Get E-Book on COVID-19

Q. My PTH level keeps on increasing. Should I suspect malignancy?

Answered by
Dr. Shaikh Sadaf
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Aug 04, 2020

Hello doctor,

I am a 31-year-old mother of two kids. I am nursing my 10 months old baby. I am in a dilemma. Last December, due to a chronic sore throat, my family doctor asked me to do thyroid ultrasound. There was nothing abnormal with my thyroid, however, they made me do a CT sacn as well with contrast. Inbetween my TSH and T3 were all normal. They suspected parathyroid adenoma in my ultrasound and CT scans. Due to COVID situation, my treatment got prolonged.

Since they were looking for parathyroid adenoma, they made me do nuclear medicine scan in June. Also, I did my blood work too. In our place, we are unable to see any doctor of our choice or repeat any scans or even blood works without concerned doctor's requisition. Also, reports are not accessible too.

My last month blood work result is

PTH level is 7.6pmol/l (indicated high).

Calcium - 2.35 mmol/l (normal).

My TSH level is still within normal limits. In the month of January my PTH level was 6.9pmol/l.

Now that my parathyroid scan rules out adenoma, they are asking me to do a mammogram and ultrasound of right axilla lymph node. To be frank, I have not yet got any appointments to do either of these. I am not in a position to come to India in this COVID circumstance. I am really desperate and so much worried. What could be the reason of my increasing level of parathyroid hormone? Is it malignancy like what they are suspecting or lymph node cancer? I really feel pathetic. Please help.

Dr. Shaikh Sadaf

Diabetology Endocrinology
#

Hello,

Welcome to icliniq.com.

I just read your query and from what you have mentioned, it appears that you have hyperparathyroidism. They will find out all causes of hyperparathyroidism. Since they cannot find any cause for hyperparathyroidism they will search for everything and rule out everything. This is usually done to be on the safe side that we checked everything possible and then nothing was found so now you will simply follow up for parathyroid hormone levels only.

Yes, cancer is one of the suspicions so they will scan the breast and axillary lymph nodes and these are simple scans not biopsies so relax and try to do it once you can. Until then, do not worry and be positive. It does not look that bad to be scared.


Was this answer helpful?

 | 

Thank you doctor,

Is breast cancer common in nursing mothers? I am not tensed about doing the breast scans but I am really really concerned about chances of getting breast cancer. If it is not breast cancer why they want me to do an axillary ultrasound? Is it because they suspect lymphoma. I am terribly worried. In your view, am I having cancer?

Dr. Shaikh Sadaf

Diabetology Endocrinology
#

Hello,

Welcome back to icliniq.com.

No, in my view, looks like a routine screening for causes of hyperparathyroidism. Yes, the possibility of breast cancer decreases in mothers who breastfeed their babies.


Was this answer helpful?

 | 

Thank you doctor,

But I am very much distressed here. It takes more than six months to do even ultrasound or mammogram or even to consult an endocrinologist. I do not know what is going on in me. From what little knowledge I have, and from what I saw on the monitor of family doctor while he was reading out result of sestamibi scan. No scintigraphic evidence of parathyroid adenoma. However some echogenicity of lymph node or so. Is it why they asked me to do axillary node ultrasound? In such case, do I have some kind of lymphoma? I am so much worried. As I had a benign tumour in my head when I was 13 years old. I had surgery with no radiation or anything since it was totally benign. Here I am living with my husband and babies. We do not have anyone else to look upon. I am so much depressed that I cannot even care the needs of my kids even. Fear of malignancy is killing me inch by inch. In your valuable long term clinical experience, can any form of nodal malignancy or metastasized node lead to hyperparathyroidism? By the time I get to do the tests after five months, my PTH level may get worse. I am really stressed out. Please help.

Dr. Shaikh Sadaf

Diabetology Endocrinology
#

Hello,

Welcome back to icliniq.com.

You know they must have found a tiny lymph node in your neck scan and since you are young, they are screening you for lymphoma that is a disease of many lymph nodes swelling up in the body. This is also a screening thing. That lymph node could be due to a simple sore throat at that time too cannot be too sure so it gets investigated.

Secondly, what tests they asked you they know that it will take time because if they thought that something bad was going on they would have fixed an early appointment themselves so please relax, like I said, be positive and take one thing at a time.

Once you book an appointment even if it takes months it is fine because the doctors know that it takes months besides lymphoma needs biopsy not mammogram and mammogram is a routine thing in women so no harm in doing it. I do not see any sinister thing going on here.


Was this answer helpful?

 | 

Thank you doctor,

Yes, as you said they had noticed something in my ultrasound neck which made them to do CT. Even the sestamibi asked to do mammo and axilla ultrasound. Here in my place, due to COVID all bookings got canceled and they have not yet resumed giving appointments unless I go to the hospital. Family doctor asked me to come back once I have done this. That is why I am more worried about. Sorry for pestering you, as I cannot open my mind to anyone here. Whatever it is, I will take it.

Dr. Shaikh Sadaf

Diabetology Endocrinology
#

Hello,

Welcome back to icliniq.com.

You are welcome. Keep in touch for further doubts.


Was this answer helpful?

 | 

Related Questions:
Does decreased TSH and normal T3 and T4 indicate subclinical hyperthyroidism?
What are the ways to treat osteoporosis?
Can Enalapril cause psychosis with auditory hallucinations?
Consult by PhoneConsult by Phone Video ChatVideo Chat
Also Read Answers From:

Comprehensive Medical Second Opinion.Submit your Case

Related Questions & Answers


Does lack of estrogen raise calcium level in urine?

Query: Hi doctor, Five years ago, I had a hysterectomy for early stage node negative breast cancer. I am 49 years old. Currently, I am on Arimidex. My prognosis was 4% risk of recurrence. Since my surgery, my calcium levels are at 9.7 to 10.2 and albumin are 4.7-5.0. Four years ago, a routine CT scan show...  Read Full »

I experience fatigue, abdominal pain and weight gain with multinodular goiter. Why?

Query: Hi doctor, I would like some help with my blood test results as my doctor has not been able to help. I have a multinodular goiter with six nodules, the largest is 5 cm x 2 cm. I am particularly concerned about the high FT4 (while FT3 is below optimal level), high PTH, low vitamin D, high CRP and E...  Read Full »

Also Read


Crohn's Disease
Crohn's disease causes inflammation of the digestive tract, which results in symptoms like severe diarrhea, stomach pain...  Read more»
I was diagnosed with Celiac disease a year back. Can you suggest any medicine?
Having celiac fromnlast 10 year dignosis recently ayear ago since then i am gluten free still cant absorb food feeling w...  Read more»
My head is shivering from 20 days, and it feels like head trauma. What is the cause?
Hello sir, My head is shivering like anything , feeling like trauma is head. And its start anytime in a day and when s...  Read more»

Ask your health query to a doctor online?

Ask an Endocrinologist Now

* guaranteed answer within 4 hours.

Disclaimer: All health Q&As published on this website is not intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek the advice from your physician or other qualified health-care providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website.