Diagnosed with hyperparathyroidism? Here is some important information you should know…
Medically Reviewed by Richard Fox, MD
Hyperparathyroidism is a common hormonal disorder. About 100,000 Americans will develop primary hyperthyroidism this year. Postmenopausal women are at the highest risk; they are affected 2-4X more often than men.
Simply put, hyperparathyroidism is the result of one or more of your parathyroid glands producing too much hormone. The parathyroid glands are four tiny glands located behind the thyroid gland in your neck. Each the size of a grain of rice, the parathyroid glands regulate levels of calcium in your blood and bones, phosphorus levels and vitamin D metabolism. When too much parathyroid hormone is released due to hyperparathyroidism, it pulls calcium out of your bones, absorbs more calcium from your intestines and causes your kidneys to retain more calcium.
All of this leads to high blood calcium (hypercalcemia) which can cause fatigue and muscle weakness, bone or joint pain, kidney stones, frequent urination, constipation, excessive thirst, osteoporosis and even depression. In medical school, doctors are sometimes taught to remember the severe symptoms of hyperparathyroidism with the phrase “stones, bones, abdominal groans and psychiatric overtones”
When the symptoms become severe, surgery is the only cure. Untreated hyperparathyroidism can lead to bone fractures, kidney damage, high blood pressure, and in rare cases, heart rhythm abnormalities.
Now for the good news. Surgery for hyperparathyroidism, when performed by the experienced endocrine/parathyroid surgeons such Dr. Fox and Dr. Beckley at Alpine Surgical, carries a 99% success rate. Experience matters, as best results are experienced by surgeons who regularly perform these procedures. Additionally, the surgery is minimally invasive in most cases, requiring only a small incision. Most patients usually go home the same day, and recovery is quick compared with other surgeries.
Why is experience so important? Even though the operation is minimally invasive, parathyroid surgery requires considerable precision, skill and expertise. While 85% percent of patients present with a single abnormal gland, 10-15% of patients present with a multi-gland situation. Textbooks generally show the four normal parathyroid glands simply located in the neck alongside or behind the thyroid gland. In actuality, this is frequently not the case. Parathyroid anatomy notoriously exhibits extreme anatomic variations, sometimes being found elsewhere in the neck or even deep into the chest cavity. Furthermore, some patients can present with extra-glands making the diagnosis even more elusive. An experienced surgeon is more accustomed to these variations which can help prevent the need for another surgery in the future.
Furthermore, the goal isn’t just to remove the dysfunctional gland. The surgeon must preserve normal parathyroid tissue and protect nearby structures. Additionally, experienced surgeons often use intraoperative parathyroid hormone testing to confirm that the condition has been cured before completing the procedure.
If you have been diagnosed with hyperparathyroidism, it is reasonable to ask a surgeon questions like “How many parathyroidectomies have you performed?” and “What is your cure and complication rate?” A little extra work up front can help to ensure this condition is effectively treated allowing you to quickly return to your normal life.
