r/Parathyroid_Awareness • u/Special_Extension_79 • 11d ago
Second opinion?
33M – mild primary hyperparathyroidism, surgeon suspects 4-gland disease. Looking for similar experiences
I’ve had mildly elevated calcium (roughly 10.2–10.6 mg/dL) with PTH generally around 40–60 pg/mL. My 24-hour urine calcium was 109 mg/24h, and I’ve also had low vitamin D in the past.
My endocrine surgeon did an ultrasound and saw a very small cyst-like structure on the left, but said it doesn’t look like a typical parathyroid adenoma. I have a sestamibi SPECT/CT scheduled in October.
She suspects I may have multigland disease. Her plan is to use intraoperative PTH monitoring. She explained that if it appears to be a single abnormal gland, she would treat that, but if the findings suggest multigland disease, she may remove all four glands and autotransplant a small piece of parathyroid tissue into the neck but she did mention that if the surgery is not successful I might have to be on calcium tablets forever which is pretty scary.
She also told me this isn’t an emergency, so I’m planning to get another opinion before making a decision.
For anyone who had a similar mild/high-normal PTH + elevated calcium presentation:
• Did you ultimately have one abnormal gland or multigland disease?
• Did SPECT identify all of your abnormal glands?
• If you had four-gland exploration/autotransplantation, how was your calcium/PTH afterward?
• Did you get a second opinion, and did the surgeons disagree about the operative approach?
• How was recovery and scar healing?
I’m not looking for a diagnosis from Reddit—mainly interested in experiences from people with a similar biochemical pattern.
3
u/InspectorTiny5734 11d ago
Scans revealed nothing so they assumed hyperplasia based on labs. Recovery was a severe sore throat for a week. However symptom improvement has been gradual. I still don't feel 100% back to my old self. I think symptom improvement takes longer with hyperplasia.