Archive for January, 2014
Tertiary HyperParaThyroidism is becoming common among older individuals. Or maybe we are just beginning to notice what it really is. The blood tests are the same as Primary HyperParaThyroidism – high Calcium and high PTH. But the cause and treatment are very different.
Tertiary HyperParaThyroidism happens when Secondary HyperParaThyroidism has been going on for so long that the “thermostat is reset too high”. The ParaThyroid Glands have been maintaining a high PTH level for so long that they forget to shut off when Calcium levels are high enough.
Again we have a patient whose Spine BMD has dropped despite good osteoporosis medication. She takes 500 mg Calcium at breakfast and at supper. She remembers that you can only absorb 5-600 mg Calcium at a meal. But what about lunch? She needs at least 200 mg more calcium in her day.
She plans to eat a yogurt for lunch. This would get her to her minimum of 1200 mg Calcium daily – if only she remembered more than once a week. We need to entice her with a “nooner”. We need her to crave her calcium. Adora Premium Chocolates could do it.
Secondary HyperParaThyroidism is the result of the ParaThyroid glands doing their job. Their job is to keep the calcium in the blood “just right”. Too often this requires stealing calcium from the bones. This is necessary to make up for not absorbing enough calcium every day. But stealing too much Calcium from bones can cause Fractures.
Most of us need 1200 mg calcium in 3 doses spread across every day. Older individuals absorb less well and can require 1500 mg. We also need high enough Vitamin D levels to absorb the calcium. This usually means 1000 to 5000 units of Vit D3 daily. Many of us fail to absorb enough calcium daily. We need Secondary HyperParaThyroidism to keep our blood calcium high enough.