Thyroid Problems/Parathyroid

Advertisement


Question
Thank you for volunteering your time. I recently got back lab results tied to, among other things, fatigue I have been experiencing. The numbers,BUN/Creatinine Ratio 21.4, Urine Creatinine is 2183 (24hr test), Calcium is 619, Ionized Calcium is 5.7 all  have my Endocrinologist believing I have parathyroid and will likely need the bad parathyroid removed. He has suggested the next step should be a NM Parathyroid Sestaming test. I have read that the tests don't really provide much in the way of diagnosis and has little value. I'm curious to know if you concur or if you believe the test to be valuable ahead of any surgery to remove a targeted "bad" parathyroid. I'm also curious to know what the surgery is like (i.e., outpatient and a local?) and how it is performed (i.e., laparoscopically, etc) and if the symptoms (i.e., fatigue, etc) typically dissipate quickly after the bad parathyroid is removed.

Thank you so much again for taking my question

Answer
Heather,
Urine calcium is bit concerning. Other than these tests(the reports which you have posted) , what other tests were ordered? I dont get the logic of ordering sestamibi scan of parathyroid before confirming the Hyperparathyroidism! First step should be to measure PTH hormone levels. And also thyroid profile considering BUN creatinine ration. If PTH is high then they can confirm the diagnosis and do sestamibi scanning for preopertative planning. This sestamibi scanning is usually done for patients whose symptoms recurr again and again even afte multiple parathyroidectomy(unsuccessful surgeries). I dont think its needed at this point of time. You discuss with your endo whats the necessity of that test now. And also can he order PTH tests first. Surgery will be done under general anaesthesia and you may need to be in hospital for couple days. We need to monitor calcium levels after surgery. There are chances of postoperative hypocalcemia which needs medical management. So its a in-patient procedure. There are many ways of minimally invasive surgeries available. But only surgeons will decide which one is suited for your case considering the location and type of lesion. If surgery is successful then youll be back to normal n feel at your best within 2 weeks.

Thanking you!

Thyroid Problems

All Answers


Answers by Expert:


Ask Experts

Volunteer


Dr.Shrinidhi Kulkarni

Expertise

Dont hesitate to ask your health related queries. 24 X 7 ready to provide solutions to your health concerns. All questions are welcome ! Speciallly Endocrinology.

Experience

Working as a Doctor in Primary Health care Centre.

Organizations
KIMS, Bangalore

Education/Credentials
MBBS, Intership in Internal Medicine

©2016 About.com. All rights reserved.