How to Know if Parathyroid Disease is Causing Your Osteoporosis

The parathyroid glands control the transfer of calcium between your bones and your blood. When you have too much calcium in your bones, the parathyroid glands send parathyroid hormone [PTH]) through your endocrine system causing the transfer of calcium to your bloodstream (which is then filtered by the kidneys and eliminated through your urine). When there is too much calcium in the blood, normally functioning parathyroid glands cause calcium to be transferred from the blood to your bones. It follows, then, that normal parathyroid gland hormone levels and blood calcium levels should move in an inverse relationship to each other.

The diagnosis of parathyroid disease can be made with relative ease in most situations. A blood test that measures calcium and PTH levels will result is high levels of both calcium and PTH. However, it is extremely rare that primary care physicians will order a test of PTH levels, especially if the calcium level is only "slightly" high. The typical primary care physician might request a second calcium test to determine whether the first value was the result of a lab error or to confirm that the calcium level is high.

In many situations, the calcium level the second time will be high normal or slightly elevated, leaving the physician probably to suggest re-testing in six months. Had the physician ordered a PTH level in addition to a second test of the calcium level, the PTH level would reveal normally functioning parathyroid glands (a low PTH score) or abnormally functioning parathyroid glands (a high PTH score). A fluctuating calcium level or a continued high level of blood calcium, combined with a high PTH level, should suggest a referral to an endocrinologist or an appropriately trained surgeon.

The abnormal loss of calcium from the bones is called osteoporosis. Aging, lack of estrogen in women over 50, and parathyroid disease are the three causes of osteoporosis. Osteoporosis is not a necessary result of aging. It is a likely result of lack of estrogen in women over 50. It will result from untreated parathyroid disease. While science has developed treatments for osteoporosis, there is no treatment for osteoporosis where the cause is hypepararthyroidism.

The treatment for hyperparathyroidism, the condition of both high PTH and high calcium, is surgery. Using various techniques, the surgeon can find the likely single offending parathyroid gland and remove it. Most surgeons use what is called MIRP, Minimally Invasive Radioguided Parathyroid surgery. Some surgeons perform this surgery under local anesthesia, while some still use general anesthesia. In either event, the surgeon should take blood calcium levels during the procedure to tell if she removed the correct parathyroid gland. (If so, the calcium level will drop dramatically. If not, there are probably other parathyroid glands that need to be removed.)

The vast majority of parathyroid surgeries are successful. This means that your osteoporosis, if caused by an abnormally functioning parathyroid gland, should eventually clear up.

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