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Parathyroid Gland Disease

What are Parathyroid Glands?

The parathyroid glands are pea-sized, oval-shaped glands which are located next to the thyroid gland. Usually, there are four parathyroid glands but in rare cases individuals can have more than four.

What do Parathyroid Glands do?

The parathyroid glands produce a substance called parathyroid hormone (or PTH) which controls the calcium level in the blood. Specifically, PTH controls the absorption of calcium from the gut, the release of calcium from the bones, and it allows the kidneys to hold on to calcium instead of excreting it in urine.

What is Hyperparathyroidism?

Hyperparathyroidism refers to an overproduction of parathyroid hormone. There are three types of hyperparathyroidism which are termed primary, secondary and tertiary hyperparathyroidism. Primary hyperparathyroidism is diagnosed when blood work shows a high calcium level and high PTH level. Secondary hyperparathyroidism occurs due to chronic vitamin D deficiency and/or chronic renal failure. Tertiary hyperparathyroidism is most often due to end stage renal failure.

In the majority of cases, primary hyperparathyroidism is caused by a benign tumor called an adenoma which forms in one of the parathyroid glands. Less commonly, extra PTH levels in the blood are caused by two adenomas or enlargement of all four parathyroid glands (called hyperplasia). Surgery is most commonly recommended for primary hyperparathyroidism, with the goal of removing the enlarged gland producing too much PTH.

How common is primary Hyperparathyroidism?

Approximately 100,000 people in the United States develop primary hyperparathyroidism per year. It most often occurs in people between age 50 and 60, with women being affected up to four times more often than men.

What are signs and symptoms of primary Hyperparathyroidism?

Signs and symptoms of primary hyperparathyroidism include osteoporosis, kidney stones, abdominal pain, fatigue, bone/joint pain, disorientation, confusion, and forgetfulness. If you have any of these symptoms and have been diagnosed with primary hyperparathyroidism by your endocrinologist, contact our team at Endeavor Health Advanced Neurosciences Center to book an appointment with our parathyroid surgery specialists.

When is Parathyroid Surgery needed?

Surgery with the goal of removing the overactive parathyroid gland or glands is the only way to completely cure primary hyperparathyroidism. Surgery can lead to improved bone density and reduce the chance of kidney stones. In addition, the psychiatric symptoms of hyperparathyroidism can also be cured with surgery.

In patients diagnosed with primary hyperparathyroidism, experienced parathyroid surgeons will order specific scans to locate the overactive parathyroid gland or glands. If a single overactive gland is located, the surgeon will perform minimally invasive surgery which uses a smaller incision to remove the gland. During surgery, the patient’s PTH level will be tested to make sure that it is reduced to a normal value. In cases of more than one gland being overactive, both sides of the neck are explored and all parathyroid glands are inspected.

If you have been diagnosed with primary hyperparathyroidism, it is important to seek out a qualified, experienced parathyroid surgeon who has sought additional training in parathyroid surgery.