DEAR DR. DONOHUE: My calcium is on the high side. My doctor isn’t sure why, but he thinks it might be the parathyroid glands. I’m familiar with the thyroid gland, but not the parathryoids. What are they? When he first mentioned it to me, he spoke of surgery. The next time I saw him, he said surgery was out. I don’t know what he’ll say the third time. Is there any medicine I can take? — L.P.

ANSWER: The parathyroid glands are four pea-size glands closely adherent to the back of the thyroid gland in the neck. Parathyroid hormone, the product of these glands, regulates the blood levels of calcium and phosphorus.

Your story is a familiar one. Parathyroid trouble often is discovered when people have multiple tests on a single blood specimen, and a high calcium level is found. These people usually have no symptoms; slightly elevated calcium rarely produces any. At higher levels, symptoms appear and range from mild fatigue, loss of appetite, unquenchable thirst, frequent urination, constipation, muscle weakness and disorientation to coma. In these days, with early discovery of high calcium, no one ever reaches the coma stage.

Finding a high blood parathyroid hormone level clinches the diagnosis.

Most of the time, excess production of hormone is confined to only one of the four glands.

A rush to surgery isn’t necessary when an older person has no symptoms and when the calcium level isn’t all that high. Watching the patient and the patient’s calcium level is acceptable.

Surgery is more urgent if the patient is younger than 50 or shows a great loss of calcium from the bones.

DEAR DR. DONOHUE: My 19-year-old daughter is home from college for the summer.

She has a job lined up. Yesterday she showed me her back. It’s covered with pink spots. She says they’re on her chest too. I insisted on taking her to the doctor that afternoon. He diagnosed pityriasis rosea and said she doesn’t need any medicine. She feels fine.

If she had these spots on her face, she wouldn’t go to work. Can’t something be done? Will she spread it if she goes to work? — L.L.

ANSWER: Pityriasis (PIT-uh-RYE-uh-sis) rosea is presumed to be a viral illness, but the virus has not been identified. It’s chiefly an illness of older children and young adults. It starts out with one, somewhat large, salmon-colored patch. Days to weeks later, smaller patches on the back, chest, abdomen, upper arms and lower legs appear in children; they might pop up on the face. Itching is the only symptom, and that’s not universal. Pityriasis calls for no medicines.

If itching is a problem, cortisone creams suppress the itch. So do antihistamines.

If pityriasis is contagious, it’s not very contagious. She doesn’t have to stay home from work.

It can take four to six weeks for all signs of this somewhat strange condition to go away.

DEAR DR. DONOHUE: I dream every night, and I remember the details of my dreams in the morning. I tell them to my husband, and it irks him no end to listen to me relating them. I don’t know why. I find them interesting. He claims he never dreams. Do vivid dreams rob me of the restoration and refreshment sleep brings? — B.W.

ANSWER: Everyone dreams, even your husband. Dreaming is most prominent during the sleep stage called rapid eye movement, REM, sleep. What dreaming does for a person is a big unknown. Some say it assists the brain in consolidating memories. Or it might be a way for the brain to air memories that could be threatening when awake. Dreaming doesn’t rob you of the benefits of sleep, unless the dreams are terrifying and the terror remains when awake.

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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