Hyperparathyroidism

Several floxies have reported that they have been diagnosed with hyperparathyroidism.

Though I think that fluoroquinolones can cause hyperparathyroidism, I am not going to go into that right now – I hope to explore the connections in future posts.

For right now, I want to encourage all floxies to get tested for hyperparathyroidism.

The parathyroid gland controls the amount of calcium in the body. Calcium homeostasis (which helps set the stage for magnesium homeostasis as well) is so important, it has its own entire little endocrine system to control it – the parathyroid glands.

Hyperparathyroidism is caused by a non-cancerous tumor on one (or more) of the four parathyroid glands. This tumor causes the parathyroid glad to release too much parathyroid hormone (PTH), which causes high blood calcium. Though parathyroid tumors are not cancerous, they are dangerous because high blood calcium can cause “osteoporosis, chronic fatigue, kidney stones, stroke, high blood pressure and increased cancer risks (a partial list).” Additionally, hyperparathyroidism is linked to tendon ruptures and many of the other symptoms of fluoroquinolone toxicity.

In a recent article in The Atlantic, “Garry Shandling and the Disease You Didn’t Know About: The comedian suffered from hyperparathyroidism, a rare and under-publicized condition that can sometimes be fatal, James Fallows notes that his doctor stated:

“a parathyroid disorder was about as damaging as smoking a pack of cigarettes per day. It weakened the bones; it raised the risk of heart attacks and some cancers, and kidney stones too; it caused mood disorders; and—I’ll confess the most alarming—it led to memory lapses, attention failures, and dementia. The bone-weakening is because the hyperactive gland continually draws calcium out of the bones and into the blood serum. Most of the other problems are because of disturbances in calcium’s role as a neurotransmitter. My wife later told me that she thought I was getting dumber by the day in the year before the operation.”

The initial tests for hyperparathyroidism involve testing levels of calcium and PTH in the blood. Getting your calcium and PTH levels tested is relatively easy, non-invasive, and inexpensive. Your doctor should be able to test your levels of both calcium and PTH (note that calcium and PTH should be tested simultaneously). High, or even high-normal levels of calcium and PTH are red flags, and test results should be paid very close attention to.

It should be noted that PTH has a very short half-life (about five minutes), and that multiple tests may need to be run in order to get an accurate reading on your calcium/PTH levels. If both calcium and PTH are way out of range, you have your diagnosis of hyperparathyroidism. If both calcium and PTH are high normal – you test again – and maybe a third time – to see if this is consistent, getting worse, or if you just happened to “catch a high” one time.  If you are getting consistently higher results on both – that’s a problem.

Unfortunately, I’ve also heard from some floxie friends whose doctors weren’t concerned about very high calcium levels. Please be aware that excess calcium is a VERY big deal – it’s not bonus good calcium making your bones stronger – it’s calcium being stolen from your bones that is now circulating through your body. If your calcium tests come back high, or even high-normal, I encourage you to chat with your doctor about the possibility of you suffering from hyperparathyroidism. If your doctor isn’t concerned about this possibility, I suggest finding another doctor.

This video is an excellent overview of hyperparathyroidism:

The solution for hyperparathyroidism is surgical removal of the parathyroid gland that has the tumor (the tumor is called an adenoma). Luckily, we don’t need all four of our parathyroid glands to live a healthy and full life – people do just fine with as few as one parathyroid gland. I certainly don’t take surgery lightly, but it is a solid solution to the problem of hyperparathyroidism.

A lot of good information about hyperparathyroidism can be found on http://www.parathyroid.com/.