Is your blood calcium level high? Could it be due to a parathyroid adenoma?

You may have had some blood drawn for a routine check-up. Or maybe it was because you were feeling tired all the time, or because you were having body aches. Anyway, when the doctor said in that blood report that "your calcium level is a little high," you might have been a little confused. You might have wondered if high calcium levels are a problem. Yes, sometimes it can be a sign of something going on inside our bodies. That's one of those conditions that we're going to talk about today.

Simply put, what is this parathyroid adenoma?

Don't worry, even though the name is a bit long, it's actually quite simple. An adenoma is not cancer. That is, it's not something dangerous that spreads throughout the body. It's a harmless, small tumor that forms in a gland.

Now let's see what these parathyroid glands are. There are four small, bone-like glands in our neck, around the thyroid gland (the gland that most people know as the "goat"). These are the parathyroid glands. Their main job is to produce a hormone, called Parathyroid Hormone (PTH) , that controls the calcium level in our body.

Think of it like a 'switch' that controls the calcium levels in our bodies. When calcium levels drop, hormones are released from these glands, which pull calcium from the bones, kidneys, and intestines into the blood to bring the levels back to the proper level.

However, if one or more of these parathyroid glands develop an adenoma, the gland becomes overactive. It then starts producing more parathyroid hormone than the body needs. This condition is called primary hyperparathyroidism . This causes the calcium level in the blood to rise unnecessarily.

Simply put: A small, non-cancerous tumor (adenoma) that develops in a parathyroid gland causes the gland to produce too much hormone. This causes the calcium level in the blood to rise. That's where the problem begins.

What symptoms can this condition cause?

Often, when calcium levels in the blood are only slightly elevated, there may be no symptoms. That's why many people find it incidentally through a blood test. However, when calcium levels are significantly elevated, a variety of problems begin to arise.

See the table below for common symptoms that can occur due to this.

Why does this type of adenoma develop? Who is most at risk?

In fact, in most cases, no specific cause has been found for the development of these adenomas, but there are some risk factors.

• Genetic causes: A very small percentage (about 10%) of people can inherit this condition through genes passed down through generations.
• Exposure to radiation: If you received radiation treatment to the neck and head area as a child or young adult, the risk may be slightly increased.
• Age and gender: This condition is about three times more likely to develop in women than in men, and is most common in people between the ages of 50 and 70.

What terrible things could happen if this is ignored?

Don't think, "If it's not cancer, why are you afraid?". Uncontrolled high blood calcium levels over a long period of time can damage many organs in our body. Especially, if calcium levels become very high, emergency situations can occur.

• Cardiac Arrhythmia: The heartbeat may become irregular.
• Parathyroid Crisis: This is a medical emergency. It can cause mental confusion, nervous system dysfunction, coma, and even death.

Therefore, even though this is an innocent tumor, its effects should not be underestimated. It is essential to see a doctor at the right time and seek treatment.

How does a doctor accurately diagnose this disease?

The process to find this is very clear.

1. Blood tests: The first thing you will do is a general blood test. This will check if your blood calcium levels are elevated .

2. Checking hormone levels: If your calcium level is confirmed to be high, another blood test will be done to check your parathyroid hormone (PTH) level . Normally, when your calcium level in the blood increases, your PTH level should decrease. But in this disease, both your calcium level and your PTH level are high. That is the main symptom.

3. Other tests: After confirming the diagnosis, the doctor may recommend several other tests.

• Scans: An ultrasound scan or a special type of scan (Tc-sestamibi scan) is done to find out exactly where the overactive gland or glands are.
• CT scan: A CT scan can be done to see if calcium deposits or stones have formed in the kidneys.
• Bone Densitometry: Measures how weak your bones are.
• 24-hour urine test: This measures how much calcium is excreted in the urine.

What is the best treatment for this?

The best and most permanent treatment for this condition is surgery to remove the overactive parathyroid gland or glands. This surgery is called a parathyroidectomy . This operation is more than 95% successful and can completely cure the disease.

Should I still have the operation even if I have no symptoms?

Yes, most doctors recommend surgery even if there are no symptoms. Because, even if there are no symptoms, high blood calcium levels can silently cause things like thinning bones and kidney damage. Surgery can prevent that long-term damage.

Are there no other options for someone who can't go for an operation?

If you are unable to have surgery because of your age or other health conditions, your doctor may recommend medication. But these medications do not lower hormone levels. Instead, they prevent calcium from being released from the bones. This means that you will have to take these medications for the rest of your life.

How the surgery is performed and the risks

Before surgery, scans are used to locate the gland in question. The surgery is performed under anesthesia.

• The doctor makes a small incision in the front of the neck and examines all four parathyroid glands.
• The abnormally enlarged or overactive gland or glands are removed.
• If all four glands are abnormal, usually 3 1/2 of the glands are removed, leaving a small portion, because some parathyroid tissue must remain to control the body's calcium levels.
• PTH hormone levels are measured during surgery. If the exact gland is removed, the hormone levels will drop by about 50% immediately.

As with all surgeries, there are some risks. The main risk is a temporary or permanent decrease in blood calcium levels (hypocalcemia) after surgery. This can cause numbness in the fingers and around the mouth, and muscle twitching. To prevent this, you should take calcium and vitamin D tablets for a few weeks after surgery, as prescribed by your doctor.

About a month after surgery, your symptoms will be largely gone. Your bone density will increase, your risk of kidney stones will decrease, and your quality of life will improve significantly.