Hello doctor, My mother is 71 years old. She started having joint and bone pain. She has osteoporosis and she recently took retest last year. Her doctor did some blood tests and then sent her to see both an endocrinologist and a rheumatologist. He thinks it is hyperparathyroid. The rheumatologist gave her a shot for her hip pains and said she had bursitis. She also told my mother to make sure the doctor test her vitamin D levels as this could be the cause. My mom got excited as it did not seem serious. But then the endocrinologist called back and said she has hyperparathyroid and she should consult with a surgeon. I spoke to her primary doctor to ask some questions. Her vitamin D level is 28 and her calcium level is 10.7. From the doctors website information it seems as if she has hyperparathyroidism. However, I have read some conflicting reports and wanted to see if my mom should get a second opinion. It also seems to contradict what the rheumatologist said. My question is do you think she has hyperparathyroidism from the calcium and vitamin D levels? Also, after reading the website, it seems there is quite a lot of variability in the quality of the surgeon. Is this something I should be concerned about? It seems that the surgeon should be able to find the bad hyperparathyroid gland before the surgery?
Hi. Joint pain, bone pain and osteoporosis are very frequently seen in hyperparathyroidism. But the very essential component in the diagnosis of hyperparathyroidism is serum parathormone (PTH) levels which need to be elevated. It can be normal in the case of secondary hyper parathyroidism. So I want to know what is her PTH level. Calcium levels can be normal or elevated in hyperparathyroidism. It is difficult to tell only on reports on calcium and vitamin D levels as calcium levels depend on serum albumin levels also. But I personally feel she has hyperparathyroidism. Now coming to the surgery, hyperparathyroidism can be due to tumors in parathyroid glands which requires surgery but there are other causes of hyperparathyroidism which do not require surgery. Ask your endocrinologist, has he evaluated the cause and then referred to a surgeon? If not I advise you to get nuclear medicine scanning with radiolabeled sestamibi of Parathyroid glands and revert back to me. If you could upload all the reports done till now it would be very helpful and I can advise you even better.