The parathyroid glands are the «calcium regulators» of the body.
They are usually 4 in number and lay at the back surface of the thyroid gland. They produce an hormone called parathormone (PTH).
PTH regulates serum calcium levels by enhancing the absorption of calcium from the bones , the kidneys and the small intestine, thereby increasing blood calcium levels.

Parathyroid diseases

The most common disease is hyperparathyroidism due to over activity of one or more glands.
The causes of this hyperfunction are:

  • Parathyroid Adenoma (benign tumor)
  • Hyperplasia Gross enlargement of the parathyroid glands due to cell proliferation
  • Carcinoma Malignant transformation of the parathyroid glands (rare)
  • Endocrine disorders Type I and II multiple endocrine neoplasia (MEN) syndrome

Symptoms of hyperparathyroidism

Many patients have no symptoms and the disease is diagnosed after a random measurement of serum calcium levels.
When there are symptoms these include:

  • Nausea
  • Vomiting
  • Lethargy
  • Constipation
  • Muscle pain
  • Peptic ulcer

Diagnostic tests

  • Measurement of serum calcium, phosphorus and levels, 24-hour urine calcium level
  • Ultrasound of the neck
  • Parathyroid scintigraphy (sestamibi scan)
  • MRI
  • Bone density scan (DEXA)

Indicated treatment for hyperparathyroidism

Surgical removal of the affected parathyroid glands.

If I do not have symptoms of hyperparathyroidism why should I undergo surgery?

Long-term effects of hyperparathyroidism if not treated are:

  • Osteoporosis
  • Automatic bone fractures
  • Nephrolithiasis (calcium deposition in the kidneys-renal srones- with concomitant decrease of renal function)
  • Osteitis fibrosa cystica (soft weak bones)