In very rare instances (less than 0.5% of cases), a parathyroid tumor is cancerous. Alendronate (Fosamax), a bisphosphonate, decreases bone turnover and increases bone density at the spine and hip region, although it doesn't correct PTH or calcium levels in the blood. Abdominal bloating and distension have a complex etiology that is not well understood. The usual cause is an adenoma a noncancerous tumor. Hi Liz - thanks, yes I had a lovely time away. It is so hard to distinguish is this all recovering as well from this major surgerythe fatigue. These glands, located behind the thyroid at the bottom of your neck, are about the size of a grain of rice. Primary hyperparathyroidism is often discovered postmenopausal women when bone health becomes an important issue. Many people find that avoiding certain foods prevents bloating and other gastrointestinal health issues. Asymptomatic primary hyperparathyroidism progresses to a more serious condition only about one-third of the time, so some experts favor simply monitoring most patients and, if necessary, managing the condition with lifestyle measures and medications. Ctd. Sometimes the diagnosis of hyperparathyroidism is made when doctors seek an explanation for low bone density noted on testing. Accessed Jan. 16, 2020. If your healthcare provider believes your hyperparathyroidism doesnt need immediate treatment, be sure to: If you have more severe hyperparathyroidism symptoms or have an enlarged parathyroid gland (or glands) or a growth on your parathyroid gland, your provider may recommend surgery to remove the overactive gland(s). A person should see a doctor for bloating or gas associated with: Abdominal bloating can be upsetting and painful. This content does not have an Arabic version. Egton Medical Information Systems Limited. Sestamibi scanning is a painless technique often used before surgery to locate abnormal parathyroid glands and determine whether minimally invasive surgery is appropriate. Phosphorus, another mineral, works along with calcium in these areas. 2 Bess MA,Edis AJ, Van-HeerdenJA. The other issue that you now have is that you have an elevated calcium level (in the blood). Rosemaryxx. I felt like I was going down with the flu most days too. Most people experience brief episodes of indigestion from time to time. Left lobe 1.36 x1.03x1.14 nodule that had been biopsied 2 yrs ago which was benign. Having your kidneys retain calcium and return it to your blood instead of flushing it out in your urine. 2 1/2 hours will go quite quickly. I wish there was something I could suggest to make you feel better but there isn't anything that will really help until the adenoma is removed. They are not interested in other doctors' scans and won't look at the (they are usually wrong and often of poor quality). Factors that may result in secondary hyperparathyroidism include: Severe vitamin D deficiency. If your kidneys work poorly, usable vitamin D may decrease and calcium levels drop. Take care. If you have an overactive parathyroid, one or more of your parathyroid glands makes too much parathyroid hormone (PTH). They lead surgeon has devoted 25 years of his life to perfecting his minimally invasive op with a local anaesthetic and it's all over in about 20 minutes. These symptoms could be caused by many disorders, including some with serious complications. Posted Hyper means too much and hypo means too little and para means around - the parathyroid glands are "around" the thyroid gland (well behind it but sort of around it). Let us know how you get on. Our clinical information meets the standards set by the NHS in their Standard for Creating Health Content guidance. Usually, bloating is not a concern if it: In this article, we look at the causes of abdominal bloating, treatments, and how to know when to see a doctor. The best thing about it is that you do NOT have to be referred by your doctor, all you need to do is to obtain copies of your results from them to send to Tampa. I told her i feel like I've become a hypocondriac for which im not at all.its like im justifying how badly i feel.i will be in touch and thx for any info u may offer xoLiz. You can buy the calcium tablets from a Wallmart store afterwards. This represents 1% or less of the cases and it occurs when the parathyroid glands develop a malignant overgrowth of cells. This is common in kidney disease and after certain intestinal surgeries or diseases. The hormone manages the levels of calcium, vitamin D, and phosphorus in your body. When a part of the thyroid is removed, or the whole thyroid is removed, the surgeon has to be VERY careful not to inadvertently remove any of the parathyroid glands. Occasionally, adenomas grow on more than one parathyroid gland. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter Digital Edition. Take care. Severe bloating may occur along with other serious symptoms, such as: Blood in your stool; Noticeable weight loss (without trying) Vaginal bleeding (between your periods, or if you are . Secondary hyperparathyroidism occurs due to another disease that first causes low calcium levels in the body. No report of Hyperparathyroidism is found for people with Abdominal bloating. By the way, about 50% of middle aged people develop thyroid nodules and they occur more as you age and my surgeon said the vast majority of them are harmless. How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, https://www.nafc.org/bhealth-blog/do-i-have-bowel-endometriosis, https://www.health.harvard.edu/blog/feeling-gassy-is-it-ever-a-cause-for-concern-2019090917599, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4991532/, https://www.niddk.nih.gov/health-information/digestive-diseases/gastroparesis, https://www.acofp.org/ACOFPIMIS/Acofporg/PDFs/OFP/articles/2019_MarApr/2019_MarApr_SympotomaticApptoGaswithOMT.pdf, https://www.merckmanuals.com/professional/gastrointestinal-disorders/symptoms-of-gastrointestinal-disorders/gas-related-complaints?redirectid=246?ruleredirectid=30, https://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/approach-to-the-patient-with-liver-disease/ascites, https://www.cdc.gov/cancer/ovarian/basic_info/symptoms.htm, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7122060/, https://www.cancer.org/cancer/stomach-cancer/detection-diagnosis-staging/signs-symptoms.html, https://iffgd.org/gi-disorders/symptoms-causes/bloating-and-distension/, https://www.merckmanuals.com/professional/gastrointestinal-disorders/gastritis-and-peptic-ulcer-disease/helicobacter-pylori-infection. Click here for an email preview. Accessed Jan. 16, 2020. Hyperparathyroidism causes smooth-muscle atony, with upper and lower gastrointestinal symptoms . However, these aren't clear heralds of hyperparathyroidism, and people often discount them and don't seek medical attention for them. Try our Symptom Checker Got any other symptoms? Keep active and get more exercise to keep your bones strong. Primary hyperparathyroidism, caused by a solitary adenoma,leadingtopancreatitis. Since you have only recently found out that you have high calcium and potentially an adenoma, maybe your Endo was planning to do a scan to try and locate where your parathyroid adenoma is as well as a check of your thyroid nodules. Stay on top of latest health news from Harvard Medical School. Registered in England and Wales. Most people who have it have just one growth on one of the glands (an adenoma). But once the adenoma has been removed, then you can take Vit D and Calcium. health information, we will treat all of that information as protected health Use of the forums is subject to our Terms of Use In contrast, the cause of IBS is unknown and is often diagnosed when there is no specific reason for symptoms. Sorry to trouble you but you know more than I will ever with this and I need to make myself well. Your provider may order a sestamibi scan to check for any growths on your parathyroid glands or enlargement of the gland(s). Bloating is primarily a sensory phenomenon in the small intestine; patients . I have not heard about not taking Vit D before a blood test - I only found that out once I had been in contact with my surgeon. Take care. It can be rather confusing. My husband took pictures of it on his mobile and emailed them to the nurse to get checked and they said it was all normal bruising - and it was. Ovarian cancer. Accessed Jan. 16, 2020. I have a tremor in my neck, and physically tired and short tempered. Normally, bloating that follows a predictable pattern is not a worry. Upper abdominal bloating may be related to slow movement of the intestine called gastroparesis, swallowing air while eating, an infection, or overeating. https://www.niddk.nih.gov/health-information/endocrine-diseases/primary-hyperparathyroidism. PTH will also be tested. God Bless and look forward to hearing how it all goes. To provide you with the most relevant and helpful information, and understand which Bloating can usually be safely treated at home by using lifestyle changes, home remedies, or over-the-counter (OTC) medications. It's important to get a prompt, accurate diagnosis and the right treatment. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. Surgery by an experienced surgeon can cure hyperparathyroidism in about 95% of cases. 1 Such calcification can also occur in the stomach, kidneys, heart, and blood vessels, with the lungs being particularly susceptible to such an occurrence. Common gas-causing offenders include beans, peas, lentils, cabbage, onions, broccoli, cauliflower, whole-grain foods, mushrooms, certain fruits, and beer and other carbonated drinks. A single copy of these materials may be reprinted for noncommercial personal use only. These high hormone levels can be the body responding appropriately to keep the calcium in the standard range, or they may be inappropriately elevating the calcium in the blood. Most doctors know little about PHPT and either dismiss the high calcium or give you the wrong diagnosis. PTH is tested in the operating room after the abnormal parathyroid gland is removed. Thiazide diuretics and lithium can also cause hypercalcemia, so if PTH is high in people taking either drug, they should temporarily halt drug therapy, if possible, and have repeat PTH and calcium tests two or three months later. Hope this helps. These chronic symptoms may lead to osteoporosis or weight loss in some people. We then stayed in Florida for a 2-week holiday after my op, we hired a car and went to Clearwater first and then onto Fort Myers for a relaxing time, we had a wonderful stay. Registered number: 10004395 Registered office: Fulford Grange, Micklefield Lane, Rawdon, Leeds, LS19 6BA. These days, some people with primary hyperparathyroidism do have such symptoms. Regarding anything going wrong, it's virtually unheard of in Tampa, they have an almost 100% success rate and in any case the hardest cases are usually the people who have already had at least one failed surgery because every surgery causes scar tissue and that gets in the way (and can also resemble cancer under the microscope). This is similar to how a thermostat controls a heating system to maintain a constant air temperature. The adenoma causes the gland to overact and make more PTH. Is the ketogenic diet right for autoimmune conditions? (I went to a specialist clinic in Florida to have mine removed). Ketamine for treatment-resistant depression: When and where is it safe? You may be at an increased risk of primary hyperparathyroidism if you: Complications of hyperparathyroidism are mainly related to the long-term effect of too little calcium in your bones and too much calcium in your bloodstream. Advertising on our site helps support our mission. the unsubscribe link in the e-mail. You may still be constipated even if you have regular bowel movements. not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in The fact that your calcium has come down a little bit is irrelevant. Good luck with sending in all your details, I will keep my fingers crossed that they will be able to carry out your surgery after analysing your results. [ 17] A helpful mnemonic, "painful bones, renal stones, abdominal . Crohns disease and IBS often produce bloating. Patient does not provide medical advice, diagnosis or treatment. 94, No. Are a woman who has gone through menopause, Have had prolonged, severe calcium or vitamin D deficiency, Have a rare, inherited disorder, such as multiple endocrine neoplasia, type 1, which usually affects multiple glands, Have had radiation treatment for cancer that has exposed your neck to radiation, Have taken lithium, a drug most often used to treat bipolar disorder. People can often treat bloating at home, but some causes may need medical attention. If a person is also experiencing unexplained weight loss, theyre more likely to have Crohns disease. Make a donation. A noncancerous (benign) growth, called an adenoma, forms on a single parathyroid gland. Bloating can be linked to diarrhea or stomach pain and will go away by removing the problem-causing food. This causes high calcium levels in the blood, which can cause a variety of health problems. It is unclear if it is due to gastrointestinal issues (upset stomach & constipation) or the metabolic effects a person may experience due to elevated calcium & PTH, probably both. El-Hajj Fuleihan G, et al. I'm getting a lot of gas, reflux and nause. Vitamin D also is involved in controlling the amount of calcium in your blood. Always speak to your doctor before acting and in cases of emergency seek Thanks for visiting. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (http://www.niddk.nih.gov/health-information/health-topics/endocrine/primary-hyperparathyroidism/Pages/fact-sheet.aspx). If you have primary hyperparathyroidism, your blood test will show a higher-than-normal levels of calcium and parathyroid hormone. FHH is ruled out with urine tests in order to avoid unnecessary parathyroid surgery. Every 12 years at the forearm, hip, and spine. The thyroid treatment if it is necessary, is done in addition to the parathyroid surgery. Sometimes one or more of the parathyroid glands produce high amounts of parathyroid hormone. However weight gain, constipation, and pain could also occur. But some people inherit a gene that causes the disorder. Persons may also have piercing abdominal pain. A radiolabeled compound (technetium sestamibi) is injected into a vein and is taken up preferentially by the abnormal parathyroids. You are right to trust your instincts and not choose the surgeon you were told only operates on the thyroid. Technically, bloating is a temporary feeling of fullness, usually due to intestinal gas, while abdominal. Accessed Jan. 16, 2020. In Tampa they do approx 3 re-ops every day because the patients weren't cured the first time around. A noncancerous growth (adenoma) on a gland is the most common cause. Well, if I was in your shoes I would forget your doctors (like I did) and get your paperwork ready to send to Tampa if you do intend to go there. Organic causes Because I was one of the 20% of people whose adenoma wasn't behind the thyroid (it was deep under my collar bone buried in my thymus gland), they had to dig a bit deeper to remove it and I had a lot of bruising but then I was also on steroids for the presumed polymyalgia that wasn't and when you are on steroids you do bruise very easily. Significant recent weight gain, which tends to be stored as intra-abdominal fat and may restrict digestion. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Ascites, a pool of fluid in the abdominal cavity is another condition that leads to abdominal pain and bloating. Mine wasn't in the usual place behind the thyroid but deep under my collar bone in the top of my chest buried in my thymus gland. National Institute of Diabetes and Digestive and Kidney Diseases. They can work out from all their information how much calcium+Vit D/what dose they need to give you and they give you a packet of calcium tablets to take away with you. If it does, surgery is over. These individuals should see a doctor if the bloating coincides with: The stomach and intestines are home to various bacteria, which help the body digest food. To confirm the hyperparathyroidism diagnosis, an endocrinologist may order additional tests for blood levels of phosphorus, vitamin D, creatinine, and biomarkers of bone turnover, as well as bone density testing using standard dual energy x-ray absorptiometry scanning. I thought perhaps its from the surgery i had 5 months ago for gerd and Hiatal Hernia repairit was during my recovery that we discovered this because i had palpitationsnow we discover its parahyperthyroid. Primary hyperparathyroidism occurs when one or more of these glands become enlarged and produce too much PTH, raising the level of calcium in the blood above the normal range. other information we have about you. It's not usually serious, but it's a good idea to avoid . Impression: Liz has a goiter in the setting of a history of a previous fine needle aspiration w/benign cytology.This all dates back 2015Now 6/21/2016 right thyroid lobectomy for benign disease 40 yrs ago. They include: lactose intolerance acid reflux constipation intestinal obstruction dyspepsia (indigestion) viral. Get calcium through food sources, not calcium supplements. Palliative care frightens some people: Heres how it helps, Parents don't always realize that their teen is suicidal. I was told by a doctor here in the UK that if the Sestamibi scan didn't show an adenoma then they would not operate so I would have been even sicker by now if I had not gone to Tampa. I hope this info helps. Common symptoms of bloating include stomach pain, discomfort, and gas. Your body responds by: Approximately 100,000 people develop hyperparathyroidism in the United States every year. In the States PHPT is known by the pneumonic "itchy, twitchy, witchy and bitchy" because of the symptoms and in the UK doctors learn the symptoms by the pneumonic "bones, stones, moans, groans and psychiatric overtones". Secondary hyperparathyroidism is the result of another condition that lowers the blood calcium, which then affects the gland's function. Proton-pump inhibitors: Should I still be taking this medication? Hormone replacement therapy. But since you should not take Vit D (or calcium) when you have PHPT, if I were you I would stop taking it period. You have to send in a series of results for them to compile a personal chart for you and they can then confirm whether you definitely are likely to have an adenona looking at the blood results and if there are any other issues that could prevent your surgery. Patient aims to help the world proactively manage its healthcare, supplying evidence-based information on a wide range of medical and health topics to patients and health professionals. They are very obliging. You may opt-out of email communications at any time by clicking on Sounds bonkers to me. Which country are you in, I don't think you are in the UK??? The question is, who? All rights reserved. I know only too well just how bad this disease makes you feel. Although cinacalcet is intended for secondary hyperparathyroidism, some healthcare providers prescribe it for primary hyperparathyroidism. Read our editorial policy. Stomach infections usually go away on their own after a few days. According to John Hopkins Medicine, constipation is the most common digestive condition in the United States. It is updated regularly. Kidney stones. Get helpful tips and guidance for everything from fighting inflammation to finding the best diets for weight lossfrom exercises to build a stronger core to advice on treating cataracts. They also do their own ultrasound just prior to operating. The Endocrine Society. I am making an appt with the primary dr and have him figure this all outthen why do i feel the way i do? MPC is a process in which calcium deposition occurs in pulmonary tissues as a result of an excessively high serum calcium level. Rosemary Will they have me on meds when i leave? Abdominal bloating and shortness of breath can sometimes occur together. An elevated calcium and a raised PTH are the classic signs of this disease. The thyroid is different to the parathyroids. This damage or dysfunction is due to high calcium levels in the blood and urine or too little calcium in bones. Chronic bloating caused by fluid retention could have a more serious cause, such as liver or kidney failure or diabetes. These symptoms are easily treated with home remedies, lifestyle changes, OTC medications, and prescription medications. Regarding the depression-type symptoms, the Tampa website has a blog written by a Psychiatrist who says that people don't just suddenly develop depression-type symptoms and that when doctors refer patients to her, the first thing she does is have them do a blood test to see if their calcium is high because so many patients are misdiagnosed with depression and given antidepressants when in fact it is being caused by the high calcium. Usually, the cause is a benign (noncancerous) tumor, or adenoma, in a single parathyroid gland. Best food forward: Are algae the future of sustainable nutrition? Over time, increased parathyroid hormone levels occur as the body fights to keep the calcium level up in the standard range. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. "Guidelines for the management of asymptomatic primary hyperparathyroidism: Summary statement from the Third International Workshop," Journal of Clinical Endocrinology and Metabolism (Feb. 2009), Vol. Indigestion, sometimes called dyspepsia, is discomfort or pain in the stomach that can include bloating. Too much PTH signals your body to make more calcium available. They tell you to get your calcium and PTH checked by your doctor 2 months after the op once everything has settled and the normal 'dormant' parathyroids have woken up and both readings should be back in the normal range by then. Cinacalcet (Sensipar) is a drug that helps normalize calcium levels by acting on the calcium-sensing receptors in the parathyroid glands to reduce PTH levels. I have noticed that people have a habit of saying "my surgeon was good, he didn't cure me, but he was really nice"!! 33539. In: Ferri's Clinical Advisor 2020. There isn't any real need for them to speak to you once you go back home. This is called tertiary hyperparathyroidism, and people with this condition may require surgery to remove parathyroid tissue. Hyperparathyroidism. Most people have not heard of the parathyroid glands and when you say parathyroid, they still think you mean thyroid. If the bloating does not go away, a person should speak with a doctor. A blood test to check your vitamin D level. U.S. Department of Health and Human Services and U.S. Department of Agriculture. Some consider weight loss an indication for surgery. Energy-boosting coffee alternatives: What to know. Cinacalcet (Sensipar) has been approved by the Food and Drug Administration for the treatment of secondary hyperparathyroidism. This causes parathyroid hormone levels to go up. Think positive. For example, try walking or moving around, using an antacid or antigas medicine, drinking some water, or using a heating pad. Experts acknowledge that medical management might be appropriate for people who don't meet the criteria for surgery (see "Decision factors for surgery in asymptomatic primary hyperparathyroidism") or who can't or won't undergo the surgery. When a patient has symptoms secondary to PHPT induced hypercalcemia, classically, PHPT targets the kidney and the skeleton. I hope this helps. What are the symptoms? 6 users are following. But my Tampa surgeon found and removed it in about 20-30 mins. This causes your parathyroid glands to overwork and produce high amounts of parathyroid hormone to maintain or restore the calcium level to the standard range. A bone density test to check for bone loss. In experienced hands, this operation has few complications, and it cures the condition 95% to 98% of the time. We want the forums to be a useful resource for our users but it is important to remember that the forums are Feb. 28, 2022. Hypercalcemia (High Level of Calcium in the Blood). As a service to our readers, Harvard Health Publishing provides access to our library of archived content. https://www.bones.nih.gov/health-info/bone/osteoporosis/conditions-behaviors/bone-smoking. However, this is where it gets confusing - behind the thyroid gland there are 4 tiny PARAthyroid glands which regulate the calcium level in the blood to within a tight range (as I explained earlier). We do not endorse non-Cleveland Clinic products or services. This is usually because an elevated level of calcium is found on routine blood tests. Caught early, treatment can prevent complications. It is a disease that can be cured - if the adenoma is removed. Menstruation, which causes water retention. Hyperparathyroidism is caused by factors that increase the production of parathyroid hormone. There are two types of hyperparathyroidism, primary and secondary: Causes of primary hyperparathyroidism include: If you have early hyperparathyroidism, you may not have any symptoms. https://www.uptodate.com/contents/search. The parathyroids just happen to be situated behind the thryoid anatomically but they have nothing to do with the thyroid, they have a different role in the body. By the way, one last thing, the adenoma needs to be removed all in one piece. London: National Institute for Health and Care Excellence (UK); 2019 May. https://www.micromedexsolutions.com. A word of caution - when you have high calcium, you should NOT take Vitamin D (or calcium supplements) as this will make you feel worse and will not help. But some people inherit a gene that causes the disorder. Most people go out to dinner afterwards the same evening. The most common cause of this fluid buildup is liver disease. Thank you, Rosemary. Cleveland Clinic is a non-profit academic medical center. Sometimes all 4 glands are enlarged (4-gland hyperplasia) but in most cases it usually means just one gland has developed a growth and is producing more PTH than it should and this causes the calcium level to be higher than it should be. Chronic kidney failure. Less commonly, abdominal bloating may be due to other serious conditions. Last medically reviewed on June 19, 2022, Bloating after eating is a feeling that most people experience occasionally. When it causes kidney or bone disease or severe symptoms, primary hyperparathyroidism almost always calls for parathyroidectomy removal of the enlarged parathyroid gland (or glands). Two CT patterns of pulmonary calcification have been described: diffuse or patchy areas of ground-glass opacity . I know it takes a while to get over an operation, but a lot of your symptoms are also those of PHPT and of course despite your op, you won't feel as well as you might expect because you have high calcium (hypercalcaemia) which in itself makes you feel unwell. In primary hyperparathyroidism, one or more parathyroid glands produce more PTH than needed, raising calcium levels above the normal range. This can cause various symptoms, commonly tiredness, feeling sick (nausea), being sick (vomiting), kidney stones and bone pains. You are right to trust your instincts and not choose the surgeon you were told only operates on the thyroid. Pathogenesis and etiology of primary hyperparathyroidism. These 4 glands just happen (normally) anatomically to be located behind the thyroid gland and regulate the body's blood calcium level. However, some people may become severely dehydrated or continue to get worse over several days. These drugs help prevent loss of calcium from bones, which reduces the risk of fracture and osteoporosis. This disease wrecks your life. information is beneficial, we may combine your email and website usage information with I wish you all the best, let us know how you get on after your blood test on Monday. Really?? If possible, avoid thiazide diuretics and lithium therapy, which can contribute to hypercalcemia. I can't wait to have it done as i dont feel myself at all. I am soooo glad I went there. (n.d.). So far, only small studies suggest the combination of the two drugs may have some benefit. Constipation. The adenoma will need to be removed. They do not want people to have any scans done before going to them because they do their own 15-20 minute Sestamibi scan. Source: Adapted from Bilezikian JP, et al. We are having a few more days away this Tuesday too - trying to make the most of the sun! God Bless and look forward to hearing how it all goes. I had it for at least 6 years and was really ill before I got it fixed. No. I am so sorry to hear that you are feeling so awful and I really can empathise because that's how I felt. If it is broken on removal, little pieces can seed all round your neck. Rarely, bloating is a sign of something more serious. You feel like you are going round in circles - because you have some better days it makes you think sometimes you are imagining things but you really are not, that is the nature of this nasty disease. Instead, your provider will monitor your blood calcium levels (every six months), blood pressure (every six months), kidney function (every year), and bone density (every one to three years).
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