What are parathyroid glands?
The parathyroid glands are four tiny glands that live behind your thyroid, in front of your windpipe. They produce parathyroid hormone (PTH), which helps keep your blood calcium levels in check.
So, what is hyperparathyroidism?
Hyperparathyroidism is the most common issue with parathyroid glands. It happens when one or more of these glands get too big or overactive, making too much PTH. This raises your blood calcium levels and can cause problems with your bones, kidneys and other parts of your body.
Kristin McCoy, MD, Carilion Clinic Endocrine Surgery, notes that parathyroid cancer can cause hyperparathyroidism but it’s very rare. It affects less than 1% of patients.
Are you at risk?
“Hyperparathyroidism can affect anyone, but it’s more common in women ages 40 – 70,” says Dr. McCoy. “Women are 3 times more likely to develop the condition.” Other risk factors include:
- Family history of hyperparathyroidism
- Previous radiation exposure to the head and neck (including radioactive iodine treatment)
- Certain medications, like lithium or hydrochlorothiazide
- Low levels of vitamin D
- Chronic kidney disease
Symptoms to watch for
The symptoms of hyperparathyroidism can be subtle and often go unnoticed. Many patients have minor symptoms and brush them off as part of the normal aging process. “Usually, the first major sign of an overactive parathyroid gland is an elevation in the serum calcium level on routine bloodwork,” explains Daniel Tershak, MD, a specialist in adult complex thyroid and parathyroid surgery.
Other symptoms to watch for include:
- Fatigue
- Muscle and joint pain
- Memory problems
- Brain fog
- Nausea
- Kidney issues
- Weakness
- Increased thirst or urination
In more severe cases, patients might experience depression, osteoporosis or kidney stones.
How is it diagnosed?
Diagnosing hyperparathyroidism usually involves a combination of:
- Blood tests
- Urine tests
- Imaging tests like ultrasounds or CT scans to spot abnormal glands
It’s important to note that a negative imaging test doesn’t rule out hyperparathyroidism.
Can it be treated?
Surgery is the gold standard for treatment. Medicines can be used to help lower your calcium level, but this only helps slow the progression of disease. The American Association of Endocrine Surgeons recommends surgery for most patients, including those without symptoms.
The goal of surgery is to remove the abnormal gland(s) so calcium levels go back to normal. The procedure involves a small cut to remove the problem gland. If all four glands are overactive, multiple glands may be removed.
“A successful operation will reverse the negative effects of an overactive parathyroid gland,” explains Dr. Tershak. “Bone health improves and patients with kidney stones usually stop forming new stones or get them less often. Patients also experience less fatigue, more energy and improvements in memory. “
If you think you might have hyperparathyroidism or notice symptoms, talk to your primary care provider. They can connect you with a specialist to take the first step toward effective treatment and improved quality of life.
