Ask the Expert: Primary Hyperparathyroid Disease and COVID-19, May 18-22 Dr. Courtney Balentine will be available from Monday, May 18 to Friday, May 22 to answer your questions about the diagnosis of primary hyperparathyroid disease and any questions/concerns regarding surgery delays resulting from Covid-19 response. Dr. Balentine is a fellowship-trained endocrine surgeon with a research program dedicated to improving outcomes for patients with endocrine disease, particularly primary hyperparathyroidism. He serves as a Medical Advisor to the Parathyroid Peeps on Inspire.  How to participate: We invite you to post your questions in the comment section below. Dr. Balentine will post answers to your questions daily. His answers will appear in the comment section as well. Answers may not immediately follow the question within the thread due to the format. You may find it helpful to refer to (click on) the “In Reply To: post number” at the top of Dr. Balentine’s replies to view the question being answered. Please understand if Dr. Balentine is unable to get to your question due to time or topic constraints. More About Dr. Balentine’s Research: Dr. Balentine’s work focuses on improving processes for diagnosing patients with hyperparathyroidism to facilitate early detection and treatment. His ultimate goal is to ensure that patients with hyperparathyroidism are diagnosed and treated as early as possible without experiencing unnecessary delays. Dr. Balentine is also interested in reducing disparities among older patients with hyperparathyroidism who are even more likely to experience delays in diagnosis and treatment than younger patients. Dr. Balentine works closely with patients and other stakeholders, including the PARAthyroid Peeps, to design and test interventions that address these gaps in care. His research program has been funded by NIH, the Agency for Healthcare Research and Quality, the Department of Veterans Affairs, and numerous surgical societies. Dr. Balentine is proud to provide endocrine surgical care to our Veterans. His clinical practice is based at the North Texas VA Hospital.  An important message from Inspire: This content is for general informational purposes only and does not necessarily reflect the views and opinions of any organization or individual. The content should not be used as a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider about any questions you may have regarding a medical condition. ————— Thank you, everyone, for all your questions and comments! This Ask the Expert session with Dr. Courtney Balentine has now come to an end. We hope you found this interactive format interesting and useful. A huge special thank you to Dr. Balentine for generously sharing their time and expertise during this session! We won’t be accepting any new questions at this time, but we will continue to update this post with additional answers from them in the coming days. We appreciate your patience as you wait for these replies. Many thanks again for your participation!

Good morning, Dr. Balentine!

I’m a 53 year old woman who was diagnosed with “early” hyperparathyroidism in March. I decided to wait until Covid is under control before I travel out of state to have surgery. At first I was so sad about that, but now I’m wondering if maybe I want to put off surgery even longer. According to some published studies there are many people who live with hyperparathyroidism without any complications or symptoms. My main and only symptom was extreme fatigue that came in waves but over the past couple of months I haven’t experienced it at all. I do not nor have I had stones.

My labs:

Calcium spanning from 2017 through 2020:
10.3, 10.3, 10.4, 10.3, 10.6, 10.3, 10.5

PTH 2019 and 2020:
54, 58, 68

Vitamin D 2020:
32 ng

24 hour Calcium 2019:
290 mg

24 hour Creatinine:
1.19

Bone density:

AP spine
T score: 1.4
Z score: .5

Femoral Neck:
T score: 1.6
Z score: .7

Total Hip:
T score: 1.9
Z score: 1.3

1/3 Forearm:
T score: .2
Z score: .6

10 year fracture risk is 5.2%

My question: Do you think it’s wishful thinking on my part that I can live with this? Do you have patients who choose to not have surgery and over time remain without complications?

Thank you!