Parathyroid disorders lead to abnormal levels of calcium and phosphorus in the blood which can lead to health problems such as kidney stones and brittle bones.
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The parathyroid gland is made up of four small glands that sit behind the thyroid gland in your neck.
They are responsible for the production of parathyroid hormone (PTH), which controls the levels of calcium and phosphorous in your blood, aids in the production of vitamin D and helps prevent the loss of too much calcium in your urine.
The main types of parathyroid gland disorder are hyperparathyroidism (overactive parathyroids) and hypoparathyroidism (underactive parathyroids).
Hyperparathyroidism
If you have hyperparathyroidism, this means your parathyroid is producing too much PTH. This can lead to high levels of calcium in the blood, known as hypercalcemia, which can cause serious health problems, including osteoporosis and kidney stones.
Hypoparathyroidism
If you have hypoparathyroidism, this means your parathyroid is not producing enough PTH. This can lead to too little calcium in your blood and too much phosphorous. This can damage your glands and can adversely affect your muscles, nerves and other functions.
In many cases, symptoms are often absent in the early stages of hyperparathyroidism.
Symptoms you may experience include:
Joint or bone pain
Muscle weakness
Fatigue
Low mood
Difficulty concentrating
Loss of appetite
Nausea and vomiting
Abdominal pain
Confusion, lack of concentration and poor memory
Thirst and increased urination
Hypoparathyroidism progresses very gradually in most cases and symptoms can be mild, and may even go unnoticed for years.
Symptoms to be aware of include:
A tingling sensation in your fingertips, toes and lips
Muscle twitches in your face
Cramps, spasms or muscle pains, particularly in your legs, feet
Abnormal heart rhythm
Fatigue
Mood changes, such as irritability, anxiety or low mood
Difficulty concentrating
Problems with memory
Frequent urination, especially at night
Abdominal pain
Dry, rough skin
Coarse hair that breaks easily or falls out
Brittle nails
In the majority of cases, hyperparathyroidism is caused by a non-cancerous tumour (an adenoma) on one of the parathyroid glands. The condition can also occur when two or more of the parathyroid glands become enlarged (hyperplasia). Rarer causes include radiation treatment to the neck, inherited conditions, such as multiple endocrine neoplasia type 1, and cancer of a parathyroid gland.
The most common cause of hypoparathyroidism is accidental damage to the parathyroid during surgery. Less common causes include certain genetic or autoimmune conditions, infiltrative disorders and low levels of magnesium.
Parathyroid disorders are diagnosed with blood testing that measures your levels of PTH, calcium, phosphorus and magnesium. A urine sample may also be needed to assess the amount of calcium and other substances being expelled in your urine.
Once a diagnosis has been made, imaging tests may be required to identify which gland or glands are affected and to determine whether surgical treatment is needed.
If you have hyperparathyroidism, you may need to have a DEXA scan (a bone density X-ray). This helps to identify any bone loss, fractures or bone softening. X-rays, CT scans or ultrasound scans may also be required to see calcium deposits or kidney stones.
Hyperparathyroidism can lead to complications such as fragile bones and kidney stones and needs specialist care. Our specialists at OneWelbeck will perform a detailed clinical and biochemical assessment to determine the best treatment strategy for you, whether that be surgical removal of the glands or medications such as cinacalcet or bisphosphonates.
The treatment of hypoparathyroidism aims to restore the balance of calcium and phosphorous in your blood. This requires careful replacement in order to avoid long-term side effects. Treatment can include taking calcium carbonate and vitamin D supplements and eating a diet high in calcium and low in phosphorous. If these are ineffective, parathyroid hormone (PTH) injections may be required.
Symptoms
Joint or bone pain, constipation, fatigue, abdom...
Causes
Non-cancerous tumour, accidental damage to the ...
Tests
DEXA scan, x-ray, ct scan, ultrasound
Treatments
Medical treatment, surgery
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