What is Hyperparathyroidsim?
If you are seeing a surgeon for a problem with your parathyroid glands, it is likely that one or more of the glands are producing too much parathyroid hormone (PTH). Normally, if the calcium level in the blood is low, the parathyroid glands sense this and release PTH. PTH then causes release of calcium from the bones and increased absorption of calcium from the intestines. If the calcium level is too high, then PTH secretion should decrease to a very low level. With hyperparathyroidism, the parathyroid glands continue producing PTH even as the calcium level becomes higher than normal, and this can cause ill effects on the body.
When the parathyroid hormone level is above normal and the calcium level is also above normal, this is called primary hyperparathyroidism. There are two other types of hyperparathyroidism called secondary and tertiary hyperparathyroidism. Tertiary hyperparathyroidism is generally seen in patients after a kidney transplant.
Secondary hyperparathyroidism due to Vitamin D deficiency is easily treated with medication for a short time and does not require surgery. Secondary hyperparathyroidism due to renal failure can be controlled with medication in some instances but for those patients with extremely high parathyroid hormone levels, surgery is the only way to adequately control the condition.
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Low Vitamin D levels can cause the parathyroid glands to produce more parathyroid hormone in some patients. Your doctors may check your Vitamin D levels to ensure your PTH level is not high for this reason, but Vitamin D deficiency will never cause your calcium level to be high as well. Many patients have Vitamin D deficiency. It is quite common in our region of the country. We see many patients with both primary hyperparathyroidism and Vitamin D deficiency, and can successfully treat both.
When is Parathyroid Surgery Needed?
Parathyroid glands make parathyroid hormone (PTH) to regulate the level of calcium in the blood. Other cells in the body, especially cells of the bones, kidneys, and small intestine, respond to PTH by increasing the calcium levels in the blood. Under normal conditions, this control is quite accurate. If one or more parathyroid glands enlarge and become overactive, your blood calcium level may increase. This condition is called primary hyperparathyroidism. These tumors are nearly always benign, but they may cause other problems such as kidney stones, mood changes or depression, and weakened or painful bones. The most common treatment for primary hyperparathyroidism is surgical removal of the abnormal gland or glands. Surgery can provide a permanent cure for this condition.
What are the Symptoms of Hyperparathyroidism?
Patients with hyperparathyroidism can suffer numerous ill effects. These include:
- osteoporosis (decreased bone density) which can lead to bone fractures
- kidney stones and decreased kidney function
- peptic ulcers from increased stomach acid secretion
- pancreatitis (inflammation of the pancreas)
- generalized muscle aches and pains
- difficulty concentrating
- difficulty with memory
- insomnia, frequent urination at night
How is the Hyperparathyroidism Treated?
Endocrine surgeons at University of Michigan routinely use advanced techniques not offered by most other institutions. The majority of patients needing parathyroid surgery are able to be treated using minimally invasive techniques.
Our surgeons also use techniques in the operating room to immediately confirm that you have been cured, rather than waiting for pathology results come back. Many times surgery can be performed under local anesthetic along with medication through an I.V. to calm you during the procedure. Most patients having surgery under local anesthetic can return home within an hour or two after surgery.