The parathyroid glands are four small glands in the neck that are part of the endocrine system. They produce parathyroid hormone (PTH), which maintains calcium and phosphorus levels in the blood. The primary disease associated with the parathyroids is overproduction of PTH, known as hyperparathyroidism.
Several problems can occur when the parathyroid glands secrete too much parathyroid hormone (PTH).
- The blood calcium level rises in a condition known as hypercalcemia. The bones lose calcium (osteoporosis) while the body absorbs too much calcium from food. Calcium levels may also increase in the urine, leading to kidney stones.
- A benign tumor called an adenoma usually forms on the overproducing parathyroid gland. It is important to note that benign tumors are not cancerous and that hyperparathyroidism is only very rarely associated with cancer.
- PTH also lowers blood phosphorus levels by increasing excretion of phosphorus in the urine.
Causes and Symptoms
Hyperparathyroidism is twice as common in women as in men, and the risk increases with age. In most cases, the cause of hyperparathyroidism is not known. Symptoms are often subtle and may include:
- Weakness, fatigue, and depression
- Nausea, vomiting, loss of appetite, and constipation
- Impaired thinking and loss of memory
- Increased thirst and urination
- High blood pressure
Surgical removal of one or more parathyroid glands is called a parathyroidectomy.
During the operation, you will be given either a general or local anesthetic. Your doctor will make a small incision in your neck and remove the gland. Your particular problem will determine how many of the parathyroid glands need to be removed. Some parathyroid tissue must be left in place to help prevent hypoparathyroidism (decreased parathyroid activity).
However, in most cases of hyperparathyroidism, only one gland has to be removed and a less invasive procedure called minimally-invasive radio-guided parathyroid (MIRP) surgery can be performed. MIRP surgery only involves a local anesthetic, requires a much smaller incision, and has a very high success rate. The operation usually takes less than 30 minutes and you may return home within one to two hours. You will be able to return to your normal daily activities after just one day.
Risks and Complications
Complications of parathyroid surgery are more common in the traditional procedure than in the MIRP procedure, but both procedures are generally safe and successful. Less than 1 percent of patients undergoing surgery experience damage to the nerves controlling the vocal cords, which can affect speech. Patients requiring more extensive surgery could develop hypoparathyroidism, resulting in low calcium levels, which may require treatment with calcium or vitamin D.