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Parathyroid disease and breast cancer

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  • marijen
    marijen Member Posts: 2,181
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    Sylvia, does hyperparathyroidism always require a calcium blood test of 10 or over?

  • Tomboy
    Tomboy Member Posts: 2,700
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    marijen, in the book and at parathyroid.com, it says that if you are under 30 I think, that you should be in the 9's, because really, your bones are still doing a lot of remodeling. but when you are in your forties and 50's, not so much and that it should always be under 10. But most doctors don't get too much training in this which is weird because they almost always check calcium levels on a CBC (complete blood count). And mine WAS in the 9's before cancer. And before tx for cancer. But just really got whacked around election time last year. Heart palpitations and nausea is what really got my attention though, it was really scaring me! at first I thought it was all the political stuff I had been watching, upsetting me. But I started throwing up for no reason too. And it seems my aches and pains increased, including sharp pains in my shins. But, I haven't had a blood test in almost a year, i had to actually miss one a few months ago and will reschedule soon. very curious to see what calcium is!

    Sylvia, I will be 59 in september, was Dx'ed at 52, a few months short of 53. Can't believe now it's been that long! it's still on my mind way too much.

  • sylviaexmouthuk
    sylviaexmouthuk Member Posts: 7,913
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    Hello marijen and Tomboy,

    I have been looking back at the book Excess Calcium Disease by Peter A Galbraith, and picking up on some salient points.

    The book is useful because it has summaries at the end of each chapter and action items for readers. On page 65 it says that many doctors will not recognise or diagnose excess calcium until it becomes severs and manifests serious objective symptoms. It says that surgery to remove the offending gland with an adenoma on it or offending glands, is the only cure. The wait and see offered by primary doctors should not be accepted. It further says the severity of high calcium disease correlates to the duration of the disease, not the level of calcium in your blood. The longer you have untreated excess calcium the more damage it will have done to your body.

    According to the book you have excess calcium disease (hyperparathyroidism) if you are over 35 and your blood test shows calcium higher than 10.0 (75% of labs list too high a range for acceptable calcium levels). In 80% of cases you will also have a high parathyroid hormone level (PTH).

    If that were me I would get a full blood test, ask what the calcium is and if it is above 10 I would ask for a PTH as well. Even if the PTH is not high, I would still get myself checked for excess calcium disease (hyperparathyroidism). It is better to be safe than sorry and you do not have to be dictated to by your doctor. Remember there is always parathyroid.com and the Norman Institute.

    I hope this helps. We all need to keep referring to this book.

    Best wishes.

    Sylvia xx

  • Canuck76
    Canuck76 Member Posts: 16
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    Hi Sylvia,

    I’m curious if you would surmise a cause of a parathyroid adenoma. We can all guess that a parathyroid gland gone haywire is a cause of parathyroid disease but what causes the gland to go haywire? I’m very curious of your response. Please PM if you don’t feel comfortable posting on here

  • sylviaexmouthuk
    sylviaexmouthuk Member Posts: 7,913
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    Hello Canuck76,

    I was so pleased to read your post. The question you are asking about what causes the gland to go haywire is the one that I have been asking myself for some time and have not found an answer, but there must be a reason, a cause. I was hoping someone might come up with the answer.

    I am fine with posting on the thread because I think everyone benefits then.

    Do you have any ideas or theories?

    The other question that torments me is that we are told that after surgery, everything goes back to normal and we are 'cured'. I had one adenoma removed, the lower right one, and was told that the other three glands had been looked at and were fine. That was nine years ago this November 11th and I often wonder if the other three are still alright. We do not get PTH levels in a routine blood test and my breast cancer and endocrinologist who did both of my surgeries told me there was no need to keep a check on the PTH through special blood tests. I have not had a full blood test for some time so do not know what my calcium level is. I do feel fine and then I always did even though I had been walking around with hyperparathyroidism. What do you think about the others possibly going haywire? To me it seems possible because we do not know the source of the adenoma.

    Have you any ideas on all of this? I do not think the answer is in the book High Calcium Disease and I do not know whether parathyroid.com answers this.

    By the way, I was wondering how your calcium and PTH is measured in Canada. Yesterday I went back and read the seven pages of the High Calcium thread (in the forum Not diagnosed with a recurrence or metastases but concerned). I posted there a lot in 2009 when I was worrying about my hyperparathyroidism and having to make a decision about surgery. I had posted my levels at that time. They were highest 3.06 and the lowest 2.52 for calcium (the normal range I was told by my GP was 2.05 to 2.55). As for my PTH it was 21.6 and 16.3 (the normal range I was told was 1.69 to 6.9). It made me realise again that my PTH was way above the range.

    I can see that the US way of measuring is different. Do you know the conversion between the UK and US measurements and then what goes on in Canada.

    I shall probably do a post about this, so that people from different countries are not confused.

    I also think we should try to keep the High Calcium thread going and read it in tandem with this one.

    I was wondering whether you had gone to the US to have your surgery.

    Have a read of the seven pages of High Calcium thread if you can. I was surprised on re-reading my posts there that I had mentioned some research about parathyroidectomy and malignancy. I had forgotten all about that.

    Sending you very best wishes.

    Sylvia

  • sylviaexmouthuk
    sylviaexmouthuk Member Posts: 7,913
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    Hello mmbNaplesFL,

    I wanted to say thank you so very much for the links that you posted on here. They are so interesting and so important. I have just read the first paper entitled Garry Shandling and the Disease You Didn't Know About – the comedian suffered from hyperparathyroidism, a rare and under publicised condition that can sometimes be fatal. It does say that he died at 66 of a heart attack, but I bet the hyperparathyroidism played a part in it, if not all. I am shocked. My consultant did tell me how serious it was back in 2009 and I was running scared about it all. I am going to read the others today and I am going to put the links on the High Calcium thread and on my breast cancer thread.

    This condition seems to be so under-diagnosed and could be a cause of some of our chronic illnesses, including breast cancer.

    Let us keep posting and keep this thread top of the list. Let us hope people will go and get their calcium levels tested and ask for a parathyroid hormone test if the calcium level is not within the accepted range for their age.

    Best wishes

    Sylvia xxxx

  • Stavasci
    Stavasci Member Posts: 1
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    I've been diagnosed with breast ca last month and having lumpectomy scheduled on next week. I've been suffering with thyroid disease for the last 20 years and finally had total thyroidectomy about 10 years ago. My thyroid antibody levels are always consistently high even though I'm on Synthroid med. Having high on thyroid antibody levels shows there's an inflammation. And now I've been diagnosed with stage 1 IDC and I do believe there's a link between thyroid and breast ca.  Conventional doctors are not too worry about thyroid antibody levels, but I know once I'm done with surgery/radiation... I will definitely check with Functional Medicine Dr and hope to lower those antibody levels to an optimal range. 

  • sylviaexmouthuk
    sylviaexmouthuk Member Posts: 7,913
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    Hello Stavasci,

    I was sorry to read that you have just been diagnosed with breast cancer, and I do hope everything will go fine with the lumpectomy surgery.

    I was interested to know that you had been suffering from thyroid disease for 20 years and had had the thyroid removed 10 years ago, That must have been a terrible shock to your body. Why was the whole thyroid removed?

    Had you been underactive thyroid (hypothyroidism) or overactive thyroid (hyperthyroidism) during all that time?

    It seems to be that women on the thread who have either a thyroid problem or a parathyroid problem, seem to be ending up with breast cancer of some kind.

    I am convinced there is a connection. I think that my hyperparathyroidism was a factor in my breast cancer. My consultant told me that the hyperparathyroidism definitely preceded the breast cancer and that I had had the hyperparathyroidism for quite some time judging by the size of the adenoma on the lower right parathyroid gland.

    What happened to your four parathyroid glands when your thyroid was removed? They sit on the thyroid and are tiny but the control calcium in the body.

    Was your thyroid problem due to iodine insuficiency?

    I think the medical world should be taking much more notice of all of this.

    Best wishes

    Sylvia

  • LizM
    LizM Member Posts: 46
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    Hi all,

    Had my first consult with surgeon for my hyperparathyroidism. The Ultrasound did not show the bad parathyroid gland/s but did show a 1.8 cm thyroid nodule, which my surgeon wants to biopsy before my parathyroid surgery in case he needs to remove part of the thyroid as well. Neither the ultrasound nor the sestamibi scan showed the bad parathyroid gland/s. I am now scheduled for a 4DCT scan. Surgeon at Johns Hopkins said he would do the surgery regardless if he locates the parathyroid. He said hyperparathyroidism is diagnosed by bloodwork (high calcium & high PTH). Btw, my thyroid nodule is on the left side, same side as my breast cancer 12 years ago. Now I am wondering if the radiation of my supraclavical and chest after surgery may have caused it & I am worried it is cancer. Wouldn't be surprised if the parathyroid overgrowth (as my surgeon called it) is also on my left side. I'll let you know after surgery. wish me luck.

  • Canuck76
    Canuck76 Member Posts: 16
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    Best of luck LizM. My overactive parathyroid gland did not show up either on CT or sestamibi. It was MRI that finally picked it up. My surgeon here is not convinced so no surgery as of yet. Do you have any root canals on the left by chance ? Again, good luck going forward

  • sylviaexmouthuk
    sylviaexmouthuk Member Posts: 7,913
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    Hello Liz,

    I read your post with interest and I do hope everything will get sorted out. I can understand that your consultant wants to deal with that nodule on the thyroid.

    Have you had a blood test to get your levels of calcium and parathyroid hormone level? I think this is the usual first step. It was for me and then I had the Sestamibi scan which showed an adenoma (a non malignant tumour) on the lower right parathyroid gland. My breast cancer in 2005 was on the right breast. I was diagnosed with the parathyroid problem and the cancer at the same time. My consultant was definite that the parathyroid problem had preceded the breast cancer and that I had had it for quite some time.

    The four parathyroid glands that sit on the thyroid are very tiny, apparently, the size of a grain of rice. I have read that they are not always located where they should be. They can, if necessary, be put elsewhere after surgery.

    I hope this helps.

    Best wishes

    Sylvia

  • LizM
    LizM Member Posts: 46
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    Yes, calcium was 10.7, then redone with PTH, with calcium at 10.4 and PTH at 125, both high. My endo and endocrine surgeon both have diagnosed me with hyperparathyroidism based on bloodwork. We are just trying to locate adenoma/s before surgery if possible. He will proceed with surgery regardless, which should be end of April, early May.

  • 2ndGenBCA
    2ndGenBCA Member Posts: 28
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    Hello, I just wanted to let the group know that since my last post I got the Calcium Pro app (only 2.99), entered my personal blood test results (calcium in the high 10's for over a year with no local doctors raising an eyebrow), bone scans and demographics and got a red-hot "very likely" reading on the hyperparathyroidism meter. I contacted the Norman Parathyroid Center, submitted all of my official lab work, had a phone consultation with Dr. Poltiz, flew to Tampa for the surgery with him and now I'm home recovering. 

    The photograph of my adenoma - from my lower right parathyroid gland - was evidence of my suspicions. (the tumor did not show on my Sestamibi scan the morning of surgery - but Dr. Poltiz knew it was there - hiding behind my thyroid!) My MO team here at home scoffed at me when I suggested hyperparathyroidism. They will get a copy of the adenoma photo and a report. (BTW, my breast cancer was on the right side.)

    I have a small incision, some bruising and a golf ball sized lump on my throat - all are considered "normal" and should subside in the days ahead as should the minor discomfort. Dr. Poltiz said I should start to get some relief from the nagging pains that have troubled me for some time. I will be curious to see what persists, as I have some other issues that developed as I began taking the AI's. However, I do know that leaving the adenoma (tumor) in place was dangerous with each passing day. (my calcium was 10.6, 10.9, 9.9, 10.8 and 10.9 over the last year and a half)  

    I am thankful for this group, this thread (I informed the doctors and staff at the Norman Parathyroid Center about breastcancer.org and this thread - since that is how I learned of their center) the opportunity to get the tumor removed and knowledge that I took a big step in avoiding kidney failure or worse. 

    I feel good about my decision to work with the Norman Parathyroid Center. They are experts and have a level of expertise that is unparalleled - they know their stuff. Dr. Norman developed the minimally invasive surgery technique, Dr. Poltiz is compassionate and highly skilled and each doctor there is part of the team for a reason. (I met several of them as I prepped for surgery.)

    Will let you know how it goes. I encourage anyone with high calcium to act, not wait. 

    Warmest wishes,

    2ndGenBCA


     

  • marijen
    marijen Member Posts: 2,181
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    Wow, thank you 2ndGenBCA. Incredible information. I am hoping you feel a whole lot better in a few days. Once again our local doctors let us down and we have to take charge of our health. It’s like group think and they are all afraid to stick out and consider new ideas and information.

    Please keep us updated.

  • sylviaexmouthuk
    sylviaexmouthuk Member Posts: 7,913
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    Hello 2ndGenBCA,

    I am just popping in to say congratulations on acting on your own initiative and getting your lower right parathyroid gland with an adenoma on it removed. I do wish you a speedy recovery and assume that your calcium level is now normal.

    As you have seen on this thread, all this happened to me back in 2005 and I had the parathyroidectomy in 2009. I was diagnosed with both in 2005.

    Here in the UK doctors seem to know little about hyperparathyroidism and seem to ignore elevated calcium. PTH level is not checked as part of full blood tests and I think this is wrong. My calcium level and PTH level were both high. My consultant told me the hyperparathyroidism had definitely preceded the breast cancer, so I could have been walking around with it for years. I had no symptoms but I do wonder what damage it caused to my body over the years, even though I appeared very healthy.

    Sam52 and I met on this forum on the High Calcium thread and we went through treatment together in 2009 and she started the thread. We both believe there is a connection between hyperparathyroidism and breast cancer.

    Wishing you all the very best.

    Sylvia

  • triscuit
    triscuit Member Posts: 32
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    2ndGenBCA,

    Glad to hear you were able to get treatment and had successful surgery. Your experience is very similar to mine, and I had the same doctors in Tampa. After the first few days, I felt very recovered and had no problems. Sounds like it should be the same for you if all is going well so far. Best wishes in your recovery and thanks for sharing.

  • 2ndGenBCA
    2ndGenBCA Member Posts: 28
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    Thank you marijen, Sylvia and triscuit. :)

  • LizM
    LizM Member Posts: 46
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    They found my parathyroid adenoma on a comprehensive ultrasound of my neck and 4DCT. Not surprise it is located behind the lower left lobe of my thyroid. My breast cancer was also on the left side plus I had chest radiation just right below my collar bone. Now I'm wondering if the radiation played a role. Still waiting on surgery date but hoping for 3/4th week of April. Probably had for a while since calcium was in low to mid 10's since 2011. Was only recently when went to 10.7 that PTH was checked which came back high (124).




  • Canuck76
    Canuck76 Member Posts: 16
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    Thank you for your story ! I hope you continue to heal and wish you a speedy recovery. If I may ask do/did you have any root canals? Did you have a lot of gastric/ digestive issues with the high calcium ? I have a right lower parathyroid tumour and root canal on the right lower jaw as well. Very curious . Again- Good luck on your recovery and thanks for your story.


  • Canuck76
    Canuck76 Member Posts: 16
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    very much so!


  • LizM
    LizM Member Posts: 46
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    Canuck76, No root canals but definate gastric/digestive/acid reflux issues. Besides improving my osteoporosis and anxiety caused by this disease, improving my digestive issues with surgery is something I am really hoping for. I'll keep you posted. If you don't mind me asking, why is your surgeon not convinced? What are your labs? The diagnosis should be made on labs only. Locating the adenoma by scan is helpful but not necessary. Surgery is really the only cure and symptoms will only get worse over time.

  • chronicpain
    chronicpain Member Posts: 217
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    A few comments:

    1. Here is a recent review of parathyroid surgery:

    https://jamanetwork.com/journals/jamasurgery/fullarticle/2542667

    2. For those who had successful parathyroidectomy with adenoma removal, with or without BC, the endocrine standard of care in the U.S. is to get an annual calcium level, at a minimum, to assure it does not come back. A small percentage of people have recurrent adenomas years later.

    If 3.5 glands were removed for hyperparathyrodism due to parathyroid hyperplasia, then it is even more critical to follow calciums at least once a year as the remaining half parathryoid can either grow back, or stop functioning and then you are hyPOparathyroid!

    Unfortunately I know someone who insisted on flying to the Norman Center for his 3.5 gland surgery on his own dime and then quickly flew home after surgery , with instructions to take a lot of calcium postop for a month, that is routine, as the bone is hungry to rebuild itself. There were no instructions (this was a few years ago, maybe it changed since) for when or if his back home doctor should recheck calcium, so it was not rechecked until months later when he landed up with first paresthesiss and then what was probably a seizure due to very low calcium, and he nad high phosphate and with inappropriately low normal PTH so dx of hypopara was made. He improved with calcium and calcitriol rx. Norman Center was not interested in hearing about this.

    3. If just a total calcium level is drawn and there are albumin abnormalities, a calcium level can look falsely low or falsely high, so it is best to do an albumin together with the calcium to adjust for that, or have a “corrected" calcium . Something as simple as dehydration can falsely raise albumin and total calcium, as calcium is mostly bound to albumin. So can diuretics, like hydrochlorothiazide.

    4. Vitamin D deficiency , which is common, can cause high PTH, i.e., secondary hyperpara, but it should not raise calcium, and D rx can take as long as two years, with adequate calcium, to lower the PTH to normal.

    5. When in doubt about if you do or do not have primary hyperpara, ask to see an endocrinologist ( not a nurse practitioner, not a PA, but a board-certified endocrinologist), preferably at your nearest academic medical center.

    And if you have surgery, make sure the doc has done at least 100 cases, if not more.

    6. There is some weak literature that fibromyalgia symptoms can improve with parathyroidectomy for proven hyperpara. So if you have been put into the “diagnostic garbage dump" of FM, which many BC pts have (my FM preceded by BC) make sure your calcium (with albumin) is normal.

    7. Marijen, there is an entity called “normocalcemic primary hyperparathyrodisim", not common, where calcium is truly normal, but PTH is high and surgery is done if there are clear symptoms (like kidney stones with high urine calcium). A Dr. Bilezekian in NYC has done a lot of work on this.


    Best to all!


    Edit: UK version:

    http://www.endocrinesurgeon.co.uk/index.php/indications-for-parathyroid-surgery





  • Canuck76
    Canuck76 Member Posts: 16
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    LizM-thanks for the reply. I will check when I get home my most recent lab values but the PTH has been well above normal for last four years-calcium has been high as well but for most part its been right at the top of the range- not quite outside of Canadian lab values. The MRI showed the cherry sized adenoma-sestamibi did not. Drs. here are not convinced I have parathyroid disease. Kidney function is normal, digestive and sleep abnormalities are crazy bad. Short term memory is terrible and word finding is even worse. I am considering surgery at Norman Center in Florida but I am awaiting a second opinion here in Canada first.


  • sylviaexmouthuk
    sylviaexmouthuk Member Posts: 7,913
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    Hello Canuck,

    I read your post with interest. I cannot understand why your doctors are not convinced that you have parathyroid disease. Undiagnosed and left untreated it is a very dangerous disease. I was lucky that I had an excellent oncologist and an excellent breast cancer surgeon who was also an endocrinologist and that they followed up my high calcium level with a PTH test and diagnosed hyperparathyroidism along with my breast cancer. Otherwise it would have remained undiagnosed and could have been fatal. I have no idea how long I was walking around with it but I was told it definitely preceded the breast cancer.

    My GP said hyperparathyroidism was 'rare' but I say it is under diagnosed here because PTH is not part of routine blood tests.

    I was afraid of the surgery because the endocrinologist told me it could change my voice, but I had no choice but to have the surgery. My vocal chords were tested by an ENT consultant before surgery to attest that everything was in order.

    I had no symptoms of which I was aware, so I could not know I even had a problem.

    I do hope you get a second opinion soon and that you manage to have the surgery.

    I remember reading in the link that the Harley Street consultant said hyperparathyroidism was quite common!

    I have noticed that you have mentioned root canal work a few times. Can you explain your thoughts on this? I have had one root canal work done but it was towards the front on the left side of my mouth. It was done in Canada. I have heard very things about root canal work.

    I have just read the April edition of the magazine What Doctors Don't Tell You (www.wddty.com) and there is an article in there entitled 'Link between gum disease and some cancers proven".

    There is also another article in the magazine about "5 ways to beat gum disease – Nature has plenty to offer when it comes to gum disease, says Joanna Evans".

    1 Coenzyme Q10

    2 Propolis

    3 Folate

    4 Green tea

    5 Vitamin C

    I found all this very interesting.

    I have had a lot of problems with my gums and teeth since my breast cancer treatment.

    Let us know how you get on.

    Best wishes.

    Sylvia

  • Canuck76
    Canuck76 Member Posts: 16
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    Hi Sylvia, good to hear from you again. Most of the information I read on the net can be either factual or speculative so I think the truth is somewhere in the middle on a lot of this stuff. I always ask about the root canals because I have one on the same side as the parathyroid adenoma-lower right root canal-lower right adenoma. My thoughts are this-the breast and lymph glands are very close to the jaw and I believe that area naturally drains close to the breast - I would have to check my textbooks to be sure. If the root canal is compromised the bacteria would migrate in the lymph . It might not just be root canals but dental infections in general as well. Last year, I had co worker with a bone infection that started in the mouth. They were on long-term IV anti-biotics for 6-8 weeks. I know there are lots of studies out there that prove that a dental infection can be found elsewhere in the body despite what most mainstream doctors think.

    As for my surgery that hasn't happened yet- I have no idea why-I have proven my case of what it is. My understanding, according to what I've read on the net and what the doctors have told me is surgery is the only cure. My only thoughts are that they are waiting on the genetic testing to come in order to plan for complete removal of parathyroid / thyroid glands or partial removal. That is my only guess.

    I am stubborn and a bit of a pit bull when it comes to my health so before I let them take something out of my body, I will need some answers on what caused this gland to go haywire. You can't put something back in the body once its removed. The second thing is what's preventing this from happening again if they don' t take everything the first time? The answers are out there-I will find out.




  • sylviaexmouthuk
    sylviaexmouthuk Member Posts: 7,913
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    Hello Canuck,

    It was nice to hear from you.

    I was most interested in what you had to say about root canal and dental infection and the proximity of the breast and lymph glands to the jaw and that area would naturally drain close to the breast. I agree with you.

    For a long time now I have connected my non-hormonal breast cancer to the hyperparathyroidism and think the hyperparathyroidism somehow contributed to the breast cancer and I also think that my gum disease was also connected and may have been the cause of everything. I was told I had gum disease back in 1990 by a dentist when I was living in London, Ontario and he referred me to a periodontist at University Hospital in London, Ontario where they did periodontal treatment. I did this for a couple of years. Before that no dentist had ever mentioned it and I had always taken care of my teeth.

    Back in England, in 1994, I continued with periodontal treatment. When I moved to Devon in 2002 the dentist said I had genetic gum disease which I would have inherited from my parents and that there was no cure. All seemed fine, but after chemotherapy treatment my gums seemed to suffer and I had to have some teeth removed. I somehow think the gum disease has been at the root of all my problems. I did have root canal work in Canada back in 1980 and the dentist said I had good strong teeth! There was no mention of gum problems.

    I agree with everything you say about dental infection being found elsewhere in the body.

    In addition, my older brother died in 1995 from cancer and he had lots of gum problems. Ironically an appointment at the hospital to look into all of this came just after he had died.

    The recent article about the link between gum disease and cancer brought this all back home to me, all the more so because when my brother was diagnosed it was already metastatic to the liver and pancreas, with the death certificate stating primary unknown, but I think it was probably bowel cancer.

    In the article I mentioned, entitled "Links between gum disease and some cancers proven" I picked up on the last lines of the article: "Their findings have been supported by separate research, which found that the bacteria in gum disease had also been found in colorectal cancer tissues".

    With reference to your surgery, I was also told that surgery was the only cure for hyperparathyroidism. The surgeon endocrinologist also told me that I did not need to get any further blood tests for PTH etc. as I was 'cured'. I have since read somewhere that you can get hyperparathyroidism again. I suppose the other parathyroid glands can go haywire. I am trying not to think about it too much as I would worry about surgery and the possibility of vocal chords being messed up. Like you, I do not like parts of my body being removed. I think doctors are too gung-ho about doing surgery and removing body parts and then stuffing you with pills as replacements!

    What genetic testing are they doing?

    I think you are right to be stubborn and a bit of a pit bull when it comes to your health. I am much the same and believe my body belongs to me and not to the NHS.

    I hope all works out well for you.

    Best wishes.

    Sylvia

  • chronicpain
    chronicpain Member Posts: 217
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    Sylvia, as I posted above (and in the links) it is standard of care in U.S. to check annual blood calcium in patients who had parathyroidectomy in the past. This is because in a very small percentage of people it can come back and other than kidney stones, symptoms can be too subtle to notice.

    Most board-certified endocrinologists know this, and definitely university based ones do.

    If NHS does not cover it, despite widely published info that it can come back, can you afford to pay privately, if not annually then at least less often? At least here in U.S., a total calcium level with an albumin is not expensive, and insurance and Medicare covers it.

    The association between breast cancer and primary hyperparathyroidism was first reported back by an academic endocrinology group (Stan Wallach) in the 1970’s. Breast cancer was blamed by most when women developed hypercalcemia (usually from bone mets, and was a bad sign, some had humoral hypercalcemia secreting a bone resorber), and since then the literature has been replete with publications noting that BC patients get more primary hyperpara than most other cancer pts, though there is unclear exact cause (perhaps there were prior triggering exposures that caused mutations.) Many oncologists do not know about it, which is sad because it can be a curable cause of osteoporosis aggravation independent of arimidex usage.

    At a minimum these days if there are symptoms in a BC lady, which can be non-specific, hypercalcemia should be checked for, and if present, a PTH should be done (along with bone scan for mets of course, and if negative a PTHrP for humoral hypercalcemia, which they did not have back then).

    BTW a “normal” PTH with a confirmed high blood calcium (adjusted for albumin) is considered “inappropriately normal” by people who know what they are doing. That is where many regular primary care docs get confused, and think they have ruled out the condition when they have not and just move on.

    Thank you for highlighting this treatable disease, present in at least one in 1000 women, and even more with BC though we do not know exact frequency because not enough docs are looking!

  • sylviaexmouthuk
    sylviaexmouthuk Member Posts: 7,913
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    Hello Chronicpain

    I read your post with great interest and I did read the links as well.

    I do think, like you, that a lot of women diagnosed with osteoporosis may be suffering from hyperparathyroidism. If my oncologist had not been so thorough when I was diagnosed with breast cancer in 2005 I would not have known that I had a problem with one of the parathyroids.

    I did not get to have surgery until 2009 when I was completely recovered from breast cancer treatment. I had triple negative breast cancer.

    I did not loose height until after breast cancer treatment, but I may have osteoporosis without knowing it as I had not had a DEXA scan. I had one after the parathyroidectomy that showed osteoporosis and I had one later that showed everything was stable.

    Under the NHS everything seems to be rationed and i was told I would probably not get another DEXA scan. I make sure I get calcium mainly through my diet and would not accept any bisphosphonates from the GP.

    It will be nine years this November 11th that I had the parathyroidectomy. At the moment I am happy to leave things as they are, as I feel fine and would not really want anymore surgery, because of risk of damage to vocal chords.

    Wishing you all the very best.

    Sylvia

  • LizM
    LizM Member Posts: 46
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    Wanted to give an update. I had my parathyroid surgery this past Tuesday, May 1st. The surgery went very well. My surgeon at Johns Hopkins removed one parathyroid adenoma, which was benign. My surgery was outpatient and I plan to be off work recovering for about a week. My pre-op labs were calcium 10.7 and PTH 125. My PTH dropped to 19 during surgery. I have a follow-up in 2 weeks and we will check my calcium, PTH, and vitamin D.

  • jpteacher1
    jpteacher1 Member Posts: 8
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    I had 3 1/2 parathyroid tumors removed March 23, 2018. I took Arimidex for 4 years from 2013 to 2017. Since taking Arimidex, my bone density went from beginning osteopenia to beginning osteoporosis. This led to the detection of my parathyroid condition. Prior to 2013 my blood calcium was normal. There is just too many coincidences in my life to say Arimidex did not cause these problems. I reported this to the manufacturer. I now have a case number.