Does Parathyroid Disease Lead to Osteoporosis?

The parathyroid glands control how much calcium is released from our bones through the action of parathyroid hormone (PTH) on osteoclasts. These cells break down bone within your body. Osteoblasts are the cells that build bone and together osteoclasts and osteoblasts work to remodel your bones. Osteoporosis is caused by excessive action of osteoclasts, which are cells that break down bone tissue.

Normally, parathyroid glands stop secreting PTH in response to normal or elevated calcium levels in the blood. With parathyroid disease, an abnormal parathyroid gland does not "turn-off" in response to a normal or elevated calcium level in the bloodstream and continues to secrete PTH. This produces elevated calcium levels in the blood stream that can, in time, lead to medical problems.

Normal symptoms of primary hyperparathyroidism include bone pain, osteoporosis (thinning of the bones), kidney stones, and abdominal discomfort.

With elevated PTH due to an abnormal parathyroid gland, patients continually lose calcium from their bones faster than they replace it. This leads to thinning of the bones - or osteoporosis.

Osteoporosis drugs such as Fosamax, Boniva or Actonel will not cure the underlying parathyroid disease. This is because the parathyroid adenoma (diseased parathyroid gland) continues to secrete PTH despite an elevated calcium level. As long as the parathyroid tumor exists, the secreted PTH will remain elevated and will be too powerful for any drug to counteract.

Osteoporosis drugs do not block the effects of PTH. These drugs have never been approved by the FDA for that purpose. No clinical trials have shown that these drugs help increase bone density in patients with parathyroid disease.

Even if the calcium levels do not rise further than slightly elevated levels, there is still continual damage being done to your bones and skeletal system. The long-term effects of this damage can be severe and permanent. A ‘wait and see’ approach is not advised if there is a suspicion of parathyroid disease.

In nearly all cases, surgery is needed to remove the diseased parathyroid gland and prevent the onset of osteoporosis. The traditional parathyroid operation technique requires the parathyroid surgeon to place a large incision in the neck to locate and examine the four parathyroid glands located behind the thyroid. The tumorous gland or glands are then located and removed. Patients that opt for traditional surgery require at least one night of hospitalization. In the end, the patient is left with a large inch scar on the neck.

Minimally invasive parathyroid surgery is an outpatient procedure that requires an incision of only a one-inch or less, and the procedure can be performed in less than half an hour. Minimally invasive surgery helps patients recover faster with minimal neck scarring.

Surgery is the only cure for parathyroid disease and the osteoporosis that it will cause.

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