Parathyroid Glands
What are Parathyroid Glands?
The parathyroid glands are four glands located behind the thyroid gland in a person’s neck. These glands are responsible for producing the parathyroid hormone (PTH) which exists to help regulate calcium levels in the bloodstream. When the calcium level in the blood is low, the parathyroid glands sense this and produce PTH. The normal level of PTH in the blood stream is between 10-65 picograms per milliliter (pg/mL) in most laboratories. Parathyroid hormone then acts on the bones to release calcium as well as phosphorus. PTH also acts on the kidneys to decrease the excretion of calcium, increase the production of Vitamin D and increase calcium absorption from the gut.
Parathyroid hormone works together with another hormone called Calcitonin to regulate your body's calcium level and maintain healthy bones. The normal calcium level in a person's blood stream ranges from 8.5-10.2 mg/dL. When the calcium level is at the high range, normal parathyroids stop producing PTH; when the calcium level is in the low range, normal parathyroids produce PTH in proportion to the amount of calcium that is required by the body. When the body's calcium metabolism and parathyroids are in balance, there is an even amount of bone breakdown and bone building so that the calcium storage in our body remains even and the bones remain dense and strong. When there is too much PTH produced (overactive PTH production), this is a condition called hyperparathyroidism, which may lead to thinning of the bones (osteopenia or osteoporosis), kidney stones, abdominal discomfort and general anxiety.
Parathyroid Glands and PTH
The major function of the parathyroid glands is to maintain the body's calcium level in both the blood and bones. There is a narrow range of calcium required for the nervous and muscular systems to function properly. When blood calcium levels drop below a certain level, receptors in the parathyroid gland release the parathyroid hormone (PTH). This hormone increases blood calcium levels by stimulating osteoclasts to release calcium by breaking down bone.
When one or more of the parathyroid glands produce too much PTH, the excess hormone removes calcium from the bones and adds it to your blood. This bone calcium loss is why anyone with a bad parathyroid gland eventually develops osteoporosis.
PTH also activates vitamin D, which helps the intestine to absorb calcium from food. Vitamin D promotes calcium reabsorption by the kidneys. Hyperparathyroidism causes a decrease in the body’s Vitamin D available for the intestines. This, in turn, reduces the amount of calcium that can be absorbed from a person’s diet.
The excess calcium in the blood is what causes sickness. Symptoms of primary hyperparathyroidism include osteoporosis (thin bones), bone pain, kidney stones, and abdominal discomfort. Osteoporosis is caused by excessive action of osteoclasts, which are cells that break down bone tissue. This in turn may lead to bone pain and even fractures. Kidney stones are also caused from excessive calcium in the kidney and urine.
In addition, PTH affects the mind and mental health. An excess of PTH can be associated with feeling of anxiety and fatigue. Other symptoms include sleep difficulty, headaches, difficulty concentrating and depression.
Is Surgery Necessary?
There is uniform agreement in the medical profession that the only way to treat primary hyperparathyroidism is through surgery. Drug therapy is usually reserved for patients who are unable to undergo surgery for some reason. This is not a cure, but a temporizing measure.
A 'wait and see' approach will not work. Hyperparathyroidism will not fix itself in time. Only the removal of the bad parathyroid gland will cure the parathyroid disease. Minimally Invasive Parathyroid Surgery can usually be performed quickly, with patients able to return home the same day.
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