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Summary part I ---Parathyroid and Celiac
1. Four people replied with their experiences:
A blood test showed that I had something wrong with mine. I had some minor
symptoms, nothing that was real bad. A tumor the size of a golf ball was on
one of them, it was removed and another scraped off. These are things about
the size of a grain of wheat. It was about six years ago.
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I had mildly high calcium, low phosphorous. Actually wasn't all that sick
but knew something was definitely wrong. Had one parathyroid adenoma removed
almost 2 years ago and calcium dropped immediately to normal. Diagnosed 3
yrs ago with celiac.
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I was diagnosed with celiac disease in November 2001, but I had my
parathyroid gland removed about 4 years ago. I have been told that if I was
following the gluten free diet I might not have had to have the gland
removed. BUT I'm not sure the information is entirely correct and anyway the
gland was removed long before the celiac disease was diagnosed.
The surgery to remove my parathyroid was relatively pain free but I went to
The University of Pennsylvania Hospital, a teaching hospital and my surgeon
was very experienced at this type of surgery. I would recommend looking for
such a surgeon and hospital. I have read that sometimes the gland is hard to
find. Before the surgery there is a test to determine which gland (there are
four) needs to be removed.
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I'm English, coeliac age female age 49 and I had hyperparathyroidism 3 years
ago with high calcium levels and parathyroid hormone levels in my blood.
After a year I had the operation to remove the enlarged gland in my neck and
am now apparently cured but I have to have blood calcium tests every year to
check things are ok. I had to have the 'old gold standard' operation here in
England as the new localised surgery isn't yet available here. I really
suffered for about 6 months after the operation, I lost my voice for several
months and I had a lump in the front of my throat that made me feel awful but
things have got better now, my voice is improved but still weak at times and
there is still the feeling of the lump there so I suggest your friend
definitely tries to get the new operation rather than the old one. My
operation was a slit across the front of the throat and the skin was
stretched back to view all 4 parathryoid glands, 2 on each side of the neck.
I wish I'd been able to have the localised surgery.
2. Two websites were recommended.
http://www.lef.org/protocols/prtcl-087.shtml
http://www.endocrineweb.com Search or click on parathyroid.
3. Ron Hoggan responded with comments and references to 10 journal articles.
Endomysium antibodies, which are usually present in untreated celiac disease,
have been shown to cross react with parathyroid tissue (1, 2). Thus, it
should not be surprising that hypoparathyroidism is often found in the
context of untreated celiac disease (3, 4, 5, 6, 7, 8, 9). Nor should it be
surprising that magnesium supplementation alone can provide considerable
benefit to celiac patients who have suffered bone mineral losses (10). Such
losses are typical of this group of patients. Because magnesium is important
to parathyroid maintenance and repair, these findings implicitly suggest that
the autoimmune attack on the intestinal wall may be echoed by similar
autoimmune damage to the parathyroid gland.
Sources:
1: Kumar V, Valeski JE, Wortsman J. Celiac disease and hypoparathyroidism:
cross-reaction of endomysial antibodies with parathyroid tissue. Clin Diagn
Lab Immunol. 1996 Mar;3(2):143-6.
2: Wortsman J, Kumar V. Case report: idiopathic hypoparathyroidism
co-existing with celiac disease: immunologic studies.
Am J Med Sci. 1994 Jun;307(6):420-7.
3 Arnala I, Kemppainen T, Kroger H, Janatuinen E, Alhava EM. Bone
histomorphometry in celiac disease. Ann Chir Gynaecol. 2001;90(2):100-4.
4: Valdimarsson T, Toss G, Lofman O, Strom M. Three years' follow-up of bone
density in adult coeliac disease: significance of secondary
hyperparathyroidism. Scand J Gastroenterol. 2000 Mar;35(3):274-80.
5: Kariv R, Sidi Y, Malnick S, Gur H. Pathologic fractures, anemia,
hypercalcemia and hypocalciuria: an association between celiac disease and
hyperparathyroidism. Isr Med Assoc J. 1999 Dec;1(4):280-1.
6: Selby PL, Davies M, Adams JE, Mawer EB. Bone loss in celiac disease is
related to secondary hyperparathyroidism. J Bone Miner Res. 1999
Apr;14(4):652-7.
7: Gannage MH, Abikaram G, Nasr F, Awada H. Osteomalacia secondary to celiac
disease, primary hyperparathyroidism, and Graves' disease. Am J Med Sci.
1998 Feb;315(2):136-9.
8: Shaker JL, Brickner RC, Findling JW, Kelly TM, Rapp R, Rizk G, Haddad JG,
Schalch DS, Shenker Y. Hypocalcemia and skeletal disease as presenting
features of celiac disease. Arch Intern Med. 1997 May 12;157(9):1013-6.
9: Keaveny AP, Freaney R, McKenna MJ, Masterson J, O'Donoghue DP.
Bone remodeling indices and secondary hyperparathyroidism in celiac disease.
Am J Gastroenterol. 1996 Jun;91(6):1226-31.
10: Rude RK, Olerich M. Magnesium deficiency: possible role in osteoporosis
associated with gluten-sensitive enteropathy.
Osteoporos Int. 1996;6(6):453-61.
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