Dear Dr. Cannell:
I am a 37 year-old woman who recently had successful surgery for hyperparathyroidism. I have galactorrhea (breast discharge) and pituitary hormone irregularities over the past 10 years. I also have worsened osteoporosis. I have been diagnosed with multiple sclerosis, and simultaneously diagnosed with gluten, and other food (dairy, egg, soy, and nut) intolerance. I continue with 5,000 IU/day of vitamin D and a well-balanced diet. I have recently had lower leg pain that resolved with removing calcium supplements from my diet.
I recently fell and bruised/partially broke a rib. I have trouble with stamina at exercise. My menses are intermittently shorter and with regularly less and less blood. I think I have a pituitary adenoma. Is there a doctor that you recommend consulting with regarding calcium, vitamin D and the pituitary? I have over 10 years of lab work, and hope for healing so I can be physically well.
Please let me know if you have any recommendations.
Mary, New Jersey
First, you need a good endocrinologist, and I don’t know any in the New Jersey area. These days, many endocrinologists know about vitamin D. Find one you trust who also knows about nutrition. You are sorely in need of some good nutrition counseling.
After surgery, some patients with hyperparathyroidism have some of their parathyroid gland left in and some do not. If you are only on 5,000 IU/day, I suspect your parathyroid glands are still functioning. Second, osteoporosis requires much more than vitamin D, it requires magnesium, zinc, K2 and an alkaline body environment, to name a few things.
Third, I agree with a well-balanced diet. However, such a diet is impossible if you remove so many things, including calcium, from your diet. If you don’t have calcium in your intestine, your body will simply remove even more calcium from bone, worsening your osteoporosis. Also, I doubt the leg pain had anything to do with dietary calcium.
Fourth, yes, you may have a pituitary adenoma explaining your menses but it could be other things, too. If it were a pituitary adenoma (most of which are benign), a good endocrinologist would have drawn a blood test of the hormones controlled by the pituitary to find out.
I would take enough vitamin D to keep your 25(OH)D in the high normal range, while you are looking for a good endocrinologist.
John Cannell, MD