Hyperparathyroidism

What Are the Parathyroid Glands?

Almost everybody has four parathyroid glands — each about the size of a grain of rice — although some people have more than twice that many. The parathyroid glands may be tiny, but they have a big influence on your health: They regulate your body’s calcium levels, which can affect your heart, kidneys, bones and nervous system.

In most people, the parathyroid glands are located just in back of the thyroid gland, at the front of the throat. But sometimes they’re found in other places, including the chest or even inside the thyroid gland.

Note that the thyroid and parathyroid glands are completely different organs. The name parathyroid just describes the fact that these tiny glands are close to the thyroid gland.

What Is Hyperparathyroidism?

If you have primary hyperparathyroidism (PHP), one or more of your parathyroid glands is working overtime, producing too much parathyroid hormone (PTH), which raises the calcium level in your bloodstream. This can weaken your bones and cause kidney damage and other serious health problems. If the condition goes untreated for a long time, that damage can be fatal.

Who’s at Risk?

Risk factors for hyperparathyroidism include:

  • An inherited gene mutation associated with the disorder
  • Age: Women who have gone through menopause are at greater risk.
  • Previous radiation treatments to the head and neck
  • Long-term use of the drug lithium
  • Extremely low levels of calcium or vitamin D over a long period of time

Symptoms

Different people experience different symptoms or combinations of symptoms of hyperparathyroidism. These may include:

  • Fatigue or lack of energy; sluggishness
  • Bone pain, bone loss or broken bones
  • Constipation
  • Hypertension (high blood pressure)
  • Poor appetite, sometimes with nausea
  • Kidney stones
  • Depression
  • Mood swings; changes in personality
  • Memory problems
  • Blurry vision
  • Itchy skin
  • Muscle weakness
  • Pain in the upper abdomen

Treatment

Surgery to remove the abnormal parathyroid gland is the only treatment that can cure it. Patients who are not eligible for surgery may be treated with medications called calcimimetics, which reduce the body’s levels of parathyroid hormone.

Surgical Precision: The Key to a Cure

Effective surgery to cure hyperparathyroidism depends on the surgeon’s ability to locate and remove the abnormal parathyroid gland.

In about 85% of people with PHP, just one of the four parathyroid glands is working improperly, usually because of a benign (non-cancerous) tumor called an adenoma. If that specific gland is removed, your PHP will be cured and your symptoms will disappear. But if only one abnormal gland is removed when several glands are abnormal, additional surgery may be necessary.

Roswell Park surgeons focus on getting it right the very first time. We use a 4-dimensional computed tomography (CT) scan with volume rendering to locate the abnormal glands and plan the best surgical route for their removal. Our surgeons are skilled in this procedure and use the smallest incisions possible. That means you’ll have minimal scarring and a faster recovery.

We combine the information from the 4-dimensional CT scan with intraoperative parathyroid hormone testing (IOPTH) to ensure that all abnormal parathyroid glands have been successfully removed.