The four small parathyroid glands are located next to the thyroid. They secrete a hormone (the parathyroid hormone) that regulates calcium levels in a person's body. Parathyroid disease is a condition where they either produce too much or too little of this hormone, causing an imbalance of calcium in the blood.
Hyperparathyroidism is a common parathyroid disease where too much of the hormone is produced. This usually (but not always) causes the amount of calcium in the blood to rise, and this elevation of the serum calcium – sometimes known as hypercalcaemia – is often only found when a blood test is done for some other reason. Hypercalcaemia can leave people feeling unwell in very vague ways.
The commonest cause of primary hyperparathyroidism is a single benign tumour of the parathyroid – an adenoma – and if it can be successfully removed the patient can be cured. However, there are a series of diagnostic considerations to be made that usually require a trained endocrinologist, and a key decision then is to find a good surgeon who operates regularly on the parathyroids.
Many patients benefit from having an endocrinologist involved in their post-operative care, and we can arrange for you to have your operation at a hospital of your choice, with the best surgeon for you. Those we work with most closely are Mr Jonathan Hubbard, who practices at The London Bridge Hospital, and Professor Fausto Palazzo at The Cromwell Hospital.
Secondary hyperparathyroidism occurs when too much parathyroid hormone is produced to compensate for some other problem in the body. It can often be caused by Vitamin D deficiency but it can also be seen in renal disease. For this reason, it’s important to recognise the condition, both to understand why it is there and to treat it accordingly. We can help you understand if it is present, why and what to do about it.
Hypoparathyroidism – when too little of the parathyroid hormone is produced – is most often a consequence of thyroid surgery. It can also occur after radiotherapy, or as a result of damage from the immune system – and magnesium deficiency is also increasingly recognised as a cause. All of these conditions can cause low calcium, muscle cramps, weakness and instability of the heart. Ensuring that you maintain your calcium, magnesium and phosphate levels is critical as all of them contribute to your bone and kidney health for decades to come.