Parathyroid Hormone & Calcium disorder
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Parathyroid Hormone & Calcium disorder
Hyperparathyroidism is a parathyroid hormone disorder whereby the over activity by the body’s four parathyroid glands leads to excessive production of parathyroid hormones into the bloodstream. The parathyroid glands are a set of four rice grain-sized glands located inside the neck. The glands are responsible for producing the hormone that balances calcium levels in the bloodstream and body tissues. Elevated calcium levels in the body can lead to disorders such as Hypercalcemia, thiazide diuretic use, granulomatous disease, and immobilization (Arrangoiz,2017). Hypercalcemic is indicated by the elevated levels of serum calcium in the body, usually indicated by measurement of more than 14mg/dl in the blood tests.
The most common presenting symptoms for Hyperparathyroidism
The symptoms associated with Hypercalcemia are mostly dependent on the cause of elevated calcium levels. The time over which the problem develops also determines the symptoms. For instance, if the calcium levels increased rapidly, then patents may experience more severe symptoms. Most patients with mild cases of Hypercalcemia are asymptomatic and can only be diagnosed through a laboratory.
Some of the most common symptoms associated with increased calcium levels in the blood include nausea, vomiting, constipation, depression, headaches, confusion, and other alterations of the mental status. The changes in hormone levels lead to mood changes and nausea and vomiting. Some patients may exhibit symptoms of mental illnesses and may require mental healthcare as well as treatment for the Hypercalcemia (Arrangoiz,2017).
In some severe cases of Hypercalcemia, the patients may go into a coma. Hypercalcemia affects the elderly more severely since older people tend to show symptoms even with moderate elevation of calcium levels. In patients with Hypercalcemia resulting from malignancy, the patient may not show the typical signs as in Hyperparathyroidism (Cianferotti, Marcucci & Brandi, 2018). The symptoms of malignancy may overlap with those of elevated calcium levels, confusing diagnosis.
How Hyperparathyroidism is routinely diagnosed
One of the primary ways of testing for Hyperparathyroidism is through the measurement of blood calcium levels as well as parathyroid hormone levels. Before conducting the blood test, a physical exam is advisable. The nurse should examine the patient’s neck area for lumps and swellings. The nurse should also take the patient’s medical history, and any cases of hereditary diseases or conditions should be recorded.
The patient can undergo a blood chemistry study. In this procedure, the patient’s blood is drawn for testing. The blood is then tested for various substances, including calcium levels. A high presence of a particular element in the blood could be a sign of an abnormality. If the substance in question is calcium, then there is a likeliness that the patient suffers from Hyperparathyroidism (Cianferotti, Marcucci & Brandi, 2018)
A parathyroid hormone test is usually conducted on patients with Hyperparathyroidism symptoms. This test is carried out to check the number of hormones released by the parathyroid glands. If the blood sample shows a high amount of hormones in the blood, then the patient can be diagnosed with Hyperparathyroidism.
Sestamibi scans can be conducted on suspected Sestamibi scan cases. The test is performed to check for the presence of overactive glands. The patient is injected with a small amount of radioactive substance that changes color when in contact with the overactive glands. This reaction can be monitored through a camera. A CT scan can be used to check for the presence of lumps and overactive glands by reviewing the different angles of the affected organs or tissues. If the patient is suspected of having a malignant growth on the neck, a SPECT scan (single-photon emission computed tomography scan) can be carried out to check for signs of increased blood flow and increased cell activity around the affected glands (Cusano, Rubin & Bilezikian, 2015). Ultrasounds are also used in the diagnosis of Hyperparathyroidism. The ultrasound waves use bouncing echoes to detect a fault in tissues and cells.
The standard treatment plan for Hyperparathyroidism
Most Hyperparathyroidism cases are treated through surgery. There are currently no medications that can cure Hyperparathyroidism. The overactive glands or the parathyroid tumor is removed through a surgical procedure whereby a small incision is made in the neck to remove the overactive gland. According to statistics, more than 30
Hyperparathyroidism can also be managed through hormone therapy and management of the symptoms. If the patient is asymptomatic, the disease can be controlled by suppressing the hormones and preventing the other symptoms from occurring (Cusano, Rubin & Bilezikian, 2015). In cases where the patient is already showing symptoms such as nausea, headaches, and vomiting, the physician should prescribe educations that can help to manage the symptoms.
Hyperparathyroidism may affect the patient’s mental health leading to issues such as confusion and depression. These symptoms should be treated by a mental health specialist to determine whether the patient should be put on medication to manage the depression.
In some cases, however, the doctor may recommend that the condition be left untreated. For instance, if the patient’s calcium levels are only slightly elevated, the kidney functions are healthy, the bone densities do not show any signs of abnormality, and the patient does not show any other severe symptoms (Rejnmark, Underbjerg & Sikjaer, 2015). In this case, the patient can have regular checkups to monitor the calcium levels in the blood as well as the patient’s bone density.
Link(s) to routine screening and treatment guidelines
There are medical guidelines for the treatment of Hyperparathyroidism. The links below contain some of the recommended treatment guidelines:
- https://www.aafp.org/afp/2013/0815/p249.pdf
- http://jamanetwork.com/journals/jamasurgery/fullarticle/2542667
References
Arrangoiz, R., Cordera, F., Caba, D., Juárez, M. M., Moreno, E., & Luque, E. (2017). Parathyroid embryology, anatomy, and pathophysiology of Primary Hyperparathyroidism. International Journal of Otolaryngology and Head & Neck Surgery, 6(4), 39-58.
Cianferotti, L., Marcucci, G., & Brandi, M. L. (2018). Causes and pathophysiology of Hyperparathyroidism. Best Practice & Research Clinical Endocrinology & Metabolism, 32(6), 909-925.
Cusano, N. E., Rubin, M. R., & Bilezikian, J. P. (2015). Parathyroid hormone therapy for Hyperparathyroidism. Best Practice & Research Clinical Endocrinology & Metabolism, 29(1), 47-55.
Rejnmark, L., Underbjerg, L., & Sikjaer, T. (2015). Hyperparathyroidism: replacement therapy with parathyroid hormone. Endocrinology and metabolism, 30(4), 436-442.