- The parathyroid glands are a group of 4 tiny pea-sized glands in the neck. They make a substance called parathyroid hormone (PTH), which controls the balance of calcium in your body and the levels of calcium in your blood.
- Calcium is a very important element for your health. It is the main element that makes up your bones, and is used by nerves to send signals and by muscles (including your heart) to contract and relax.
- Primary hyperparathyroidism is a condition where one or more of the parathyroid glands becomes overactive and produces too much PTH in the bloodstream. This causes the calcium level in your body to go UP, causing your blood tests to show that your calcium level is too HIGH.
- Primary hyperparathyroidism is usually found by accident when a routine blood test during your yearly physical shows a high calcium level. A few other simple blood tests are then done to confirm that the high calcium level is due to primary hyperparathyroidism, and not another cause.
- Primary hyperparathyroidism is a serious disease, but luckily, we have a cure for it! If left untreated, primary hyperparathyroidism can result in kidney stones, severe osteoporosis (thinning of the bones), bone pain, foggy memory, unexplained anxiety, or sleep difficulties. Many people will not have any symptoms, but that does not mean it should not be treated. In fact, most people who have primary hyperparathyroidism should be treated, whether or not they have symptoms.
- The treatment for primary hyperparathyroidism is surgery to remove the abnormal parathyroid gland (or glands, if more than one is abnormal). The good thing about primary hyperparathyroidism is that the vast majority (over 90%) of people are completely cured after surgery!
About parathyroid surgery
- Parathyroid surgery, known as parathyroidectomy, is the ONLY treatment that can cure primary hyperparathyroidism.
- In some specific cases, for example if the patient is very old and has a very mild case, or has other medical issues making surgery very dangerous, surgery may not be performed. However, most people with primary hyperparathyroidism should undergo surgery.
- Before surgery, your doctor will order some tests. These tests help to confirm the diagnosis and also determine which of the glands needs to be removed. These tests may include:
- Blood tests
- A bone density study
- An ultrasound of your neck
- A CT scan of your neck
- A nuclear medicine study, known as Sestamibi scan, of your neck.
- In most cases, only one parathyroid gland is abnormal, and the tests you have done will help your surgeon determine which gland it is. In this situation, your surgery may take as little as 45 minutes to an hour. In other cases, it’s not clear which of the parathyroid glands is abnormal, and in these cases surgery may take longer, sometimes up to 2-3 hours.
- In both cases, however, the recovery is relatively easy. The surgery is done through a 2 inch incision in the neck, and pain after surgery is usually mild and easily treated with pain medications. You will usually go home the same day, and will have no activity limitations other than needing to avoid heavy lifting, bending, or straining for the first week.
- Immediately after parathyroid surgery, you will need to start taking calcium supplements to make up for all the calcium that was being stolen from your bones and being put into your bloodstream by the abnormal parathyroid gland(s). Your surgeon will prescribe the amount of calcium you should take. It can take up to a few years for you to replace all of the calcium that was lost, but most patients report feeling a noticeable improvement in their symptoms within hours or days after surgery!
- Complications after parathyroid surgery are rare, but can occur, just like for any other surgery. These include, but are not limited to, bleeding (<5%), infection of the surgical site (<5%), hoarseness due to injury of the vocal cord/laryngeal nerve (<2%), or recurrence of high calcium down the line and need for repeat surgery (<5%).
- Have you been told you have an overactive parathyroid gland?
- Do you have a high calcium level in your blood?
- Do you suffer from kidney stones, osteoporosis, bone pain, foggy memory, unexplained anxiety, or sleep difficulties?