Brief Answer:
Not as a direct result of removal of the glands

Detailed Answer:
Good morning. My name is Dr. Dariush Saghafi and I am a neurologist from the XXXXXXX OH region of the world. I'd like to answer your question in the following way.

I understand that you've had parathyroidectomy of 2 of your parathyroid glands and that you believe you have neuropathy in your feet and your hands which began shortly after this procedure. You are suffering from pain and you've not found anything to relieve the symptoms. You've been to other doctors and tried a variety of interventions including creams, acupuncture, and foot baths and nothing seems to work.

Now, here are some facts regarding neuropathies.

1. Neuropathy implies that a nerve or nerves is malfunctioning due to some process which is interfering with its normal metabolic pathways or machinery which allows the nerve or group of nerves to perform their jobs of transmitting sensations (hot, cold, vibration, pain, touch, etc.)

2. There are many causes for neuropathy such as diabetes mellitus, nutritional deficiencies of Vitamin B12, folate, D, radiation exposure, hereditary or genetic causes, toxicity from heavy metals such as lead, mercury, and arsenic, and many other causes both common and uncommon.

3. The condition of HYPERPARATHYROIDISM causes a state of excessive calcium in the bloodstream and this is a clear and present risk factor as well as cause of neuropathy which can be recognized as numbness, tingling, weakness, and pain. The treatment for this condition is the removal of the parathyroid gland or glands depending upon the severity of the condition.

4. However, the condition of HYPOPARATHYROIDISM whereby lower than normal levels of calcium may be a complication of surgery or some other reason for low functioning of the glands is NOT known to be a condition that leads to MALFUNCTIONING of the nerves in the body (i.e. neuropathy). Symptoms of tingling and pain are not uncommon in this situation often times in the fingertips and toes. However, the explanation of these symptoms which can be mistaken or confused for neuropathy is attributed to the hypersensitivity or hyper-irritability if you will of the neuromuscular junction which causes instability in the muscle fibers and muscles, depending upon severity.

Therefore, the treatment of such a condition that you are describing must be directed at the more likely cause of HYPOcalcemia or low calcium levels by first measuring calcium and ionized calcium in the bloodstream and then, replacing as necessary or until symptoms abate.

Another POSSIBLE complication of the surgery you had that COULD cause neuropathy would be damage to the THYROID Gland itself. Though rare and usually picked up right away after such procedures it is possible that a patient may be experiencing some degree of HYPOTHYROIDISM as a result of damage to the thyroid gland which over time can take its toll on nerves and nerve function.

Again, for this to be recognized as the cause blood work needs to be done which can establish the lower than normal functioning of the thyroid gland which is usually done with blood samples and then, if considered low replaced.

I hope this answers your question and puts you a little farther ahead of where you were in terms of knowledge of your problem and if so could I ask you for a favor to provide some brief written feedback on the response as well as CLOSING THE QUERY if you have no further questions. Otherwise, feel free to ask me another question on anything that may not be entirely clear and I will try to answer your question.

In the future if you would like to contact me directly with any type of medical question you may follow the following link to my page and submit questions directly to my attention:

http://doctor.healthcaremagic.com/doctors/dr-dariush-saghafi/68474


This query required 50 minutes of physician specific time for review, research, and final draft documentation for envoy.

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Brief Answer:
Check symptoms out for other problems

Detailed Answer:
Good morning and thank you for writing back to tell me a bit more information.

9.5 for a calcium level sounds about right to me although technically speaking you'd really want to know what the lab norms are to know for sure whether or not that number is within range. But it certainly doesn't sound LOW which is what you are most concerned about in parathyroidectomy situations.

Anyways, as I mentioned in the detailed explanation above is that the painful symptoms of your hands and feet are not likely due to the parathyroid removal. I'm not even really sure that I'd call the symptom of pain neuropathy since you haven't given me very much more detail about the pain itself in the hands and feet.

I think that if you haven't seen a neurologist yet that should be your next move and if they clear you for NOT having neuropathy then, they can tell you who best to see for your symptoms if your own doctor isn't sure about it. On the other hand, if the neurologist feels as you do that this is definitely NEUROPATHY then, they could institute a workup which involves testing and then, trials of other types of medications for the symptoms.

In terms of the labs you're going to get I would make sure that they had not just a total calcium level but also an IONIZED calcium test to do as well. I'm sure it'll be fine with what you've told me but all the same get it done. Have them do B12, folate, TSH, and FT4 testing as well and that will cover the B12 nutrients and thyroid bases.

In conclusion, your parathyroid surgery seems to have not resulted in any adverse symptoms in your hands and feet which may be still worked up for other causes by either a neurologist or other type of specialist if your doctor is not able to come up with any alternatives or explanations.

I hope these answers were useful for you and if so some brief written feedback as well as CLOSING THE QUERY if you have no further questions would be greatly appreciated.

As always, I am at your service if you would like to contact me directly with any type of medical question by following the link to my page and submitting questions directly to my attention:

http://doctor.healthcaremagic.com/doctors/dr-dariush-saghafi/68474

This query required 15 minutes of physician specific time for review, research, and final draft documentation for envoy.

Cheers!

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Brief Answer:
Please do not Forget to rate our encounter

Detailed Answer:
All the best to you Ms. XXXXXXX Grey Hutchins.

Please don't forget to rate our conversation with a brief bit of written feedback if you think the information I've provided was helpful. And also CLOSING THE QUERY on your end will help me out immensely in terms of the transaction being processed and credited to me on a timely basis.

Thank you once again and please let me know if I can be of help to you in the future by looking me up on the website (DARIUSH SAGHAFI, MD).

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