Bone & Calcium
Calcium & Parathyroid Disorders
High or low calcium is frequently found by chance on a routine blood test. Establishing why — and in particular distinguishing hyperparathyroidism — determines whether the answer is an operation, a tablet, or simply observation.
Symptoms that bring people in
- Tingling around the mouth, or in the hands and feet
- Muscle cramps, or spasm of the hands
- Seizures, in severe cases of low calcium
- Kidney stones
- Bone pain, or a fracture after minor injury
- Excessive thirst, constipation, nausea
- Unexplained tiredness, low mood or poor concentration
Having one of these does not mean you have this condition — several overlap with far more common problems. It means the question is worth asking properly.
Calcium in the blood is held within a narrow range by parathyroid hormone, vitamin D and the kidneys. When it drifts outside that range the cause is usually identifiable and the treatment specific — so the work is diagnostic before it is therapeutic. Dr Ghosh has published on both hypoparathyroidism and primary hyperparathyroidism, including hyperparathyroidism in pregnancy.
Raised calcium
Most cases are primary hyperparathyroidism — typically a single benign parathyroid adenoma producing too much hormone. It is often silent, discovered on a routine profile, but it can cause kidney stones, bone loss and vague but real symptoms of fatigue and low mood. Diagnosis rests on simultaneous calcium and parathyroid hormone measurements, with vitamin D, kidney function and 24-hour urine calcium, followed by localisation imaging where surgery is contemplated. Surgical removal is curative in the right patient; equally, mild disease in an older person may be reasonably monitored. Malignancy is the other important cause of hypercalcaemia and is excluded where the picture suggests it.
Low calcium
The commonest cause is loss of parathyroid function after thyroid or neck surgery. Others include severe vitamin D deficiency, magnesium depletion, kidney disease and — less often — genetic causes of hypoparathyroidism, on which Dr Ghosh has reported novel mutations. Treatment combines calcium and active vitamin D, with careful titration: the goal is to relieve symptoms and keep calcium in the low-normal range without causing high urine calcium and kidney damage. Regular monitoring of blood and urine is not optional in this condition.
Urgent symptoms
Spasm of the hands or face, difficulty breathing, or a seizure suggests severe hypocalcaemia and needs emergency treatment. Marked confusion or drowsiness with known hypercalcaemia needs the same urgency.
This page is general information. Doses and treatment choices in endocrinology are individual, and are decided at a consultation with your reports in front of us. Please do not start, stop or change a medicine based on this page.
Common questions
Before your first visit
How do I book an appointment?
Use the appointment form on this website and the clinic will telephone you to confirm a time, usually within one working day. For a same-day or urgent request, please ring the number in the page header instead — a phone call is always faster than a form.
Hospital OPDs at CMRI and Narayana Memorial are booked through the hospital's own reception. For district chambers, it is worth calling the chamber number listed on its page before travelling.
Which chamber should I choose?
Whichever is easiest for you to reach and return to. Endocrine conditions need review over months and years rather than a single visit, so the chamber you can get to comfortably every few months is nearly always the better choice than the one that seems most impressive.
That said: if your problem needs same-day tests, an ultrasound, or admission, a hospital OPD is the better setting. The Chambers page lists every location with its days and timings, and the weekly timetable shows them all side by side.
Do chamber timings ever change?
Yes — and this is worth taking seriously if you are travelling any distance. Several district visits run on a monthly rotation, such as the 1st and 3rd Saturday, and a hospital OPD can be rescheduled at short notice. Timings shown on this website are kept up to date and any known cancellation appears on the chamber's page, but please telephone ahead before a long journey.
What should I bring to the first consultation?
Bring everything you have, even if it seems old or irrelevant:
- all previous prescriptions, including from other doctors
- every blood report and scan you hold, in date order if possible
- the actual strips or boxes of the medicines you take, or a written list with doses
- your home blood sugar or blood pressure diary, if you keep one
- for a child, the growth chart and immunisation record
Old reports are genuinely useful. A five-year-old thyroid result or an earlier scan often changes the plan, because what matters in endocrinology is frequently the trend rather than today's number.
Consultation
Request an appointment
Tell us which chamber suits you and when. We will confirm your slot by phone.