3 important facts about parathyroid disease – Cleveland Clinic


You’ve probably heard of calcium and vitamin D and your needs for these essential nutrients, plus the fact that most of us don’t get enough of them.

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But what doesn’t make the headlines is the parathyroid, the four small glands in your neck that are closely related to both calcium and vitamin D. When your parathyroid glands aren’t working properly, your blood levels are calcium gets carried away, which can lead to longer term problems such as kidney stones and osteoporosis.

Fortunately, parathyroid disease – especially the more common form, hyperparathyroidism – is easy to diagnose. Endocrinologist Leila Khan, MD, clears common misconceptions and covers the basics of finding and treating this disease.

Important facts about parathyroid disease

1. Parathyroid vs thyroid

The parathyroid and thyroid are often confused because they sound the same and are located close to each other in your neck. However, the parathyroid has its own separate job.

Parathyroid hormone (PTH) keeps the calcium in your blood under control. If you have abnormal growth on one or more of your parathyroid glands that overproduces PTH, too much calcium can build up in your blood and can sometimes reach dangerous levels. It is one of the causes of hyperparathyroidism. But the most common causes of hyperparathyroidism are vitamin D deficiency, calcium deficiency and chronic kidney disease.

2. Vitamin D is crucial

It may seem strange that a calcium deficiency can cause your body to produce too much PTH, but that’s exactly what can happen in hyperparathyroidism. When your body receives too little calcium, your parathyroid glands produce excess PTH to increase your calcium levels by improving the absorption of calcium in your gut.

“A lot of patients ask me how much calcium to take daily to avoid this,” says Dr Khan. “Most adults need 1,200 to 1,500 mg per day, and if you cannot meet these needs through diet, supplementation is necessary. Use the National Osteoporosis Foundation program calcium calculator to calculate if you are getting enough calcium in your diet.

Vitamin D is a similar story. Because vitamin D helps you absorb calcium in your gut, the two are linked. Not consuming enough vitamin D can cause you to take in too little calcium, leading to parathyroid problems. Supplements can help, and most adults can take 1,000 international units of vitamin D (D3 is the best option) without worry.

“At some point, especially if you have symptoms related to calcium deficiency, work with your doctor to determine their needs and how to meet them,” says Dr. Khan.

3. Primary hyperparathyroidismm

Most people with primary parathyroid disease – caused by excessive enlargement or abnormal growth of the parathyroid glands – do not have any symptoms. In fact, symptoms usually do not trigger a diagnosis; basic blood tests during a regular exam do this. If identified, it can help prevent kidney stones and brittle bones.

“The first thing you want to know is what your blood calcium levels are,” says Dr. Khan. “If it increases, you start looking for the cause. ”

Initial tests include checking for PTH, calcium values, and vitamin D levels. The three tests combined are often sufficient to diagnose primary hyperparathyroidism, which usually occurs in people after age 50, although it can appear earlier. Once the condition is confirmed, your doctor may advise you to get a special type of x-ray to see if your bones are weaker than normal. Additionally, you may be examined for kidney stones.

The good news is that parathyroid disease is easy to spot, you can treat it and prevent long-term problems like kidney stones, osteoporosis, and osteopenia. If primary hyperparathyroidism is identified, surgery is usually the next step.

Removing your abnormal parathyroid gland (s) can essentially solve the problem in almost all cases. Removing one or more of your glands – and usually leaving part or all of a healthy gland to continue to regulate calcium – can protect your body from kidney stones and lead to a marked improvement in bone strength over time. over the next few years.

“In the hands of a good surgeon, the risk of complications is minimal,” says Dr. Khan. “The benefits are very positive. For patients with stone disease, for example, surgery is wonderful. You have just healed them and I hope they have no more events. Osteoporosis can be reversed and there can also sometimes be an improvement in energy and mental confusion.


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