often done by endocrinologists who do not see parathyroid patients very often and they order a BUNCH of tests on your first visit shotgun approach. Remember, almost everybody with high calcium will have parathyroid disease. If your doctor does not order a protein electrophoresis on your first visit, then good for them. You are almost guaranteed to never need it and you have a good doctor.
Sarcoidosis, or "sarcoid" for short, is a disease where the body's immune system is over activated for unclear reasons. Sarcoidosis can often go many years before being detected, and is often found by accident when a chest x-ray is obtained for some other reason.
Other patients can have symptoms such as cough or shortness of breath. If a patient has symptoms the disease is usually treated with steroids. The cause of sarcoidosis is unknown. How sarcoidosis causes high calcium is not known, but is probably due to the same two ways that cancer causes increased calcium. This disease is very uncommon.
Vitamin D is extremely important in helping maintain the balance of calcium in our bodies. In fact, that's the most important thing that vitamin D does! Vitamin D has a direct effect on the intestines and encourages the intestines to absorb calcium from the food that you have eaten this is why most milks are fortified with vitamin D. Vitamin D also has an effect on the kidneys and tells the kidneys to not let any calcium escape into the urine.
Therefore, it is possible for a person to take too much vitamin D so that they absorb too much calcium from their diet and hold on to too much calcium in their kidneys Vitamin D in normal doses, like the amount you get from drinking fortified milk or from being out in the sun, will NOT cause high calcium. But very high doses of Vitamin D supplements can cause your calcium to bump into the high range - this is essentially an overdose on Vitamin D.
This has become much more common as people are taking very high doses, such as units of Vitamin D3 or more daily. If you are taking these massive doses of Vitamin D and your calcium is high, you should stop taking Vitamin D now. You may have a parathyroid tumor, or you may be overdosing on Vitamin D - either way, stop the Vitamin D and recheck your calcium level. Note that if your high calcium is due to a Vitamin D overdose, your parathyroid hormone PTH will be low.
This is one of the most confusing things for doctors to understand. Some uninformed doctors will see that your calcium is high and your vitamin D is low and they will prescribe a high dosage of vitamin D "to help make the calcium go down". Giving Vitamin D to a patient with high blood calcium can be dangerous and shows that the doctor doesn't understand parathyroid disease very well. It is possible for certain drugs that people are prescribed for high blood pressure to have an effect on the kidney in such a way that the kidney doesn't let enough calcium escape the blood into the urine
0コメント