Parathyroid Disease affects the Parathyroid glands. The parathyroid glands are four small, nodular structures typically found on the back of the thyroid gland at each of its four corners. These glands are responsible for producing the parathyroid hormone (PTH), which plays a crucial role in regulating the balance of calcium in the bloodstream and in tissues that rely on calcium for proper functioning. PTH is particularly important for the health of nerves, muscles, and bones.
Typically, the glands only produce sufficient PTH to maintain normal calcium levels. However, disease disrupts its balance. If the Parathyroid hormone levels are either too low or too high, it can result in various health issues such as muscle cramps and nerve or bone disorders.
Types of Parathyroid Disease
There are three kinds of parathyroid disease that include Hyperparathyroidism, hypoparathyroidism, and parathyroid cancer.Hyperparathyroidism
Hyperparathyroidism is the most common type of parathyroid disease that affects people. It occurs when the parathyroid glands produce high amounts of parathyroid hormone in the bloodstream. There are two types of hyperthyroidism: 1. primary and 2. secondary.- Primary Hyperparathyroidism: When a person has primary hyperparathyroidism, one or more of their parathyroid glands become overactive, leading to excessive production of parathyroid hormone (PTH). Primary hyperparathyroidism is a disorder that originates in the parathyroid glands rather than being caused by another health issue.
- Secondary Hyperparathyroidism: Secondary hyperparathyroidism occurs when another disease first causes low calcium levels in the body. As a response, the body produces higher levels of parathyroid hormone to maintain normal calcium levels. This is often seen in individuals with kidney disease or following specific intestinal surgeries or illnesses.
Hypoparathyroidism
Hypoparathyroidism occurs when one or more of the parathyroid glands do not make enough PTH, which causes the blood calcium level to be too low. The low or decreased production of PTH causes low blood calcium levels and elevated blood phosphorus levels. The condition is usually caused by autoimmune attacks on the glands, but it can also be caused by neck surgery or damage to the parathyroid.Parathyroid Cancer
Parathyroid cancer is a very rare disease, a condition where cancerous cells develop in the tissues of a parathyroid gland. It typically affects individuals in their 50s or 60s. Certain inherited disorders can elevate the risk of developing this type of cancer. Symptoms of parathyroid cancer may include fatigue, weakness, and the presence of a neck lump.Management and Treatment of Parathyroid Disease
The treatment of parathyroid disease depends on its type and condition. Your physician might use blood tests to diagnose parathyroid disease. Further tests like ultrasound, bone densitometry, body CT, and body MRI may be done to evaluate any complications from the condition. Treatment options encompass surgery, medication, dietary supplements, and monitoring.Treatment and Management for Hyperparathyroidism
The type of treatment for Hyperparathyroidism depends on whether you have primary or secondary hyperparathyroidism. Treatments could include surgery, supplements, and lifestyle management.1. Primary Hyperparathyroidism
- Surgery:Surgery is the most common treatment for primary hyperparathyroidism; it involves removing a growth or an enlarged parathyroid gland. A surgeon will remove those glands that are enlarged or have a tumor. If all four glands are affected, the surgeon will probably remove only three glands and possibly a part of the fourth one to leave some of the functioning parathyroid tissue. A thyroid specialist might be more likely to recommend surgery if you’re younger than 50 or you have other medical conditions.
- Medication and Lifestyle Changes:Medical treatment and lifestyle changes can be extremely useful in selected patients. A thyroid specialist will monitor your symptoms, calcium levels, and kidney function. Treatment for primary hyperparathyroidism is designed to address osteoporosis or hypercalcemia. Cinacalcet can lower serum calcium levels but typically does not increase bone mineral density. On the other hand, antiresorptive agents can enhance bone density but may not be as effective in reducing serum calcium. In cases where both issues need to be addressed, a combination of therapies is recommended. Lifestyle changes include a healthy diet, exercise, and monitoring the amount of calcium and vitamin D in your diet.
2. Secondary Hyperparathyroidism
The sole treatment for individuals with secondary hyperparathyroidism resulting from kidney failure is to undergo a kidney transplant. If the root issue cannot be resolved, the most effective approach is medical intervention, and surgery is only considered for patients for whom standard medical treatment is ineffective.-
- Medication & Lifestyle:
Treatment and Management for Hypoparathyroidism
When treating Hypoparathyroidism, the main purpose is to relieve symptoms and to bring calcium and phosphorus levels in your body back into a balanced range. The treatment options include:- Medication:Most people with hypoparathyroidism have to take calcium carbonate and vitamin D supplements for life. This is the primary treatment for hypoparathyroidism since your body requires vitamin D to absorb and utilize calcium. If you have hypoparathyroidism, you will need to take both supplements.
- Diet:Your healthcare professional may suggest consulting a registered dietitian, who may recommend a diet that includes consuming more calcium and less phosphorous. This is because people with hypoparathyroidism may not get sufficient calcium from their diet alone.
- Injection:Parathyroid hormone injections are recommended for patients when calcium and vitamin D supplements are ineffective in treating their hypoparathyroidism.
Treatment and Management for Parathyroid Cancer
- Surgery:To treat Parathyroid Cancer, surgically removing the affected gland and other surrounding tissues is the only cure. The prognosis for patients is more favorable when the entire parathyroid cancer is successfully removed during the initial surgery.
Non-surgical treatments are generally ineffective in curing parathyroid cancer. In cases where surgical intervention is not curative, the primary focus shifts to managing elevated blood calcium levels. This may involve the prescription of medications such as bisphosphonates, calcitonin, cinacalcet, denosumab, or gallium nitrate.
