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Hypoparathyroidism & Parkinson Disease
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Altered Calcium Balance: Hypoparathyroidism is when the parathyroid glands do not produce enough parathyroid hormone, which is the hormone that regulates calcium blood levels. The correct calcium level should be between 8.5 and 10.5 mg/dL (Braun & Anderson, 2017).
There are four parathyroid glands that are behind the thyroid gland. There are two major sources in our body that are responsible for calcium storage or absorption, those are the bones which is a huge calcium storage site and then the kidneys which absorb calcium and move it back into the blood supply when filtering urine.
Throughout the body when the calcium levels get above 10.5 mg/dL it gives a signal to the parathyroid glands to reduce their production. This negative feedback loop is important to maintain calcium homeostasis (Braun & Anderson, 2017). When the parathyroid glands cannot increase the calcium levels in the body it leads to hypocalcemia which is when the blood calcium levels get below 8.5 mg/dL.
There are many clinical manifestations when it comes to hypoparathyroidism those include: hair dryness and loss, nail ridges and breakage, skin dryness, bone loss, tingling in extremities (parathesia), visual changes, muscle cramps, seizures, and fatigue, in children it can also lead to unusual facial characteristics (Braun & Anderson, 2017, p.215). When it comes to diagnosing hypoparathyroidism there are many things that contribute.
The first thing that doctors will look at will be past medical and surgical history along with a physical exam. The laboratory tests that will be done will be blood calcium, phosphorus, and magnesium which can look at electrolyte imbalance by comparing numbers (Braun & Anderson, 2017). They will also measure the calcium in the urine which will determine how well the kidneys are absorbing the calcium to disperse back into the bloodstream.
Treatment of hypoparathyroidism includes long-term treatment due to this being a chronic condition. This will include supplemental calcium, along with vitamin D. There was recently a new study that came out with a new treatment that includes recombinant parathyroid hormone along with the calcium and vitamin D (Braun & Anderson, 2017).
Parkinson Disease (PD) is a chronic condition that is progressive and affects the pigmented dopaminergic neurons which are in the substantia nigra and locus ceruleus of the basal ganglia (Braun & Anderson, 2017). The decay of neurons in the brain usually occurs in middle to old age adults. There is still no cure for PD. PD is more common in men than women. PD is known to effect parts of the brain that are located in the basal ganglia, these structures include: striatum, globus pallidus interna, the subthalamic nucleus, and the substantia nigra (Braun & Anderson, 2017, p.259).
There have been no specific structure that explains where PD has been found (Braun & Anderson, 2017). PD is thought to be caused by the alteration of neurons in the brain, it can be inherited, or it can occur intermittently. There are four clinical manifestations of PD that are the prime ones that people experience, those include: tremor, rigidity, bradykinesia, and postural instability (Braun & Anderson, 2017, p.259). Tremors involves the hands, arms, legs, and face, it usually begins on one side of the body and moves to the other side.
Bradykinesia is when someone is very slow moving, many people that have PD get to a point where they shuffle to walk or have a bent over posture. The rigidity movements can also involve the tongue, throat and mouth which can be very serious and cause aspiration during eating or drinking. There are other clinical manifestations that patients can encounter that are objective such as altered blood pressure. Research has found that dementia can also be a manifestation of PD (Braun & Anderson, 2017).
There is no one exact test that can diagnose PD, there is a scale that medical personal use when diagnosing patients with PD there are five stages. Stage one clinical manifestations are only on one side of the body, they are mild and not disabling, patients’ friends have noticed a difference in their posture and facial expressions. Stage two is when the symptoms are now showing on both sides of the body, they have minimal disability and their posture and walking is affected. Stage three is very slow body movements, impaired balance when standing and walking, and sever dysfunction.
Stage four which has severe symptoms, walking is very limited, and they cannot live on their own when PD gets to this stage. Stage five which includes extreme weight loss, cannot walk or stand up, and needs constant care by a nurse (Braun & Anderson, 2017). When it comes to treatment of PD it can be very confusing and challenging as the treatment can involve many different medications with many different doses, because the body will get immune to the medication and require a high dose or alterations in order to be effective.
The most popular pharmacological drug used is levodopa, which is a replacement of dopamine, this drug is often used in combination with other drugs. There are also other options which could include surgery which would include a pallidotomy and deep brain stimulation. This surgery will destruct the globus pallidus (Braun & Anderson, 2017). Before any surgically treatment is done there has to be an MRI or CT scan that identifies symptoms. The most common treatment is pharmacologic.
Braun, C., & Anderson, C. (2017). Applied pathophysiology (3rd ed.). [CoursePoint]. https://thepoint.lww.com/Book/Show/993500#/about-this-product?groupby=learningactivity&ts=1631720455018
