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Increased Risk of Primary Hyperparathyroidism in Celiac Disease

Celiac.com 05/07/2012 - People with celiac disease face a higher risk of developing primary hyperparathyroidism (PHPT) in the early years after their celiac disease is diagnosed, according to a new report from Sweden. The report appears in the The Journal of Clinical Endocrinology & Metabolism.

Image: CC-Nomadic LassA team of researchers recently set out to examine the risk of primary hyperparathyroidism (PHPT) in people with celiac disease. The researchers included Dr. Jonas F. Ludvigsson, Olle Kämpe, Benjamin Lebwohl, Peter H. R. Green, Shonni J. Silverberg and Anders Ekbom. They are affiliated with the Department of Pediatrics (J.F.L.) at Örebro University Hospital in Örebro, Sweden, the Clinical Epidemiology Unit (J.F.L., A.E.) of the Department of Medicine at Karolinska Institutet in Stockholm, Sweden; the Department of Medical Sciences (O.K.) at Uppsala University and University Hospital in Uppsala, Sweden; and Celiac Disease Center (B.L., P.H.R.G.), and Division of Endocrinology, Department of Medicine (S.J.S.) at Columbia University College of Physicians and Surgeons in New York city, USA.

At least one other study has suggested an association between celiac disease and primary hyperparathyroidism.

For their study, Dr. Jonas F. Ludvigsson from Orebro University Hospital and colleagues examined the risk of PHPT among 17,121 patients with biopsy-verified celiac disease. They found that patients with celiac disease faced a 1.91-fold increased risk of PHPT compared to 85,166 matched controls.

Ignoring the first year, due to a risk of ascertainment bias, the team found that the risk level for PHPT increased 3.29-fold through 60 months, and disappeared after that period.

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The decrease in risk level over time may be due to the beneficial effect of the gluten-free diet, the team noted. For every per 100,000 person-years at risk, the absolute risk level from one to five years of follow-up was 61 cases in patient, compared with just 22 cases in controls. The overall risk level was even greater, by 2.53 times, when the outcome was restricted to PHPT with an adenoma diagnosis in the National Cancer Registry.

A review of the data show that the increased risk of PHPT persisted after restricting the analysis to 1987 or later, which post-date changes in ICD coding. The risk for PHPT was slightly higher for women diagnosed with celiac disease after menopause than for women diagnosed earlier in life.

Their study does not "provide any insight into the nature of the association between celiac disease and PHPT," the authors admit. They are unsure whether the association  is causal or whether celiac disease and PHPT might be tied another unidentified condition.

Because most patients with untreated celiac disease have vitamin D and calcium deficiencies, the team expected to find a "constellation of celiac disease and elevated parathyroid hormone levels," but that they did not expect to see a connection between celiac disease with hypercalcemia and PHPT.

The team calls for future studies to focus on thoroughly investigating the connection, so that researchers can understand all possible aspects of the link between these two conditions.

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1 Response:

 
Margie
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said this on
14 May 2012 10:27:18 AM PDT
You have four parathyroid glands. They are small the size of your pinky finger nail. I had one that needed to be removed because of hyperparathyroidism. It happened within two years of my celiac diagnosis.




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The Rash and various other symptoms are strong signs of Celiac, multiple people in your family also have it. I see several of your symptoms as very familiar to me myself, and I know that supplementation will help resolve the rest of your issues with a gluten-free diet. While we do suggest getting tested for confirmation if your limited as you say with insurance, and money then doing what is best for your health should be your focus right now. Go ahead and remove the gluten from your diet if you wish and go gluten free. If something happens later you MIGHT be able to put up with a gluten challenge and get tested at a later time. I feel for you and see the issues, I have Medicaid myself and my severe gluten reactions and allergies got me on disability for a good while. Testing was a pain in the ass for me as finding a doctor that takes Medicaid is bloody near impossible where I live. I do suggest supplementing Magnesium, Iron, Vitamin D, and B vitamins primarily right now. Others you might be low in are folate, E,C,A and various others. The nerve issues are strongly related to various b vitamins, magnesium, and D. I will share a link of what I take for a example. BTW have you checked out the newbie 101 thread? And if you need help finding gluten-free foods I have a huge list that I have complied for people although we normally suggest a whole foods diet only for the first month or so. Might want to drop dairy and oats for a bit, by the sound of your deficiency issues I would say it would be a huge help doing so. https://www.celiac.com/gluten-free/topic/117090-gluten-free-food-alternatives-list/ https://www.celiac.com/gluten-free/topic/116482-supplement-and-foods-you-take/

It is meant to show you are a real person not a spammer. Not sure if it works anymore. Only Admin can see it and he doesn't do anything with it.

MelissaNZ, Has your daughter been checked for vitamin deficiencies??? Vitamin D deficiency symptoms include urinary incontinence, oral candidiasis (thrush), skin rashes, bumps on the backs of arms, joint pain, distended stomach and short stature. Bones can't grow much without vitamin D. Vitamin D deficiency causes delayed gastric emptying (food doesn't move through the gastrointestinal tract at a normal speed and the intestines bloat) which explains your daughter's delayed reaction to the cake. Vitamin A deficiency is also a cause of bumps on the back of the arms. Vitamin A deficiency causes vision problems. Vitamin A and D are both fat soluble vitamins. Absorption of fats is a problem for Celiacs. So is absorption of B vitamins and important minerals. B Complex vitamins are water soluble and must be replenished every day. Skin rashes are associated with several B vitamins like niacin (B3), B12, and thiamine (B1). I went through a period of severe malnutrition prior to diagnosis. It was not a pleasant experience. I had symptoms similar to your daughter's, including the incontinence, which resolved on vitamin D supplementation. Please, please have your daughter tested for vitamin D deficiency. And have her B vitamins checked as well. Celiac Disease causes malabsorption. Malabsorption causes deficiency diseases. Newly diagnosed Celiacs need to be checked for deficiencies. I hope this helps.

I will try to make my long story short, I have been searching my whole life for a diagnosis, I have seen pretty much every doctor possible I even went through a spinal tap recently because they thought I had multiple sclerosis, when I was younger I was always throwing up and having stomach problems, a couple hospital visits they thought I had appendicitis, I started having a neurological symptoms as well as anxiety and depression, The fatigue was just over bearing, I was having numbness and tingling and muscle spasms all the time eventually started having seizures, which kind of cycled through and stop happening after a couple months, and then it dawned upon me my brother has celiac pretty severely, my grandmother also has celiac, my dad does as well, I don't know why I never thought that it could be my issue, for the last week I have Been gluten-free and steering clear of cross-contamination, my dizziness is improved my fatigue is improved as well as rashes I was getting on my arms and sides, I have no more muscle jerks or spasms, The problem is I have horrible insurance and I cannot afford testing, so I am at least trying to do it an home blood test, I know it's not very accurate on telling me if I have celiac or not, But the thought I may never know for sure if I have it is very daunting. My family keeps telling me you don't need to spend thousands of dollars to have a doctor tell you you can't eat something you already know you can't. Just was wondering if anybody else has been in my position and seeing if anybody has a vi just was wondering if anybody else has been in my position and seeing if anybody has advice, I don't want to be known as one of those people who believe they have something and people with the disease frown upon them it's a very scary thing to think about.

...ON a side note this is quite easy, you can make your own out of any gluten-free Bread mix, I recently started using a coconut flour blend for this.......Most often people associate caraway with Rye Bread so you just add caraway seeds to the dough and a bit more vinegar to sour it a tad and BAM gluten-free Rye Bread knock off. I think Authentic Foods even has a additive to put in bread mixes to make it taste like Rye Bread....Or you can buy it preamade, I have issues with all the other ingredients but as for one of the best gluten-free Breads out the Canyon House makes a Rye like bread https://canyonglutenfree.com/buy-gluten-free-bread-products/Gluten-Free-Rye-Deli-Sandwich-Bread.html