DEAR DR. DONOHUE: I am a female and 85 years old. I was diagnosed with osteoporosis seven years ago, and started taking Fosamax, Citracal and vitamin D.

Last year, the results of my blood test showed that my calcium level was high. Since then, I have my calcium checked every three months, and the level fluctuates. I no longer take calcium supplements.

The glandular specialist mentioned that the parathyroid was the cause of this elevated calcium. This is the first time I have heard this medical word mentioned. He told me that if the level remained high, I might have to undergo surgery. Would an 85-year-old be a candidate for such surgery? – E.S.

ANSWER: “Para” means “close neighbor of.” The four parathyroid glands, about the size of small peas, are plastered to the back of the thyroid gland in the lower neck. The hormone these glands make – parathyroid hormone – regulates the blood level of calcium and conducts calcium into and directs its exit from bones. Too much parathyroid hormone depletes bone calcium and raises blood calcium. High blood calcium can cause a host of problems. It makes people lose their appetite, brings on nausea and vomiting, produces stomach pain, weakens muscles, leads to kidney stones and can cloud thinking. It can also make people excessively thirsty, forcing them to drink large quantities of water. Consequently, they have to run to relieve themselves frequently. Not all these signs and symptoms happen to everyone with too much parathyroid hormone and too high a blood level of calcium. Many have no symptoms at all. Symptoms generally don’t appear until the calcium blood level exceeds 11.5 mg/dL (2.9 mmol/L). Normal values lie between 9 and 10.5 (2.2-2.6).

If a person has a higher-than-normal (but not excessively high) blood calcium level and if that person has no symptoms, then watchful waiting is a quite acceptable treatment, so long as the blood calcium isn’t causing organ or bone trouble. If the calcium is high and symptoms have appeared, even an 85-year-old can safely have the renegade parathyroid gland removed. Usually only one of the four glands is involved.

DEAR DR. DONOHUE: For several years, I’ve read articles that say taking one teaspoon of plain gelatin each day relieves the pain of arthritis. What’s your opinion on this? – M.W.

ANSWER: My opinion is that it doesn’t work. However, there’s no objection to you trying the gelatin remedy. It won’t hurt you.

DEAR DR. DONOHUE: What is endometriosis, exactly? I read a magazine article about it, and I have some of the symptoms described there. Would you help me grasp better what it is and how it’s diagnosed and treated? – C.P.

ANSWER: The endometrium is the topmost lining of the uterus. At the time of a menstrual period, the endometrium is shed. Then another cycle begins and the endometrium is regenerated until the next menstrual period. In the condition called endometriosis, bits of the lining tissue migrate into the pelvis through the fallopian tubes, the tubes that bring eggs to the uterus. Those endometrial pieces can nest on the ovaries, the ligaments that support the uterus, the fallopian tubes and even distant places like the lungs. This transplanted endometrium responds to the month cycle of hormone stimulation just as the endometrium in the uterus does. The displaced endometrium, however, irritates these sites where it has implanted. The result is pelvic pain that increases in intensity at the time of menstruation. Many women with endometriosis lose large amounts of blood with their periods. Sexual relations often become painful. As many as 30 percent to 50 percent of affected women cannot become pregnant.

The ultimate method for making the diagnosis is inspection of the pelvis with a scope device that has entered the pelvis through a small incision.

There are many drugs that can help this condition. A popular one is the birth control pill. Transplanted endometrial tissue tends to wither during pregnancy. Birth control pills can simulate the environment of pregnancy and cause the tissue to shrink. There are many other medicines that can alter the hormonal state of the body to starve misplaced endometrium. Gynecologists can surgically remove the tissue. Sometimes the removal is accomplished using the same scope that the doctor used to find the tissue. The endometriosis booklet provides the details on this common condition. Readers can order a copy by writing: Dr. Donohue, No. 1105, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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