PARATHYROID TUMORS

Parathyroid Tumors?  What are Parathyroids?

First of all, in case you found this page first, instead of page one, I need to restate that I am not a medical doctor.  My knowledge of parathyroid tumors and the associated illnesses comes from first hand experience, which is a form of awareness that cannot be learned in a college classroom or from a textbook.  I am concerned for others who suffer from these illnesses, so I began this site in hope of being supportive.  

The only known purpose of the parathyroid glands is to control calcium within the blood in a very tight range between 8.5 and 10.5.  In this way, they control how much calcium is in the bones, and therefore, how strong or dense the bones are.  The parathyroid glands are located closely to the thyroid gland anatomically, but they have no related function to the thyroid.

The thyroid gland regulates the body’s metabolism and has no effect on calcium levels, while parathyroid glands regulate calcium levels and have no effect on metabolism.

Calcium is the primary element which causes muscles to contract.  Calcium levels are also very important to the normal conduction of electrical currents along nerves.  Knowing these two major functions of calcium helps explain why people can get a tingling sensation in their fingers or cramps in the muscles of their hands when calcium levels drop below 8.5.  Likewise, too high a calcium level can cause a person to feel run down, cause them to sleep poorly, make them more irritable than usual, and even cause a loss of memory.

Although the four parathyroid glands are quite small, they are very vascular.  Since they are required to monitor the calcium level in the blood 24 hours a day, they fact that they are vascular fits their function well. As the blood filters through the parathyroid glands, they detect the amount of calcium present in the blood and react by making more or less parathyroid hormone (called PTH).  The hormone is a small protein capable of causeing distant cells in the body to react in a specific manner.  When the calcium level in the blood is too low, the cells of the parathyroids sense that, and they make parathyroid hormone.  Once the parathyroid hormone is released into the blood, it circulates to act in a number of places to increase the amount of calcium in the blood.  When the calcium level in the blood is too high, the cells of the parathyroids make less parathyroid hormone, allowing calcium levels to decrease. This feed-back mechanism runs constantly, thereby maintaining calcium and parathyroid hormone in a very narrow normal range.

The common cause of excess hormone production is the development of a benign tumor in one of the parathyroid glands. This enlargement of one parathyroid gland is called a parathyroid adenoma which accounts for the large majority of patients with primary hyperparathyroidism. This situation is shown in the above drawing.  One of the parathyroid glands has developed a tumor which is secreting ALL of the hormone, while the other three glands are small and responding appropriately to the high calcium by becoming dormant. The "dominant" parathyroid gland is usually not cancerous, yet it slowly but surely causes extreme damage to the body.  It induces an abnormally high level of calcium in the blood which will destroy a number of tissues. Parathyroid adenomas typically are much bigger than the normal parathyroid gland, which is generally about the size of a "garden pea" or smaller (I had one this size).  Yet, a surgeon found a parathyroid tumor as large as a ping-pong ball in a patient (me).

     * Personal note here:  I had my first "benign" parathyroid tumor removed long ago.  It was discovered after my body had made over 15 kidney stones in a matter of two years.  I had to have several kidney surgeries, and one was an emergency to keep me from bleeding to death.  (Quite a bit of damage for a "benign" tumor, right?)  

My second surgery for my next "benign" parathyroid tumor happened in April of 1997.  I begged the surgeon to go ahead and take out the other two parathyroids while he was removing the tumerous one.  I told him I'd rather take a pill for the rest of my life than to have to have yet a third and fourth parathyroid surgery sometime down the line.  I have my own theory that when one parathyroid tumor is removed, another parathyroid decides to take over and become the dominant one..., kind of like a seccession of dictators.  The surgeon didn't share my views of parathyroids becoming dictators, and he insisted that he would remove only the one parathyroid, which was suspected of being the tumor because according to an MRI it was shown to be slightly larger than a "garden pea".  Well, about three hours into the surgery, after scraping away heavy scar tissue that was attached to my vocal cord nerves, the surgeon happened to notice another parathyroid tumor.  You might be interested to know that it was a "ping pong ball" sized one, and it had not shown itself in the MRI because it had hidden itself well inside of the scar tissue.  My fourth and last parathyroid was left intact, against my wishes.  Since that time I've discovered that there can be fifth, sixth, seventh, and so on, "extra" parathyroids, hidden in the thymus gland and other various places in the body.  So I guess it doesn't matter whether or not the surgeon removed the fourth one.  I figure if it isn't forming its dictatorship by now, there is probably an "extra" parathyroid lurking in my thymus or scar tissue, waiting to perform a coup d'etat.

I had a clinical bone densitometry test done on me.  It is a simple and painless exam that diagnoses the level of osteoporosis.  Bone densitometry measures the bone mineral content and density of specific bone sites, mainly the hip and spine, which are the most likely to fracture due to osteoporosis and other degenerative bone diseases.  It was found that my "benign" parathyroid tumors have left me with bones that are equivalent to that of a 90 year old person.  In the next paragraph, I will explain how and why this happened.     

Parathyroid hormone (PTH) has a very powerful influence on the cells of the bones which causes them to release their calcium into the bloodstream.  Calcium is the main structural component of bones which give them their rigidity.  Under the presence of parathyroid hormone, bones will give up their calcium in an attempt to increase the blood level of calcium.  Under normal conditions, this process is very highly tuned and the amount of calcium in our bones remains at a normal high level.  Under the presence of too much parathyroid hormone, however, the bones will continue to release their calcium into the blood at a rate which is too high resulting in bones which have too little calcium.  This condition results in a condition called osteoporosis, and it means that the bones have larger pores, or less bone mass.  When bones are exposed to high levels of parathyroid hormone for several years they become extremely brittle and much more prone to crack and/or break. ¹

Another way the parathyroid hormone acts to increase blood levels of calcium is through its influence on the intestines. Under the presence of parathyroid hormone the lining of the intestine becomes more efficient at absorbing calcium normally found in our diet.

The primary disease of parathyroid glands is usually overactivity, or too much parathyroid hormone is produced. This is called hyperparathyroidism. Under this condition, one or more of the parathyroid glands behaves inappropriately by making excess hormone regardless of the level of calcium. In other words, the parathyroid glands continue to make large amounts of parathyroid hormone even when the calcium level is normal and they should not be making hormone at all.  In most cases it is strictly a hormone problem, not a cancer problem, but extremely rare cases of cancerous parathyroid glands have been found. ²

SYMPTOMS OF HYPERPARATHYROIDISM

or

"Moans, Groans, Stones, and Bones"

1.) Since hyperparathyroidism was first described in 1925, the symptoms have described in many ways.  I've heard instructors in college tell their pre-med students that hyperparathyroidism is "Moans, Groans, Stones, and Bones".  I've known some people with hyperparathyroidism who say that they never knew they were sick.  Yet they always thought of themselves as "just high strung, irritable, and nervous" types.  Once they were older, many of them fully realized just how much hidden destruction the illness had done to their bodies.    

2) I've found that the extreme removal of calcium from bones causes bone pain.  I've had numerous broken or cracked bones due to osteoporosis, so I know how broken bones feel.  I often feel "broken bone" types of pain in places where I have never had broken bones, yet it's exactly the same type of pain.  I've been told by one of my doctors that bones can also have small hemorrhages within their center which will cause bone pain.

3.) I didn't know about it until I studied the facts, but additional symptoms of hyperparathyroidism are the development of gastric ulcers and pancreatitis.   High levels of calcium in the blood can be dangerous to a number of cells including the lining of the stomach and the pancreas causing both of these organs to become inflamed and painful.  I had experienced the gastric ulcers and digestive system pains, but I had always thought it was "my nerves". 

4.) As stated before, another common problem for persistently elevated calcium levels is the development of kidney stones.  Since the major function of the kidney is to filter and clean the blood, they will be constantly exposed to high levels of calcium.  The constant filtering of large amounts of calcium will cause the collection of calcium within the renal tubules leading to kidney stones.  In extreme cases the entire kidney can become calcified, and even take on the characteristics of bone!  The deposition of so much calcium within the tissues is more than the kidneys can endure.  Therefore, not only is this painful because of the presence of kidney stones, in severe cases the "benign" tumor can cause kidney failure.

In Summary:
POTENTIAL DANGERS OF HYPERPARATHYROIDISM
Severe Osteoporosis and Osteopenia
Bone Fractures
Bone Pains
Kidney Stones
Gastrointestinal Pain
Peptic Ulcers
Pancreatitis
Nervous System Complaints

Email: ThreePeb@aol.com

Index of Pages

My mother died of heart failure,
as a result of pancreatic cancer:
"Tribute to My Mother"

A Founding Member of:
PHEOCHROMOCYTOMA MEMBERS GROUP SITE

Footnotes:

¹  Information from research library at University of California Medical Center, San Franciso CA, Francis S. Greenspan FACP, noted Endocrinologist.

² Information from Encarta Encyclopedia, Endocrine Tumors and Diseases. Version 1998, Division of MicroSoft, Inc. Link: Encarta Online Home