Does parathyroid hormone worsen osteoporosis?

[Purple-Owl]

I have just had a blood test and learn that my parathyroid hormone level is high/abnormal. (I learned from Google that the parathyroid gland is actaully nothing to do with thyroid level. It's so named because it is located in the neck behind the thyroid gland.) As I understand it the parathyroid hormone actually controls the level of calcium in the body. An excess of the hormone diverts calcium from the bones where in my case it is needed, to the blood, where I fear it may be contributing to hardening of the arteries. I looked for some recommended treatment for this excess, but the only thing I could find was surgical removal of the parathyroid gland. Does anybody know anything more about this?

[Chris_1236]

The parathyroid glands are one component of a negative feedback loop which regulates the body's serum calcium levels. Here's a summary:

pubmed.ncbi.nlm.nih.gov/297...

Elevated PTH levels probably correlate with low serum calcium levels. This could certainly contribute to osteoporosis worsening.

But there could be other causes of elevated PTH levels.

I'm sure your physician will have a diagnosis for you.

Disclaimer: I'm not a doctor and this doesn't constitute medical advice.

[PMRpro Ambassador]

It needs investigating to identify WHY the PTH is high. The calcium level is also significant, whether it is normal or high,

Elevated PTH and normal/low calcium may signal you don't have enough calcium in your diet, Or there may be a vit D problem. Further blood tests are needed first to work it all out. If it turns out it may be a growth on the parathyroid gland it will be removed. They are mostly benign (non-cancerous) so rarely anything to worry about.

healthline.com/health/pth

my.clevelandclinic.org/heal....

[Purple-Owl in reply to PMRpro]

Thanks so much for your very helpful responses PMRpro and Chris_1236. i have followed the informative links you give and am a lot clearer now about what may be going on.

I am exhausted all the time on 5mg prednisalone for PMR, so am particularly interested that tiredness/fatigue may also be a symptom of elevated PTH.

PS: One point of interest about me is that I have been taking Alendronate weekly probably for longer than anyone else in the universe! 20 years, with two one-year breaks. I sill have osteoporosis.

[PMRpro Ambassador in reply to Purple-Owl]

Alendronate usually only maintains existing bone density - if you are osteoporitic, it makes more sense these days to be offered Prolia/denosumab to increase the bone density and then continue with the bisphosphonate.

[Marcy47]

I have this as well. I take vitamin K2 which takes the calcium from your blood and puts it back in your bones. My calcium levels have remained stable for several years now.Good luck. Marci

[Sophiestree]

I have just had a parathyroid gland removed at the front of my neck. My calcium levels and PTH were high pre-diagnosis of LVV but as soon as I started pred they dropped and so the concern wasn't there. A small tumour showed on a nuclear scan, as PMRPro says, common and unlikely to be sinister, but as my levels weren't showing they didn't do anything. It wasn't until I started to reduce the pred that they started to rise again and my second PET CT flagged it up again. That's when they decided to remove it. I have quite poor bone health (-3.9) and so will be be very interested to see if this changes anything. I understand it can take anything up to 9 months and so I plan to request a DEXA at the end of the year.

The surgeon did ask me what my symptoms were but I just laughed at him. I have an underactive thyroid and am on steroids, they all present in a way you couldn't discern one from the other.

The only thing I do know is I don't feel any worse. I did read that patients can often feel instantly better post surgery. I don't think I have that luxury, but I also read it can take a few weeks so time will tell.

I do have a pretty neat scar though!

[Exflex]

Prolia cause you to lose jaw bone. Where did you come across this info?

My wife is on twice yearly Prolia and is unaware.

[PMRpro Ambassador in reply to Exflex]

ncbi.nlm.nih.gov/pmc/articl...

It is very rare, figures are given in the article, and greater in patients on it for cancer

[Exflex in reply to PMRpro]

still frightening. My wife has been receiving Prolia for many years following menopause, and before Prolia she was taking AA. I suppose it’s a case of which is worse, broken bones or necrosis.

I stopped Risedronate when I got to 2mg, although the GP recommends I take it until 0mg. I expect them to say that. I’m having a Dexa sometime July / August.

[Thirtynine39 in reply to Exflex]

Osteonecrosis of the jaw (ONJ) is a rare condition you lose all or part of your jawbone. My 92 year old mother and few of her friends suffer from this. You are right to say it is a case of which is worse. I refuse to take AA or similar medicine.

[PMRpro Ambassador]

That is an unnecessarily sweeping and scaring opinion, It is a rare effect and is common to all such medications.

[Nannie-C]

Sadly parathyroid glands disease is so often overlooked/misunderstood. Many medics still think you must have raised calcium to have this condition but that is not strictly true. Samples of calcium, vit d and a separate one for parathyroid in an EDTA tube (usually lilac/purple top) with all taken from same blood draw. This is to accurately assess the relationships between the calcium and parathyroid. Normally if all is working well they will have an inverse affect with one higher end and one lower end, like a seesaw but if they are not like that then there’s an issue.

Primary Hyperparathyroidism and it’s variants of normocalcaemic or normohormonal hyperparathyroidism needs removal of faulty gland (s) to treat/cure it which halts further damage of this progressive condition and allows bones and body start to heal.

Other forms are secondary and tertiary which can be caused by renal failure, low vit d or several other conditions.

Great informative site is parathyroid.com