Minutus

Can anyone share experiences or information re parathyroid tumor?
The pt is my mom, about 80, pretty frail, has vigorously resisted the idea
of surgery for several years, but nothing seems to have helped her so far
(neither I nor a couple of more experienced h'ths have found a remedy that's
helped much, and her symptoms are getting steadily worse.)

The main symptom (which I *assume* to be from the parathyroid) is cramps (at
night in bed) in the calf and/or foot. These used to come only when she had
eaten certain foods (dairy), and this began I think decades ago. Then for
the past years (10?) they came only when she had calcium in supplements --
even tiny amounts. Now she is getting the cramps 2-3 times per night,
severe, for no reason she can find.

I feel she *needs* to have the surgery done, but she refuses.
It's hard to get information from her!!! While I'm trying to find out about
the cramps -- sensation and all that -- or more general info, she is busy
giving me full details of what she takes and why (tons of vitamins etc.),
what foods produce what effects, what this or that doctor said and why it
was dumb... It's really hard to just get the info, but even when I *do*
keep her attention for long enough, I can't make much of it. (I do *not*
mean she isn't lucid -- she is!!! But, well, she has a lot to say, and gets
more than a bit obsessive about it...)

E.g.: She says the cramps can be in back of calf and/or bottom of foot --
and the cramp pulls her toes upward, and she forces them back down, and ends
the cramp, by walking/stamping. ??????? How does a cramp in the calf or
sole cause the toes to turn upward??????

I want to treat this constitutionally, and there is a *LOT* of
constitutional case -- an overwheming amount, really. Strong personality,
very unusual history, personal, health and familial; *lots* of health
issues. Almost no medical/suppressive treatment, but many years worth of
self-medication/palliation/"symptom management" thru supplements and funny
diets. While I do think this was way better than the other options (drugs),
it complicates things in the present...

I'm not asking for a remedy (tho suggestions will be gratefully
considered!), but only fishing for whatever anyone might be able to offer on
the topic of treating parathyroid tumors. (Open-ended enough?) Or anything
else you might think possibly useful to me...

Thanks (mumble, mumble...),
Shannon

Those are the symptoms of hypercalcemia, from an excess of parathormone, either from a parathyroid tumour or hyperplasia.
Question: did she have a CT or MRI or US of the neck?
If you find a tumour or a hyperplasia, you might be in the situation of "one-sided disease" where the lesion has become independant from the patient, and no amount of constitutional treatment or organotherapy will help, you might have to convince her to have the lesion removed, if there is one, then go further.
Remember that calcium levels have also a very important action on the heart, raised level can cause serious arrythmias and even cardiac arrest in systole.
Not to be played with if the calcium levels are high.

Feel free to cross post to the other lists if you want to.

Dr. J. Rozencwajg, MD, PhD.
"The greatest enemy of any science is a closed mind""

Thanks for the interesting post, Dr. J.

Referenceworks search on parathyroid
Parathyroid: 3Parathyr., anac., anti-tetox., aran-ix., benzoq., beryl., calc., calc-f., cimic., parat., parath., pitu-gl., plat., prot., tetox., thyr., visc.

The Calcarea remedies particularly Calc-c, Calc-p, and Calc-f have the cramps in calves at night strongly.

There is also
EXTERNAL THROAT; TUMORS (K475, G405) (7) : aran-ix., bar-c., brom., calc-f., cist., nat-c., sil. (and from synthesis add ars and graph)

So, if Calc-f has not been looked at or taken, it is one to eliminate from contention (this is of course just one idea).

Calc-f (known in connection with parathyroid related disturbances of calcium metabolism, and calcium metabolism in general (eg osteoporosis))
--Cramps of the calves at night, better uncovering and stretching.(Julian)
--Parathyroid lesion (non-inflammatory) of the bone (Recklinghausen's disease) (Julian)

==================
It is also interesting to see Aranea ixobola come up as another one to investigate. The write-up points at parathyroid deficiency instead of overactivity, but the locale plus cramps plus tumor of neck is there.

Aranea Ixobola
Spasms of the striped muscles.
==================

Shannon, any more useful sx of the person or objective physicals available?

Hope this helpful,
Andy

===================

"Dr. J. Rozencwajg. MD. PhD." wrote:

She hasn't had any of these scans, and none of the several doctors she's
been working with has suggested that. (What is a US?) Would either of
these three be an equally good choice -- since it sounds like the idea will
have to come from her?

I've been having the suspicion that the thing is beyond constitutional
treatment at this point, and have wondered about whether e.g. Eizayaga's
"lesional" approach would be appropriate. But, all I know about that is
that it prescribes based on "symptoms of the disease", and I have no
confidence that I'd know how to choose and evaluate her
parathyroid/hypercalcemia symptoms. (Actually, I'm confident that I
*wouldn't*, but may have to try anyway. Is anyone on who uses this method,
who could comment?)

(BTW, she doesn't seem to have any heart symptoms, presumably because she
takes I think it's 1,000 mg of magnesium daily, to prevent "jerking"/muscle
twitches. I assume that the huge magnesium need is related to the huge
calcium overload, and seems to be quite an effective palliation, at least in
certain areas; but it seems she's reaching the limit of that now!)

I'll definitely urge her to have some sort of scan, for a start -- thank
you!

Shannon
on 8/2/03 12:36 AM, Dr. J. Rozencwajg. MD. PhD. at jroz@ihug.co.nz wrote:

In my opinion there is too much supposition here - why not just take the
case and gather all the symptom pictures and be highly alert to what
pathology might be going on, encourage a diagnosis if necessary - all sorts
can be causing the symptoms you describe.

One prominent symptom is her need for supplements and this needs to be fully
explored, could even amount to odd cravings or eating disorder. It is really
best to keep as open a mind as possible and don't assume anything.

Just my opinion, best, Joy
on 8/2/03 1:24 PM, Bob&Shannon at shannonnelson@tds.net wrote:

She hasn't had any of these scans, and none of the several doctors she's
been working with has suggested that. (What is a US?) Would either of
these three be an equally good choice -- since it sounds like the idea will
have to come from her?

I've been having the suspicion that the thing is beyond constitutional
treatment at this point, and have wondered about whether e.g. Eizayaga's
"lesional" approach would be appropriate. But, all I know about that is
that it prescribes based on "symptoms of the disease", and I have no
confidence that I'd know how to choose and evaluate her
parathyroid/hypercalcemia symptoms. (Actually, I'm confident that I
*wouldn't*, but may have to try anyway. Is anyone on who uses this method,
who could comment?)

(BTW, she doesn't seem to have any heart symptoms, presumably because she
takes I think it's 1,000 mg of magnesium daily, to prevent "jerking"/muscle
twitches. I assume that the huge magnesium need is related to the huge
calcium overload, and seems to be quite an effective palliation, at least in
certain areas; but it seems she's reaching the limit of that now!)

I'll definitely urge her to have some sort of scan, for a start -- thank
you!

Shannon
on 8/2/03 12:36 AM, Dr. J. Rozencwajg. MD. PhD. at jroz@ihug.co.nz wrote:
[Non-text portions of this message have been removed]

Thanks Andy, I'll look more at all of those.
And thanks for the reminder -- I need to check back with her re calc-f.
Last time she took it (6c, I think) she said it gave her skin the
creepy-crawlies -- which I gather that was a new symptom, so sounds like
dissimilar agg/wrong remedy, but odd that she'd respond that strongly to a
single dose of 6c! Anyway, she was going to try again, and I'll have to ask
what happened.

Aran-ix is an interesting idea, as I could sorta see her as a spider rx, and
she fits *part* of that picture, but not other parts.

Other useful sxs? Sigh, there are so many, but I don't have most of my
records to hand. I'll try to come up with more coherent thoughts later...

Thanks, and I'll look more!
Shannon
on 8/2/03 2:31 AM, andyh@mcn.org at andyh@mcn.org wrote:

Hi Joy,

I've taken the case (numerous times, at great length and detail, at least as
much as I could thru the profusion of unhelpful detail. Here's a general
look, in case it brings up ideas.

M/E: This can vary quite a bit, depending on what's happening with her.
Over past few years she developed severe hypothyroid, and during that time
had become increasingly slow, exhausted, fragile, irritable (nasty, even),
forgetful -- all the usual hypothyroid stuff. She resisted taking meds
(first Synthroid, now Armour) but finally did, and is now much better in
those areas (sure I realize it's not curative, and "the right remedy" would
have been much better).

In earlier years her M/E picture has varied at different times in her life,
but she is a very vibrant, quick-thinking, creative, active, assertive
person, ran two businesses while raising four kids. She would have
preferred to stay home with the kids and be a mommy, but worked for
practical reasons, put husband thru law school. Years of overwork led to a
period of alcoholism, near-nervous breakdown, and that's when she got onto
her supplements kick, by which she "cured" her alcoholism (30 years ago, no
relapse) and got off antidepressants (this was *way* before supplements were
anything remotely resembling mainstream).

Symptoms that her supplements have controlled include: Twitching muscles
(face; jerking head, and ?), leg cramps (began quite early), *severe*
tension, anger (she used alcohol to palliate; nux-v would no doubt have
worked better!); severe digestive trouble -- bloating, gas, "heaviness".
Various foods cause various symptoms, but I don't remember (or have handy)
those details. Craves peanut butter, ice cream (but eats neither due to
reactions), and I forget if there was more.

Severe constipation with no urging, from early childhood. She used to smoke
to bring on a bowel movement, but in later years was able to substitute
really huge amounts of fiber, plus huge amounts of magnesium.

Childhood history includes what seem to me like quite frightening
situations, which she laughs when telling (tried Opium, on that plus other
indications, no result). Father died from complications of alcoholism when
she was about 10.

I asked about dreams: In past years she rarely dreams at all. But what she
remembers from when she *did* dream regularly, she describes as "Sensual --
not sexual, but something like standing on a hilltop with the wind blowing,
and beautiful smells, feeling the sun..." (Not a quote, but close, I
think.) Used to tell herself fantasy stories at night -- "I loved the
night, because that's when I could go to my own [inner] places."

"Identity" issues, I would say -- has always believed herself to be a
"wallflower" type, too passive, too boring. Yeah, and so was Elvis,
ROTFL!!!!

Her mother was *awesomely* overbearing, in a totally well-intentioned but
*really excessive* sort of way, and my mom seemed to take her completely in
stride -- as a girl (from her telling), she would laugh and go along; as an
adult, she would grit her teeth and stand her ground. Relationship with her
mother was always good (so far as I ever saw), in spite of the "boundary
issues" (her mother's!-- Carc did nothing.)

The "need for supplements" comes not from an eating disorder, but from a
need for relief of the symptoms, and she knows how to achieve that
(largely). But the many years of using them does make it harder for me to
get a "clean" symptom picture. So I have tried to use the same approach as
one would for prescription or OTC drugs, and rely on her memories of "why"
she started taking this and that, plus her mentals, but it has led me
nowhere much so far.

She is idealistic (a tad naive even still), spiritually oriented.
*Very* interested in people, has always had a talent and an instinct for
drawing people out. Nowadays she can get stuck in "send" (talking too much,
and talking to her own interest rather than the listener's), can get a bit
overwhelming (to my mother-in-law, for e.g. !) I do not recall her
doing that in earlier years, but as she's gotten older, she's becoming more
wrapped up in her own process, it seems. On the other hand, if the listener
is *interested* -- and often they are, as she knows quite a lot -- well, she
can be great fun to talk to, and she loves to do that! (She runs a bed and
breakfast, and so has *lots* of people to talk to, tho now she longs to have
everybody just go away so she can get on with (gag) sorting her papers and
whatnot, and then have time to "put pictures in my baby book -- that's what
I really want to be doing! But how can I get the *time*?" (Phos did
nothing. Med 30 produced a really *striking* improvement -- which lasted
only a day or two. Maybe I should try Med in LM...)

The pathology that seems clear so far are: thyroid (per tests and per
response to med), adrenal (she was told years ago that she was nearly into
Addisons at that point), and presumably parathyroid. (Actually, several
other organs are also in hypofunction, I gather.)

Joy, what are the other possibilities you think of, that might explain the
symptoms, esp. the cramping from any calcium? Eager for any insights and
ideas, and again --

Thanks so much!
Shannon
on 8/2/03 7:49 AM, Joy Lucas at joy.lucas@ntlworld.com wrote:

US = ultra sound, the cheapest and least invasive option but the one that give the most unclear results. If it was for me, I would go for the MRI.
You are right that the magnesium keeps her well, so have her take it.

Let us know.

Dr. J. Rozencwajg, MD, PhD.
"The greatest enemy of any science is a closed mind""

Dear Shannon, I have some extra time at present and would like to work a bit
on this case if it is ok with you to discuss this case openly with the
group.

Would you say there is a connection with the alcoholism, workaholic and now
supplementolic! - i.e. a addictive or compulsive personality. Have you an
idea about the real pain she is trying to elude, (kick off, kick away with
the muscle cramps?) i.e. emotional - you hint at it with her past. How would
you sum this up? What is the predominant sensation here.

What are her energy levels like now, what do you notice when you observe
her? How does she present?

Does she have any typical acutes that she 'throws out'?

There is a connection with poor assimilation of lactic acid and some of the
sx you mention, not that I am suggesting that is her rx.

Best, Joy

Hi Joy,

This would be wonderful, thank you!!!
What I have so far:

on 8/3/03 3:45 AM, Joy Lucas at joy.lucas@ntlworld.com wrote:
Mmmm, this could be hard for me to answer, but here's what I think I see:
I don't think she is at heart a workaholic. What she *wanted* was to stay
home with the kids -- and have several more, LOL! Of course I did not know
her before her kids were born (smile), and she only got to do the "home with
the kids" thing until I was about 2 (that's when my father entered law
school and she bought and ran her brother's business to pay the bills). But
we are a very "family stories" kind of family, so I was sort of raised on
tales of my parents' pasts -- with all the complicated combination of
accuracy and not that such stories carry!

I would say that she is (and always was) very conscientious, a very hard
worker. She is (and always was) very "interactive", interested in people
and their stories, interested in (groping for the right phrase)
understanding things, knowing how they work, and a sort of "fix-it"
approach. In school she was in "every" committee, president of her class,
"class poet", played fiddle weekly in a dance band, and *looooved* to party!
For most of my growing-up years, my parents had frequent parties -- small
but *very* lively, the same group of close friends, who all (from
observation) really enjoyed having a good time. (In a white collar/college
student, hardworking sort of way.)

To counterbalance the "party" theme, I'll note that she also did (and does)
hold close to "the rules" -- morality, truthfulness, doing what's needed.
She has always been (I would say) a bit naive, which I'm not sure how to
explain or describe right now. She is (and always was) very idealistic (I
should describe that more, but can't think how right now).

Over the past years, tho, she has also become *extremely* irritable, can fly
into a (literal) rage over what I would call trivia -- someone moved the
scissors, something didn't get put back, a phone message wasn't delivered...
(Sepia, Nux, Lach?) When she's feeling well this isn't so marked, but when
she's feeling poorly and anything goes wrong, look out!

My guess is that this is not how she started out, but developed from decades
of overwork (then) and frustration (now). She can go on, and on, and on,
and on, about how if you tell somebody (e.g. the housekeeper) something
*nicely*, they won't remember. So "you have to be mean!", by which she
means, e.g., This is where the scissors go. Make *sure* you put them back.
If you don't, I'll be SO ANGRY, I'll be looking and looking, wasting my
time, and you just HAVE to put them back. EVERY time..." Etc. She used to
this sort of thing even when I was a kid -- there was no such thing as a
"quick reminder"... I've always felt that sort of approach backfires,
because one sort of goes deaf as a survival mechanism... I've tried telling
her that sometimes "less is more", but she insists that No, if you tell
someone something nicely, they won't hear you at all. (Argh...)

Sudden thought, that goes nicely with the feeling (delusion!!!!!) of herself
as a "wallflower type" (NOT!!!); something about not feeling heard/seen.
Mmm, I've tried to think about this...
Backing up a bit, there is quite definitely a strong miasmatic weakness
(speaking of self-cancelling phrases).
Father died from alcoholism (huge h/o grief w/in him, I would say);
One brother was also alcoholic and died early
The other brother (syph?) was a truly brilliant man (mathematician), but
never had much of a grip on "reality", never coped very well with the world
and recently died from an unknown illness. He had cut himself off from all
of his family decades ago, and I'm sure that was painful.

There was much that was good in her childhood, and I think she would deny
that there's pain there, but my sense is like yours, that there is. She's
talked about her father taking her taking her around with him to bars on his
drinking rounds, showing her off. (This is as a little kid; she loved it.)

Her parents were moonshiners in Chicago during the Prohibition (is this
US-cenetric history that I should explain?) She talks about how
periodically there would be banging on the apartment door in the night, and
someone would rush to pull the plug in the bathtub to get rid of the
"evidence" (yum!). Once her father was being arrested (for moonshine) and
she threw herself between him and the police, (age 6ish, she says?) yelling,
"No, you *can't* take my father away! I cause him *enough* trouble
already!" A cute and funny story, but well...

But I don't know if I know much more...

*Maybe* the predominant sensation is something like nostalgia? It feels
that way to me, and when I've asked her, If you could get rid of the
doorbell, the phone, the stacks of mail, the clutter, and do *just* what you
want to, what would it be? She answered, on a few occasions and without
hesitation, "Working on my baby books!"

She is a photo fanatic, and some years ago started organizing decades worth
of photos (and home movies) into beautifully and whimsically laid-out
albums, marked by years, pages arranged by themes (people and/or times
etc.), pictures artfully clipped and arranged, interspersed with little
sayings she clips from magazines, etc. Can't recall examples, but they're
either to-the-point relating to the person in the picture, or just funny
little sayings or jokes -- really fun to look thru! The picture and
clippings are in tray after tray, spread out over several tables in her
"workroom", and apparently this is what she does for a few odd minutes
before she goes to sleep -- at around 2:00 in the morning, then gets up at
7:00 briefly to set breakfast out, then rests until 9:00.

She says she can't get to bed before 2:00 a.m., because it takes that long
to finish dealing with the stuff of the day, and then deal with (she lists)
shutting the windows, locking the doors (reasonable enough), getting the
next morning's breakfast started (she does a somewhat elaborate "breakfast
drink"/healthy stuff for my dad), picking up (it's a big house with a lot
going on even with us kids long gone!), and maybe she does some of the mail
then too, I'm not sure.

Hm, maybe she *is* a little obsessive, as I think about it! She subscribes
to I think she said eight health newsletters, which she says she can't bear
to cancel any of, yet she doesn't find time to read more than a snippet here
and there of any of them. She insists that she' gotten *wonderful*
information now and then from each of them, which has really helped her, and
she wants to give up the *other* stuff, not her newsletters, yet she's
drowning in them... And they get *incredible* amounts of junk mail, which
she says she just *has* to give at least a quick look to, or she'll throw
away something important. (*Maybe* that's true, but...)
It varies. When she's doing well, she is pretty energetic in that she seems
to be feeling well, chats easily and happily, gets around okay, mood pretty
good. On the other hand, she has gotten *much* more frail over the past few
years (I assume that's to do with worsening osteoporosis). She has a very
marked sideways curve to her spine, as well as being rather bent forward.
She used to love brisk walks, but walking isn't very easy any more.

Her face tends to be puffy, esp. in the morning or esp. when she is not
doing well. (Presumed kidney weakness, and her mother died (age 90) of
kidney failure.) Coloring on the sallow side, tho that's variable.

Sometimes she appears slow, and I would almost say stuporous (that's too
strong a term, but sort of like that), and other times she appears really
pretty well. I'm not always sure what's making the difference -- sleep?
food? stressful events? supplements???

She very seldom gets sick. She's had a very occasional flu-type thing (2 in
the past 3-5 years?), but nothing else comes to mind.
She says she is extremely overacid. I'm not certain what that's based on
other than home saliva test kits, on which she is overacid off the scale. I
don't really know anything about lactic acid metabolism???

Let me know what else might help, and thanks so much! I've definitely been
in an "I give up" frame of mind about this, but can't afford that, argh...

Best,
Shannon