Doc: Parathyroid glands set level
Dear Dr. Roach: Three weeks ago, I had a comprehensive exam, something sponsored by my company. I am a 53-year-old man and in good health. I have no complaints. I am quite active and able to hold my own in basketball games with my 16-year-old son and his friends.
Nothing was found on the exam. My lab tests were good, except for a high blood calcium. The doctor thinks it might be my parathyroid glands. I know nothing about them or what they do. Will I need surgery (it was mentioned)? I am having more tests and will see my doctor in two weeks.
Dear J.M.: The parathyroid glands are four small glands plastered to the back of the thyroid gland in the lower neck. Their job is regulating blood calcium. If calcium dips, these glands release parathyroid hormone, which removes calcium from bone to restore the blood calcium level.
A rise in blood calcium is an indication that one of these glands is making too much parathyroid hormone. Since the calcium is taken from bones, one of the signs of an overactive gland — hyperparathyroidism — is bone weakening. A second complication is kidney stones. Weakness and fatigue are other symptoms.
You are like most people who have a high blood calcium. You have no symptoms. Close to 80 percent of those with hyperparathyroidism in its early stages have none.
Surgery is the ultimate answer for this condition. All those with signs of high calcium need surgery. Doctors recommend surgery for all those younger than 50. If the calcium is 1 mg/dl (0.25 mmol/L) higher than normal, surgery is advised. If hyperparathyroidism is harming the kidneys or bones, that’s another indication for surgery.
For older people with no symptoms, surgery can be deferred. Your doctor will follow you to see if your calcium level is increasing or if you are developing symptoms; you might never do so. You can keep things from worsening by staying active and drinking lots of fluid every day. The fluid prevents kidney-stone formation.
Dear Dr. Roach: I’m preparing for a 12-hour flight. When sitting for a long time, my legs feel like hot needles are pricking them. What can I do for my legs during or before this flight?
I have varicose veins on my right leg.
Dear E.M.: During the flight, get up and walk up and down the aisle as often as possible. If the attendant takes a dim view of this, explain why you’re doing it. If you must remain seated, contract your thigh and lower leg muscles many times every 15 minutes. Elastic stockings — called compression hose — also would be of help.
Email questions to ToYourGoodHealth@med.cornell.edu.