Parathyroid Gland Disorders
Parathyroid gland disorders cause abnormal levels of calcium and phosphorus to build up in the blood, which may lead to problems like brittle bones, kidney stones, fatigue, and weakness.
What are parathyroid gland disorders?
You have 4 parathyroid glands in the front of your neck. They’re found near your thyroid gland, but their functions are very different.
Each parathyroid gland is roughly the size of a grain of rice, and its main job is to release parathyroid hormone (PTH). This hormone controls calcium levels in the blood, which is important for muscle and nerve function.
In a healthy set of parathyroid glands, PTH is released when calcium levels in the blood are low. This triggers calcium to be transferred from the bones to the bloodstream.
If calcium levels in the blood are too high, the parathyroid glands reduce PTH levels, which triggers calcium to move from the bloodstream back into the bones.
Parathyroid gland disorders happen when the parathyroid glands produce too much or too little PTH. These include:
hyperparathyroidism – the most common parathyroid gland disorder, when your parathyroid glands create high amounts of PTH, causing high levels of calcium in the blood
hypoparathyroidism – a rare condition where the body doesn't make enough PTH, causing low levels of calcium and high levels of phosphorus in the blood
Our consultant endocrinologists see patients with parathyroid gland disorders in our purpose-built Endocrinology centre, where they offer the most advanced care in both diagnostics and treatment.
More information
The symptoms of parathyroid gland disorders vary depending on whether calcium levels are low or high. Sometimes there are no symptoms at all.
Hyperparathyroidism signs can include:
muscle weakness
fatigue
needing to sleep more
depression
aches and pains in the joints and bones
loss of appetite
nausea and vomiting
constipation
confusion, trouble thinking, and poor memory
feeling more thirsty and peeing more than usual
Hypoparathyroidism symptoms may include:
tingling or burning in the fingers, toes, and lips
muscle aches or cramps in the legs, feet, stomach or face
twitching or spasms of muscles around the mouth, hands, arms, and throat
tiredness or weakness
headaches
memory loss
Hyperparathyroidism is caused by excess production of PTH. There are 2 types of hyperparathyroidism, which include:
primary hyperparathyroidism – when one or more of the parathyroid glands become damaged, causing excess PTH. You’re more at risk if you have a noncancerous growth (adenoma), 2 or more parathyroid glands that have become enlarged, or parathyroid cancer
secondary hyperparathyroidism – when another condition that causes calcium loss forces the parathyroid glands to produce more PTH. You’re more at risk of secondary hyperparathyroidism if you have a severe calcium or vitamin D deficiency or chronic kidney failure
Hypoparathyroidism happens when the parathyroid glands don’t make enough PTH. You may be more likely to develop it if you have:
had neck surgery – it’s the most common cause of hypoparathyroidism, when the parathyroid glands get damaged by mistake, or are removed, during surgery
an autoimmune disease – when the body's immune system attacks healthy tissues by mistake. If the parathyroid glands are attacked, they stop making PTH
hereditary hypoparathyroidism – when the condition runs in families. It can be triggered by being born without parathyroid glands, or when the glands don't work correctly
low levels of magnesium in the blood – this can affect how well the parathyroid glands work
had cancer radiation treatment of the head or neck – radiation can destroy the parathyroid glands, such as radiation treatment for thyroid diseases, called radioactive iodine
If you have any symptoms of a parathyroid gland disorder, we recommend making an appointment with one of our consultants in our outpatient Endocrinology centre.
At a consultation, your specialist will ask you about your symptoms, medical history, and run some other tests, such as:
blood and urine tests – to measure your levels of PTH, calcium, phosphorus, and magnesium in the blood, and calcium and other substances in your urine
imaging tests – such as a DEXA, CT, or ultrasound scans, or an X-ray. These can help identify which gland or glands are affected, and work out if surgery is needed
It’s not possible to avoid parathyroid gland disorders completely, but managing any underlying conditions, like chronic kidney disease, may help reduce your risk of secondary hyperparathyroidism.
If you’re due to have thyroid or neck surgery, talk to your surgeon about the risk of damage to your parathyroid glands.
If left untreated, parathyroid gland disorders can lead to serious complications.
Hyperparathyroidism may cause hypercalcemia, which is when calcium levels in the blood are too high. It may lead to:
osteoporosis, which can cause fractures
kidney stones
high blood pressure – this can increase your chances of developing heart disease and stroke
Untreated hypoparathyroidism may lead to other health problems, such as:
Addison's disease – when the adrenal glands don't make enough hormones. This risk is associated only with autoimmune-related hypoparathyroidism
seizures
kidney failure
irregular heart rhythms and fainting
cataracts
pernicious anemia – when the body can’t make enough red blood cells because of low vitamin B12 levels
There’s a range of treatments available for parathyroid gland disorders, but the best option for you depends on what’s causing the disorder.
Treatments may include:
surgery – removing overactive or enlarged parathyroid glands is an effective way of treating primary hyperparathyroidism
medication – medicines called calcimimetics can decrease the amount of PTH produced by the parathyroid glands, bisphosphonates can help reduce calcium levels in the blood, and hormone replacement therapy (HRT) may be given to women with hyperparathyroidism, who’ve gone through menopause and are showing signs of osteoporosis
lifestyle changes – calcium and vitamin D supplements may be recommended. To help bring calcium and phosphorus levels back to a healthy range in hypoparathyroidism, you may also need to follow a diet low in phosphorus and high in calcium, with the support of a dietician
PTH injections – these may be required if dietary changes haven’t helped
monitoring – which can include blood tests, physical exams, and bone density measurements. This is often recommended if symptoms are mild, there are no symptoms at all, only slightly elevated blood calcium levels, and normal kidney function and bone density results
At Welbeck, our endocrinologists are experts in their field and are dedicated to providing world-class care to every patient.
With access to colleagues across other specialties, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.
All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.
Your health is important to us, so we strive to offer same-day appointments whenever possible.
Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.
Get in touch today to book an appointment.
Our specialists
Dr Scott AkkerConsultant Endocrinologist
Dr Candy SzeConsultant Endocrinologist
Dr Raghav DwivediConsultant ENT, Head, Neck & Thyroid Surgeon
Mr Colin ButlerConsultant ENT Surgeon
Professor Fausto PalazzoConsultant Endocrine Surgeon
Mr Khalid GhufoorConsultant ENT Surgeon
Mr Jahangir AhmedConsultant ENT Surgeon- Mr Tom KurzawinskiConsultant Endocrinologist and Endocrine Surgeon
- Dr Simon MorleyConsultant Radiologist
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Frequently asked questions
It’s possible to have parathyroid gland disease and not notice any symptoms at first. But eventually, symptoms or complications can make it clear that something isn’t right.
Hypoparathyroidism is a condition that can’t be cured and needs to be managed well. You’ll usually have blood tests to check your calcium and phosphorus levels weekly or monthly at first. This may extend to once or twice a year over time, but regular testing is important to make sure your calcium and phosphorus levels are in a healthy range.
Parathyroid hyperplasia is a different condition to hyperparathyroidism. With hyperplasia, all 4 parathyroid glands become enlarged, but an adenoma doesn’t grow inside the glands. There’s no known cause, but it’s thought that long-term use of the drug lithium may increase the risk of developing the condition.
Some people manage hyperparathyroidism well, without it affecting their health. In other cases, especially in people with kidney disease, hyperparathyroidism can cause serious complications, such as kidney stones and even renal failure, if left untreated.