Thanks for waiting, Beth. This one’s for you. Beth asked if I’d covered hyperparathyroidism and chronic kidney disease. Lo and behold, I hadn’t. Haven’t a clue how I missed that one. Let’s rectify that right now.
The Merriam-Webster Dictionary, still my favorite after all these years, defines the parathyroid as:
“any of usually four small endocrine glands that are adjacent to or embedded in the thyroid gland and
produce parathyroid hormone”
Wonderful, a definition that leaves us with other words that need to be defined. Using the same dictionary, we have the following meanings:
“Endocrine: secreting internally, specifically: producing secretions that are distributed in the body by way of the bloodstream
Hormone: a product of living cells that circulates in body fluids (such as blood) or sap and produces a specific often stimulatory effect on the activity of cells usually remote from its point of origin
Parathyroid hormone: a hormone of the parathyroid gland that regulates the metabolism of calcium and phosphorus in the body
Thyroid: a gland at the base of the neck that produces hormones which affect growth, development, and the rate at which the body uses energy”
Now it makes sense. But wait a minute. Beth asked about hyperparathyroidism. No problem. We know hyper means overactive, so we’ll be dealing with an overactive parathyroid gland.
Now let’s see what symptoms there are. The Mayo Clinic has that covered:
“Hyperparathyroidism is often diagnosed before signs or symptoms of the disorder are apparent. When symptoms do occur, they’re the result of damage or dysfunction in other organs or tissues due to high calcium levels in the blood and urine or too little calcium in bones.
Symptoms may be so mild and nonspecific that they don’t seem related to parathyroid function, or they may be severe. The range of signs and symptoms include:
Osteoporosis
Kidney stones
Excessive urination
Abdominal pain
Tiring easily or weakness
Depression or forgetfulness
Bone and joint pain
Frequent complaints of illness with no apparent cause
Nausea, vomiting or loss of appetite”
Calcium? Now we’re getting to the part ckd plays in hyperparathyroidism. Reminder: ckd is a decrease in the function of your kidneys for at least three months.
I went to Kidney Health Australia for more information about calcium and the kidneys:
“If you have kidney disease your body is not able to keep the levels of calcium and phosphate at healthy levels. When your kidneys start to fail they cannot remove the excess phosphate from your body. Kidney disease also leads to an increase in production of parathyroid hormone. This also leads to too much phosphate in your body. The phosphate builds up in your body and binds to calcium. This causes your calcium levels to decrease, which may weaken your bones. The phosphate and calcium can narrow your blood vessels and increase your risk of heart disease and stroke. It can also cause skin ulcers and lumps in your joints.”
So, we see that it’s not only calcium involved in hyperparathyroidism but also phosphate. Think of it like the scales of justice. Calcium goes down and phosphate goes up. Conversely, phosphate goes down and calcium goes up.
The National Kidney Foundation explains:
“Normal working kidneys can remove extra phosphorus in your blood. When you have chronic kidney disease (CKD), your kidneys cannot remove phosphorus very well. High phosphorus levels can cause damage to your body. Extra phosphorus causes body changes that pull calcium out of your bones, making them weak.”
Phosphate and phosphorous are used interchangeably in discussing kidney function, although they’re not exactly the same thing.
There may also be confusion in another area as noted by Medline Plus:
“Though their names are similar, the thyroid and parathyroid glands are completely different. The parathyroid glands make parathyroid hormone (PTH), which helps your body keep the right balance of calcium and phosphorous.”
You should also know there are three kinds of hyperparathyroidism. The first – primary – is not kidney related so we’ll skip that and let Healthline demystify the other two:
“Secondary Hyperparathyroidism
Treatment involves bringing your PTH level back to normal by treating the underlying cause. Methods of treatment include taking prescription vitamin D for severe deficiencies and calcium and vitamin D for chronic kidney failure. You might also need medication and dialysis if you have chronic kidney failure.
What Are the Complications Associated with Hyperparathyroidism?
If you suffer from hyperparathyroidism, you might also have a condition called osteoporosis which is also sometimes referred to as “thinning” of the bone. Common symptoms include bone fractures and height loss due to vertebral body (spinal column) fractures. This can develop when excess PTH production causes too much calcium loss in your bones, making them weak. Osteoporosis typically occurs when you have too much calcium in your blood and not enough calcium in your bones for a prolonged period.
Osteoporosis puts you at a higher risk for bone fractures. Your primary care provider can check for signs of osteoporosis by taking bone X-rays or doing a bone mineral density test. This test measures calcium and bone mineral levels using special X-ray devices….
Tertiary Hyperparathyroidism
This type occurs when your parathyroid glands keep making too much PTH after your calcium levels return to normal. This type usually occurs in people with kidney problems.
This is looking serious. How do you know if you have hyperparathyroidism? I’ll let WebMD handle this one:
“Your doctor will ask about your medical history and look for symptoms including a swollen thyroid, a fast pulse, moist skin, and shaking in your hands or fingers. They’ll give you tests that might include:
Thyroid panel. This blood test measures levels of thyroid hormones and thyroid-stimulating hormone (TSH).
Thyroid scan. A technician injects a small amount of radioactive iodine into your bloodstream. Your thyroid absorbs it, and a special camera takes pictures of the gland to look for nodules or other signs of problems.
Ultrasound. A technician runs a device called a transducer over your neck. It uses sound waves to create images of your thyroid.
Radioactive iodine uptake test. You swallow a small amount of radioactive iodine. A device called a gamma probe measures how much of the iodine collects in your thyroid. If this uptake is high, you probably have Graves’ disease or thyroid nodules.”
For treatment – as mentioned – there’s drugs, radioactive iodine, surgery, and more. Treatment is individualized, so that will be between you and your doctor. Aren’t you glad Beth asked for this blog?
Until next week,
Keep living your life!
SlowItDownCKD 