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Ear, Nose, and Throat Disorders

Surgery for Parathyroid Adenoma

04/08/2010

Question:

I had surgery to remove a parathyroid adenoma. The ENT surgeon left in approximately 2 1/2 parathyroid glands, but did a total thyroidectomy because it looked in bad shape and he had trouble finding the parathyroid glands.

I`m having trouble getting my calcium levels and parathyroid levels back on track. Six weeks after the surgery, my serum calcium level was 8.3 and the ionized calcium level was 1.05. The PTH level was 14.6. Twelve weeks after the surgery, my serum calcium level jumped to 10.1 and the ionized level was 1.27; but the PTH dropped to 2.5.

Questions:

1. Do the PTH levels indicate that the parathyroid glands are functioning? 2. Could the lower PTH level after twelve weeks have been caused by an overdose of Calcitriol and/or calcium citrate? 3. Isn`t it better to keep the calcium levels on the lower side of the normal range to minimize kidney damage and give the parathyroids a better chance to wake up? 4. How important are the TSH levels once the thyroid has been removed? My T4 level is within normal range but my TSH level is only 0.11. 5. Once calcium levels are within normal range, does this mean that the calcium that I am now taking has "satisfied" the hungry bone syndrome?

I think my main concern at this point in time is whether the Calcitriol and calcium supplements that I`m taking might be suppressing the parathyroid glands and contribute to their "sluggishness".

Answer:

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