Once a decision for surgery has been made and the surgeon has selected the desired imaging prior to the surgery, what actually takes place during the operation? How does the surgeon determine which gland or glands are abnormal? The answers to these questions are not quite as straightforward or consistent among surgeons as one might […]
Once the diagnosis of primary hyperparathyroidism has been established from the calcium and PTH levels, and a decision for surgery is made, the next step is usually to determine what additional information should be obtained in order to assure a successful operation. This is where imaging becomes useful. It is worth repeating the central point […]
It is extremely important to understand that we do not need imaging to make a diagnosis of primary hyperparathyroidism. The diagnosis is based on the laboratory findings. Sometimes those findings are very clear, and sometimes they fall into a gray zone. If the calcium is repeatedly high and the parathyroid hormone level is elevated—or even […]
u In most patients with primary hyperparathyroidism, surgery is the treatment that should be considered first. It is the only treatment that actually cures the problem. Once the diagnosis is clear, the main question is usually not whether anything should be done, but whether there is a good reason not to proceed with surgery right […]
Patients often ask this question after they learn their calcium is high. That is the right question. The answer is that the decision almost always starts with the lab work, but it should also include the patient’s symptoms and any signs that the disease may already be affecting the kidneys, bones, or other organs. Primary […]
1. Intraoperative PTH monitoring is a tool, not the whole operation.Patients may hear a lot about intraoperative PTH monitoring and assume it is the main thing that makes parathyroid surgery successful. It is better thought of as one useful tool. The real goal of surgery is to identify and remove the overactive parathyroid gland or […]
When a blood test shows a high calcium level, one of the first questions is what is causing it. In many cases, the answer is a parathyroid problem, specifically primary hyperparathyroidism. But not every case of high calcium comes from the parathyroid glands, so the lab results have to be interpreted carefully. The key test […]
Many people are surprised when a routine blood test shows a high calcium level. They may feel fine, or they may have symptoms they never connected to calcium at all. Either way, it is not something to ignore. Persistent hypercalcemia deserves a careful evaluation, and one of the most common causes is primary hyperparathyroidism. A […]
One of the most common misunderstandings about high calcium is the idea that a slightly elevated calcium level means a patient has only a mild problem. That is not a reliable way to think about primary hyperparathyroidism. But first let’s clarify that we are talking about someone who has a PTH level that is inappropriately […]
Vitamin K2 has been getting more attention lately in relation to hyperparathyroidism, calcium, and vitamin D supplements, especially in conversations about bone health and calcium metabolism. Interestingly, despite a growing amount of information available online, vitamin K2 still lives mostly in the background when it comes to mainstream, peer-reviewed medical literature. There are a few […]
