Information About Parathyroid Disorders
What Are Parathyroid Glands?
The parathyroids are tiny endocrine glands located near the thyroid in the neck. Everyone has four of them, and they all do just one thing: regulate calcium levels in the blood. They do this by producing parathyroid hormone (PTH). When the calcium in the blood is low, the parathyroid glands make more PTH in order to bring the calcium back up. When the blood calcium is too high, the parathyroid glands stop making PTH, which will lead to a drop in blood calcium.
Most of the body’s calcium is stored in the bones, but calcium is more than just a component of bones. The brain, nerves, and muscles depend on calcium for signaling. The blood needs proper calcium levels to clot effectively. The parathyroid glands ensure that calcium levels remain within a very tight range for these organs to function optimally.
Parathyroid disorders are characterized by abnormal functioning of the parathyroid glands. The most common disorder of the parathyroid glands is called primary hyperparathyroidism, which is overactivity of one or more of the parathyroid glands. This is usually caused by a benign parathyroid tumor, or adenoma, that produces too much parathyroid hormone (PTH). PTH works in several ways to increase the calcium in the bloodstream, called hypercalcemia. This can be seen on routine blood tests, and this is often how patients find out that they have parathyroid disease.
Although parathyroid tumors are almost always benign (non-cancerous), they are not harmless. Untreated parathyroid disease can lead to chronic fatigue, insomnia, memory loss, kidney stones, cardiac arrhythmias (like atrial fibrillation), chronic kidney disease, and osteoporosis. The disease significantly impairs quality of life. Fortunately, primary hyperparathyroidism can be cured with an outpatient procedure that is safe and effective.
Receiving Treatment for Parathyroid Disorders at the TGH Thyroid & Parathyroid Institute
Our center’s parathyroid surgeons are the only surgeons in the world who operate solely on the parathyroid glands. They perform 75 to 80 parathyroid operations every week, and have some of the highest cure rates, with minimal complications. Patients in the center are cared for by a team of nurses, physicians, technicians, and others who are committed to providing the highest quality experience for patients with parathyroid disease. Most patients can leave the hospital within two hours after the procedure. Each person is given the cell phone number of his or her parathyroid surgeon, and the surgeon calls the patient that evening to check-in. Our system is highly efficient, but also personalized and patient-centered.
As a patient at the TGH Thyroid & Parathyroid Institute, you will be evaluated by the world’s leading specialists in parathyroid treatment and surgery. Because our physicians focus exclusively on the surgical treatment of thyroid and parathyroid disorders, we have in-depth knowledge about all aspects of diagnosing and treating these conditions. Named by U.S. News & World Report as one of America's Best Hospitals for Diabetes & Endocrinology in 2018-19, TGH is a destination for parathyroid patients from around the world.
What is Unique About Parathyroid Surgery at Our Center?
- Our six surgeons each perform more parathyroid operations than any other surgeons in the U.S., and our surgeons work together on every case. Every patient has two of our surgeons evaluate all four parathyroid glands. With the extreme variability of parathyroid anatomy and appearance, this is of paramount importance and ensures the best outcomes for our patients.
- All four parathyroid glands are assessed to make sure no tumor is left behind (approximately 30% of patients will have more than one parathyroid tumor, and these generally are not seen on any scans). Many surgeons will only evaluate one parathyroid gland, as finding and evaluating all four glands safely can be very challenging. Our surgeons have the extensive experience necessary to be able to find and evaluate all four glands on most patients.
- The physiologic activity of each parathyroid gland is assessed in real time to assure hyperfunctioning glands are removed and normal glands are left behind.
- Our center avoids unnecessary and expensive tests that add little to the diagnosis and treatment of parathyroid disease. This includes many of the localization studies that attempt to locate the parathyroid tumor preoperatively, including CT scans. Our patients do not need any imaging studies prior to the day of surgery. On the day of surgery, each patient gets a sestamibi scan to ensure that the tumor is not in an unusual location, and a thyroid ultrasound to evaluate the thyroid for any suspicious nodules that might change the operation. These studies may not show the adenoma, but because our surgeons are experienced in finding all four parathyroid glands, it is not necessary to perform any further imaging before the operation.
- Everyone at the center, from the OR technicians who work with the surgeons to the transporters who take patients to the scanner, is dedicated solely to caring for parathyroid patients. They are all part of one team.
Click here to watch a video of a minimally invasive radioguided parathyroid surgery.
Click here to watch a video about one TGH patient’s experience at the Parathyroid Center.