Parathyroid

    What is the Parathyroid ?


    The parathyroid glands are four pea-sized glands located on the thyroid gland in the neck.  
    Though their names are similar, the thyroid and parathyroid glands are entirely different glands, each producing distinct hormones with specific functions.
      
    The parathyroid glands secrete PTH, a substance that helps maintain the correct balance of calcium and phosphorus in the body. PTH regulates the level of calcium in the blood, release of calcium from bone, absorption of calcium in the intestine, and excretion of calcium in the urine.  When the level of calcium in the blood falls too low, the parathyroid glands secrete just enough PTH to restore the blood calcium level.

     

    What is Hyperparathyroidism ?


    When the parathyroid secrete too much PTH  or secrete PTH when the body does not need it (the calcium level is normal) the condition is known as Hyperparathyroidism.

    Hyperparathyroidism causes the balance of calcium to become disrupted: Blood calcium rises. This condition of excessive calcium in the blood, called hypercalcemia, is what usually signals the doctor that something may be wrong with the parathyroid glands. In 85 percent of people with hyperparathyroidism, a benign tumor called an adenoma has formed on one of the parathyroid glands, causing it to become overactive. Benign tumors are noncancerous. In most other cases, the excess hormone comes from two or more enlarged parathyroid glands, a condition called hyperplasia.  Very rarely, hyperparathyroidism is caused by cancer of a parathyroid gland.

    Excess PTH triggers the release of too much calcium into the bloodstream. The bones may lose calcium, and too much calcium may be absorbed from food. The levels of calcium may increase in the urine, causing kidney stones. PTH also lowers blood phosphorus levels by increasing excretion of phosphorus in the urine.

    How is Hyperparathyroidism treated?



    Surgery to remove the enlarged gland (or glands) is the main treatment for the disorder and cures it in 95 percent of operations. 

    Calcimimetics are a new class of drug that turns off secretion of PTH. They have been approved by the Food and Drug Administration for the treatment of hyperparathyroidism secondary to kidney failure with dialysis, and primary hyperparathyroidism caused by parathyroid cancer. They have not been approved for primary hyperparathyroidism, but some physicians have begun prescribing calcimimetics for some patients with this condition. Patients can discuss this class of drug in more detail with their physicians.

    Some patients who have mild disease may not need immediate treatment.  Patients who are symptom-free, whose blood calcium is only slightly elevated, and whose kidneys and bones are normal may wish to talk with their physicians about long-term monitoring. Periodic monitoring would consist of clinical evaluation, measurement of serum calcium levels, and bone density measurement. If the patient and physician choose long-term follow-up, the patient should try to drink lots of water, get plenty of exercise, and avoid certain diuretics, such as the thiazides. Immobilization (inability to move) and gastrointestinal illness with vomiting or diarrhea can cause calcium levels to rise. Patients with hyperparathyroidism should seek medical attention if they find themselves immobilized, vomiting, or having diarrhea.

     

    Tools for testing your nerve's function