Parathyroid Dysfunction

What do the parathyroid glands do?

The parathyroids are four glands located in the anterior neck, behind the thyroid gland, which are responsible for regulating calcium levels in the body.

 

What is primary hyperparathyroidism?

Primary hyperparathyroidism is the most common cause of hypercalcemia. It typically occurs when one or more of the four parathyroid glands hypertrophy or grow an adenoma that begins to produce extra parathyroid hormone, which in turn increases the calcium levels in the bloodstream. This calcium typically comes from the bones, which is why this can lead to osteoporosis. The symptoms of hypercalcemia usually include “bones, stones, groans, and moans.” This refers to bone pain and bone loss, kidney stones, stomach discomfort including reflux, nausea, vomiting, constipation, or diarrhea, and changes in moods and mental status.

 

What is hypoparathyroidism?

Hypoparathyroidism is typically a result of surgery either of the thyroid or parathyroids. Because of their close proximity, parathyroids are sometimes accidentally removed or damaged during a thyroid surgery resulting in a much lower production of parathyroid hormone and a drop in blood calcium levels. This results in muscular irritability which causes the symptoms of muscle cramps and tingling.

 

What is the treatment of hyperparathyroidism?

Typically, diagnostic testing is used to localize the parathyroid gland that is producing extra hormone and then surgical removal of that parathyroid gland is curative. However, if patients are unable to undergo surgery, there are medications and other interventions that can help lower calcium levels.

 

How are parathyroid and calcium abnormalities diagnosed?

Our team evaluates calcium status with both blood and urine tests. In addition to that, we typically do ultrasounds of the neck. For hyperparathyroidism, patients will usually receive additional testing that is specific for localizing the parathyroid gland that has hypertrophied and they will also have bone density evaluation and a kidney ultrasound performed to assess for sequelae of hyperparathyroidism.

 

What is the treatment for hypoparathyroidism?

Treatment for hypoparathyroidism typically involves aggressive calcium and Vitamin D supplementation as well as bone density monitoring.

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