Dani sat in front of me, frustration written all over her face. She was tired of being exhausted, moody, and achy. She wanted her life back.
At 37, she realized time was running out if she ever wanted to have children. After a full preconception care review and necessary tests, she took charge of her journey. Five months later, she walked into the office, beaming, holding a positive pregnancy test.
Unlike most expectant mothers in their first trimester, Dani was full of energy. She worked out, practiced pregnancy yoga, ate well, stayed hydrated, and diligently took her prenatal supplements. The pregnancy progressed smoothly, and when labor arrived, she opted for a natural experience, moving around and using a birthing ball. By evening, her baby girl was born, healthy and strong.
Motherhood suited Dani well. She breastfed exclusively for six months, eased back into exercise, and effortlessly returned to her pre-pregnancy weight. But things changed when her baby turned ten months. Fatigue set in, initially dismissed as the challenges of returning to work. Exercise, once her source of vitality, became a painful struggle. Muscle and bone pain replaced the refreshing post-workout high.
Then came the insomnia, loss of appetite, and an overwhelming sense of ill-health. The most alarming change was depression. Always the lively, optimistic force in any room, Dani found herself withdrawing from colleagues, dreading social interactions, and struggling to perform in her demanding career in the performing arts.
Seeking answers, she came back to my office. A thorough physical examination revealed nothing out of the ordinary. Routine blood work showed normal levels—no anemia, no infection, and no thyroid, liver, or kidney abnormalities. Uncertain of the cause, I referred her to a physician, a psychiatrist, and an orthopedic specialist for further evaluation.
A week later, she called at 3 a.m., in agonizing right-sided abdominal pain. She was headed to the emergency room, barely able to speak between waves of excruciating pain, describing it as worse than labor.
At the hospital, tests revealed a partially blocked ureter, swollen with accumulated urine. A kidney specialist was called in, and further investigations confirmed multiple kidney stones. The urologist performed lithotripsy, successfully breaking them down. But the presence of multiple stones prompted deeper evaluation.
The final diagnosis was primary hyperparathyroidism, a condition caused by excessive secretion of parathyroid hormone due to an overgrowth of tissue in one of the four tiny parathyroid glands. Normally, these glands regulate calcium levels in the blood, but in Dani’s case, an adenoma in one of them caused continuous hormone secretion, leading to an overload of calcium.
With too much calcium in the blood, the bones released even more to compensate, leading to weakness and pain. The kidneys worked overtime to excrete the excess, forming stones in the process. High calcium levels also affected her muscles, nerves, and mood, explaining her fatigue, depression, and cognitive difficulties.
This condition is often found in older adults, particularly postmenopausal women, making Dani’s case unusual. The symptoms aligned perfectly with what has long been described as the disease of “stones, bones, groans, and moans” kidney stones, bone pain, digestive issues, and neuropsychiatric symptoms.
Dani underwent surgery to remove the affected gland, allowing the remaining three to regain proper function. While she will require ongoing monitoring due to the risk of recurring kidney stones, her life has taken a turn for the better. With her energy restored, she is finally getting back to the vibrant, active person she once was.
