Parathyroid Gland Disorders

Q: What is the parathyroid gland?

A: The parathyroid glands are small, pea-sized glands located near or embedded in the thyroid gland in the neck. Most people have four parathyroid glands, but some people can have the fifth or even sixth gland as well. Despite their proximity to the thyroid, the parathyroid glands have a distinct function and are not directly related to thyroid function.

The main function of the parathyroid glands is to regulate calcium and phosphate levels in the body. They accomplish this by producing a hormone called parathyroid hormone (PTH). Here are some key points about the parathyroid glands and parathyroid hormone:

Parathyroid hormone (PTH) — PTH plays a crucial role in maintaining the balance of calcium and phosphate in the body. It acts on the bones, kidneys, and intestines to regulate the levels of these minerals.

Calcium regulation — PTH increases the release of calcium from the bones into the bloodstream. It also enhances the absorption of calcium from the intestines and reduces the excretion of calcium in the urine.

Phosphate regulation — PTH decreases the reabsorption of phosphate in the kidneys, leading to increased excretion of phosphate in the urine.

Negative feedback system — the secretion of PTH is regulated by a negative feedback system. When calcium levels in the blood are low, the parathyroid glands release PTH, which acts to raise calcium levels. Once calcium levels are restored, PTH secretion decreases.

Hypoparathyroidism — if the parathyroid glands are underactive or absent, it can lead to a condition known as hypoparathyroidism, resulting in low levels of calcium in the blood.

Hyperparathyroidism — conversely, if the parathyroid glands are overactive, it can lead to hyperparathyroidism. This condition is characterized by elevated levels of PTH, which can result in increased calcium levels in the blood. Hyperparathyroidism can cause thinning of the bones (osteoporosis), kidney stones etc.

Q: What is the treatment for a parathyroid gland disorder?

A: There are different approaches depending on the type of disorder.

Surgical procedures, such as thyroidectomy, can sometimes involve the removal or inadvertent damage to the parathyroid glands, leading to potential issues with calcium regulation. Surgeons take precautions to preserve the parathyroid glands whenever possible during such procedures.

Hypoparathyroidism (a lack of parathyroid function) is treated with calcium and Vitamin D supplements.

Hyperparathyroidism (overactive parathyroid glands) can be treated surgically or with medications. Sometimes monitoring of calcium levels is all that is required. Surgical treatment is indicated in patients with very high calcium, those who have osteoporosis or history of osteoporotic fractures, kidney stones or constipation.  Age of less than 50 is also an indication for surgery.