— — Parathyroid Diseases
Parathyroid diseases generally arise from dysfunctions of the small glands located near the thyroid gland. These diseases often progress silently but have a wide impact, ranging from bone health to kidney function. In this article, we will comprehensively examine the structure and functions of the parathyroid glands, the most common diseases affecting them, and the treatment methods.
What is the Parathyroid Gland?
The parathyroid glands are small endocrine glands, usually four in number, embedded on the posterior surface of the thyroid gland. These glands produce parathyroid hormone (PTH), which regulates calcium and phosphorus metabolism in the body.
Functions of the Parathyroid Glands
- Maintaining calcium levels in the blood
- Promoting calcium release from bones into the bloodstream
- Increasing calcium reabsorption in the kidneys
- Supporting vitamin D activation
- Facilitating calcium absorption from the intestines
What Are Parathyroid Diseases?
The main diseases of the parathyroid glands are related to either excessive or insufficient hormone production. The most common condition is hyperparathyroidism, characterized by excessive PTH secretion.
Table of Parathyroid Diseases
| Disease Name | Definition | Calcium Level | PTH Level |
|---|---|---|---|
| Primary Hyperparathyroidism | Excess PTH production due to tumor or growth in one gland | High | High |
| Secondary Hyperparathyroidism | Increased PTH due to chronic kidney failure or vitamin D deficiency | Low/Normal | High |
| Tertiary Hyperparathyroidism | Uncontrolled PTH production following prolonged secondary hyperparathyroidism | High | Very High |
| Hypoparathyroidism | Insufficient PTH production by the parathyroid glands | Low | Low |
Primary Hyperparathyroidism
What is it?
It is the excessive production of PTH from one (or rarely more) parathyroid glands due to a benign tumor (adenoma). This leads to hypercalcemia (high calcium) in the blood.
Symptoms
- Bone pain and osteoporosis
- Kidney stones
- Nausea and constipation
- Muscle weakness
- Depression, forgetfulness
- Frequent urination
- General fatigue
Causes
- Parathyroid adenomas (most common cause)
- Parathyroid hyperplasia (growth of all glands)
- Rarely, parathyroid cancer
Diagnosis
- Elevated serum calcium
- Elevated parathyroid hormone (PTH)
- Low phosphorus levels
- Parathyroid scintigraphy or ultrasound
- Bone mineral density test
Treatment
- Surgical treatment (parathyroidectomy): the most effective and permanent method
- Calcimimetic drugs for patients who cannot undergo surgery
- Increased fluid intake, avoiding calcium-rich foods
Secondary Hyperparathyroidism
What is it?
It is the continuous production of PTH by the parathyroid glands in response to low calcium levels in the blood. It is commonly associated with chronic kidney disease and vitamin D deficiency.
Symptoms
- Muscle cramps
- Bone pain
- Tetany due to low calcium (involuntary muscle contractions)
- Dental problems
- Weak bone structure
Diagnosis
- Low/normal calcium
- High PTH
- Low vitamin D
- High phosphorus (especially in kidney failure)
Treatment
- Vitamin D and calcium supplementation
- Phosphate binder medications
- Parathyroidectomy may be necessary in patients on dialysis
Tertiary Hyperparathyroidism
What is it?
In patients with prolonged secondary hyperparathyroidism (especially those on dialysis), the parathyroid glands begin producing PTH autonomously, becoming unresponsive to external stimuli.
Symptoms and Treatment
Symptoms are similar to primary hyperparathyroidism and usually require surgical treatment.
Hypoparathyroidism
What is it?
A rare but serious condition caused by insufficient PTH production, usually following inadvertent removal of the parathyroid glands during thyroid surgery.
Symptoms
- Muscle cramps
- Numbness in fingers and toes
- Tetany (uncontrolled muscle contractions)
- Hair loss, dry skin
- Brittle nails
- Anxiety, difficulty concentrating
Diagnosis
- Low calcium
- Low PTH
- High phosphorus
- QT prolongation on ECG
Treatment
- Calcium and vitamin D supplements
- Long-term follow-up
- Synthetic PTH analogs (in rare cases)
Diagnostic Methods for Parathyroid Diseases
| Method | Description |
|---|---|
| Blood Tests | Evaluation of calcium, phosphorus, PTH, and vitamin D levels |
| Urine Tests | Measurement of calcium excretion to detect hypercalciuria |
| Parathyroid Scintigraphy | Determines gland location and overactivity |
| Ultrasound | Detects enlarged glands or adenomas |
| Bone Densitometry | Assesses osteoporosis |
Nutrition and Lifestyle Recommendations for Parathyroid Diseases
Recommended
- Calcium supplements (as prescribed by a doctor)
- Vitamin D support (through sunlight and supplements)
- Reducing phosphorus intake (important for kidney patients)
- Adequate fluid intake
- Regular exercise
- Avoiding alcohol and smoking
To Avoid
- Excessive calcium-rich foods (milk, cheese, yogurt) if hypercalcemia is present
- Unsanctioned supplement use with potential drug interactions
- Uncontrolled vitamin D consumption
Information About Parathyroid Surgery
Surgery is generally a permanent and effective solution for patients with overactive parathyroid glands. Minimally invasive parathyroidectomy allows removal of only the diseased gland while preserving healthy tissue. Surgery is usually performed for localized adenomas and has a success rate above 95%.
Conclusion
Parathyroid diseases often progress silently but can lead to serious complications. Their key role in calcium and phosphorus metabolism makes maintaining the health of these small glands critically important. They often go unnoticed for years before diagnosis. Therefore, complaints such as bone pain, kidney stones, muscle cramps, and fatigue may be related to parathyroid dysfunction.
Early diagnosis, correct treatment, and regular monitoring make controlling parathyroid diseases possible. It is especially important for individuals who have undergone thyroid surgery to regularly check their PTH levels.
All content on this site is for informational purposes only and is based on scientific sources valid as of the preparation date. For any symptoms, diagnosis, or treatment needs related to health, please consult your physician or an authorized healthcare institution directly.