Doc: Recurring kidney stones, hyperparathyroidism link?
Dear Dr. Roach: I would appreciate any advice on my recurring kidney stones. In 2013 and 2014, I had kidney stones that got stuck in my lower left kidney tube. It required a lithotomy procedure to break up the stone fragments so they could pass easier. I had to visit my urologist again this month because I was feeling the same pressure and pain on my left side, and again I have two adjacent 4-mm stones in my lower left tube. I was told the composition of the stones is calcium. So, am I somehow having abnormal calcium absorption?
My PTH level is 81.1 (15-65 is normal), but my vitamin D level is very low. My calcium number is normal. I looked into it myself on the internet, and I worry that I might have hyperparathyroidism. Right now all my urologist has told me to do is take 5,000 mg of vitamin D and drink plenty of water all day. But it would seem more logical to stop the stones from forming in the first place.
Do you think I have this parathyroidism? Would I be better off treating this issue? What kind of doctor should I see?
Dear A.M.: The combination of normal calcium and high parathyroid hormone makes hyperparathyroidism extremely likely. The four parathyroid glands, which are on the thyroid gland, are responsible for making parathyroid hormone, which helps to regulate calcium levels in the body. Vitamin D levels often are low in people with high PTH. Calcium levels may be at the upper limit of normal in some people, or very high in those with high PTH.
Many people with hyperparathyroidism have no symptoms, but high calcium may cause vague symptoms, such as fatigue, weakness, poor appetite and mild depression. These may not be recognized as being due to the parathyroidism. In most cases, it is a benign tumor of one of the glands that is responsible for the elevated hormone levels.
Kidney stones develop in 15 to 20 percent of people with high PTH, and calcium oxalate is the most common type of stone (that’s likely, in your case). Surgical removal of the tumor is the definitive treatment, and it is usually recommended in people with primary hyperparathyroidism and kidney stones. Your internist or family doctor is familiar with hyperparathyroidism, but may still refer you to an endocrinologist or nephrologist if he or she isn’t sure about surgical referral.
Dear Dr. Roach: I have been reading a lot lately about the benefits of drinking essiac tea to cure cancer. Can you share your thoughts and facts on this? Thank you!
Dear B.Q.: Essiac tea is an extraction of burdock root, rhubarb root, sheep sorrel and slippery elm bark. Some of these have anticancer properties when tested in cell lines; however, they have cancer-causing properties, as well. There has never been a clinical study showing any of these components or the tea having benefit in treating or preventing any cancer.
I have read recommendations (from nonreputable sites) that this tea is more effective than chemotherapy or other traditional treatments for cancer. There is no evidence to suggest that this is true. While I am in favor of nontraditional treatments if they help people tolerate the side effects of effective treatment, this tea should not be used instead of potentially curative cancer treatment.
Email questions to ToYourGoodHealth@med.cornell.edu.