Fatigue snuck up slowly and settled over Alexis Dominguez before she knew it was there.
She only realized it once the panic attacks hit - anxiety so bad that she would wake up in the middle of the night to make sure her children were safe. Her once-normal blood pressure rose too high.
When she finally went to the doctor, there was one other surprise – another number that was just a little high.
Her blood calcium.
Fortunately for Dominguez, a Tampa dentist, her doctor immediately suspected what was wrong. Her solution: a 15-minute operation at Tampa General Hospital that made Dominguez feel better within a day.
“It was almost an instant cure,” says Dominguez, who had surgery the day before Thanksgiving in 2015 and was able to attend her family’s celebration the next day.
Dominguez’ story is a familiar one to her surgeon, Dr. Jim Norman, FACS, FACE, director of the Parathyroid Center at Tampa General Hospital. Norman and his colleagues do thousands of these operations each year. Dominguez had a benign tumor on one of her tiny parathyroid glands. Normally the size of a grain of rice, it had swollen to the size of a lima bean, causing her blood calcium levels to rise.
Calcium runs the electrical system in our nerves, Norman says. The neck’s four parathyroid glands produce hormones that usually regulate calcium precisely.
“Just as the voltage system in our house should be 120 volts with no variability,” he says, “Our blood calcium should be 9.7 with no variability.”
One of Norman’s biggest frustrations is that many patients are told their calcium level is “a little high” and only needs to be monitored. Adults over 40 should never have calcium levels over 10 mg/dl, he says. Given national rates of the disease, Norman estimates there are at least 20,000 people with untreated parathyroid disease just in the Tampa Bay area.
“People aren’t being treated because they’re being told their calcium is ‘not that high,’ ” he says, “but they don’t understand that just “a little high” makes people feel bad.”
When blood calcium rises even just a little bit, it can cause fatigue, depression, sleep difficulties, mood changes, and a general sense of feeling unwell. Too much calcium leaching out of your bones may cause them to ache.
The elevated calcium levels in the blood also means there’s less calcium for bones, so patients with a parathyroid problem often get osteoporosis. The high blood calcium also can cause kidney stones, and a series of cardiovascular problems, from high blood pressure to heart arrhythmias. It increases the rates of some cancers.
A parathyroid tumor may not kill you, Norman says, but “you’ll die five to 7 years younger than you otherwise would.” Many of his patients come in taking blood pressure medications, anti-depressants and other drugs.
Norman, whose surgical team performs the tumor removal procedure more frequently than elsewhere in the U.S., says it’s important that surgeons check each gland for disease. Surgeons also need to have the skill to not disturb nerves around the vocal cords or other delicate structures.
For Dominguez, having the surgery meant immediate changes. She stopped waking up at night. Her high blood pressure vanished, as did the anxiety. Best of all, she has more energy to
devote to her dental practice and her two children, ages 6 and 3. These days, she wakes up at 4 a.m. to go to 5 a.m. gym classes.
“I feel more like myself,” she says. “I’m much more active now.”
Most of us don’t know much about the thyroid and parathyroid glands – those small organs in our neck that produce hormones – until there’s a problem. You can read a related story about cancer in the thyroid gland here.
Photos by Daniel Wallace, TGH Health News.