Parathyroid Glands
The parathyroids are small glands located at the base of the neck and usually next to the thyroid. Most people have four parathyroid glands which are are around the size of a grain of a rice with two on each side of the thyroid.
The parathyroid glands control how our body uses calcium by producing parathyroid hormone. It is common for the parathyroid glands to produce too much parathyroid hormone (called hyperparathyroidism) which causes a high calcium level (called hypercalcemia) in the blood. This is often detected incidentally or unexpectedly when you have blood tests for other reasons but a high parathyroid hormone and calcium levels can also cause symptoms.
Having a high parathyroid hormone and calcium level can cause:
osteoporosis or thinning of the bones leading to fractures
kidney stones
lethargy, low mood or depression and brain fog
muscle and abdominal pain
if the calcium levels become very high, they can cause confusion and seizures
Having a high parathyroid hormone level also may contribute to high blood pressure and an increased risk of having a stroke or heart attack.
Causes of high parathyroid hormone level
For most people having a high parathyroid hormone level is due to a parathyroid gland becoming enlarged and producing too much hormone - this is called a parathyroid adenoma. A parathyroid adenoma is a benign or non-cancerous enlargement of a parathyroid gland and can cause the parathyroid to grow to many times its original size.
In some situations such as having kidney failure, multiple parathyroid glands can become enlarged which is called hyperplasia.
Treatment of high parathyroid hormone levels
The usual treatment for high parathyroid hormone levels is to try and identify which of the four parathyroids are enlarged and then to remove the enlarged parathyroid/s by an operation called a parathyroidectomy.
To identify an enlarge parathyroid this is done by scans and then during surgery by an examination of the parathyroids. It is important to know that even if a parathyroid scan does not show an enlarged parathyroid gland you may still have one which can only by detected during surgery.
For people with a mildy elevated calcium or parathyroid hormone level it may be possible to have observation of your blood tests if they don’t have any symptoms and do not wish to proceed with surgery but most people will benefit from having an enlarged parathyroid removed.
It is important to understand the options when you are deciding on treatment. A/Prof Glover through this training and experience is an expert in parathyroid management and seeks to personalise treatment.