In samples of patients undergoing parathyroidectomy for primary hyperparathyroidism (PHPT), these disturbances have been identified at a rate of 43.1%–53.0% for anxiety, 33.0%–62.1% for depression, 22.0% for thoughts of death or suicide, 51.9% for anger and irritability, 5.0%–20.0% for hallucinations and delusions, and 37.3%–46.5% for impaired cognition.
In fact, it has been noted that there are more neuropsychiatric phenomena in PHPT than is often recognized and that these symptoms are easily missed, particularly in the elderly population.
This excerpt is from, Psychiatric Complications of Primary Hyperparathyroidism and Mild Hypercalcemia, published in Psychiatry Online.
I’ve recently been reading as much as I can about this condition, for personal and professional reasons. As soon as I learn about something new I go digging to see if there is an anxiety connection. And I must say I was very surprised to read these stats. It’s not something I’ve heard discussed or taught at mental health conferences.
The authors also state this about the condition:
The incidence of primary hyperparathyroidism (PHPT) is about 21 cases per 100,000 person-years, and the disorder is usually caused by a solitary parathyroid adenoma. PHPT has traditionally been recognized by its characteristic symptoms, including urolithiasis (“stones”); osteopenia and osteoporosis (“bones”); abdominal cramping, nausea, and peptic ulceration (“moans”); and depression, anxiety, cognitive dysfunction, insomnia, confusion, and personality changes (“psychiatric overtones”).
How do changes in serum calcium levels contribute to mental health and cognitive symptoms?
It’s always helpful to understand the mechanism and it was the first thought that went through my mind – how does hyperparathyroidism and changes in serum calcium levels cause these mental health and cognitive symptoms? The authors share this:
Although the pathogenesis [or cause] of psychiatric symptoms in primary hyperparathyroidism remains unclear, calcium is thought to figure prominently in determining changes in monoamine metabolism in the central nervous system(CNS), thereby modifying neurotransmission and resulting in alterations in mood and cognition.
I went digging and found this paper – Acute psychosis secondary to suspected hyperparathyroidism: A case report and literature review.
The authors also state that the mechanism isn’t known for certain. And although they are referring specifically to psychosis, the explanation could be applied to other symptoms too: “It is thought that the changes in serum calcium level slow down nerve function and neurotransmission rate, inducing psychosis (and other symptoms like anxiety, depression, anger, irritability and suicidal thoughts).
Understanding this possible mechanism helps us find a temporary solution for these symptoms until the hyperparathyroidism is addressed with surgery i.e. using amino acids as supplements.
Using amino acids to ease symptoms while you are seeking the root cause/s
If you’ve been following my work and have read my book The Antianxiety Food Solution, you’ll be familiar with using targeted amino acids as supplements to support low levels of neurotransmitters. These provide quick relief of symptoms (in a day or less) while you are seeking the root cause.
If we look at the above symptoms:
- Anxiety can be a sign of low serotonin (worry type of anxiety) and/or low GABA (physical type of anxiety) – and tryptophan/5-HTP and/or GABA help ease symptoms.
- Depression can be a sign of low serotonin (negativity), low dopamine (curl-up-in-bed depression) an/or low endorphins (weepy depression) – and tryptophan/5-HTP, tyrosine and/or DPA help ease symptoms.
- Irritability and anger are common with low serotonin – and tryptophan/5-HTP helps to ease symptoms.
- Low GABA can also be involved with anger and rage
- Cognitive issues can be caused by low dopamine and low GABA – and tyrosine and/or GABA help ease symptoms
(You can find the symptoms questionnaire here. As always, amino acids are used based on symptom clusters and dosed according to your unique needs.)
If you find you have been using the amino acids long term and have explored all the possible root causes described in my book and summarized here, it may be worth investigating primary hyperthyroidism especially if you’re menopausal.
Case: “I had to have a parathyroid gland removed a few years ago… I literally felt better from the moment I came round from the surgery”
We always want to find the root cause when we have various symptoms. With this condition, it’s common to observe very quick resolution of symptoms after parathyroid surgery to remove the adenoma/s. Someone in our community shared this:
I had to have a parathyroid gland removed a few years ago … I literally felt better from the moment I came round from the surgery. It’s a miserable disease. I thought I was going to die! Lots of people get so low that they don’t feel like they can go on.
Bone pain was awful. Fatigue, depression etc.
I had had some dental issues around that time. One of my teeth crumbled. My Vitamin D went down to 9 so I am sure that was a large part of the puzzle.
I was actually diagnosed fairly quickly but was retested many times. I self-referred to a surgeon that was in-network in the end as my insurance wouldn’t cover various surgeons that my doctor wanted me to go too.
I had had breast cancer a few years ago and so had had weekly blood tests and, when I went back and looked, my calcium had been high for years. So important to read our own results.
The surgery was so easy.
What an amazing outcome for this woman and I appreciate her for sharing so we all get to learn and benefit from her journey. And yes, I agree, we need to advocate for ourselves and ask for and keep copies of all our labs. And get educated and ask questions. It’s really unfortunate that high calcium and hyperparathyroidism is so often missed.
Not everyone has all the listed symptoms of primary hyperparathyroidism. This woman did experience fatigue, depression and bone pain. She did not experience anxiety and didn’t have kidney stones. I do suspect dietary oxalate issues (without kidney stones) can be an issue for some folks because of the calcium disruption.
Some reasons why hyperparathyroidism is underdiagnosed
In the last few months I have learned that primary hyperparathyroidism is underdiagnosed. PTH (parathyroid hormone) is not routinely tested and I believe that it should be. Also, as you read above, elevated calcium levels are often ignored or brushed off as being a non-issue. And to complicate things further calcium is not always elevated. Hyperparathyroidism is also underdiagnosed and undertreated in the elderly.
For many women (and men) the discovery happens after they are diagnosed with osteoporosis and then calcium and PTH are tested, and/or past elevated calcium levels are “discovered.” If the hyperparathyroidism diagnosis happens first then osteoporosis screening is not always done and I believe it should be. And don’t get me started on when I believe osteoporosis screening should start (at 45 and not 65 or 70 years old) and issues with DEXA screening (more to come on this).
The good news is that primary hyperparathyroidism is a well-established cause of secondary osteoporosis which starts to resolve after the surgery too.
I’m still very much in learning mode
Primary hyperparathyroidism only recently appeared on my radar as a result of the 2023 osteoporosis summit, hosted by my friend and colleague, Margie Bissinger, Physical Therapist and osteoporosis coach. Dr. Deva Boone was a speaker on this condition on the summit and her site is a wealth of information. I appreciate them both.
As I mentioned above, I am also amazed it’s not something I’ve heard about at mental health or integrative health conferences and when doing continuing education.
I will admit I’m no expert and I’m still very much in learning mode – for myself and for you and this community. But, as you know, I like to share what I learn. As I continue to learn, I plan to share additional perspectives and the osteoporosis/menopause and oxalate links.
I am also in the process of creating a hyperparathyroidism questionnaire to use with my clients. Not everyone has all the above symptoms and not all the papers and resources list all the symptoms covered here today. For example, fatigue is listed on many sites but not in the above two papers and very few sites emphasize the mental health symptoms.
I’m also learning there are clues to look for – like forearm results on the DEXA scan and a good TBS/trabecular bone score has some significance. Stay tuned.
Resources if you are new to using amino acids as supplements
If you are new to using amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the symptoms of neurotransmitter imbalances, including low GABA, low serotonin, low dopamine and low endorphins).
If you suspect low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids on your own so you are knowledgeable. And be sure to share it with the practitioner/health team you or your loved one is working with.
There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, anxiety and mood issues.
The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acids that I use with my individual clients and those in my group programs. You can find them all in my online store.
If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms too). This is a paid online/virtual group program where you get my guidance and community support.
If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. This is also a paid online/virtual program with an opportunity to interact with me and other practitioners who are also using the amino acids.
If you’ve been diagnosed with hyperparathyroidism (or a family member has been) you can likely relate to much of this. Please share your/their journey. I’d love to hear how long it took for a diagnosis and treatment and what symptoms resolved after surgery, and how quickly.
Did you find the amino acids helped anxiety, mood and cognition symptoms in the short term, and then were no longer needed after surgery?
If you’re new to hyperparathyroidism, feel free to ask your questions and share what you’d like to hear more about in the follow-up blog.
If you are a practitioner, is primary hyperparathyroidism on your radar and do you recommend PTH testing in addition to calcium testing? Have you found the amino acids to be a good short-term solution for your clients/patients?
And if hyperparathyroidism is your area of expertise, feel free to add to the discussion.
Feel free to post your feedback here in the comments.
Hello! As always, thank you for providing so many with such important information, so that we can be self-advocates for our own health, as well as for those we care about.
Which type of practitioner typically makes a diagnosis of hyperparathyroidism…an Endo?
Julie
You are most welcome. Your conventional MD (or GP in Australia/UK/South Africa) should be picking up elevated serum calcium (which is not always elevated in hyperparathyroidism) and low vitamin D, and recommending bone density testing.
And yes an endocrinologist and/or parathyroid specialist typically makes the diagnosis – “The key to making the diagnosis of primary hyperparathyroidism is REPEATED measures of 1) serum calcium, 2) ionized calcium, 3) PTH. Measure them weekly for 2 or 3 weeks and the diagnosis will be clear in almost all cases.” https://www.parathyroid.com/hyperparathyroidism-diagnosis.htm (this site is another excellent resource and as you can see from this article diagnosis can be involved)
I’d love to see all this being tested regularly especially in menopausal women with many of the symptoms listed in this blog. And in younger women and men with these symptoms. And always with osteopenia/ osteoporosis.
And we should be asking for and checking these tests ourselves.
Symptoms of PHPT seem to align with ADHD, especially for post menopausal women who have osteoporosis and have found that their ADHD symptoms have gotten worse as they get older. Seems that elevated calcium levels would warrant further testing for sure, especially if there are symptoms of high oxalates as well.
Christine
There is some limited research on hyperparathyroidism and ADHD but it’s worth ruling out when there are cognitive issues, osteoporosis and oxalate issues in menopause, together with some of the other symptoms listed.
Elevated serum calcium levels should always be investigated and addressed. “The key to making the diagnosis of primary hyperparathyroidism is REPEATED measures of 1) serum calcium, 2) ionized calcium, 3) PTH. Measure them weekly for 2 or 3 weeks and the diagnosis will be clear in almost all cases.” https://www.parathyroid.com/hyperparathyroidism-diagnosis.htm (this site is another excellent resource and as you can see from this article diagnosis can be involved)
With ADHD we also explore low dopamine, low iron, low omega-3s, low zinc, low GABA etc and all the dietary factors covered in my book The Antianxiety Food Solution. More here https://www.everywomanover29.com/blog/the-antianxiety-food-solution-by-trudy-scott/
Does any of this relate to you or are you referring to clients/patients?
they relate to me personally. I’m diagnosed ADHD and have only recently discovered that my calcium levels have typically shown to be in the high normal range. my doctor has just ordered that pituitary be tested and I’m scheduled to consult with an endocrinologist next month.
Chris
Keep us posted
My mum had a lot of issues around menopause. Problems increased. She was very irritable and had trouble with diabetes. Years passed with a lot of trips to the Naturopath.
My dad reported she was sleeping too much. One day she developed an issue around speech. She would get half way through a good sentence and then stop. This happened repeatedly. The first half of the sentence was fine but she couldn’t continue. She didn’t like me so would not let me take her to the doctor. My brother was able to get her to the emergency room.
We went to the endocrinologist who questioned why the doctor hadn’t noticed a high calcium level. Apparently it wasn’t showing in blood tests.
They removed a lump in a parathyroid and after the operation I couldn’t believe what I was seeing. She was bright, alert, she had made her bed, packed her bag and was sitting on the bed ready to leave. She had a surge of energy and alertness.
The surgeon had us visit after the operation and noted he had never seen anyone like that before with a speech problem connected to the parathyroid.
Is this the kind of issue you are discussing?
Helen
Thanks for sharing your mom’s journey. Glad to hear she rebounded so quickly after surgery – this is not uncommon with parathyroid surgery. I hope she continues to do well.
It sounds like she had many of the classic issues – fatigue (and sleeping a lot), irritability, diabetes, focus issues/cognitive issues.
As mentioned in the blog there are many symptoms and vocal cord/fold paralysis and voice issues is another one but likely not very common – Parathyroid Adenoma as a Cause of Vocal Fold Paralysis https://jamanetwork.com/journals/jamaotolaryngology/article-abstract/410271
Had they not been testing serum calcium or did they miss that it was high? Do you happen to know how high it was?
Hi Trudy, I am an OT and work in a in integrative medicine clinic. I work primarily with adults suffering from chronic pain and post concussion. Quite often they have anxiety, stress or sleep issues related to their health issue. I am familiar with the basics in nutrition, like anti-inflammatory diet, elimination diets, etc. but I’m wondering if you have a program or course where one could gain a certificate of nutrition, knowledge of amino acids application, etc to apply in a setting such as mine. Let me know! And thank you.
TK
I love the meshing of OT work and integrative medicine especially in the setting of chronic pain and post concussion. Combining this with the use of targeted amino acids is perfect since low GABA/low serotonin/low endorphins all can play a role in pain, and post-concussion we can see disruptions in serotonin, GABA and dopamine. In both instances, the aminos offer quick relief while all the other aspects are being addressed.
The Balancing Neurotransmitters: the Fundamentals program is a paid online/virtual program with an opportunity learn from me and to interact with me and other practitioners who are also using the amino acids. More here https://www.anxietynutritioninstitute.com/balancingneurotransmitters/
And don’t forget that pain is one of the common symptoms of hyperparathyroidism.
I really enjoy your posts. I am interested in anything on oxalates. I was using almonds as a healthy snack [2-3 times the single serving amount] and begin being concerned that I was getting way too much oxalates. My last blood test showed low calcium. I stopped eating almonds about 2-3 months ago. However there are a lot of other foods containing oxalates.
Thank you.
Jeanene
Be sure to search the blog (top right) for oxalates as I’ve written about them extensively. And yes almonds are just one source of oxalates.
Also, this article explains how “Low Vitamin D levels can lead to low calcium, which in turn raises the PTH level.” https://www.parathyroid.com/hyperparathyroidism-diagnosis.htm What is your serum calcium and vitamin D levels?
I do have a story of my own journey that fits this category of hyperparathyroidism undiagnosed. Just a little bit of my history here to get to what happened to me first. I was in my mid-forties when health issues suddenly raised their ugly head in my life. I wanted 12 children and wanted them while I was young and did have 11, including twins over a period of 12 years. I know crazy , huh, but that was what I wanted. I had my last baby when I was 32 and the following year I had a partial hysteretomy. I had gone back to univeristy to get my teaching degree and was working as a high school teacher when I started having issues with my knees. I also had a new job opportunity and did get the job as a full time Activities Director at a large high school. I had bilateral knee surgeries the summer before I started that job. Instead of healing well I was never able to regain motion in either knee. That sets the stage for my story.
Unable to recover from the knee surgeries with lots of physical therapy I was sent to Los Angeles to work with a doctor who was the co-inventor of knee replacements. They could not find anything wrong with my knees and even did an exploratory suregery looking for cancer. Eventually they decided to do knee replacements to see if that would help.
The surgeon also sent me to a rheumatoligist due to my knee issues. At one appointemt I asked the doctor what the sign on his door meant that I read everytime I left his office. it was about having a bone scan for osteroporosis. He told me I wasn’t old enough to need to do that yet, but then said let’s just do one now though so we have it for a baseline when you are older. We did it and he came back to me shocked that it already showed I had osteoporosis.
During this same time period I was under a lot of stress from my job that required a lot of time running everything at that school. I started losing weight which was fine until it didn’t stop. Over my two years working this job along with my health issues I had become anorexic. This was the beginning of my journey from good health all my life to becomng very ill.
It was a few years later down the line when I had been to see my doctor and he ordered blood work for me to do. After it was done I received a call from him telling me I had high calcium in my blood and I would need to see an endocrinologist. I did see her once and all she said was we needed to keep an eye on this. My doctor fortuantely did not agree and told me he wanted me to go to Scripp’s Green Hospital to see a surgeon he knows who specializes in this surgery. He arranged for me to see him. He was very careful in his work to prepare for this and did many different types of x-rays not available in all hospitals to prepare for the surgery. I had the surgery and he found I had one parathyroid gland with a large tumor on it. He told me the normal size for a tiny parathyroid gland was 25 and mine was large at 79. The fact that it was so large likley means I had it for a long time and that makes sense too that it didn’t show up in my bloods earlier. This also makes sense for the early diagnosis of osteroprosis. I do wonder if this is what brought on all of the things that led me to anorexia and the problems that led to.
That is when I was put on a benzodiazepene by a well meaning doctor for sleep. Many years later I had to deal with the withdrawal from that medication which was the worst experieince of my life. I did find a functional medicine doctor who does not give prescription medications to work with after my taper. She told me we would turn this aorund with proper nutrtion and supplements. I do not have a problem with osteoporosis any longer and she was right. This whole experience is what led me to my own passion for helping people trough functional medicine health coaching.
Karole
Thanks for sharing your journey here. And gosh, unnecessary knee surgery but wonderful that your rheumatologist was open to have you do osteoporosis testing. And then your next doctor picked up the high calcium and pushed for seeing a surgeon. I’m learning the “wait and see” approach is common but should not be happening with an endocrinologist.
I believe 6mm is the size of a normal gland and 25mm (1 inch) probably the size of a small adenoma. And yet yours was very big at 79mm.
The anorexia may have been a combination of nutritional deficiencies/adrenal dysfunction (possibly after having had 11 children), neurotransmitter imbalances from the hyperparathyroidism (I write about low serotonin and anorexia here https://www.everywomanover29.com/blog/tryptophan-supplementation-for-anorexia/), and hormone imbalances after your partial hysterectomy.
Yes osteoporosis is classic with hyperparathyroidism (and with estrogen loss) and reverses by 10% in the first year after surgery – as do other symptoms.
It’s interesting you were prescribed a benzo for sleep after the parathyroid surgery. Insomnia is a common symptom of hyperparathyroidism and typically improves after surgery. Did it get worse for you?
I am sorry to hear about your benzo withdrawal but I’m so glad you turned this around to help others! (I’m sharing a benzo link here for other readers who may be new to this https://www.everywomanover29.com/blog/world-benzodiazepine-awareness-day-2017-awareness-anxiety-nutrition-solutions/)
Thank you for your thoughtful and enlightening response, Trudy. I really appreciate it and this is the first thing that has put some puzzle pieces together for me as to this anorexia that nearly ended my life. I never could understand how or why it went there other than stress related.
My insomnia did get better but it that is because I was on that sleeping pill. I will never know if the surgery helped with sleep or not. All I know is sleep was never a problem for me my whole life until this happened. I do understand about the nutritional deficiencies due to the anorexia. Interesting to see how one thing leads to another. I appreciate your time in answering this and in doing all the research you do. Thank you!
Karole
Glad this has put some puzzle pieces together for you – and you’re weclome
I should add here that when after becoming a health coach I studied with Carolyn Ledowsky and when she taught me about the OAT (Organic Acids test) and we did one on myself, I learned I had high oxalates. I recall now that I began having issues with that during that same time period. My oxalates are fine now and I never did develop any kidney stones thank goodness.
Karole
So you no longer have oxalate issues after your hyperparathyroidism surgery? How bad was the issue before surgery and did you happen to do a repeat OAT after surgery?
I want to add this commnet to my parathyroid story regarding oxalate issues. I
did comment on my experience with oxaltes from my expereince from mold but had not yet realized the connection to another issue long before that with regards to oxalates.
I am sure I had high oxalates years before that from the parathyroid issue. I know that because I was teaching at a new school where they didn’t put restrooms in the place that was designed for them for teachers to use so we had to go all the way to the front office to use the bathroom in the faculty room. That’s hard when you have students coming in and out between classes! I saw a urologist due to those issues at the time and he ran some tests on me and it the way he explained it was water went right through me. He actually wrote a letter to my school district telling them they had to put a bathroom in the pod of classrooms I was teaching from. They did and all the teachers in my building couldn’t thank me enough for getting that done. I am sure that was an oxalate issue. I do not have that problem any longer either, thankfully.
Karole
Thanks for clarifying – it’s great when we start to put the puzzle pieces together. And well done for getting this change made!
hi
very interested by your post, for both
more calcium tests seem necessary : I had it for 20 years and it s 3 days before my op of thyroid cancer they tested my calcium and realise the mistake : it was a parathyroid cancer, even the cyto punction did not show it was a parathyroid adenoma and not a thyroid one.
And second the impact of calcium on the Psy part. I had memory losses for years and irm and tests but no calcium tests. My memory is back after the op.
For me, anxiety was worst post op in hypo calcemia, every 5 hours and in hyperthyroidy with the change of med.
For my daughter it is the lack of iron which cause depression, 3 days of iron taking and she is back to a normalself
Magnesium and lithium have great impact on anxiety.
Good luck with your research and book and thanks for your text
sorry for my poor english
Isabelle
I’m sorry to hear you have been looking for answers for so long. I think you’re saying you had symptoms (memory loss) for 20 years but no calcium testing. Did you have hyperparathyroidism (a benign adenoma) and also a cancerous one? What age did you have the surgery and what eventually led to the proper testing? Glad to hear you’re doing well after the surgery. Did any other symptoms improve – sleep, energy, anxiety, depression, constipation, pain?
I have heard the post surgery drop in calcium can increase anxiety for a short period. Did supplemental calcium help? I wonder if GABA or tryptophan would help this too.
Glad to hear addressing low iron helps your daughter.
You are most welcome!
hi Trudy
thanks to have understood.
after 20 years of memory losses and fatigue, I saw a lump in the mirror.
The first diagnostic was a thyroid adenoma of 4 cm but just before the op I did a calcium test. My calcium level was 3.6 and PTH 972 so they changed for a parathyroid operation.
One month later, the biopsy confirmed a parathyroid cancer.
it took me 2 years of supplement, 3 g per day to adapt to a normal calcium so they thought I had it for 20 years before.
I was living nearly normally, work and sport with a so high calcium. Symptoms were discrete , slow heart beat, (around 45) headaches, gastro problems, always tired, but not very specific, one kidney stone, and the worst memory losses.
thanks for your research
Isabelle
Thanks for confirming this – glad you found answers
I had to do my own research and advocate for myself to get a diagnosis. I had classic symptoms, hair thinning from crown to forehead, needed a nap almost daily, irritable, then as it got worse, palpitations, bone pain and kidney stones. The normal range for calcium here in the US is 8.5 – 10.4. As explained on parathyroid.com site anything over 10.0 is too high for adults over 35 years of age. Mine was 9.9 for about ten years but never had the PTH tested until I asked for it. If it weren’t for the one time my calcium was 10.5 it wouldn’t have flagged high and I wouldn’t have researched. As my calcium went down a little, the PTH went higher. I wasn’t a clear cut case for local doctors who treated me like a hypochondriac. I sent my test results to the experts at Tampa where I was diagnosed by blood work. I flew to Florida, had surgery the next day, woke up feeling so much better and flew home the following day. They removed two adenomas (which did not show up on testing/scans). The surgeons estimated I had it for 8-10 years.
The range needs to be lowered so that at 9.9 or higher and PTH test would be done along with another calcium test. Until the standard range is changed, the doctors don’t want to order additional testing because insurance won’t cover it unless it is flagged high or low.
I am interested to know the connection between amino acids and PTH as I think there has to be a reason the endocrine system gets out of whack. If I hadn’t experienced it myself, I wouldn’t have believed the sudden difference the surgery made. I was alert and felt like doing things again, even cleaning house and chores.
I would guess menopausal changes may have played a part as that is about when the issues crept up on me.
Lynn
Thanks for sharing your journey and the fact that you also had to advocate for yourself. I’m sorry you were treated like a hypochondriac – that’s not ok! But good to hear you received good treatment eventually and that it’s make a difference.
I’m glad you mentioned your adenomas not showing up on scans. This is common.
Calcium can actually be normal with hyperparathyroidism and based on what I’m learning doctors need much more education around the basics and the nuances of lab combinations and even the scans issue. And we have get educated and advocate for ourselves like you did.
Women are affected at 3.3:1 male, female patients older at presentation and symptoms/lab values do also differ – more on that here – The role of gender in primary hyperparathyroidism: same disease, different presentation https://pubmed.ncbi.nlm.nih.gov/22535262/ I’m going to be looking into the mechanisms as to why but it’s likely estradiol decline in many cases.
I’m not sure what you mean by “I am interested to know the connection between amino acids and PTH”
I’ve been following your articles on GABA and 5HTP because I have family members with issues that I believe would benefit from a protocol using the correct dosages. There seems to be plenty of relatives on my fathers side of the family that have/had endocrine issues. Pituitary tumor, my PHPT, thyroid goiter, but no one person has had more than one which relieves me from worrying about MEN Syndromes. My son has anxiety/sleep issues and some symptoms that have me suspicious of pyroluria or an imbalance of amino acids.
Hi Trudy,
In answer to your question about the OAT test. This was two years ago and what we discovered among other things was she was suspicious that I had mold. I did the Mycotoxin test and it was positive. We did her mold protocol and we also worked on the oxalate issue and histamine also. I did three OATs tests over that period of about a year and a half. The last one I did I did not have any high oxalates. My surgery for the parathyroid was some years before this so that was not playing a role in this.
Karole
Thanks for clarifying. I do suspect dietary oxalate issues can also be a factor with hyperparathyroidism given the research on kidney stones and the fact that oxalate issues and hyperparathyroidism are more common in menopause.
Thanks again for sharing your journey. I plan to do additional blog posts on hyperparathyroidism and osteoporosis and would love to share your story in a new post.
That would be fine with me. I plan to use it now that I understand more about as I never made the connection until now with what happened to me. My own family needs to hear and understand this as I was so lost those years and could not figure out what happened to me . I had no answers, just confusion. Thank you again for your research and sharing here. So much makes sense now!
Trudy,
I’m curious where in the world did you get the idea that gaba is only related to the ‘physical type of anxiety’? Benzodiazepines (BZs) produce most, if not all, of their pharmacological actions by specifically enhancing the effects of endogenous and exogenous GABA that are mediated by GABAA receptors. And people take benzos mainly because they can’t stop worrying, because they’re too anxious, and because they can’t turn off that wired but tired overthinking that comes from WORRYING too much.
At the same time, I’m not sure where you got the idea that low serotonin is connected with anxiety. Patients with some anxiety disorders, including social anxiety, have been found to have higher, not lower, levels of serotonin.
Kelly
Please refer to the symptoms questionnaire and you’ll see that low GABA does have symptoms that go beyond just physical https://www.everywomanover29.com/blog/amino-acids-mood-questionnaire-from-the-antianxiety-food-solution/
And yes low serotonin and high serotonin can increase anxiety levels.
You will find my book “The Antianxiety Food Solution” helpful since it is referenced. More info here https://www.everywomanover29.com/blog/the-antianxiety-food-solution-by-trudy-scott/ I also include references in my blog posts.
Then I’m not sure why you didn’t include that — or narrowed it down to just physical anxiety — in your article above:
“Anxiety can be a sign of low serotonin (worry type of anxiety) and/or low GABA (physical type of anxiety).”
Your statement, not mine.
Also, on another page there was a discussion about depression and anxiety reactions from Gelatin and/or collagen supplements. The reason some people react MAY be due to their gut microbial balance, mainly lower levels of bifidobacteria. At least according to this study:
https://www.cell.com/cell-metabolism/fulltext/S1550-4131(22)00128-0#%20
Thanks for your reply.
Kelly
Very true but this is how I typically differentiate the types of anxiety and there is no way to include all possible symptoms in each blog. I refer to the symptoms questionnaire and my book in each blog for this reason.
Thanks for the link to this proline paper – I’m intrigued and will look into it as another possible cause.
Hello Trudy,
My name is Rebecca and this is not feedback, rather an inquiry. Also unrelated I believe to hypothyroidism, and more related to your expertise. I was hoping I could get some idea of your clinical practice regarding my daughter.
Aaliyah is a 14 year old girl who has generalised seizures, in the form of absence seizures at this stage, diagnosed since she was nine and symptomatic since she was 8years old. She has always been a sensory kid, weary of food with certain textures, smells, colour, etc, and sensitive to clothing, who struggled with separation from me at school.
We started her on the keto diet to manage her epilepsy because the medication for epilepsy took a massive toll on her tiny body when she was 9 years old. The keto diet whilst effective in diminishing the seizures whilst on it, created stress as she struggled to maintain it, wanting to fit in with all her peers and eat normally. After 18 months on keto we decided to wean her off because she was lying about her food and getting her friends to bring her packaged, non keto meals to school… catch 22… fixing one thing but creating another. Weaning her off coincided with puberty, and her body changed overnight. She went from a tiny petite young girl to a well endowed young lady and her body became voluptuous and consequently she developed body image issues which led to her eating disorder- atypical anorexia. She now fluctuates between binging and restriction with her version of keto= protein and a cucumber. She doesn’t absorb many nutrients from other amazing foods. She also commenced lamotrogen medication for her epilepsy which is also a mood stabilising drug.
Aailiyah has struggled with anxiety from a young age, living with her brother who is anaphylactic to many things and has had several serious reactions where he has been hospitalised. Her huge caretaker part is overwhelmed. Her anxiety has impacted her relationships and connections and she has experienced significant ruptures. My husbands family also have a trajectory of anxiety and depression in their lineage. A neuropsych assessed Aaliyah in year 6 and concluded that she showed signs of mild ADHD without considering her anxiety.
More recently we have discovered Aaliyah is self harming and suicidal. She is currently in an adolescent mental health unit after attempting to take her life. She seems to be struggling with symptoms of depression. I am concerned this will be the start of clinicians experimentation of different drugs with her. I have always been concerned with the contribution lamotrogen has had with aaliyah’s symptoms.
I’m wondering how you would feel about providing your insight if you take Aaliyah’s case on, particularly considering the substitutes you suggest in your blogs like GABA, etc.
Rebecca
I’m sorry to hear about your daughter’s struggles. It would be best for you to work with an integrative/holistic GP given her medications and current placement in a mental health unit.
Based on her history with seizures and a keto diet it sounds like she would likely benefit from dietary approaches to help with her mood, anxiety and the self-harming. A gluten-free diet on it’s own can have a major impact. I recommend discussing targeted individual amino acids such as GABA and/or tryptophan/5-HTP with the GP and exploring all possible biochemical causes such as gut health/dysbiosis/parasites, infections, thyroid health, pyroluria etc and even hyperparathyroidism.
You will need to become your daughter’s best advocate and continue to learn as much about all this as you can. My book “The Antianxiety Food Solution” is a great foundation https://www.everywomanover29.com/blog/the-antianxiety-food-solution-by-trudy-scott/ .
There is a wealth of information on the blog (use the search function) and in the incredible interviews on the Anxiety Summits https://www.theanxietysummit.com/
can very low levels of vitamin D and effecting absorbtion of calcium cause kidney stones . is there a connection there ? I take plenty K2 now but suspecting very low vit D . struggling sleep , very dry skin , very pale , lots of hair falling out and general weakness. I have overwhelming thoughts , worrying , anxiety , strong phases of depression and only very little highs . last few years I’ve struggled to go out in the day due to people seeing me and the horrible thoughts on how I may look . mirror tells me different things all the time . forced myself into hospital for help just to be told I have low mood , how insulting . no matter what I do my teeth get worse and gums play up (even with plenty K2)
why I suspect low vit D and calcium problems , I have hand pains , knee pains , hip , only 28 . also get strange sharp pains around my chest middle back , short breath so on . I have also had comments about looking very pale also . my stress is no doubt above normal over the years , was a social drinker but stopped massively over past 3 years to maybe help with health but dnt seem to be much connection . I have had 2 kidney stones within 7 years but drunk more water now but I suspect there’s a thyroid , calcium , vit D connection here , thoughts ? also black lines and dots in site of eyes comes and goes strongly . and lastly I seem to have high bilirubin in my blood tests..
Jim
Best is to test levels of vitamin D and consider testing for hyperparathyroidism if calcium is high. I have clients look into dietary oxalates as a possible factor for pain and even some of the mood symptoms. More on that here https://www.everywomanover29.com/blog/oxalate-crystal-disease-dietary-oxalates-and-pain-the-research-questions/
With high bilirubin, Gilbert’s needs to be considered and addressed. This condition can cause mood symptoms too.