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Parathyroid Conditions

Dr Ben Lancashire is a specialist endocrine surgeon. He has a particular interest in thyroid surgery and parathyroid surgery.

What are parathyroid glands?

The parathyroid glands are endocrine glands that produce parathyroid hormone (PTH). There are usually four of them (two on each side) at the back of your thyroid gland, though they may be found anywhere in the neck, even down as low as inside the chest cavity. A normal parathyroid is small – not much bigger than a grain of rice.

What is hyperparathyroidism?

Parathyroid hormone (PTH) regulates the level of calcium in the blood. Calcium is important for the functioning of the heart, muscles and nerves, as well as the strength of your bones. High calcium levels due to parathyroid disease (hyperparathyroidism) can also result in

  • abdominal pains
  • irregular heart beat (arrhythmia)
  • constipation
  • high blood pressure
  • kidney stones
  • thinning of the bones (osteoporosis) which can result in bone fractures
  • mood disturbances
  • tiredness
  • memory problems

Often, people will not have any symptoms of hyperparathyroidism, but a routine blood test (for other reasons) may show a high calcium level. Most doctors will follow this up and investigate you for a parathyroid problem.

What causes hyperparathyroidism?

There are multiple causes of hyperparathyroidism, and some of them are quite complex. The most common type is called primary hyperparathyroidism.

The causes of primary hyperparathyroidism are:

  • A single benign tumour called a parathyroid adenoma (~85%)
  • Multiple benign parathyroid adenomas (10%)
  • Parathyroid hyperplasia (5%)
  • Parathyroid cancer (<1% - very rare)

How do you diagnose primary hyperparathyroidism?

Investigations are usually first arranged by a GP or endocrinologist. Diagnosis and work-up generally involves:

  • Blood tests for calcium, vitamin D and parathyroid hormone (PTH) levels
  • A urine test (usually a 24 hour collection)
  • An ultrasound scan of the neck
  • A bone mineral density scan (BMD)
  • A special nuclear medicine scan called a sestamibi scan
  • A four-dimentional CT scan (4D-CT)

These tests can diagnose whether or not you have hyperparathyroidism, but may not always show your doctors where the abnormal gland is. There are a few other specialised scans and tests that Dr Lancashire will arrange if this is required.

Treatment of hyperparathyroidism

Surgery is the only effective treatment for hyperparathyroidism. There are no medications currently available that can cure primary hyperparathyroidism.   

For people without any symptoms, there are guidelines that may help decide if you should consider surgery. Dr Lancashire will be able to discuss if you will benefit from surgery.

You can read more about parathyroid surgery by following the link below:

Parathyroid Surgery