hyperparathyroid

The parathyroid gland controls calcium and phosphate homeostasis. Calcium, in particular, has very important functions in the blood because it is an electrolyte. It's important for muscle contraction, heart function, cognition, and other functions. Calcium is formed into bone not only because it is strong and physically functional in that state, but also because the bone becomes a large reserve of calcium that your body can draw from if levels of calcium in the blood become too low, like in times where you may not be getting enough calcium in your diet.

Managing the level of calcium in your blood is the function of parathyroid hormone. When serum calcium is too low, parathyroid hormone levels increase to signal the body to resorb calcium from your bones. Vice versa, when levels are optimal, excess calcium is mineralised into bone, or excreted if unneeded. In primary hyperparathyroidism, levels of parathyroid hormone are elevated regardless of adequate calcium levels, resulting in gradual weakening of bones, symptoms of hypercalcemia, increased risk of artherosclerosis, and calcification of soft tissues.

The main question you need to ask first, is what is causing the condition. Not to worry you, but the condition is often the result of a parathyroid tumour. As tumours are uncontrolled cell growth, and parathyroid cells produce parathyroid hormone, a tumour results in greatly elevated hormone levels. Tumour doesn't mean cancer however, as most cases are benign and easily treated with surgery. Other causes can include paraneoplastic syndrom from a cancer somewhere within the body, hyperplasia of the gland, where the parathyroid is growing and secreting more hormone, and certain kinds of endocrine disorders. Knowing the cause is paramount to understanding how it will be treated.

Another good question, if the condition has been ongoing for some time, is to ask whether your bones have been weakened by the condition. Hyperparathyroidism can cause osteomalacia because calcium is constantly being leached from the bones. If this has happened, it will start to reverse once hormone levels are normalised. It'd be wise to check levels of vitamin D after your condition is treated to ensure calcium will return to bone.

Other questions you may want to ask about diet and treatment include how much calcium you should be consuming until you are able to have the condition corrected, and what your options are for treatment leading up to surgery if this is required. Calcimimetics and bisphosphonates can often be used to trick the parathyroid gland into thinking there is more calcium in the blood, or force more calcium back into bone to decrease blood levels.

If you do have surgery, you should try and get this done at a clinic or hospital which specialises in this kind of surgery. Due to the proximity of the parathyroid to the thyroid, larynx, and the nerve that controls speech, it is important to find a surgeon who is comfortable operating on this area. You should ask your surgeon whether they intend to monitor hormone levels during the surgery, and how this would be done. Generally, most parathyroid surgeons test hormone levels during the surgery to know when it is normalised and enough tissue has been removed. It depends on the exact cause however.

If you have surgery, and the condition had been present for many months, you will also need to be treated with adequate amounts of calcium following the surgery. There is the potential to develop a temporary condition called hungry bone syndrome. Once levels of hormone drop to normal, the bones begin to rapidly absorb calcium from the blood to repair themselves, dropping calcium levels low and resulting in the need for extra calcium in the diet for several weeks. You should ask how much calcium you will require in your diet after the surgery and have your calcium levels tested if you experience symptoms of hypocalcemia in the days following the surgery.

In summary, ask what the cause is, whether you will need surgery, what treatment options are available up until the time of surgery if there will be a wait, and how much calcium you should be consuming, how experienced the surgeon is in this kind of operation, how the operation will be performed and successful hormone normalisation measured, and what you need to do following the surgery.

neither is much affected by diets...(some mineraal are implicated such as selenium.) having a good varied diet should sufice.