Kidney stones and Parathyroid – Hip Hip Hooray Leave a comment

 

Parathyroid

The job of the parathyroid glands are to control calcium in the body. When an adenoma (benign growth) forms it causes the parathroid glands to misfire by releasing too much calcium into the body beause it can no longer judge the correct amount needed.

Noy only is it important to take enough calcium  daily depending on age, it is even more im ortnant as the parathyroid is ridding the body of calcium and thi will cause bone density loss and problems with bones and teeth. Many people think that because they have calcium oxalate stones that they need to avois calcium intake when in fact they need to keep up with their intake, It is also not advised to take calcium in pill form as only 30% is absorbed into the bodyand it is healthier to get calcium from food and drinks, If you eother want a varity or are watching cholesterol or weight it does not have to be ingested through cows milk. Salmon, broccoli are just 2 examples of calcium rich food and there are many milk alternatives available. Due to not being allowed to eat soy or almonds I opted for oat milk which I find is a welcome change. Of course, yogurt and cheese are good calcium sources.

The ONLY way to “cure” hyperparathyroidism (over active parathyroid) is surgery. There is not other way to control this illness.

There are many different symptoms for hyperparathyroid issues, the most common  being fatigue, brain fog, body aches and pains and weight gain.

Blood and 24 (48) hour urine tests 25 May 2022

Blood test results

Ideal Calcium 2.15 – 2.60 mmol/L     My result 2.79 

24hr Urine results

Ideal Calcium 2.50 – 7.50 mmol/L   My results 14.43

Ideal Oxalate 40-340 umol/L   My results 530 

Blood test for PTH – parathyroid hormone

Ideal PTH  1.6 – 6.9 pmol/L  My results 11.8   

Urologist follow up 13 July 2022

This appointment went well and I asked questions about the low oxalate diet. I asked if it was correct to take enough calcium in and to drink calcium with higher oxalate foods. I was understanding the diet correctly but it was nice to have that confirmed.

Basically you need to restrict your oxalates to 100mg per day, or less depending on your doctors instructions. Any higher oxalate foods ie potatoes, then consume a glass of milk AT THE SAME TIME. It is important for it to be at the same time because the calcium helps flush the oxalates away and deter the oxalates from lurking in the kidney.

Bone Density Scan 25 August 2022

Due to the calcium loss due to what appears to be a parathyroid issue I asked for a bone density scan. My previous GP had not followed up with a scan after 5 years which is why I asked.

Unfortunately the results have worsened and gone from a high density with low risk of fracture to a medium densiry with a higher risk of fracture, Due to this I will be getting a scan in 1 year rather than the usual 5 as before

Renal Ultrasound 7 September 2022

The kidneys are normal in size. The right kidney measures 10.3 cm in length and the left kidney measures 11.1 cm.

There are benign left renal cortical cysts. The largest cyst is seen in the midpole of the left kidney measuring 3.4 x 1.9 cm. The right renal contour appears smooth.

There is suggestion of a small 0.3 cm stone in the lower pole of the
left kidney, no renal stone is seen on the right.

There is mild bilateral renal pelvic caliectasis but no significant hydronephrosis.

Urologist Appointment 21 September 2022

The urologist was pleased with the renal scan for the suggestion of a renal stone he explained to me that they write the worst case scenario and it could be nothing,

As my PTH was high it was at this visit that I was referred to an endocrinologist. Endocrinologists deal with hormones amongst other things.

I would have a visit in the new year.

Bloodwork 29 September 2022

This bloodwork was ordered by the endocrinologist to check parathyroid hormone levels (PTH) and Vitamin D.

Ideal PTH     1.6 – 6.9 pmol/L   My result 15.2

Ideal Vitamin D     75 – 250 nmol/L  My result 45.9

Ideal Calcium     2.15 – 2.60 mmol/L  My result 2.70

It is very obvious that this is a parathyroid issue.

Endocrinologist 7 October 2022

This was a phone call to talk about what’s going on with high PTH (parathyroid hormone)

Due to a link between low Vitamin D and high PTH the endo decided to put me on Vitamin D 1000IU at 5 tablets per day to see if it made any changes.

This would be reviewed in 3 months. I was anxious that another 3 months would go by with no looking at the parathyroid, however the endo decided she should put me in touch with an ENT doctor (ear nose and throat).

ENT 17 October 2022

I was very impressed that it only took 10 days for an appointment to happen and the discussion was that I needed a $D scan because neither an ultrasound or CT scan had found anything.

It was explained to me that for the surgery they make a small incision in the neck and then sliced one side of the thyroid and flip it to the other side to access the parathyroid which lies behind the thyroid. Then when the adenomas (benign growths) are removed then the thyroid flap is stitched back.

Bloodwork 17 Jan 2023 Parathyroid

Ideal Parathyroid Hormone (PTH) 1.6 – 6.9 pmol/L     My result 9.8 

Ideal Vitamin D 75 – 250  My result 99.7

Ideal Calcium     2.15 – 2.60 mmol/L My result 2.76

Renal Ultrasound 17 January 2023

Few simple cysts are seen in the left kidney that are unchanged in size measuring up to 3.3 cm. No left-sided renal

calculi or hydronephrosis.

There is mild right hydronephrosis and a nonobstructive calculus in the lower pole of the right kidney measuring 6 mm.

Both ureteric jets are visualized in the urinary bladder. Prevoid bladder volume is 419 cc and post void is 20 cc (5%).

No free fluid.

I was most upset in reading there is a 6mm stone in the right kidney, but where did the 3mm one in the left kidney disappear to?

24 hr Urine Test 18/19 January 2023

Quantity 4.3 litres, so I am drinking enough during the day!

Ideal Calcium 2.50 – 7.50 mmol/L  My result 11.44 (previously 14.43)

Oxalates were not tested this time because the main concern was the amount of calcium.

ENT 19 January 2023

This visit was not related (or I wonder if it is) to parathyroid but instead I have been getting a pain behind my left ear, sometimes in my ear, which leads to a severe headache on the left side. This is so bad I’m taking painkillers every day. She didn’t think it was anything to do with parathyroid but i have read ear pain can be a rare symptom.

She sent a request for a CT scan and the appointment is set for 22 April 2023

It was at this appointment that she (luckily) mentioned that my 4D scan was soon which was the first I’d heard about it. Apparently someone forgot to let me know! I would not have known had I not gone to her for something else.

I now had 8 days to prepare!

Endocrinologist 24 January 2023

First time seeing the Endo in person and she acknowleged that the vitamin D had brought down the PTH a little but  not sufficently and that the high level of PTH was the cause of the kidney stones. It was confirmed that it was not due to diet and following a low oxalate diet would not make a difference.  She wanted to see the reuslts of the 4D scan also.

4D Scan 27 January 2023

For this scan I had to fast for 8 hours but was allowed to drink clear liquids such as black tea or water. Water was encouragfed so that was normal for me.

The scan did not take very long, probably about 15 to 20 minutes. Part way through the scan they inject a dye to help diagnose any adenomas.

I read my results online and they did not find any adenomas. This will now need to be my decision (which I have already made) as to whether I want to proceed or not with exploratory surgery. I talked to the ENT last time I visited and she said it was a decision for me to make, It was easy to decide to go ahead with this because it is obviously a parathyroid problem as all the test results have confirmed and the main factor is this…….

THERE IS NO OTHER CURE.

On talking to the ENT she did mention that she has never opened anyone up and stitched them back without finding anything, so that makes me feel a bit  better. The Facebook support group I’m part of has many people in the same situation who opt for exploratory surgery because nothing shows on the scan, even 4D, and they do have adenoma(s) that are then removed.

Urologist 1 February 2023

This was a follow up to the renal ultrasound and 24 hr urine test. He was not concened, at this stage, with the kidney stone and explained that they always report “worst case scaenario”. He also mentioned what I was wondering, about the stone in the left kidney that has “disappeared” and said they may have guessed. At this stage, with the Endo and ENT doctors dealing with parathyroid he was not concerned about a potential kidney stone. He wanted to wait and see how the parathyroid issue was being dealt with before doing anything. He will follow up another ultrasound in 3 months.

 

 

 

 

 

 

 

 

 

 

 

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