DEAR DR. DONOHUE: My wife has been tested and found to have high levels of parathyroid hormone and calcium. She also has kidney stones. Please advise as to treatment. — G.H.

ANSWER: The parathyroid glands are four small glands lying directly behind the thyroid gland in the neck. Their hormone, parathyroid hormone, regulates how much calcium is in the blood. Overactive parathyroid glands, also called hyperparathyroidism, lead to high blood calcium. Although hyperparathyroidism isn’t as everyday as the common cold, it isn’t an exotic illness, either. It affects 1 in 500 to 1,000 people. If you do the math, that’s a considerable number. It most often appears in the 50s or later, and women outnumber men by three to one. The usual cause is enlargement of one parathyroid gland.

The diagnosis is made by measuring the blood level of both the hormone and calcium. Supporting evidence comes from X-rays of bones, which show changes of having too little calcium. Another consequence of hyperparathyroidism is kidney stones. Fatigue and weakness are prominent.

How best to handle the problem depends on a person’s age and the level of blood calcium. People under 50 are advised to have surgery to remove the overactive gland. Older people with no symptoms often are watched until symptoms appear. (They may never.) Your wife has one complication of this illness — kidney stones. That favors surgical treatment. The operation produces gratifying results and puts an end to the problem.

If surgery isn’t chosen, then your wife must stay well hydrated to prevent more stone formation, and she must exercise daily to keep her bones strong. Her diet should be one with a moderate intake of calcium, another way to promote bone strength. She might have to take the same medicines used to treat osteoporosis. She’ll be followed closely to monitor what’s happening to her blood calcium and what’s happening to her bones.

DEAR DR. DONOHUE: How much is too much vitamin D? I am 78 years old and in good health.

Daily I take a vitamin D capsule of 1,000 IU. I take a calcium capsule that contains 200 IU of vitamin D. I also take a multivitamin that contains 500 IU of D.

At 1,700 IU am I overdosing? — C.S.

ANSWER: The upper daily limit for vitamin D is set at 2,000 IU. You’re not overdosing. People with depleted levels of this vitamin can take up to 10,000 IU a day. You should, however, not exceed 2,000 IU. Too much D can raise calcium blood levels too high, and that creates a good deal of trouble.

The most recent recommendation for the daily vitamin D dose is 800 IU for people 71 years old and older. For adults younger than 71, it is 600 IU.

Many experts in this field suggest an optimum daily intake of 800 to 1,000 IU for all adults.

DEAR DR. DONOHUE: I had my gallbladder taken out in 2007. I have heard that the gallbladder stores bile from the liver.

Since I don’t have a gallbladder now, where does the bile go? Does having your gallbladder taken out interfere with weight loss? — E.C.

ANSWER: You’re quite right. The gallbladder stores bile made in the liver. When you eat, especially when you eat fatty or fried foods, the gallbladder contracts to send a jet of bile into the small intestine for food digestion. Without a gallbladder, you drip bile into the digestive tract on a more or less constant basis. Digestion still takes place quite well. Hundreds of thousands of people manage to thrive without a gallbladder.

It does not interfere with weight loss.

DEAR DR. DONOHUE: What is the meaning of a positive ANA on a blood test? — S.L.

ANSWER: “ANA” is “antinuclear antibody.”

A positive ANA is seen in illnesses like lupus and rheumatoid arthritis. However, a positive test without any signs and symptoms of illness, or without any supporting laboratory evidence of illness, doesn’t mean a whole lot.

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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