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ParathyroidAtlanta, Tucker, GA (2025)

11/03/2025

What Are the Symptoms of Abnormal Parathyroid Hormone Levels?

Parathyroid hormone (PTH) helps your body keep calcium in a healthy range. When PTH is too high—most often from primary hyperparathyroidism (PHPTH)—your calcium level can rise. High calcium and high PTH can affect many parts of your body, so symptoms can seem unrelated at first. You might notice one or two symptoms—or many. Not everyone has all of them.

Common symptoms with elevated PTH (often from PHPTH):
• Fatigue and low energy
• Brain fog or trouble with memory and focus
• Bone loss (osteoporosis) or fractures
• Kidney stones or frequent urination
• Bone and joint pain or aches
• High blood pressure
• Anxiety or depression or mood changes
• Gastrointestinal issues like nausea, constipation, or abdominal discomfort

Why do these happen? High PTH tells your bones to release calcium, your kidneys to keep more calcium, and your intestines to absorb more calcium. Over time, this can raise blood calcium and stress bones and kidneys, which leads to symptoms like fractures or stones. Mood and thinking can also be affected.

If you have symptoms—or repeated high calcium on blood tests—talk with your clinician. Diagnosis is based on labs (calcium and PTH together), sometimes repeated more than once. If you’re taking biotin (found in many hair/nail vitamins), stop it for about a week before PTH testing because it can skew results. The decision for or against treatment is best made with an experienced parathyroid surgeon, who can review your case and discuss options. For primary hyperparathyroidism, surgery is the only cure.

This information is educational and not a substitute for medical advice. Talk with your own clinician about your situation.

10/29/2025

“My calcium is always high, but my PTH is ‘normal.’ Can it still be hyperparathyroidism?”

Yes—it can. When your blood calcium is high, healthy parathyroid glands should shut down and make very low PTH. If your PTH is still in the “normal” range while calcium is high, that PTH is inappropriately normal—it isn’t responding the way it should. This pattern can still mean primary hyperparathyroidism (PHPTH).
To make the diagnosis, your clinician should look at calcium and PTH together, not each number alone. A high calcium paired with a PTH that is not suppressed (high normal or high) supports PHPTH. Sometimes one set of labs is not enough. If the results are borderline or confusing, it’s common to repeat testing—often more than once.

For the most useful information, it helps to draw calcium and PTH at the same time, ideally in the morning. This keeps conditions consistent and makes the results easier to compare. Also, be aware that biotin supplements (often found in hair/nail vitamins) can interfere with some PTH tests and make the result look lower than it truly is. If you take biotin, it’s best to stop for about a week before testing (ask your clinician first).

Finally, decisions about testing and treatment are best made with an experienced parathyroid surgeon. They can review your history, symptoms, medications, and lab trends to confirm the diagnosis and discuss whether surgery is right for you.

This information is educational and not a substitute for medical advice. Talk with your own clinician about your situation.

10/13/2025

“My scans were normal—do I have to wait to see which gland is abnormal?”

Short answer: No. You can still be a good candidate for surgery even if your sestamibi scan and ultrasound look normal. Primary hyperparathyroidism (PHPTH) is diagnosed by your blood tests—a high calcium with an inappropriately high parathyroid hormone (PTH). Ultrasound and sestamibi can help plan surgery, but they are not required to make the diagnosis.

Why do scans sometimes look normal? Parathyroid glands are tiny and sit close to the thyroid. Normal glands are almost never seen, and a small overactive gland may blend in, or it may sit behind the thyroid or lower in the neck where it’s hard to see. Ultrasound is also operator-dependent: subtle findings can be missed by people who do not perform or read these tests often. An expert review can sometimes spot clues that others overlook.

Most important: the decision for or against surgery should be made with an experienced parathyroid surgeon. High-volume surgeons know how to plan an operation even when imaging is negative. Their goal is to cure the disease safely, with the lowest risk. They will match your labs, your symptoms, and any imaging to choose the best approach. If a scan later helps localize a gland, great—it can refine the plan. But a “perfect” scan is not a must-have before surgery.

Bottom line: Don’t delay treatment you need while waiting for a scan to “light up.” If your labs confirm PHPTH, talk with a surgeon who treats this every week and can walk you through cure rates, risks, and next steps for you.

This information is educational and not a substitute for medical advice. Talk with your own clinician about your situation.

10/08/2025

“They saw a thyroid nodule on my ultrasound—should I be worried?”

If you’re being checked for primary hyperparathyroidism (PHPTH), you might have an ultrasound of your neck. Good news: an ultrasound is not needed to diagnose PHPTH. Diagnosis comes from your blood tests—a high calcium with an inappropriately high parathyroid hormone (PTH). That said, ultrasound can help your surgeon plan the safest and smallest operation.

It’s common for the ultrasound to show a thyroid nodule. Thyroid nodules are very common in adults and most are benign. Many do not need more testing. If a nodule looks suspicious or is large, your doctor may suggest a fine-needle aspiration (FNA) biopsy. This is a quick office procedure that helps decide next steps.

When we do surgery for PHPTH, we rarely remove incidental thyroid nodules at the same time. Why? Because the main job is to fix the parathyroid problem first, with the least risk. If a thyroid nodule truly needs attention, it can be handled either during the parathyroid surgery or separately, after careful review.

Also, sometimes a “nodule” that seems to be in the thyroid is actually an enlarged parathyroid gland sitting right next to it. Your surgeon will compare the imaging with your labs and, if needed, other scans to tell the difference.

Bottom line: focus on getting the right operation for PHPTH the first time. Choose an experienced parathyroid surgeon—someone who does this often, can explain their cure rates, and has a clear plan if a nodule shows up on imaging.

This information is educational and not a substitute for medical advice. Talk with your own clinician about your situation.

08/11/2025

Catching a Silent Condition: How Routine Tests Changed PHPT

You could feel perfectly healthy, yet have a condition quietly affecting your bones, kidneys, and heart. That’s the case with many people who have primary hyperparathyroidism (PHPT).
PHPT happens when tiny glands in your neck make too much parathyroid hormone (PTH), sometimes raising calcium in your blood. Left untreated, it can cause bone loss, kidney stones, and even heart problems.
Not long ago, PHPT was usually found only after people became very sick—often with severe fatigue, brittle bones, or painful kidney stones. But the story has changed. Modern blood tests automatically check calcium levels, so most cases are caught early—before symptoms start.

In the U.S., about 233 out of every 100,000 women and 85 out of every 100,000 men have PHPT. Many of these are “asymptomatic” cases—people feel fine, but their bloodwork says otherwise. Or the symptoms may be attributed to just getting older, working too hard, menopause, or one of many other conditions. Typical symptoms include lack of energy, tiredness, muscle fatigue, memory and concentration problems, bone pain, excessive thirst and urination.

Doctors have also uncovered a form called “normocalcemic PHPT,” where calcium is normal but PTH is high. This was spotted when osteoporosis patients were tested for PTH, even without high calcium.

Early detection has made a big difference—years ago, extreme PHPT could be deadly in 60% of cases. Today, with treatment, that number is closer to 6%.

The only cure for hyperparathyroidism is surgical removal of the abnormal gland. Fortunately the operation can be done as an outpatient, with a very low risk of complications, and immediate return to a normal calcium level.

If you believe you could be silently suffering from hyperparathyroidism or want more information, please give our office a call (404-508-4320). We would be more than happy to get you into our office so you can get on top of your parathyroid health. Don’t suffer in silence, get your calcium and PTH levels checked today.

09/09/2024

“My routine lab work report shows the calcium level of 10.4, and that is just outside the range of normal. My doctor doesn't seem concerned. Should I be concerned?”

If this question resonates with you, and you have been looking online for information, you are in the right place. It is amazing to me how many patients end up searching for themselves online for more answers about their calcium level. The short answer to the question above is, “yes, you should look into this more”.

Routine lab work includes measurement of many electrolytes in the blood, including sodium, potassium, chloride, bicarbonate, among others. Calcium level is often checked routinely as well. It should be no surprise that all these electrolytes have some range of normal across an entire population. Our bodies can tolerate more variation in some of these electrolytes than others. Calcium happens to be one that needs to be more tightly controlled for the body to function optimally. The other electrolytes mentioned above might fall out of the “normal" more often, without creating a problem. The calcium level is controlled more tightly, and if the level is too high or too low, you can have more significant effects on the body even with comparatively minor extremes.

I think physicians have come to be almost expecting that some of these numerous lab values might be slightly out of range, so if the calcium level is “just a little high”, they may fail to recognize the special attention that should be paid to a high calcium level, as opposed to for example, a slightly elevated sodium or potassium.
So what does it matter if your calcium level is just a little high? Well, I think a good analogy would be a high performance engine that needs a tune up. The car can run just fine, but it cannot perform to its capability without correcting the high calcium level. Most patients with a high calcium level will have some symptoms as a result, such as weakness, fatigue, concentration or memory issues, bone pain, among others. And if left untreated for a long time, can result in organ issues, like poorly functioning kidneys, aggravation of atherosclerosis which is related to heart attacks and strokes, kidney stones, irregular heart rhythms, and the list goes on.

So if you have a high calcium level, or basically a calcium level that is repeatedly above 10, you should check to see if you have hyperparathyroidism. It is so simple to check. Simply have another serum calcium level drawn with a simultaneous intact PTH level. PTH, short for parathyroid hormone, is what your parathyroid glands produce in order to raise the blood calcium level. This is a very important function, but the PTH level should only be high if your calcium level is too low. If your PTH level is still high, or even in the upper normal range, when your calcium is high, It means that one or more of your parathyroid glands is simply working overtime, and is creating the problem of a high calcium level, just like a poorly tuned high performance engine.

If you are diagnosed with hyperparathyroidism, it means we can reliably predict that one, sometimes more, of your parathyroid glands is overproducing PTH. In experienced hands, a simple outpatient operation can find and remove that abnormal parathyroid gland and restore your calcium level to normal. Period. Just like that. We can be certain of that, just based on those test results.

So if you are looking for answers about a high calcium level, get your parathyroid function checked. And if you do have hyperparathyroidism, let us help you get your high performance engine back in tune! You can find more information at our website, https://www.parathyroidatlanta.com/.

08/12/2024

I recently had a patient ask if I check the PTH level DURING the operation. The answer is, "not very often".

There are a lot of surgeons who use intraoperative PTH monitoring as a substitute for finding all four glands. Surgeons taking this approach go after the single gland that shows up on imaging, remove it, then do the blood test to see if it drops. If it drops they look no further. If it remains elevated they keep looking. This approach runs the risk of missing a second gland because the PTH level dropped some, masquerading the presence of another smaller but still overactive gland. What I and other more experienced surgeons have found is that it's best to just simply plan to find all four glands in every case. That way, you can be confident that the PTH level will drop, with only a 1-2% failure rate. I check the PTH level in the recovery room, which documents that you are cured.

03/29/2024

It's always humbling to receive letters of appreciation from patients whose lives have been favorably impacted by their parathyroid surgery. Some letters stand out, and the letter that follows is one of those.

Dear Dr. Kennedy:
I am writing to you to express my gratitude for your skillful hands and mind, which have saved me from profound misery and suffering. Over the last five years, I knew I was ill and that things in my body just were not right, but it was impossible for any of us to put the puzzle pieces together. I went from specialist to specialist, trying to understand each new symptom: pseudogout, muscle loss, weakness, inexorable fatigue, sudden 20-pound weight loss, depression with suicidal ideation, GERD, joint pain, burning bone pain, elevated blood sugar, spasms of hands and neck, difficult to control hypertension, osteoporosis, heart palpitations, dizziness and loss of balance (necessitating a cane on uneven surfaces), dry eyes and mouth, failing vision, difficulty swallowing, poor short term memory. dry skin, and thinning hair.
Despite all these problems, I soldiered on, intent on living my life to the fullest all the while accepting my mortality and decrepitude. Finally, after my routine bone density test, the pieces came together when I asked my primary care physician to refer me to yet another endocrinologist to explore my progression from osteopenia to osteoporosis. My new and third endocrinologist was the first to request both a calcium level as well as PHT which was 62 and later 71. This doctor was also the first to mention hyperparathyroidism. I researched that term and was shocked how all of my symptoms easily aligned with the list of hyperparathyroidism symptoms.
Armed with a spreadsheet, detailing the symptoms, date of onset and physician diagnosis, I was confident I would easily find a surgeon to remove the adenoma or adenomas from my parathyroid glands. I was shocked that one of the top endocrine surgeons would not suggest surgery, but watching and waiting, despite my pleas and obvious agony.
Luckily, my thorough research led me to you, Dr. Kennedy, a true healer and a compassionate man whose kindness and sincerity radiate healing energy. As a result of your skillful hands, two tumors were removed and a third suspicious gland biopsied. Today, I am healed in body and spirit. Thank you for opening this bright, new stage of my life.
In gratitude,
Charlene F. Clinton

12/30/2023

High Calcium -- “Watch and Wait”

My son was home for the holidays and suggested we watch a popular movie from last year, “Everything, Everywhere, All at Once”. It’s kind of a crazy movie, and to really understand it, you probably need to watch it about 3 times. Let me try to briefly explain the plot, so you’ll understand where I’m going with this.

The story revolves around a Chinese couple who find themselves traveling between multiple parallel universes, each universe moving toward a different outcome, according to choices made earlier in life. Though the plot is much more complex than that, let’s keep it simple for the purposes of this post

For those of you reading this who have a high calcium level, and a diagnosis of hyperparathyroidism is either suspected or already established, perhaps your doctor has recommended a “watch and wait” decision. I have had many patients who have taken that recommendation, maybe months, or even years ago. In the meantime, they have remained symptomatic, often with fatigue, memory and concentration problems, osteoporosis, bone pain, rapid heart rate, among other things. Having followed a “watch and wait” recommendation, they have lived in this universe of always feeling lousy, and no one seems to take them seriously about how badly they feel, and how “there must be something wrong”. Some of those patients have eventually taken matters into their own hands, and have found a surgeon such as me, who recognizes how dramatic the symptomatic improvement can be with a curative parathyroid operation. If they had only been referred for surgery much earlier, they might have lived in a “different universe”, one in which their symptoms were relieved so much earlier in their life.

If your current universe is one in which you know you have a high calcium level that might be or is already known to be from hyperparathyroidism, I recommend that you make a choice for prompt evaluation for possible surgery. It’s very likely to steer you into a future universe that’s free of many of the symptoms you might be suffering from on a daily basis.

For more information on hyperparathyroidism and high calcium, go to www.parathyroidatlanta.com.

12/22/2023

Another fun fact about calcium!!

TRUE or FALSE? Even a slight elevation in your calcium level, if it's due to a parathyroid problem (primary hyperparthyroidism) can have a major impact on your life. See the answer below:

TRUE!! Don't just take it from me. Here is a letter I recently received from a patient who had been suffering with typical symptoms for about 4 years, with a calcium level that was "only" in the low 10's. She recently underwent a simple outpatient operation to remove the overactive parathyroid gland and get her calcium and PTH back to normal.

"Dear Dr Kennedy,
I wanted to thank you again, for all of your help! I also wanted to give you a quick update on my progress!

My body seems to be healing by leaps and bounds since parathyroid surgery on xx/xx/23!

I'm now OFF all 4 of my BP meds (I met with cardiologist yesterday). My BP used to be in the 220/117 range (even with all the BP meds), and yesterday in his office it was 120/78 without taking any BP meds since November.

I've been able to stop my daily muscle relaxer /AND I've also cut back on pain meds for my lumbar spinal pain. Chronic fatigue is improving daily!!

A "normal day" for me before surgery was to struggle to get to work (and I work from home) by 9AM, and then I'd go right back to bed whenever I finished work. No hobbies, and I'd have to rest on all days off.

Since surgery, now I have no problem getting to (and thru) my work days, I'm also studying Japanese again AND planning a ski trip to Japan in Winter 2025 plus I hope to make it to the Philippines to visit friends on the same trip! (I used to live in Japan, that's where I learned to ski). I've also started hiking again and will try light mountain biking again this weekend. I'm also doing weights again on the days I'm not hiking! This is all just after 6 weeks or so.... I can't wait to see the changes after 6 months! Mood problems (extreme anxiety and depression) haven't been a problem since I healed from surgery.

I wanted to wish you and all of your loved ones a Merry Christmas, Happy New Year, and a wonderful holiday season!

Thank you again!

SD"

For more info about calcium and parathyroid disease, check out www.parathryoidatlanta.com.

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