Calcium & Parathyroid Gland Disorders
The parathyroid glands are four glands (each around the size of a grain of rice) located in the neck near the thyroid gland.
Their purpose is the secretion of parathyroid hormone (PTH) which regulates our body’s calcium levels by influencing the cells in our bones to release calcium into the bloodstream.
Calcium is the main element that allows our muscles to contract, and the parathyroid helps our muscular and nervous system to properly function.
Although the parathyroid and thyroid glands share a name, they are not related.
What are parathyroid gland disorders?
If the parathyroid releases too much, or too little PTH into our system, it can cause the following disorders:
Hyperparathyroidism (HPT)
HPT is caused from an excess of PTH hormone.
This is the most common parathyroid disorder and occurs when one or more of our parathyroid glands becomes overactive which can result in too much calcium in the blood. This condition is called hypercalcemia. It is typical for a benign tumour on the parathyroid gland to cause HPT.
In rarer cases, when 2 or more of the parathyroid glands become overactive the condition is called hyperplasia.
Hypercalcemia may cause serious problems such as kidney stones, heart disease, high blood pressure, or osteoporosis, peptic ulcers, pancreatitis.
What are the symptoms of HPT?
There are often no symptoms of HPT, however some patients may experience some mild symptoms including:
- Muscle weakness, aches and pains in the joints and bones
- Fatigue or an increased need for sleep
- Depression
Those with more advanced HPT may experience:
- Appetite loss
- Nausea, vomiting
- Increased thirst and urination
- Constipation
- Memory impairment or confusion
Who is at risk of HPT?
HPT most commonly occurs in people aged between 50 and 60 with women having approximately three times a higher incidence as men.
In some instances, HPT occurs due to a rare genetic disorder, and HPT may also occur as a result of another problem such as kidney failure which can cause the parathyroid glands to become overactive.
How is HPT diagnosed?
There are a number of tests for the diagnosis for HPT including:
- Blood tests
- A bone density X-Ray (DEXA scan)
- X-Ray
- CT scan
- Ultrasound scan
How is HPT treated?
Whether you have primary, secondary, or tertiary HPT and your calcium levels will determine Dr Nandi’s treatment advice. This can include:
Primary HPT
- Medicine to lower calcium levels
- Correction of dehydration with fluids (usually with an intravenous drip)
- Surgery to remove the parathyroid gland
Secondary HPT
- Oral vitamin D
Tertiary HPT
- Specialist medication
Hypoparathyroidism
Hypoparathyroidism is a rare condition that results from our body not making enough PTH resulting in our blood’s calcium levels to fall, and phosphorous levels to rise. Hypoparathyroidism most often occurs as a result of neck surgery or if the parathyroids are damaged, from low magnesium levels, or from autoimmune conditions.
Hypoparathyroidism can cause:
- Addison’s disease
- Cataracts
- Parkinson’s disease
- Pernicious anaemia
What are the symptoms of Hypoparathyroidism?
Symptoms are wide ranging and can include:
- Muscle cramps, pain, and twitching
- Tingling in the fingertips, lips, and toes
- Mood swings
- Fatigue
- Rough, dry skin
- Hair that breaks easily and may fall out
- Fingernails that break easily
How is hypoparathyroidism diagnosed?
Blood tests are used to determine low PTH levels, low calcium levels, high phosphorous levels.
How is hypoparathyroidism treated?
The treatment is aimed at the relief of symptoms and bringing your calcium and other minerals in your blood back to normal levels. Dr Nandi will arrange for you to have regular blood tests to monitor your calcium and phosphorous levels as well as prescribe supplements of calcium carbonate and vitamin D.
Other recommendations for the management of hypoparathyroidism will include dietary advice based on a high-calcium, low phosphorous diet.
