During parathyroid surgery for primary hyperparathyroidism (high calcium preoperatively), I was found to have hyperplasia. My calcium is now normal but I have read that patients with hyperplasia have a higher chance of developing recurrent disease. What are the chances that I will get this again?

My calcium is always noted to be “high-normal” but doctors are not concerned. Could I have parathyroid disease?

Why do you look at all four parathyroid glands during the operation? Doesn’t that pose a risk to the glands?

Is it safe to wait for surgery? I was diagnosed with primary hyperparathyroidism and told that I need surgery. Unfortunately I cannot get the operation done this month. Is it safe to delay the operation for a few months?

I have had high calcium levels for over 30 years, but have never been diagnosed with parathyroid disease. I’ve never had any health problems. Do I have primary hyperparathyroidism?

Did lithium cause my parathyroid disease? Many years ago, I took lithium for several months. Recently I was diagnosed with primary hyperparathyroidism. Is the lithium to blame?

When can I expect to feel better after surgery? I’ve been feeling terrible.

What causes primary hyperparathyroidism?

What are the most common symptoms of primary hyperparathyroidism?

What is Parathyroid Disease?

Hi Dr Boone. I have high calcium. Does it mean I have parathyroid disease? Also your website doesn’t mention primary parathyroid disease. Is it by design? Thanks.

I've had high calcium levels for the last four years. Over the last six months I have started having more frequent headaches and body aches. Sometimes I feel really tired even when getting lots of sleep. I think these symptoms may be due to parathyroid disease, but on other days I feel just fine, so I think they may be caused by something else. Can symptoms of parathyroid disease come and go like this?

Hi Dr. Boone, Can hyperparathyroidism cause MGUS? If so, are you aware of any patients whose MGUS healed after parathyroidectomy? Thank you.

I had a calcium level of 10.6 and then 10.4 on a recheck a week layer. PTH is 58. I am 56 years old. I will discuss with doctor. He might say it is normal and to monitor. Any thoughts?

Does parathyroid surgery have to be performed for primary hyperparathyroidism if I don't have any symptoms? Can nutrition or natural medicine correct hyperparathyroidism?

I had a parathyroid adenoma removed when I was 37 years old. I am now 73 years old and have been diagnosed with a second parathyroid adenoma (calcium is 10.8 mg/dl and PTH 78 pg/ml) which will require surgery. How common is this and are most doctors aware it can reoccur?

My brother is 33 years old. Last year his calcium level was 10.4 mg/dl and this year its 10.3. Should we be concerned since it is above 10? Should we request the doctor to do more lab tests?

Thank you for taking time to answer questions. I had 3 1/2 parathyroids removed six months ago. A month after surgery my PTH was 42 pg/ml, Vitamin D 25-OH was 38 ng/ml, but I’m confused what my calcium was as there were two results on the same day. One calcium level (in the metabolic panel) was 9.7 mg/dl and the other one that was listed with the PTH was 10.2 mg/dl. This confused me, but I felt better than I had in years so I wasn’t worried. However, it didn’t last long. The bone pain, fatigue and brain fog ( to name a few) returned and consistently have gotten worse. I have been taking calcium with vitamin D and magnesium as instructed after surgery. About 3 weeks ago I stopped taking it because the bone pain has gotten worse and I feared my calcium was high again. I am right back to feeling like I did pre surgery. I’m very disappointed and discouraged. My most recent lab results show that my calcium is 10.2 mg/dl. My vitamin D is 23 ng/ml and PTH is 17 pg/ml. I am 53 years old. What would cause my calcium to still be high and my other numbers to be so low? I’m so confused. I should probably mention I have an identical twin sister who has had a parathyroidectomy as well and still doesn’t feel well either, but she had a one sided surgery. Thank you for your time and I look forward to your response.

My endocrinologist suspects hyperparathyroid. She just did a blood test of PTH without calcium. It was 22. Is this a normal test and result? I had other labs showing calcium of 10.5 mg/dl and PTH 88 pg/ml. I am 65 years old.

My confusion seems to be increasing. Could this be due to my having hyperparathyroidism?

Hi Dr. Boone, I am so grateful to have come across your website, it has brought me clarity and understanding in a subject very foreign to me. My question is, my sisters have MEN1, I have a genetic appointment in May for my testing. They all have hyperparathyroidism and have had surgery. My calcium level is 9.8 and my doctor said she corrected it due to albumin. My albumin was normal at 4.6 and my calcium was 9.8, this brought it to a 9.3. she tested my PTH at 43.7. She didn't test my vitamin D because she said she didn't feel she needed to. I have horrible bone pain too, but she said she didn't know that. She is sending me for a pituitary MRI due to high prolactin and vision problems. Why would she correct my CA if it didn't need to be corrected? Thank you so much!

Hi I'm a 21 year old male my height is 6'1 and my calcium levels over last three months checked at an interval of 10-15 days have been: 10.5, 10.4, 10.0, 9.6 mg/dl.. I'm worried I might have hyperparathyroidism. My calcium levels hover between 9.6 and 10.5 whenever checked.

I’m a 32 year old female. I have extreme fatigue and mood swings that are abnormal. It prompted me to ask my PCP for blood tests to try and determine cause. My vitamin D 25-hydroxy came back low at 12 ng/ml and my calcium at 10.4 mg/dl. My PCP prescribed me 50,000 iu of D3 once a week for 12 weeks and told me my calcium was low and to find a daily supplement with calcium in it. The more I read online about calcium and vitamin D, I feel like the root cause of my issues are related to parathyroid. I’m also concerned about the recommendation to take calcium when my mychart shows my calcium on the higher side of the bar chart.

I have a calcium of 11.1 mg/dl (age 55, female). We still need to order other labs. I have so many symptoms consistent with hyperparathyroidism. A lot of the reading I’ve done seems to say that they don’t do surgery under 12 as it “should” be asymptomatic. Can an 11 level cause symptoms?

I'm a 36 year old woman, and my calcium levels have been trending up for the last 4 years and my health has been in a rapid decline. I now have osteopenia. The fatigue and brain fog is so bad most days I can barely concentrate or function. My recent calcium was 10.5 mg/dl and I haven't had my PTH checked recently but last time it wasn't elevated. I am waiting for new lab orders. Before the increasing calcium the last few years I lived in the low 9s and that is where it seemed to stay (9.2-9.4 mg/dl) and looking at the trend it is now consistently high 9s with the highest being 10.5. I am terrified my health is going to keep declining. Do you do consults for people in my position?

This question is regarding Direct Visualization of all 4 parathyroids versus radioguided parathyroidectomy. When directly visualizing the 4 parathyroids, is it easy to tell a normal gland versus a hyperactive gland? I'm sure it is easy to tell if one is grossly enlarged but if it is going abnormal (producing too much PTH) but not yet enlarged, can that be seen or can it only detected by the radioactivity? If 2 of the glands are abnormal or will become abnormal, do they usually become abnormal at the same time? The reason I ask this question is that I see you worked at the Norman Parathyroid Center who uses the radioguided method while you prefer the direct visualization method. Do you still run a sestamibi scan before each surgery but simply don't take a sample of each gland to test individually for radioactivity? Is it just a difference in your views on sampling via visual and being able to tell by size or texture or other feature rather than radioactivity and consequential exposure for patients? Since 20% have more than one gland hyperactive, I'm wondering how certain the visualization is or if in certain cases you do test. I see your method is different now from what you did at Norman Center and just wondered why you changed.

Hi! Is there any food you have to avoid if you have high calcium and high parathyroid levels?

Hi Dr. Boone. I have recently been diagnosed with Vitamin D deficiency and have had a lot of symptoms. I am 34 years old and my Vit D level is 21 ng/ml, PTH 52 pg/ml, Calcium range from 9.8-10.2 mg/dl. Back in 2021 my Calcium level was 9 even. Is this a cause for concern or possibly just Vit D deficiency?

The local endocrinologist diagnosed me with primary hyperthyroidism. Ultrasound showed a 22 mm thyroid nodule. Should I have a FNA prior to having a surgical evaluation at your center? My calcium is 10.6 mg/dl and PTH 116 pg/ml.

I had a recent CT scan of parathyroid that was reported normal. I was put on low calcium diet for next 2 months then repeat tests. Can CTs be false negative & can diet change results and help confirm need for surgery or is it a waste of time? Seems surgery is needed now? Thank you from Ontario, Canada. Calcium is 2.83 mmol/L (11.3 mg/dl) and PTH 14.2 pmol/L (134 pg/ml). I am 68 years old.