RLS, PTH and PD

[Rufous2]

I found Arty-fact's post on hyperparathyroidism enlightening, as I'd never heard of a connection between HPT and PD. Looking for studies on the subject, I was surprised to learn of a possible connection with restless leg syndrome too, and thought those with this affliction might want to read this paper; ncbi.nlm.nih.gov/pmc/articl...

"Overall, 80% of patients with PD exhibited low vitamin D levels, and hyperparathyroidism was diagnosed in 45%. The analysis of the non-motor symptoms profile using the non-motor symptom questionnaire (NMSQ) revealed 36% of leg restlessness, a main feature of RLS. This was significantly associated with worse motor symptoms, quality of sleep, and quality of life. Moreover, it was associated with hyperparathyroidism (OR: 3.48) and with PTH levels, independent of vitamin D, calcium/phosphate levels, and motor status."

45% is a lot, and got me wondering......since hyperparathyroidism usually leads to elevated calcium levels, could this play a part in why dairy consumption is associated with worsening PD? Probably a stretch, but those with RLS might want to get their parathyroid levels checked.

[arty-fact]

That’s so interesting Rufous2 - maths is not my strong suit but does this suggest that more than one third of PWP have hyperparathyoidism?

Especially since

“Primary hyperparathyroidism (PHPT) is a relatively common endocrine disorder, with prevalence estimates of one to seven cases per 1000 adults”

I don’t understand why this hasn’t been more fully investigated in the PD medical world

[Rufous2 in reply to arty-fact]

The study only involved 50 people, so I don't think you can extrapolate to a wider population. But I agree that it seems strange that more investigation hasn't been done regarding PTH and PD. Then again, hyperparathyroidism gets overlooked a lot in general, so......?

[LAJ12345]

interesting. In that case do other plant milks with added calcium pose a risk too?

[Rufous2 in reply to LAJ12345]

Good question, wish I knew the answer to it. It would depend on whether the calcium content of dairy is responsible for it's effects in PD, and there's certainly no consensus on that. I really shouldn't have wondered out loud like I did....sheer speculation on my part, unsubstantiated by evidence. Calcium is an essential nutrient and I don't want to demonize it. 

I haven't run across anything about milk substitutes and PD, but that doesn't mean no one is looking at this. Laurie Mischley studies the effects of dietary components on progression, maybe somebody who works with her can tell us if she's opposed to the use of calcium fortified milk alternatives.

[LAJ12345 in reply to Rufous2]

I saw she says plant based milks are fine so I guess they mostly have added calcium.

[Curlyquick]

Interesting possible connection.

My husband had high blood calcium levels for several years. Our PC doctor ignored it. I read up on it and became really concerned. Symptoms can be vague and it can leach calcium from the bones. I requested a Dexa scan. It showed osteopenia! He was 75. He had an active tremor and was showing other signs of Parkinson's. I didn't think we needed both osteopenia and Parkinson's! I called a parathyroid surgeon, sent his numbers. The surgeon confirmed one enlarged parathyroid gland. Surgery brought his calcium levels to normal. That was in August of 2022. That November he started L-Dopa.

(A year later his Dexa numbers had returned to normal.)

Everyone, keep watch on your blood calcium numbers. If high, you should take action. Interesting that there could be a link to PD.

[Rufous2 in reply to Curlyquick]

I applaud your diligence in getting your husband's hyperparathyroidism diagnosed and treated. One always has to be one's own advocate, but especially in this area, where docs are all too likely to brush off rising calcium levels.

Elevated blood calcium probably doesn't "cause" PD all by itself but it certainly doesn't help, and can make people feel miserable. And the osteopenia/osteoporosis that HPT causes is especially bad news in a disease that predisposes to falls. So great that your hubby's dexa is back to normal.

In addition to keeping an eye on blood calcium numbers, I suggest asking for parathyroid hormone levels to be checked. I say this because my dad had hyperparathyroidism (and severe osteoporosis) even though his calcium level never went above "normal." If no one will order it (PTH) just do it yourself online.