This app will help you and your doctor diagnose hyperparathyroidism by analyzing and graphing your information. The more of your data you enter into this app, the better your analysis will be and the easier it will be for you and your doctor to decide if you do or do not have primary hyperparathyroidism.
The physicians at the Norman Parathyroid Center who have developed this app have evaluated over 30,000 patients for the presence of hyperparathyroidism. The primary reason we developed this app is because most doctors, and even many endocrinologists do not know how to diagnose primary hyperparathyroidism. Most doctors make the diagnosis of hyperparathyroidism too complex, looking for strange, rare things and ordering far too many tests. Many times they are unsure, so they will “monitor” and keep checking the blood for months or years. Many times doctors will confuse primary hyperparathyroidism with vitamin D deficiency (this app should help you tell the difference quite easily). Often the terminology of “secondary hyperparathyroidism” will surface, and again, this app should prevent this confusion. Endocrinologists often order many tests and repeat these tests several times, often providing vitamin D “to see if the vitamin D changes your calcium and PTH levels”. Hopefully this app will prevent these maneuvers and the delay in diagnosis that is so common in this disease. Please, use this tool with your doctor so you both can learn from it. Remember, high calcium is not normal and it is almost always caused by a parathyroid tumor. The longer this tumor remains, the worse your health is likely to become.
The diagnosis of primary hyperparathyroidism is made by examining a number of tests: blood calcium, parathyroid hormone (PTH), vitamin D, and ionized calcium, combined with a few other items like the patient’s age, sex, history of kidney stones, and presence of osteoporosis. A few tests that are often obtained by doctors actually have very little value in making the diagnosis of primary hyperparathyroidism, including the 24 hour urine test and blood phosphorus levels. Importantly, diagnosing primary hyperparathyroidism correctly requires that these different tests be examined at the same time in combination with one-another because the result of one can have a direct effect on another. This comparison of multiple test results at the same time is something that a computer can often do better than a doctor—especially a doctor who hasn’t seen thousands of cases of this disease and the various different ways it presents itself.
Hyperparathyroidism is unique in that it can be diagnosed without a doctor touching or examining the patient. Parathyroid tumors cannot be felt (even the really big ones can’t be felt by a doctor), so having a doctor feel your neck to see if a parathyroid tumor is present is unnecessary. Hyperparathyroidism is also unique in that x-rays and scans have no role in the diagnosis of this disease. Scans such as sestamibi parathyroid scans, ultrasound, MRI and CAT scans cannot be used to diagnose hyperparathyroidism, so a doctor that orders a scan to “see if a tumor is present” is not going about this correctly. Although scans can be useful to help a surgeon plan and conduct the operation, scans are not to be used to determine if a person has a parathyroid tumor. Scans are not diagnostic tools. Furthermore, scans and x-rays should not be used to determine which patients should have surgery and which patients can be “observed” for a while. Scans are way over-used and one of the reasons this app was developed. In general, it is a mistake to make a decision about this disease based upon the results of a scan. Doctors need to stop ordering so many scans. Scans are wrong more than they are right.
About 90% of cases of primary hyperparathyroidism are very easy to diagnose (and this app will make these cases very clear to you and your doctor). About 10% will be more difficult to diagnose and the “art” of medicine and doctor experience becomes very important. Most cases (94%) will have frequent or persistent elevations of blood calcium. This alone makes the diagnosis of primary hyperparathyroidism very likely because very few other diseases can cause high blood calcium. About 6% of cases of primary hyperparathyroidism will have normal blood calcium (or only rare high blood calcium). This is called “normo-calcemic, primary hyperparathyroidism”. These cases can be more difficult to diagnose, and are typically found in patients with advanced osteoporosis where the doctor is looking for reasons for the bad osteoporosis. Remember, even a slightly high calcium level is inappropriate and should be investigated.
Our goal is that this app will allow you and your doctor to come up with the proper diagnosis in a timely fashion that did not take years, many blood tests, and unnecessary scans to accomplish.
For more detailed information on this topic: http://www.parathyroid.com/hyperparathyroidism-diagnosis.htm . Advanced diagnostic information can be found here: http://www.parathyroid.com/hyperparathyroidism-diagnosis.htm