Approved for Surgery Parathyroid has thrown me a curve
Hi guys! Hope someone on here can shed some light on my situation. I have been working since January on the requirements to be approved for RNY surgery. The very last appointment before approval they told me that my PTH level was higher than it should be even after getting my vitamin levels up which indicated that I have Hyperparathyroid. They said this "should" not affect my surgery and have sent it to the insurance for approval and I got approval last week. So now I'm scheduled to meet with my surgeon in a couple of weeks but in the mean time I am seeing my family doctor to get a referral to an endocrinologist. My main questions are: Has anyone else dealt with this? I know RNYers sometimes get this after the surgery due to malabsorption but I have it before doing the surgery. This makes me think that maybe an RNY is not the way to go? I'm just very confused right now. It's a hurry up and wait situation to figure out what to do.
A high PTH often means you aren't getting enough calcium. What happens if you aren't taking or absorbing enough calcium, is your body makes extra PTH, which causes calcium to leak out of your bones so that the level of calcium in your blood stays good. That's because if the calcium in your blood gets too low, your heart is unable to beat.
What was your vitamin D level? If it's below 80, that means you can't absorb calcium as well as you should, no matter how much you take.
I would go get a bone density scan, too, to see how your bones are doing.
Kelly
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
When I went in February my D level was low and he put me on a high dosage of D. He then rechecked it and the D level was good but instead of my PTH going down like he thought it would it went even higher. I had a bone density scan a year ago. I'm only 44 but they did one anyway because I had a total hysterectomy and have never taken hormones. I did have some bone loss so they put me on Fosamax.....as it turns out it was probably the PTH causing it instead of lack of hormones.
When you say your D is good now, what is it? If it's below 80, according to the Linus Pauling Institute of the Oregon State University, you're at higher risk for osteoporosis. Docs sometimes (often) say your D level is good when it's really much lower than 80. That's why I'm asking about the level.
Were you on the prescription Drisdol? If so, that's vitamin D2, which isn't absorbed well. If you took that once or twice a week (which is how it's usually prescribed), your level probably didn't go up that much, which would explain why your PTH went up.
Kelly
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
Any history of kidney problems? We see abnormal iPTH a lot in kidney disease, even in early stages. If there is history of kidney problems I would get in to nephrologist as well as endocrinologist.
What were your iPTH , calcium, and D levels? Did you get a phosphorous level drawn? Phos can be off if iPTH is off too. IPTH helps regulate bone turnover, so it can effect calcium and phosphorous. Also if calcium or phosphorous or vitamin D are off, that can effect iPTH. It is pretty complex. Best to see the endocrinologist and get it checked out.
I would be surprised if abnormal iPTH would keep you from getting RNY. You may need to wait until it is controlled, but that is my best guess.
Please keep us posted as to how you make out with the endo.
